Combined physiotherapy and education is efficacious for chronic low back pain

Manual therapy, exercise and education target distinct aspects of chronic low back pain and probably have distinct effects, This study aimed to determine the efficacy of a combined physiotherapy treatment that comprised all of these strategies. By concealed randomisation, 57 chronic low back pain patients were allocated to either the four-week physiotherapy program or management as directed by their general practitioners, The dependent variables of interest were pain and disability. Assessors were blind to treatment group. Outcome data from 49 subjects (86%) showed a significant treatment effect. The physiotherapy program reduced pain and disability by a mean of 1.5/10 points on a numerical rating scale (95% CI 0.7 to 2.3) and 3.9 points on the 18-point Roland Morris Disability Questionnaire (95% CI 2 to 5.8), respectively. The number needed to treat in order to gain a clinically meaningful change was 3 (95% CI 3 to 8) for pain, and 2 (95% CI 2 to 5) for disability. A treatment effect was maintained at one-year follow-up. The findings support the efficacy of combined physiotherapy treatment in producing symptomatic and functional change in moderately disabled chronic low back pain patients.

A uniform white-noise model for fixed-point roundoff errors in digital systems

Fixed-point roundoff noise in digital implementation of linear systems arises due to overflow, quantization of coefficients and input signals, and arithmetical errors. In uniform white-noise models, the last two types of roundoff errors are regarded as uniformly distributed independent random vectors on cubes of suitable size. For input signal quantization errors, the heuristic model is justified by a quantization theorem, which cannot be directly applied to arithmetical errors due to the complicated input-dependence of errors. The complete uniform white-noise model is shown to be valid in the sense of weak convergence of probabilistic measures as the lattice step tends to zero if the matrices of realization of the system in the state space satisfy certain nonresonance conditions and the finite-dimensional distributions of the input signal are absolutely continuous.

Point source inoculation of Mesocyclops (Copepoda : Cyclopidae) gives widespread control of Ochlerotatus and Aedes (Diptera : Culicidae) immatures in service manholes and pits in North Queensland, Australia

This study details the novel application of predacious copepods, genus Mesocyclops, for control of Ochlerotatus tremulus (Theobald) group and Aedes aegypti (L.) mosquito larvae in subterranean habitats in north Queensland, Australia. During June 1997, 50 Mesocyclops sp. I were inoculated into one service manhole in South Townsville. Wet season rainfall and flooding in both 1998 and 2000 was responsible for the dispersal of copepods via the underground pipe system to 29 of 35 manholes over an area of 1.33 km(2). Significant reductions in Aedes and Ochlerotatus larvae ensued. In these habitats, Mesocyclops and Metacyclops were able to survive dry periods, when substrate moisture content ranged from 13.8 to 79.9%. At the semiarid inland towns of Hughenden and Richmond, cracking clay soil prevents drainage of water from shallow service pits where Oc. tremulus immatures numbered from 292-18,460 per pit. Introduction of Mesocyclops copepods into these sites during May 1999 resulted in 100% control of Oc. tremulus for 18 mo. One uninoculated pit subsequently became positive for Mesocyclops with resultant control of mosquito larvae.

The nonexistence of spurious solutions to discrete, two-point boundary value problems

We investigate difference equations which arise as discrete approximations to two-point boundary value problems for systems of second-order, ordinary differential equations. We formulate conditions under which all solutions to the discrete problem satisfy certain a priori bounds which axe independent of the step-size. As a result, the nonexistence of spurious solutions are guaranteed. Some existence and convergence theorems for solutions to the discrete problem are also presented. (C) 2002 Elsevier Science Ltd. All rights reserved.

On the robustness of short-term interest rate models

This paper investigates the robustness of a range of short–term interest rate models. We examine the robustness of these models over different data sets, time periods, sampling frequencies, and estimation techniques. We examine a range of popular one–factor models that allow the conditional mean (drift) and conditional variance (diffusion) to be functions of the current short rate. We find that parameter estimates are highly sensitive to all of these factors in the eight countries that we examine. Since parameter estimates are not robust, these models should be used with caution in practice.

A comparison of model laws as a starting point for the development of an enforceable international consumer protection regime

This article is concerned primarily with an examination and comparison of select aspects of the model international consumer protection laws proposed by the United Nations (UN), the European Union (EU), and the Organisation for Economic Co-operation and Development (OECD), using the Trade Practices Act 1974 (Australia) as a basis for examination and comparison. As a secondary consideration, it also broadly examines the content of, and differences between, the model laws. The motive for this article is that any future enforceable international consumer protection regime (possibly in the form of an international treaty or convention) would need to take into account the UN, EU and OECD guidelines. A cross-comparison of those model laws, and a comparison of them with the consumer protection provisions of a well established national consumer protection law, should provide a useful starting point for the development of such a regime. The 'select aspects' of the model laws in question are the various provisions of those laws which could relate to situations involving the wrong delivery or non-delivery of goods.

The uniqueness of solutions to discrete, victor, two-point boundary value problems

Difference equations which may arise as discrete approximations to two-point boundary value problems for systems of second-order, ordinary differential equations are investigated and conditions are formulated under which solutions to the discrete problem are unique. Some existence, uniqueness implies existence, and convergence theorems for solutions to the discrete problem are also presented.

A reduced load approximation accounting for link interactions in a loss network

This paper is concerned with evaluating the performance of loss networks. Accurate determination of loss network performance can assist in the design and dimen- sioning of telecommunications networks. However, exact determination can be difficult and generally cannot be done in reasonable time. For these reasons there is much interest in developing fast and accurate approximations. We develop a reduced load approximation that improves on the famous Erlang fixed point approximation (EFPA) in a variety of circumstances. We illustrate our results with reference to a range of networks for which the EFPA may be expected to perform badly.

Reforma administrativa e marco legal das organiza????es sociais no Brasil: as d??vidas dos juristas sobre o modelo das organiza????es sociais

O modelo brasileiro das organiza????es sociais representa uma das respostas poss??veis ?? crise do aparelho do Estado no ??mbito da presta????o dos servi??os sociais. Essas entidades s??o percebidas como uma forma de parceria do Estado com as institui????es privadas de fins p??blicos (perspectiva ex parte principe) ou, sob outro ??ngulo, uma forma de participa????o popular na gest??o administrativa (perspectiva ex parte populi). No texto s??o tematizadas as diferen??as e semelhan??as entre o marco legal das organiza????es sociais e das entidades de utilidade p??blica no Brasil, as notas distintivas entre a disciplina dos servi??os privados de interesse p??blico e dos servi??os p??blicos, bem como o que distingue juridicamente o modelo das organiza????es sociais de processos de privatiza????o e terceiriza????o. Em todos esses temas os juristas aparecem como protagonistas na determina????o dos limites do modelo das organiza????es sociais, evidenciando que processos de reforma normativa exigem, para serem eficazes, uma concomitante reforma na mentalidade dos agentes p??blicos.

Eu só quero chocolate : um estudo sobre a importância de aspectos pessoais e contextuais no consumo de chocolate

Muitos alimentos são conhecidos apenas em alguns grupos humanos, por diversas razões. Outros, entretanto, tornaram-se praticamente universais, sendo conhecidos e apreciados em quase todas as sociedades humanas com condições econômicas que permitam sua inclusão no âmbito do comércio internacional. Um deles, em especial, está no foco de interesse da presente investigação. Não se trata de alimento relevante para a composição dos hábitos alimentares cotidianos em qualquer grupo humano, mas que ocupa posição privilegiada em termos de preferência em diferentes lugares do mundo: o chocolate. O presente trabalho buscou conhecer e analisar fatores que influenciam o consumo de chocolate de um conjunto de pessoas e as modalidades de explicação ou justificação que apresentam para o seu padrão de consumo e para o tipo de interesse que têm pelo chocolate. Para a coleta de dados foi utilizado um questionário com 62 questões fechadas e 1 questão aberta - que utilizou a técnica da evocação. Participaram 313 homens e mulheres, a maioria na faixa etária entre 16 e 25 anos. Foram exploradas variáveis como situação sócio-econômica, peso corporal, estado de saúde, frequência e quantidade de chocolate consumido, preferência em relação ao consumo de alimentos em geral, além de terem sido verificadas quais situações os participantes admitem estarem associadas a variações no padrão de consumo de chocolate, tendo sido incluídas tanto situações estressantes quanto relaxantes. Foram abordados também alguns pontos considerados controversos a respeito do consumo de chocolate, que são objeto de interesse científico e merecem grande atenção dos meios de comunicação. Houve interesse especial na discussão das diferenças encontradas quando os padrões de consumo de homens e mulheres são comparados. Ficou evidente, no grupo de participantes, que a influência de muitos dos aspectos considerados sobre o consumo do chocolate não se processam de forma idêntica sobre homens e mulheres. Confirma-se a grande difusão cultural da ideia de que mulheres comem mais chocolate que homens e que a seleção de alimentos feminina é mais sensível a fatores associados a variações de estados afetivos, o que pode ter papel na discussão de dependências e transtornos alimentares. Em consonância com a literatura sobre comportamento alimentar, os dados apoiam a proposição de que é insuficiente considerar apenas fatores culturais ou biológicos, de maneira isolada, para explicar os motivos que levam ao consumo de determinados alimentos.

Um corpo-dissertação em movimento : uma questão de aprendizagem

Este trabalho ganha corpo a partir das experiências do antropólogo Carlos Castaneda. Além de ponto de partida para pensar as questões relativas ao corpo, o movimento e aprendizagem, as obras A Erva do diabo, Uma estranha realidade e Porta para o infinito, do autor mencionado, comparecem aqui para 1) investigarmos os relatos de experiência; 2) apresentarmos alguns conceitos-chaves, relativos a aprendizagem da “feitiçaria”, tal como a vontade. Vale frisar que nosso interesse na obra de Castaneda, não está nas questões místicas do xamanismo, nem mesmo nos pontos relativos ao campo da antropologia, mas na questão da aprendizagem. Para Dom Juan, o vellho índio feiticeiro e principal mestre de Carlos Castaneda, o propósito final do aprendizado da feitiçaria é justamente tornar-se um homem de conhecimento. Com o objetivo de analisar o lugar do movimento e do corpo no processo de aprendizagem, faremos o seguinte percurso analítico: de Skinner e Piaget abordaremos respectivamente a aprendizagem do comportamento operante e a aprendizagem em sentido amplo. Em seguida, apresentamos o pensamento de Francisco Varela e Bruno Latour, principalmente os conceitos de enação, corpos articulados e aprendizagem por afetação. Com Vincianne Despret discutiremos o aspecto afectivo, corporal e involuntário da aprendizagem. Com este apanhado conceitual, visamos então colocar em análise os efeitos ético-políticos dos modos de produção de conhecimento, efeitos irremediavelmente neste corpo-dissertação, e mais ainda efeitos na vida. Por fim, ao que parece, as modulações nos conceitos de corpo, movimento/ação, ao longo da exposição dos autores indicaram, por vezes, a participação de outros elementos, tais como a vontade e a percepção-atenção, implicando variações na forma de conceber a aprendizagem. Percebemos que de acordo com a formulação de aprendizagem e as nuances do movimento/ação e do corpo, isto implica produções diferenciadas de conhecimento e de realidade.

An e-marketplace of healthcare and social care services: the perceived interest

Purpose – The health and social care sector is receiving growing attention due to the increased life expectancy and to the public demand for a better quality of life and better health services. New cost-efficient approaches are required, and the paper aims to present and discuss the main results of a study undertaken in a Portuguese municipality on the perceived relevance of an e-marketplace of social and healthcare services for the inhabitants in general, and for people with special needs in particular, and the identification of the most relevant services to be offered through this platform. Design/methodology/approach – A wide survey was undertaken to identify the needs of potential users and their expectancies with relation to the proposed platform. The results of the study are a support for the project promoters to understand the viability of the solution and the requirements to the deployment of the pilot experiment, as well as to drive the selection of domains of activities/classes of services to be offered by the platform. Findings – Services such as information about healthcare services, home monitoring/accompanying services 24 hours per day, and personal hygiene services provided at home are the ones recognized by the inquired citizens as the most important, which indicates that the potential users will be mostly people with special needs or their family or caregivers. Originality/value – While still at a preliminary development phase, the project represents a good opportunity to develop a totally innovative service with high potential impact for the senior population and for individuals with special needs.