Incorporating nerve-gliding techniques in the conservative treatment of cubital Tunnel syndrome

Objective: To discuss the diagnosis and treatment of a patient with cubital tunnel syndrome and to illustrate novel treatment modalities for the ulnar nerve and its surrounding structures and target tissues. The rationale for the addition of nerve-gliding techniques will be highlighted. Clinical Features: Two months after onset, a 17-year-old female nursing student who had a traumatic onset of cubital tunnel syndrome still experienced pain around the elbow and paresthesia in the ulnar nerve distribution. Electrodiagnostic tests were negative. Segmental cervicothoracic motion dysfunctions were present which were regarded as contributing factors hindering natural recovery. Intervention and Outcomes: After 6 sessions consisting of nerve-gliding techniques and segmental joint manipulation and a home exercise program consisting of nerve gliding and light free-weight exercises, a substantial improvement was recorded on both the impairment and functional level (pain scales, clinical tests, and Northwick Park Questionnaire). Symptoms did not recur within a 10-month follow-up period, and pain and disability had completely resolved. Conclusions: Movement-based management may be beneficial in the conservative management of cubital tunnel syndrome. As this intervention is in contrast with the traditional recommendation of immobilization, comparing the effects of both interventions in a systematic way is an essential next step to determine the optimal treatment of patients with cubital tunnel syndrome.

Parents' and staff's perceptions of parental needs during a child's admission to hospital: an English perspective

The aim of this research was to compare perceptions of parental needs held by parents of hospitalized children and the staff caring for them, so that potential communication breakdown could be avoided. A well-trialled tool was used with a convenience sample in paediatric facilities in a National Health Service trust in north-east England. Some differences were found between parents and staff for scores for perceived importance of the 51 needs that were included in the questionnaire, and whether or not they were being satisfactorily met during the child’s hospital admission, but there were no consistent patterns, so it is difficult to draw conclusions. Parents declared themselves more independent than the staff perceived them to be. Such findings facilitate improvements in communication between parents and staff and can be included in education programmes for both.

Gingerol content of diploid and tetraploid clones of ginger (Zingiber officinale Roscoe)

Ginger (Zingiber officinale, Roscoe), a monocotyledonous, sterile cultigen, is widely used as a spice, flavoring agent, and herbal medicine. The pungency of fresh ginger is due to a series of homologous phenolic ketones of which [6]-gingerol is the major one. The gingerols are thermally unstable and can be converted to their corresponding shogaols, which are present in dried ginger, Fresh rhizomes of 17 clones of Australian ginger, including commercial cultivars and experimental tetraploid clones, were assayed by HPLC for gingerols and shogaols. [6]-Gingerol was identified as the major pungent phenolic compound in all samples, while [8]- and [10]-gingerol occurred in lower concentrations. One cultivar known as Jamaican contained the highest concentrations of all three gingerols and was the most pungent of the clones analyzed. Gingerols were stable in ethanolic solution over a 5-month period when stored at 4 degrees C. Shogaols were not identified in the extracts prepared from fresh rhizomes at ambient temperature, confirming that these compounds are not native constituents of fresh ginger, In contrast to previous findings, this study did not find significant differences in gingerol concentrations between the tetraploid clones and their parent diploid cultivar.

Training & Education: The CM Educator

Primary healthcare professionals’ lack of knowledge about complementary medicine is a concern to both patients and government. Educational institutions in the field outline needs and propose various models.

Quality-of-life in children and adolescents with cystic fibrosis managed in both regional outreach and cystic fibrosis center settings in Queensland

To assess the health-related quality-of-life (HRQOL) of children/adolescents with cystic fibrosis (CF) and compare HRQOL in children managed by cystic fibrosis outreach service (CFOS) with those treated in a cystic fibrosis center (CFC). To compare HRQOL of children with CF in Queensland with previously published HRQOL data from the United States and examine the relationship between HRQOL scores and pulmonary function. Study design: Participants were children/adolescents with CF and their parents managed by the Royal Children’s Hospital Queensland at a CFC or CFOS. Two HRQOL surveys were used: PedsQL™ and Cystic Fibrosis Questionnaire (CFQ). Results: There were 91 CFC and 71 CFOS participants with similar demographics. PedsQL™ total summary score was statistically higher in CFOS, P = .05. There was no significant difference in CFQ scores between groups. Queensland parents reported lower HRQOL for their children compared with US parents (P

Tradition, myth and the dilemma of Australian foreign policy

For a middle power with a relatively short history of framing a self determined foreign policy, Australia has actively sought to engage with both its immediate region and the wider world. Elite agreement on this external orientation, however, has by no means entailed consensus on what this orientation might involve in terms of policy. Consequently, two, often conflicting, traditions and their associated myths have informed Australian foreign policy-making. The most enduring tradition shaping foreign policy views Australia as a somewhat isolated bastion of Western civilisation. In this mode Australia's myth is pragmatic, but uncertain and sees Asia as both an opportunity and a potential threat which requires the support and counsel of culturally similar external powers engaged in the region to ensure stability. Against this, an alternative and historically later tradition crafted a foreign policy that advanced Australian independence through engagement with a seemingly monolithic and increasingly prosperous Asia. This paper explores the evolution and limitations of these foreign policy traditions and the myths that sustain them. It further considers what features of these traditions continue to have resonance in a region that has become more fluid and heterogeneous than it was during the Cold War and which requires a foreign policy flexibility that can address this complex and strategically uncertain environment.