Interprofessional practices of physiotherapists working with adults with low back pain in Québec's private sector: results of a qualitative study.

BACKGROUND: Collaboration and interprofessional practices are highly valued in health systems, because they are thought to improve outcomes of care for persons with complex health problems, such as low back pain. Physiotherapists, like all health providers, are encouraged to take part in interprofessional practices. However, little is known about these practices, especially for private sector physiotherapists. This study aimed to: 1) explore how physiotherapists working in the private sector with adults with low back pain describe their interprofessional practices, 2) identify factors that influence their interprofessional practices, and 3) identify their perceived effects. METHODS: Participants were 13 physiotherapists, 10 women/3 men, having between 3 and 21 years of professional experience. For this descriptive qualitative study, we used face-to-face semi-structured interviews and conducted content analysis encompassing data coding and thematic regrouping. RESULTS: Physiotherapists described interprofessional practices heterogeneously, including numerous processes such as sharing information and referring. Factors that influenced physiotherapists' interprofessional practices were related to patients, providers, organizations, and wider systems (e.g. professional system). Physiotherapists mostly viewed positive effects of interprofessional practices, including elements such as gaining new knowledge as a provider and being valued in one's own role, as well as improvements in overall treatment and outcome. CONCLUSIONS: This qualitative study offers new insights into the interprofessional practices of physiotherapists working with adults with low back pain, as perceived by the physiotherapists' themselves. Based on the results, the development of strategies aiming to increase interprofessionalism in the management of low back pain would most likely require taking into consideration factors associated with patients, providers, the organizations within which they work, and the wider systems.

Development of a Subgrade Drainage Model for Unpaved Roads, TR-654, 2015

With over 68 thousand miles of gravel roads in Iowa and the importance of these roads within the farm-to-market transportation system, proper water management becomes critical for maintaining the integrity of the roadway materials. However, the build-up of water within the aggregate subbase can lead to frost boils and ultimately potholes forming at the road surface. The aggregate subbase and subgrade soils under these gravel roads are produced with material opportunistically chosen from local sources near the site and, many times, the compositions of these sublayers are far from ideal in terms of proper water drainage with the full effects of this shortcut not being fully understood. The primary objective of this project was to provide a physically-based model for evaluating the drainability of potential subbase and subgrade materials for gravel roads in Iowa. The Richards equation provided the appropriate framework to study the transient unsaturated flow that usually occurs through the subbase and subgrade of a gravel road. From which, we identified that the saturated hydraulic conductivity, Ks, was a key parameter driving the time to drain of subgrade soils found in Iowa, thus being a good proxy variable for accessing roadway drainability. Using Ks, derived from soil texture, we were able to identify potential problem areas in terms of roadway drainage . It was found that there is a threshold for Ks of 15 cm/day that determines if the roadway will drain efficiently, based on the requirement that the time to drain, Td, the surface roadway layer does not exceed a 2-hr limit. Two of the three highest abundant textures (loam and silty clay loam), which cover nearly 60% of the state of Iowa, were found to have average Td values greater than the 2-hr limit. With such a large percentage of the state at risk for the formation of boils due to the soil with relatively low saturated hydraulic conductivity values, it seems pertinent that we propose alternative design and/or maintenance practices to limit the expensive repair work in Iowa. The addition of drain tiles or French mattresses my help address drainage problems. However, before pursuing this recommendation, a comprehensive cost-benefit analysis is needed.

09007-004 Upper Buffalo Creek Watershed Final Report

The main channel of Upper Buffalo Creek has been identified on Iowa's 303(d) List of Impaired Waters as having a biological impairment (i.e., greater than 50% decrease in mussel species) due to habitat modification, stream alteration, nutrients, and/or siltation. The Buchanan County SWCD has identified this as a priority watershed because mussel population decreases have been well documented to be directly associated with decreases in ecological value, recreational value, and overall water quality. The presence of a diverse and reproducing mussel population indicates that a healthy aquatic ecosystem is intact, which means good fishing, good water quality for wildlife, and assurance that water is safe for recreation. Dan Cohen, Buchanan Conservation Board Director, stated that "should water quality conditions improve, and fishing holes and habitat be enhanced, there is no doubt that many people would take advantage of the renewed recreational opportunities". This watershed contains two "threatened" species of mussels and five "sensitive" species of fish. The District feels that a watershed project will assist in implementing conservation practices that will greatly improve water quality and enhance biological and recreational venues.

05044-016 Upper Miller Creek Watershed Final Report

A water quality resource concern has come to the forefront in the Upper Miller Creek watershed in Black Hawk County after five to seven inches of rain fell on the area on May 22nd and 23rd of 2004 and unprecedented amounts of soil and organic debris were washed from cultivated areas, clogging most culverts and roadside ditches. The quantity of soil deposited in ditches gave a good indication of the amounts that were transported into the stream. The estimated total cost to Black Hawk County for cleanup and repair within the road right-of-way was $345,000. There were undetermined environmental costs incurred when the incredibly high volumes of soil washed from the fields into Miller Creek which flows directly into the Cedar River that is identified by the Department of Natural Resources as an impaired water body. The Upper Miller Creek Watershed Project is an innovative, collaborative project intended to meet a specific need identified by a local steering committee made up of concerned community agencies and local landowners. Led by the Soil and Water Conservation District and the Black Hawk County Board of Supervisors, the Miller Creek Watershed Project seeks to reduce soil erosion, improve water quality, and reduce county road infrastructure cost by implementing conservation practices, reducing nutrient and pesticide use and improving wildlife habitat.

09020-012 Fox River Watershed Final Report

With WIRB funding the Fox River Ecosystem Development board will continue to install prioritized practices identified by assessments within the impaired segment of Fox River. The FRED board is also asking to continue funding for a new 5 year position for assessment, planning and technical assistance. With new assessments and water quality monitoring already being done on the impaired segment of the Fox River a lot of valuable information is at hand. Ecosystem Development board is requesting funding from WIRB to install grade stabilization structures, water sediment basins, and terraces to reduce sediment delivery to Fox River. The FRED board in both Iowa and Missouri are committed not only to seek funding to continue water quality efforts for more practices but also to enhance and protect existing practices and investments that protect our water quality and economic viability in both states. We are off to a good start and want to continue our progress on the Fox River.

Aggregate stability in soils cultivated with eucalyptus

The objective of this work was to evaluate the aggregate stability of tropical soils under eucalyptus plantation and native vegetation, and assess the relationships between aggregate stability and some soil chemical and physical properties. Argisols, Cambisol, Latosols and Plinthosol within three eucalyptus-cultivated regions, in the states of Espírito Santo, Rio Grande do Sul and Minas Gerais, Brazil, were studied. For each region, soils under native vegetation were compared to those under minimum tillage with eucalyptus cultivation. The aggregate stability was measured using the high-energy moisture characteristic (HEMC) technique, i.e., the moisture release curve at very low suctions. This method compares the resistance of aggregates to slaking on a relative scale from zero to one. Thus, the aggregate stability from different soils and management practices can be directly compared. The aggregate stability ratio was greater than 50% for all soils, which shows that the aggregate stability index is high, both in eucalyptus and native vegetation areas. This suggests that soil management adopted for eucalyptus cultivation does not substantially modify this property. In these soils, the aggregate stability ratio does not show a good relationship with clay or soil organic matter contents. However, soil organic matter shows a positive relationship with clay content and cation exchange capacity.

Consumer Focus: These Chips and Good for You: New Credit and Debit Card Chips, April 2016

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: New Credit and Debit Card Chips

Genetic analysis of sudden cardiac death victims: a survey of current forensic autopsy practices.

Autopsy-negative sudden cardiac deaths (SCD) seen in forensic practice are most often thought to be the result of sudden arrhythmic death syndrome. Postmortem genetic analysis is recommended in such cases, but is currently performed in only a few academic centers. In order to determine actual current practice, an on-line questionnaire was sent by e-mail to members of various forensic medical associations. The questions addressed routine procedures employed in cases of sudden cardiac death (autopsy ordering, macroscopic and microscopic cardiac examination, conduction tissue examination, immunohistochemistry and electron microscopy, biochemical markers, sampling and storage of material for genetic analyses, toxicological analyses, and molecular autopsy). Some questions concerned the legal and ethical aspects of genetic analyses in postmortem examinations, as well as any existing multidisciplinary collaborations in SCD cases. There were 97 respondents, mostly from European countries. Genetic testing in cases of sudden cardiac death is rarely practiced in routine forensic investigation. Approximately 60% of respondents reported not having the means to perform genetic postmortem testing and 40% do not collect adequate material to perform these investigations at a later date, despite working at university hospitals. The survey demonstrated that many of the problems involved in the adequate investigation of SCD cases are often financial in origin, due to the fact that activities in forensic medicine are often paid by and dependent on the judicial authorities. Problems also exist concerning the contact with family members and/or the family doctor, as well as the often-nonexistent collaboration with others clinicians with special expertise beneficial in the investigation of SCD cases, such as cardiologists and geneticists. This study highlights the importance in establishing guidelines for molecular autopsies in forensic medicine.