Exercise Prescription for Patients with Non-specific Chronic Low Back Pain: a Qualitative Exploration of Decision Making in Physiotherapy Practice

Background: Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. Objective: To explore how shared decision making and patient partnership are addressed by physiotherapists in the process of exercise prescription for patients with NSCLBP. Design: A qualitative study using a philosophical hermeneutic approach. Methods: Eight physiotherapists were each observed on three occasions undertaking their usual clinical activities (total n=24 observations). They conducted brief interviews after each observation and a later in depth semi-structured interview. Iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. Findings: The findings revealed how physiotherapy practice often resulted in unequal possibilities for patient participation which were in turn linked to the physiotherapists? assumptions about the patients, clinical orientation, cognitive and decision making processes. Three linked themes emerged: (1) I want them to exercise, (2) Which exercise? - the tension between evidence and everyday practice and (3) Compliance-orientated more than concordance based. Conclusions: This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes for these patients.

Preparatory and field work phases in the qualitative empirical research process in management: the case studies approach

Purpose: The aim of this paper is to promote qualitative methodology within the scientific community of management. The specific objective is oriented to propose an empirical research process based on case study method. This is to ensure rigor in the empirical research process, that future research may follow a similar procedure to that is proposed. Design/methodology/approach: Following a qualitative methodological approach, we propose a research process that develops according to four phases, each with several stages. This study analyses the preparatory and field work phases and their stages. Findings: The paper shows the influence that case studies have on qualitative empirical research process in management. Originality/value:. Case study method assumes an important role within qualitative research by allowing for the study and analysis of certain types of phenomena that occur inside organisations, and in respect of which quantitative studies cannot provide an answer.

Analysis of diffusion process in fractured reservoirs using fractional derivative approach

The fractal geometry is used to model of a naturally fractured reservoir and the concept of fractional derivative is applied to the diffusion equation to incorporate the history of fluid flow in naturally fractured reservoirs. The resulting fractally fractional diffusion (FFD) equation is solved analytically in the Laplace space for three outer boundary conditions. The analytical solutions are used to analyze the response of a naturally fractured reservoir considering the anomalous behavior of oil production. Several synthetic examples are provided to illustrate the methodology proposed in this work and to explain the diffusion process in fractally fractured systems.

Electrodialytic remediation of two types of air pollution control residues and their applicability in construction materials

Dissertação para obtenção do Grau de Mestre em Engenharia do Ambiente Perfil de Engenharia de Sistemas Ambientais

Policing and planning child and adolescent neuropsychiatry : the reform process in Bologna 2009-2014

Desde a aprovação do plano de saúde mental regional em Itália ... o Departamento Local de Saúde Mental e Perturbações aditivas em Bolonha, tem desenvolvido um projeto de reforma cujo objectivo é inovar o sistema de saúde mental local. ...ABSTRACT: Since the Regional mental health plan 2009-2011 was approved in Italy the Department of Mental Health and addictions of the Bologna local health trust developed as a laboratory aimed at innovating the mental health systen locally. ...

Examining and describing professional development and continuing education in the personal training and fitness industry : sites and issues of disconnect

The following phenomenologically oriented study examines and describes the relevance and effectiveness of professional development and continuing education programs for real-world situations of personal trainers. The participants were personal trainers, facility managers, and persons involved in the accreditation process. Data collection took place in 3 phases. The first phase consisted of the participants completing the PUMP Questionnaire, followed by focus groups with personal trainers and interviews with managers. The study's 3 data sets required reduction via a content analysis by question, content analysis by existential categories, and further thematic analysis using the lived relation existential dimension. The discussion contains the salient sites and issues of disconnect between clients, personal trainers, and facility managers and how they might affect the personal training experience. The intergenerational disconnect emphasized between Boomers as clients and Millennials as personal trainers requires further exploration and dialogue and underscores the need for different approaches to content and delivery of professional development and continuing education experiences for personal trainers and managers of fitness facilities.

The relationship between product design and business models in the context of sustainability

Dans les sphères du développement durable, des modèles d’affaires et du design de produit, certains leviers rendent le croisement de ces trois sphères de plus en plus pertinent. Au croisement de ces trois sphères se trouve une opportunité de comprendre les relations existantes entre le design de produit et les modèles d’affaires afin d’aider les décideurs à développer des solutions davantage durables. L’approche méthodologique de cette recherche utilise un système complexe et est basée sur un paradigme pragmatique. En vue de répondre à la question « Dans quelle mesure des modèles d’affaires et le design de produit sont liés dans un contexte de développement durable? », cette recherche a soigneusement analysé trois cas: Better Place, une compagnie californienne ayant développé une infrastructure permettant le chargement des voitures électriques; Interface Inc., un manufacturier mondial de tuiles de tapis commerciales établi à Atlanta; et Métacycle, un concept d’entreprise développé par une équipe de chercheurs en design à Montréal. Chaque cas a été analysé en corrélant des aspects du design de produit à des éléments de leur modèle d’affaires. Les résultats montrent que dans le contexte du développement durable, le design de produit et les modèles d’affaires sont interdépendants. Les résultats peuvent être résumés en six points: il existe des relations applicables universellement; les innovations de design substantielles jouent un rôle important dans le développement durable; la « durabilité » peut être une qualité émergente d’un modèle d’affaires; les partenariats peuvent être vitaux pour l’intégration des systèmes; un modèle de services a des bénéfices et des limitations considérables; le design peut agir comme levier à l’utilisation d’énergies renouvelables. Pratiquer simultanément l’innovation du modèle d’affaires et du produit peut apporter une valeur ajoutée, susciter des opportunités et augmenter l’efficience sur plusieurs facettes. Toutefois, les risques et les coûts de tels procédés sont souvent très élevés. En aidant à comprendre et définir comment les trois sphères mentionnées plus tôt sont interdépendantes, cette recherche pourrait idéalement inspirer des recherches supplémentaires sur le sujet. L’application par des organisations de la méthodologie et des apprentissages résultant de cette recherche peut permettre à d’autres d’utiliser le croisement entre l’innovation de produit et l’innovation du modèle d’affaires afin de résoudre des enjeux sociaux et environnementaux complexes.

Stressors and turning points in high school and dropout : a stress process, life course framework

High school dropout is commonly seen as the result of a long-term process of failure and disengagement. As useful as it is, this view has obscured the heterogeneity of pathways leading to dropout. Research suggests, for instance, that some students leave school not as a result of protracted difficulties but in response to situations that emerge late in their schooling careers, such as health problems or severe peer victimization. Conversely, others with a history of early difficulties persevere when their circumstances improve during high school. Thus, an adequate understanding of why and when students drop out requires a consideration of both long-term vulnerabilities and proximal disruptive events and contingencies. The goal of this review is to integrate long-term and immediate determinants of dropout by proposing a stress process, life course model of dropout. This model is also helpful for understanding how the determinants of dropout vary across socioeconomic conditions and geographical and historical contexts.

Preparation of useful raw materials from Refinery sludge and its utilisation in rubber processing

Petroleum, a mixture of organic compounds, comes from underground rock formations ranging in age from ten to several hundred million years. The process by which it is formed and developed is not yet completely known. Studies indicate that petroleum is formed mainly from microscopic-sized marine animals and plants. When these organisms died in water of low oxygen content, they did not decompose. Thus their remains sank to the bottom to be buried under accumulations of sediment. Their conversion to petroleum remains a subject of research even today.

“Studies on glucose tolerant β-glucosidases from a novel Byssochlamys fulva and their applications in biomass to ethanol conversion”

Beta-glucosidases are critical enzymes in biomass hydrolysis process and is important in creating highly efficient enzyme cocktails for the bio-ethanol industry. Among the two strategies proposed for overcoming the glucose inhibition of commercial cellulases, one is to use heavy dose of BGL in the enzyme blends and the second is to do simultaneous saccharification and fermentation where glucose is converted to alcohol as soon as it is being generated. While the former needs extremely high quantities of enzyme, the latter is inefficient since the conditions for hydrolysis and fermentation are different. This makes the process technically challenging and also in this case, the alcohol generation is lesser, making its recovery difficult. A third option is to use glucose tolerant β-glucosidases which can work at elevated glucose concentrations. However, there are very few reports on such enzymes from microbial sources especially filamentous fungi which can be cultivated on cheap biomass as raw material. There has been very less number of studies directed at this, though there is every possibility that filamentous fungi that are efficient degraders of biomass may harbor such enzymes. The study therefore aimed at isolating a fungus capable of secreting glucose tolerant β- glucosidase enzyme. Production, characterization of β-glucosidases and application of BGL for bioethanol production were attempted.

Development and Deployment of Wireless Sensor Network in Paddy Fields of Kuttanad

The evolution of wireless sensor network technology has enabled us to develop advanced systems for real time monitoring. In the present scenario wireless sensor networks are increasingly being used for precision agriculture. The advantages of using wireless sensor networks in agriculture are distributed data collection and monitoring, monitor and control of climate, irrigation and nutrient supply. Hence decreasing the cost of production and increasing the efficiency of production. This paper describes the development and deployment of wireless sensor network for crop monitoring in the paddy fields of Kuttanad, a region of Kerala, the southern state of India.

Lipase from marine Aspergillus awamori BTMFW032: Production, partial purification and application in oil effluent treatment

Marine fungus BTMFW032, isolated from seawater and identified as Aspergillus awamori, was observed to produce an extracellular lipase, which could reduce 92% fat and oil content in the effluent laden with oil. In this study, medium for lipase production under submerged fermentation was optimized statistically employing response surface method toward maximal enzyme production. Medium with soyabean meal- 0.77% (w/v); (NH4)2SO4-0.1 M; KH2PO4-0.05 M; rice bran oil-2% (v/v); CaCl2-0.05 M; PEG 6000-0.05% (w/v); NaCl-1% (w/v); inoculum-1% (v/v); pH 3.0; incubation temperature 35 8C and incubation period-five days were identified as optimal conditions for maximal lipase production. The time course experiment under optimized condition, after statistical modeling, indicated that enzyme production commenced after 36 hours of incubation and reached a maximum after 96 hours (495.0 U/ml), whereas maximal specific activity of enzyme was recorded at 108 hours (1164.63 U/mg protein). After optimization an overall 4.6- fold increase in lipase production was achieved. Partial purification by (NH4)2SO4 precipitation and ion exchange chromatography resulted in 33.7% final yield. The lipase was noted to have a molecular mass of 90 kDa and optimal activity at pH 7 and 40 8C. Results indicated the scope for potential application of this marine fungal lipase in bioremediation.

Occurrence of filamentous algae and soil characteristics in the paddy fields of Kuttanad and Kole lands of Kerala

The present work is the study of filamentous algae in the paddy fields of Kuttanad and Kole lands of Kerala. This investigation was initiated by sampling of filamentous algae in Kuttanad during December 2010 to February 2011. A second phase of sampling was done from November 2011 to February 2012. The sampling periodicity corresponded to the crop growth starting from field preparation through sowing, and continued till the harvest. Sampling locations were selected from the active paddy cultivation regions of the six agronomic zones of Kuttanad. The numbers of sampling locations were proportional to the area of each zone. Algae of the Kole lands were collected during from October 2011 to January 2012. It was observed that blue-green algae dominated in both Kuttanad and Kole lands. Thirty two species of blue-green algae and eight species of green algae were identified from Kuttanad. The highest number of algal species was observed from Kayal lands in Kuttanad throughout the cropping season. Among the thirty two species of blue-green algae twenty five species are nonheterocystous and seven species are heterocystous. Twenty eight species of blue-green and six species of green algae were identified from Kole lands, and highest number of species was observed in Palakkal throughout the cropping season. Among the twenty eight species of blue-green algae collected from Kole lands twenty one species are non-heterocystous, and only seven species are heterocystous filamentous algae. Blooms of Spirogyra were observed during the second phase of sampling in Kuttanad and also in the Kole lands. The results of the germination study revealed that the extract of Spirogyra sp. inhibited seed germination and reduced seedling vigour. The growth of the treated seedlings was evaluated by pot experiments. The results clearly showed that Spirogyra sp. can negatively affect the seed germination, seedling vigour, and the yield of rice.

Organic inputs and farmers' management strategies in millet fields of western Niger

Research on soil fertility management in sub-Saharan Africa was criticized lately for largely ignoring farmers’ management strategies and the underlying principles. To fill this gap of knowledge, detailed interviews were conducted with 108 farm households about their rationale in managing the soil fertility of 307 individual fields in the agro-pastoral village territory of Chikal in western Niger. To amplify the farmers’ information on manuring and corralling practices, repeated measurements of applied amounts of manure were carried out within six 1-km^2 monitoring areas from February to October 1998. The interviews revealed that only 2% of the fields were completely fallowed for a period of 1–15 years, but 40% of the fields were at least partially fallowed. Mulching of crop residues was mainly practiced to fight wind erosion but was restricted to 36% of the surveyed fields given the alternative use of straw as livestock feed. Manure application and livestock corralling, as most effective tools to enhance soil fertility, were targeted to less than 30% of the surveyed fields. The application of complete fallow and manuring and corralling practices were strongly related to the households’ endowment with resources, especially with land and livestock. Within particular fields, measures were mainly applied to spots of poor soil fertility, while the restoration of the productivity of hard pans was of secondary importance. Given the limited spatial coverage of indigenous soil fertility measures and their strong dependence on farmers’ wealth, supplementary strategies to restrict the decline of soil fertility in the drought prone areas of Niger with their heavily weathered soils are needed.