A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy

Aim: To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy.

Background: International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness.

Design: A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy.

Data Sources: Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013).

Review Methods: Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool.

Results: Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low.

Conclusion: There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice.

Combinations of Prompt and Target Response Modalities and Their Impact on Emergent Relations and Teaching Efficiency.

In the present study, native Spanish speakers were taught a small English vocabulary (Spanish-to-English intraverbals). Four different training conditions were created by combining textual and echoic prompts with written and vocal target responses. The efficiency of each training condition was examined by analysing emergent relations (i.e., tacts) and the total number of sessions required to reach mastery under each training condition. All combinations of prompt-response modalities generated increases in correct responding on tests for emergent relations but when target responses were written, mastery criterion was reached faster. Results are discussed in terms of efficiency for emergent relations and recommendations for future directions are provided.

Technological aids for the rehabilitation of memory and executive functioning in children and adolescents with acquired brain injury (Review).

Background The use of technology in healthcare settings is on the increase and may represent a cost-effective means of delivering rehabilitation. Reductions in treatment time, and delivery in the home, are also thought to be benefits of this approach. Children and adolescents with brain injury often experience deficits in memory and executive functioning that can negatively affect their school work, social lives, and future occupations. Effective interventions that can be delivered at home, without the need for high-cost clinical involvement, could provide a means to address a current lack of provision. We have systematically reviewed studies examining the effects of technology-based interventions for the rehabilitation of deficits in memory and executive functioning in children and adolescents with acquired brain injury. Objectives To assess the effects of technology-based interventions compared to placebo intervention, no treatment, or other types of intervention, on the executive functioning and memory of children and adolescents with acquired brain injury. Search methods We ran the search on the 30 September 2015. We searched the Cochrane Injuries Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic + EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED, SSCI, CPCI-S, and CPSI-SSH), CINAHL Plus (EBSCO), two other databases, and clinical trials registers. We also searched the internet, screened reference lists, and contacted authors of included studies. Selection criteria Randomised controlled trials comparing the use of a technological aid for the rehabilitation of children and adolescents with memory or executive-functioning deficits with placebo, no treatment, or another intervention. Data collection and analysis Two review authors independently reviewed titles and abstracts identified by the search strategy. Following retrieval of full-text manuscripts, two review authors independently performed data extraction and assessed the risk of bias. Main results Four studies (involving 206 participants) met the inclusion criteria for this review. Three studies, involving 194 participants, assessed the effects of online interventions to target executive functioning (that is monitoring and changing behaviour, problem solving, planning, etc.). These studies, which were all conducted by the same research team, compared online interventions against a 'placebo' (participants were given internet resources on brain injury). The interventions were delivered in the family home with additional support or training, or both, from a psychologist or doctoral student. The fourth study investigated the use of a computer program to target memory in addition to components of executive functioning (that is attention, organisation, and problem solving). No information on the study setting was provided, however a speech-language pathologist, teacher, or occupational therapist accompanied participants. Two studies assessed adolescents and young adults with mild to severe traumatic brain injury (TBI), while the remaining two studies assessed children and adolescents with moderate to severe TBI. Risk of bias We assessed the risk of selection bias as low for three studies and unclear for one study. Allocation bias was high in two studies, unclear in one study, and low in one study. Only one study (n = 120) was able to conceal allocation from participants, therefore overall selection bias was assessed as high. One study took steps to conceal assessors from allocation (low risk of detection bias), while the other three did not do so (high risk of detection bias). Primary outcome 1: Executive functioning: Technology-based intervention versus placebo Results from meta-analysis of three studies (n = 194) comparing online interventions with a placebo for children and adolescents with TBI, favoured the intervention immediately post-treatment (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.66 to -0.09; P = 0.62; I2 = 0%). (As there is no 'gold standard' measure in the field, we have not translated the SMD back to any particular scale.) This result is thought to represent only a small to medium effect size (using Cohen’s rule of thumb, where 0.2 is a small effect, 0.5 a medium one, and 0.8 or above is a large effect); this is unlikely to have a clinically important effect on the participant. The fourth study (n = 12) reported differences between the intervention and control groups on problem solving (an important component of executive functioning). No means or standard deviations were presented for this outcome, therefore an effect size could not be calculated. The quality of evidence for this outcome according to GRADE was very low. This means future research is highly likely to change the estimate of effect. Primary outcome 2: Memory One small study (n = 12) reported a statistically significant difference in improvement in sentence recall between the intervention and control group following an eight-week remediation programme. No means or standard deviations were presented for this outcome, therefore an effect size could not be calculated. Secondary outcomes Two studies (n = 158) reported on anxiety/depression as measured by the Child Behavior Checklist (CBCL) and were included in a meta-analysis. We found no evidence of an effect with the intervention (mean difference -5.59, 95% CI -11.46 to 0.28; I2 = 53%). The GRADE quality of evidence for this outcome was very low, meaning future research is likely to change the estimate of effect. A single study sought to record adverse events and reported none. Two studies reported on use of the intervention (range 0 to 13 and 1 to 24 sessions). One study reported on social functioning/social competence and found no effect. The included studies reported no data for other secondary outcomes (that is quality of life and academic achievement). Authors' conclusions This review provides low-quality evidence for the use of technology-based interventions in the rehabilitation of executive functions and memory for children and adolescents with TBI. As all of the included studies contained relatively small numbers of participants (12 to 120), our findings should be interpreted with caution. The involvement of a clinician or therapist, rather than use of the technology, may have led to the success of these interventions. Future research should seek to replicate these findings with larger samples, in other regions, using ecologically valid outcome measures, and reduced clinician involvement.

The effect of pantethine and ultraviolet-B radiation on the development of lenticular opacity in the emory mouse.

PURPOSE: Few studies have examined the impact of long-term treatments or exposures on the development of cataract in maturity-onset animal models. We studied the effect of treatment with D-pantethine and exposure to ultraviolet-B (UVB) radiation on the development of lenticular opacity in the Emory mouse. METHODS: A total of 164 Emory mice were randomized by litter at weaning to exposure to UVB light at 12 mJ/cm(2) for 6 hr/day (UV) or usual room light (A), and within litter, were further randomized to bi-weekly intra-peritoneal injections of 0.8 g/kg pantethine (T) or no treatment (C). Retro illumination lens photos were taken at 2, 4, 6, 8, and 10 months after weaning, and graded in masked fashion. The animals were sacrificed at 10 months and the lenses analyzed for total pantethine and total cysteamine. RESULTS: Lens pantethine and cysteamine levels were significantly (P < 0.001) higher for the T as compared to C litters. Mean cataract grade increased monotonically over time for all four groups. Unadjusted mean grade for the AT group at 8 (1.32) and 10 (1.86) months appeared lower than for the other groups (AC: 2.17, 2.39; UVC: 1.77, 2.40; UVT: 1.88, 2.37). However, the mean grade for the pantethine-treated litters did not differ significantly from the untreated litters except at 2 months (when untreated litters had significantly lower grades), when adjusting for UV treatment, gender and litter effect. No significant difference in cataract score existed between UV-exposed and ambient litters. Mortality was higher among pantethine-treated (hazard ratio = 1.8, p = 0.05) and UV-exposed animals (hazard ratio = 1.8, p = 0. 03) than among the untreated and unexposed litters. CONCLUSION: Significantly increased lens levels of pantethine are achieved with long-term intra-peritoneal dosing. The impact of pantethine on the progression of lenticular opacity in the Emory mouse is less than has been reported in other models. This level of chronic UVB exposure appeared to have no effect on the development of cataract in this model.

Containing precious metals: hallmarking, minting and the materiality of gold and silver in medieval and modern England.

This book chapter extends the argument constructed by Oakley in his conference paper ‘Containing gold: Institutional attempts to define and constrict the values of precious metal objects’ presented at ‘Itineraries of the Material’, a conference held at Goethe Universitaet, Frankfurt am Main in 2011. Oakley’s chapter investigates the social forces that define the identities, social pathways and physical movement of objects made of precious metal. It presents a case study in which constitutive substance rather than the conceptual object is the key driver behind the social trajectories of numerous artefacts and their reception by contemporary audiences. This supports the main contention of the book as a whole: the need to reconsider, and when necessary challenge, the dominance of the social biography of objects in the study of material culture. Oakley’s research used historical and ethnographic approaches, including three years’ of ethnographic field research in the jewellery industry. This included training as a precious metal assayer at the Birmingham Assay Office and observing the industry and public response to government proposals to abolish the hallmarking legislation. This fieldwork was augmented by archive, library and object collection research on the histories of assaying and goldsmithing. Oakley presents an analysis of the historical development and contemporary social relevance of hallmarking, a technological process that has never previously been subject to ethnographic study, yet is fundamental to one of the UK’s creative industries.

A Race to the bottom – Prison Education and the English and Welsh Policy Context

This article examines prison education in England and Wales arguing that a disjuncture exists between the policy rhetoric of entitlement to education in prison at the European level and the playing out of that entitlement in English and Welsh prisons. Caught between conflicting discourses around a need to combat recidivism and a need for incarceration, prison education in England exists within a policy context informed, in part, by an international human rights agenda on the one hand and global recession, financial cutbacks, and a moral panic about crime on the other. The European Commission has highlighted a number of challenges facing prison education in Europe including over‐crowded institutions, increasing diversity in prison populations, the need to keep pace with pedagogical changes in mainstream education and the adoption of new technologies for learning (Hawley et al., 2013). These are challenges confronting all policy makers involved in prison education in England and Wales in a policy context that is messy, contradictory and fiercely contested. The article argues that this policy context, exacerbated by socio‐economic discourses around neo‐liberalism, is leading to a race‐to‐the‐bottom in the standards of educational provision for prisoners in England and Wales.

Exploring the Roles of Technology and Social Play in Art Museums

This co-written chapter was included in an edited book featuring invited authors from different countries and different areas of museum research and practice. The chapter uses a theory of play by Johan Huizinga (1938) to frame case studies of play-based interactive experiences in museums in various countries. The aim was to use theory to ground museum practice, in order to evaluate existing practical implementations as well as to inform the design of new ones. The book was nominated as one of the 10 best museum education books of 2011 by Museum Education Monitor, and the chapter led to a subsequent technology residency the author undertook in the Spike Island gallery, Bristol in 2012, funded by the National Endowment for Science, Technology and the Arts, Arts and Humanities Research Council and Arts Council England. It also informed his subsequent postgraduate teaching, an example of which is a recent MA project, which deconstructs play from a computational perspective. Collaborations have continued with the co-author, which have resulted in a number of invited lectures. In this chapter the authors explore play as a structure for supporting visitor learning, drawing from international research in museums and interaction design. Four aspects of play first proposed by Huizinga are explored – the free-choice aspect of play, play as distinct from real life, play as an ordering structure, and the role of play in bridging communities. The chapter argues that play provides museums with ready-made structures and concepts, which can help planning for visitor learning. The research was equally divided between the co-authors, who developed the conceptual and theoretical aspects of the article by drawing on their own research alongside key examples of museum design and digital media.

Calvin Spencer division of estate and estate settlement

This document establishes the division of Calvin Spencer's estate among his heirs as well as the settlement of his estate among his wife and heirs.

Average age of pending and disposed cases report for period 7/1/2012 thru 6/30/2013

This gives the average age of pending and disposes criminal cases broken down by county and circuit.

AGREED-UPON PROCEDURES REPORT ON CONTRACT FOR PURCHASE OF NURSING CARE SERVICES WITH STATE OF SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

The Medicaid Audits Section of the South Carolina Office of the State Auditor performs audits and reviews of cost reports filed by institutional providers of Medicaid services. These cost reports are used by the Health and Human Services Finance Commission to establish amounts to be paid to these providers for services provided to qualified Medicaid recipients. This report deals with A. Sam Karesh Long Term Care Nursing Facility in North Augusta, S.C.

Muslims in Public and Media Discourse in Western Europe: The Reproduction of Aporia and Exclusion

This chapter scrutinizes the dominant public discourse in Western Europe. Drawing on examples from the UK, Germany, and France but also from the Netherlands, Denmark and Spain it illustrates the gradual transformation of discourse from an “exotic Islam” to a “threatening Islam” that endangers European values and safety and suggests that the combination of this “securitization” of Islam and the monopoly of the “Muslim voice” by radical Muslim activists leads to a vicious circle of misrecognition and enhancing the aporia of Europe's Muslims.

A Bilingual Thesaurus of Everyday Life in Medieval England: Some Issues at the Interface of Semantics and Lexicography

This paper reports on issues at the interface between semantics and lexicography that arose out of the data collection and classification of vocabulary in Anglo-Norman and Middle English in order to create a bilingual thesaurus of everyday life in medieval England. The Bilingual Thesaurus project is based at Birmingham City University and the University of Westminster. Issues to be resolved included the definition of an occupational domain; the creation of a methodology of data collection; the delimitation of domain-specific vocabulary; making distinctions between sense and usage; and the categorisation of the lexical items. Some of these issues are general to thesaurus-making, some are specific to the making of historical thesauruses, while some are unique to the production of a thesaurus of two languages whose use overlapped for several centuries in the late medieval period in England.

Heb 5.7, Jesus' Prayer on the Mount of Olives and Jewish Christianity: Hearing Early Christian Voices in Canonical and Apocryphal Texts

(Résumé de l'ouvrage) The book of Hebrews has often been the Cinderella of the New Testament, overlooked and marginalized; and yet it is one of the most interesting and theologically significant books in the New Testament. A Cloud of Witness examines the theology of the book in the light of its ancient historical context. There are chapters devoted to the structure of Hebrews, the person of Jesus Christ, Hebrews within the context of Second Temple Judaism and the Greco-Roman empire and the role of Hebrews in early Christian thought.

An analysis of protocols and publications suggested that most discontinuations of clinical trials were not based on preplanned interim analyses or stopping rules.

OBJECTIVES: To investigate the frequency of interim analyses, stopping rules, and data safety and monitoring boards (DSMBs) in protocols of randomized controlled trials (RCTs); to examine these features across different reasons for trial discontinuation; and to identify discrepancies in reporting between protocols and publications. STUDY DESIGN AND SETTING: We used data from a cohort of RCT protocols approved between 2000 and 2003 by six research ethics committees in Switzerland, Germany, and Canada. RESULTS: Of 894 RCT protocols, 289 prespecified interim analyses (32.3%), 153 stopping rules (17.1%), and 257 DSMBs (28.7%). Overall, 249 of 894 RCTs (27.9%) were prematurely discontinued; mostly due to reasons such as poor recruitment, administrative reasons, or unexpected harm. Forty-six of 249 RCTs (18.4%) were discontinued due to early benefit or futility; of those, 37 (80.4%) were stopped outside a formal interim analysis or stopping rule. Of 515 published RCTs, there were discrepancies between protocols and publications for interim analyses (21.1%), stopping rules (14.4%), and DSMBs (19.6%). CONCLUSION: Two-thirds of RCT protocols did not consider interim analyses, stopping rules, or DSMBs. Most RCTs discontinued for early benefit or futility were stopped without a prespecified mechanism. When assessing trial manuscripts, journals should require access to the protocol.

Co-operative education and the development of self-esteem, an internal locus of control and work habits

This study compared approximately 50 grade 12 students studying In th~ co-operative education mode with approximately 50 grade 12 students studying in a traditional English course. Measures of self-esteem, locus of control and work habits were compared before and at the conclusion of one semester's involvement in the different programs. Using Coopersmith's Self-Esteem Inventory, the students who had chosen to study in the co-operative education mode scored significantly higher than the students in the traditional course. At the end of the semester, the co-operative education students' scores remained significantly higher than the English students'. Although the test showed no sjgnifi~ant changes in self-esteem. anecdotal reports indicated that co-operative education students had increased self-esteem over the semester. No significant differences in locus of control were observed between the two groups at any time. Significant differences in work habits were observed. While both groups had the same number of absences and the same marks before taking these courses, students who were involved in co-operative education had significantly fewer absences and significantly higher marks than the students studying in the traditional course. Anecdotal reports also indicated an improv~ment in work habits for students who had been involved in co-operative education. Recommendations of the study are for further research to determine more exactly how self-esteem and work habits develop in co-operative education students. Also. students. parents, teachers. and administrators need to be made aware of the success of this program.