Population based intervention to change back pain beliefs and disability : three part evaluation

Objective To evaluate the effectiveness of a population based, state-wide public health intervention designed to alter beliefs about back pain, influence medical management, and reduce disability and costs of compensation. Design Quasi-experimental, non-randomised, non-equivalent, before and after telephone surveys of the general population and postal surveys of general practitioners with an adjacent state as control group and descriptive analysis of claims database. Setting Two states in Australia Participants 4730 members of general population before and two and two and a half years after campaign started, in a ratio of2:1:1; 2556 general practitioners before and two years after campaign onset. Main outcome measures Back beliefs questionnaire, knowledge and attitude statements about back pain, incidence of workers' financial compensation claims for back problems, rate of days compensated, and medical payments for claims related to back pain and other claims. Results In the intervention state beliefs about back pain became more positive between successive surveys (mean improvement in questionnaire score 1.9 (95% confidence interval 1.3 to 2.5), P<0.001 and 3.2 (2.6 to 3.9), P < 0.001, between baseline and the second and third survey, respectively). Beliefs about back pain also improved among doctors. There was a clear decline in number of claims for back pain, rates of days compensated, and medical payments for claims for back pain over the duration of the campaign. Conclusions A population based strategy of provision of positive messages about back pain improves population and general practitioner beliefs about back pain and seems to influence medical management and reduce disability and workers' compensation costs related to back pain.

Safety and efficacy of routine postoperative ibuprofen for pain and disability related to ectopic bone formation after hip replacement surgery (HIPAID): a randomised control trial

Objectives To determine the benefits and risks of a non-steroidal anti-inflammatory drug (NSAID) as prophylaxis for ectopic bone formation in patients undergoing total hip replacement (or revision) surgery.
Design Double blind randomised placebo controlled clinical trial, stratified by treatment site and surgery (primary or revision).
Setting 20 orthopaedic surgery centres in Australia and New Zealand.
Participants 902 patients undergoing elective primary or revision total hip replacement surgery.
Intervention 14 days' treatment with ibuprofen (1200 mg daily) or matching placebo started within 24 hours of surgery.
Main outcome measures Changes in self reported hip pain and physical function 6 to 12 months after surgery (Western Ontario and McMaster University Arthritis index).
Results There were no significant differences between the groups for improvements in hip pain (mean difference -0.1, 95% confidence interval -0.4 to 0.2, P = 0.6) or physical function (-0.1, -0.4 to 0.2, P = 0.5), despite a decreased risk of ectopic bone formation (relative risk 0.69, 0.56 to 0.83) associated with ibuprofen. There was a significantly increased risk of major bleeding complications in the ibuprofen group during the admission period (2.09, 1.00 to 4.39).
Conclusions These data do not support the use of routine prophylaxis with NSAIDs in patients undergoing total hip replacement surgery.
Trial registration NCT00145730.

Low back pain and disability in community-based women : prevalence and association factors

Objective: Although low back pain is characterized by both pain and disability, there is a paucity of studies that have concurrently examined risk factors for these features in community-dwelling women. We aimed to investigate the prevalence and identify factors associated with both back pain and disability.

Design: A questionnaire was mailed to 542 women from a community-based research database. Detailed demographic data were collected, including participants' menopause, relationship, and employment status. Point and period prevalence estimates for back pain were derived. Participants were classified based on pain intensity and disability scores calculated from the Chronic Pain Grade Questionnaire, and factors associated with high levels of pain and disability were examined.

Results: A total of 506 (93.4%) women completed the questionnaire. More than 90% of participants had experienced low back pain, with 75.1% and 22.5% reporting pain in the past 12 months and currently, respectively. Seven percent of women reported a high level of disability and 16% reported high-intensity pain. Women with higher levels of disability were more likely to have a higher body mass index and to have pain currently, whereas those with greater pain intensity were more likely to be younger, have a higher body mass index, not be employed outside the home, drink alcohol, and have current pain.

Conclusions: Low back pain is a common problem for community-based women. A high body mass index and current pain were factors independently associated with both high pain intensity and disability. Longitudinal investigation is required to determine the predictive nature of these factors and their potential role in preventing pain and disability.

An empirical study on the relationship between intellectual ability and an understanding of the legal process in male remand prisoners

Research conducted in Australia and around the world in the last decade has shown that people with significant intellectual impairments are over-represented in all areas of the criminal justice system. They are particularly over-represented in remand populations appearing before court. Previous research has suggested that as many as one-quarter of offenders facing sentencing in court have difficulty in understanding court procedures and it is suspected that a majority of these individuals suffer a significant intellectual impairment. The purpose of this study was to establish whether remandees with significant intellectual impairments (IQ < 70) have an accurate understanding of the court system. Seventy-four remand prisoners took part in the study. Remandees with an IQ of less than 70 demonstrated a significantly poorer understanding of the court system than those remandees with an IQ of 70 and above. The implications of these results are discussed in relation to the need for law reform and diversionary practices for this population of remandees.

Cognitive ability and FFM personality predictors of military training performance

This study demonstrated the validity of the Five-Factor Model (FFM) of personality trait domains over a measure of general cognitive ability in predicting training performance among military trainees. The results provide support to the growing consensus on the superiority of the FFM traits in predicting criteria on practical importance.

Disability and disability services

This chapter provides a profile of people who are at various points on this disability continuum, but with an emphasis on those facing more severe limitations. Information is presented on both mainstream and sector-specific service use, and the outcomes associated with the use of these services. The focus in this chapter is on people aged under 65 years.

The relationship between repeated sprint ability and the aerobic and anaerobic energy systems

A large number of team games require participants to repeatedly produce maximal or near maximal sprints of short duration with brief recovery periods. The purpose of the present study was to determine the relationship between a repeated sprint ability (RSA) test that is specific to the energy demands of Australian Rules football (ARF), and the aerobic and anaerobic energy systems. 

The sociological imaginary and disability enquiry in late modernity

Mills’s idea of the sociological imagination has captured many generations of scholars interested in the difficult social issues that people grapple with in their lives. Yet, sociology has traditionally had a poor record of linking disabled people’s ‘private’ accounts of their difficulties to ‘public’ issues. We contend that disability is still marginal to the sociological imaginary, despite attempts by disability studies and subdisciplines within sociology to make the concept relevant to the larger discipline. There is a range of conceptual tensions in sociology such as public/private and normal/abnormal that can be better illuminated by focusing on disability. We argue that critical disability studies, with its reimagining of disability within late modernity, may be better positioned to make more effectively the case for disability’s significance to the sociological imaginary. Facilitating dialogue with sociology on the concept of disability, however, may require disability scholars to develop more explicit strategies of engagement.