Tarsal tunnel syndrome: A narrative literature review

Background Tarsal tunnel syndrome is classified as a focal compressive neuropathy of the posterior tibial nerve or one of its associated branches individually or collectively. The tunnel courses deep to fascia, the flexor retinaculum and within the abductor hallucis muscle of the foot/ankle. The condition is rare and regularly under-diagnosed leading to a range of symptoms affecting the plantar margins of the foot. There are many intervention strategies for treating tarsal tunnel syndrome with limited robust evidence to guide the clinical management of this condition. The role of conservative versus surgical interventions at various stages of the disease process remains unclear, and there is a need for a structured, step-wise approach in treating patients with this syndrome based on derived empirical evidence. This narrative review attempts to scrutinize the literature to date by clarifying initial presentation, investigations and definitive treatment for the purpose of assisting future informed clinical decision and prospective research endeavours. Process The literature searches that have been incorporated in compiling a rigorous review of this condition have included: the Cochrane Neuromuscular Group's Specialized Register (Cochrane Library 2013), the databases of EMBASE, AMED, MEDLINE, CINAHL, Physiotherapy evidence database (PEDRO), Biomed Central, Science Direct and Trip Database (1972 to the present). Reference listings of located articles were also searched and scrutinized. Authors and experts within the field of lower-limb orthopaedics were contacted to discuss applicable data. Subject-specific criteria searches utilizing the following key terms were performed across all databases: tarsal tunnel syndrome, tibial neuralgia, compression neuropathy syndromes, tibial nerve impingement, tarsal tunnel neuropathy, entrapment tibial nerve, posterior tibial neuropathy. These search strategies were modified with differing databases, adopting specific sensitivity-searching tools and functions unique to each. This search strategy identified 88 journal articles of relevance for this narrative literature review. Findings This literature review has appraised the clinical significance of tarsal tunnel syndrome, whilst assessing varied management interventions (non-surgical and surgical) for the treatment of this condition in both adults and children. According to our review, there is limited high-level robust evidence to guide and refine the clinical management of tarsal tunnel syndrome. Requirements for small-scaled randomized controlled trials in groups with homogenous aetiology are needed to analyse the effectiveness of specific treatment modalities. Conclusions It is necessary that further research endeavours be pursued for the clinical understanding, assessment and treatment of tarsal tunnel syndrome. Accordingly, a structured approach to managing patients who have been correctly diagnosed with this condition should be formulated on the basis of empirical evidence where possible.

Nursing fever management in adult oncology patients: A literature review

Fever associated with neutropenia, blood transfusion and disease processes is common in adult cancer patients. The literature indicates however that the aetiology, rationale and symptoms of fever are often misunderstood, resulting in fever management that is not evidence-based in this cohort. Thus in this review, an overview of fever, with a focus on fever in cancer contexts, is provided. Content includes an explanation of the therapeutic function of fever, an analysis of the physiological consequences of fever and an exploration of the aetiology of fever in cancer patients. Current guidelines for fever management in cancer patients and existing nursing practice are also discussed.

Creative writing: Literature review and evidence-based research

There is growing evidence, especially in the USA and UK, that creative writing can form an important part of the recovery experience of people affected by severe mental illness. In this chapter, I consider theoretical models that explain how creative writing might contribute to recovery, and discuss the potential for creative writing in psychosocial rehabilitation. It is argued that the rehabilitation benefits of creative writing might be optimized through focus on process and technique in writing, rather than expression or content alone, and that consequently, the involvement of professional writers might be important. I will explore the recent history of theoretical frameworks and explanatory models that link creative writing and recovery, and examine such empirical evidence as is available on the contribution of creative writing to recovery from severe mental illness.

Commonwealth government agency libraries review: Literature review

Ongoing financial, administrative, and technological changes present significant challenges and opportunities for government libraries in delivering services to their clients. Determining how government library and information services might best confront these challenges and take advantage of new opportunities is crucial for the future of the sector. The Australian Government Libraries Information Network (AGLIN) has commissioned a review of service delivery models in Commonwealth Government libraries. As an initial step in the project, a literature review was undertaken in order to consider the issues which impact directly on government library service provision today. The literature review builds on and updates the review prepared for the Queensland Government Agency Libraries Review (QGALR) five years ago.

Literature Review: Investigating Drug Transport at the Blood-Brain Barrier and the Effects of P-glycoprotein on the Brain Distribution of Drugs.

The blood-brain barrier (BBB) is a unique barrier that strictly regulates the entry of endogenous substrates and xenobiotics into the brain. This is due to its tight junctions and the array of transporters and metabolic enzymes that are expressed. The determination of brain concentrations in vivo is difficult, laborious and expensive which means that there is interest in developing predictive tools of brain distribution. Predicting brain concentrations is important even in early drug development to ensure efficacy of central nervous system (CNS) targeted drugs and safety of non-CNS drugs. The literature review covers the most common current in vitro, in vivo and in silico methods of studying transport into the brain, concentrating on transporter effects. The consequences of efflux mediated by p-glycoprotein, the most widely characterized transporter expressed at the BBB, is also discussed. The aim of the experimental study was to build a pharmacokinetic (PK) model to describe p-glycoprotein substrate drug concentrations in the brain using commonly measured in vivo parameters of brain distribution. The possibility of replacing in vivo parameter values with their in vitro counterparts was also studied. All data for the study was taken from the literature. A simple 2-compartment PK model was built using the Stella™ software. Brain concentrations of morphine, loperamide and quinidine were simulated and compared with published studies. Correlation of in vitro measured efflux ratio (ER) from different studies was evaluated in addition to studying correlation between in vitro and in vivo measured ER. A Stella™ model was also constructed to simulate an in vitro transcellular monolayer experiment, to study the sensitivity of measured ER to changes in passive permeability and Michaelis-Menten kinetic parameter values. Interspecies differences in rats and mice were investigated with regards to brain permeability and drug binding in brain tissue. Although the PK brain model was able to capture the concentration-time profiles for all 3 compounds in both brain and plasma and performed fairly well for morphine, for quinidine it underestimated and for loperamide it overestimated brain concentrations. Because the ratio of concentrations in brain and blood is dependent on the ER, it is suggested that the variable values cited for this parameter and its inaccuracy could be one explanation for the failure of predictions. Validation of the model with more compounds is needed to draw further conclusions. In vitro ER showed variable correlation between studies, indicating variability due to experimental factors such as test concentration, but overall differences were small. Good correlation between in vitro and in vivo ER at low concentrations supports the possibility of using of in vitro ER in the PK model. The in vitro simulation illustrated that in the simulation setting, efflux is significant only with low passive permeability, which highlights the fact that the cell model used to measure ER must have low enough paracellular permeability to correctly mimic the in vivo situation.

Potential Application of Adsorptive Media to Enhance Phosphorus Uptake in Stormwater Basins and Wetlands at Lake Tahoe : literature review. Report to the University of California Davis Tahoe Research Group

Phosphorus removal by wetlands and basins in Lake Tahoe may be improved through designing these systems to filter storm water through media having higher phosphorus removal capabilities than local parent material. Substrates rich in iron, aluminum and calcium oftentimes have enhanced phosphorus removal. These substrates can be naturally occurring, byproducts of industrial or water treatment processes, or engineered. Phosphorus removal fundamentally occurs through chemical adsorption and/or precipitation and much of the phosphorus can be irreversibly bound. In addition to these standard media, other engineered substrates are available to enhance P removal. One such substrate is locally available in Reno and uses lanthanum coated diatomaceous earth for arsenate removal. This material, which has a high positive surface charge, can also irreversibly remove phosphorus. Physical factors also affect P removal. Specifically, specific surface area and particle shape affect filtration capacity, contact area between water and the surface area, and likelihood of clogging and blinding. A number of substrates have been shown to effectively remove P in case studies. Based upon these studies, promising substrates include WTRs, blast furnace slag, steel furnace slag, OPC, calcite, marble Utelite and other LWAs, zeolite and shale. However, other nonperformance factors such as environmental considerations, application logistics, costs, and potential for cementification narrow the list of possible media for application at Tahoe. Industrial byproducts such as slags risk possible leaching of heavy metals and this potential cannot be easily predicted. Fly ash and other fine particle substrates would be more difficult to apply because they would need to be blended, making them less desirable and more costly to apply than larger diameter media. High transportation costs rule out non-local products. Finally, amorphous calcium products will eventually cementify reducing their effectiveness in filtration systems. Based upon these considerations, bauxite, LWAs and expanded shales/clays, iron-rich sands, activated alumina, marble and dolomite, and natural and lanthanum activated diatomaceous earth are the products most likely to be tested for application at Tahoe. These materials are typically iron, calcium or aluminum based; many have a high specific surface area; and all have low transportation costs. (PDF contains 21 pages)

The contribution of fish intake, aquaculture, and small-scale fisheries to improving nutrition security: a literature review

Much of fish consumed by the poor are caught by household members and traded in local markets. These fish are rarely or poorly included in national statistics, and it is therefore difficult to estimate precisely the real contribution of fish to the rural poor households. This report is the first global overview of the role played by fish in improving nutrition. Fish consumption patterns of the poor, the nutritional value of fish, and small-scale fisheries and aquaculture activities are considered. It also highlights the gap in knowledge where more research is needed.

Literature Review of Integrated Impact Assessment Models of Climate Change with Emphasis on Damage Functions

35 p.

Forensic Fisheries Science: Literature Review and Research Suggestions

Recent years have seen a dramatic increase in litigation against the National Marine Fisheries Service, NOAA. Litigation may affect personnel throughout the agency, including scientists, whose work is often directly or indirectly influenced by complex legal requirements, but who may not be in a position to comment or engage in public dialogue. It may be helpful for scientists and other agency personnel to join the ongoing discussion in the legal community regarding the interface of science and law. This paper provides a starting point with a selected introduction to relevant legal literature in this area. It uses the phrase “forensic fisheries science” to describe the application of science to legal requirements in the fishery management context. It concludes with suggestions for future research that could assist NMFS scientists as they grapple with the challenge of using science to help the agency meet its complex legal requirements. Forensic: belonging to, used in, or suitable to courts of judicature or to public discussion and debate; argumentative, rhetorical; relating to or dealing with the application of scientific knowledge to legal problems (Merriam-Webster Online Dictionary )