Keele University

About: Keele University is a education organization based out in Newcastle-under-Lyme, United Kingdom. It is known for research contribution in the topics: Population & Stars. The organization has 11318 authors who have published 26323 publications receiving 894671 citations. The organization is also known as: Keele University.

Behavioural treatment for chronic low-back pain

Abstract: BACKGROUND: Behavioural treatment, commonly used in the treatment of chronic low-back pain (CLBP), is primarily focused at reducing disability through the modification of environmental contingencies and cognitive processes. In general, three behavioural treatment approaches are distinguished: operant, cognitive and respondent. OBJECTIVES: To determine if behavioural therapy is more effective than reference treatments for CLBP, and which type of behavioural treatment is most effective. SEARCH STRATEGY: We searched the CENTRAL, MEDLINE, EMBASE, and PsycLIT databases up to October 2003. References of identified randomised trials and relevant systematic reviews were screened. SELECTION CRITERIA: Only randomised trials on behavioural treatment for non-specific CLBP were included. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the methodological quality and extracted the data. The magnitude of effect was assessed by computing a pooled effect size for post-treatment and long-term results for each comparison, for each domain (i.e., behavioural outcomes, overall improvement, back pain specific and generic functional status, return to work, and pain intensity) using the random effects model. MAIN RESULTS: Seven studies (33%) were considered high quality. Comparing behavioural treatment to waiting list control (WLC) revealed strong evidence (4 trials, 134 people) in favour of a combined respondent-cognitive therapy for a medium positive effect on pain, and moderate evidence (2 trials, 39 people) in favour of progressive relaxation for a large positive effect on pain and behavioural outcomes (short-term only). When comparing operant treatment to WLC no significant differences could be detected on general functional status (strong evidence: 2 trials, 87 people) or on behavioural outcomes (moderate evidence; 3 trials, 153 people) (short-term only). There is limited evidence (1 trial, 98 people) that a graded activity program in an industrial setting is more effective than usual care for early return to work and reduced long-term sick leave. There is limited evidence (1 trail, 39 people) that there are no differences between behavioural treatment and exercises. Finally, there is moderate evidence (6 trials, 210 people) that there are no significant differences in short-term and long-term effectiveness when behavioural components are added to usual treatment programs for CLBP (i.e. physiotherapy, back education) on pain, generic functional status and behavioural outcomes. AUTHORS' CONCLUSIONS: Combined respondent-cognitive therapy and progressive relaxation therapy are more effective than WLC on short-term pain relief. However, it is unknown whether these results sustain in the long term. No significant differences could be detected between behavioural treatment and exercise therapy. Whether clinicians should refer patients with CLBP to behavioural treatment programs or to active conservative treatment cannot be concluded from this review.

Interrater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters

Abstract: Objective: To evaluate interrater reliability using 5 newly trained observers in the assessment of pressure pain threshold (PPT) using a fixed-angle algometer. Methods: The study design comprised 2 phases. Phase 1: 5 undergraduate physical therapists were trained in algometry at a predefined angle, at a rate of 5 Newtons (N)/s, to the first dorsal interosseous muscle. Each observer then underwent a competency test of the application speed. The aim was to achieve repeated applications at 5 N/s without visual feedback from the algometer. Phase 2: the 5 observers measured PPT of 13 healthy volunteers, at the first dorsal interosseous muscle. The sequence of observer measurements for each participant was randomized. Mean PPT values for each observer were analyzed using repeated measures analysis of variance, intraclass correlation coefficient (ICC2,1), and standard error of measurement, with 95% confidence intervals (CIs). Results: No significant differences between observers’ mean values were found (P = 0.094), suggesting no bias. The ICC was 0.91 (95% CI 0.82, 0.97). The standard error of measurement value was 6.27 N/cm 2 (95% CI 5.35, 7.59). Differences in PPT measurements of more than 17.39 N/cm 2 (1.77 kg/cm 2 ) are likely to exceed the magnitude of measurement error, and could be used to indicate true change. This margin of error is, however, somewhat larger than a previously proposed minimum clinically important difference in PPT of 14.71 N/cm 2 (1.5 kg/cm 2 ). Discussion: This study provides new evidence that trained observers can apply an algometer at a consistent rate and provide highly reliable measures of PPT in healthy humans, when PPT is calculated as the mean of 3 trials.

The origin of subdwarf B stars – II

Abstract: We have carried out a detailed binary population synthesis (BPS) study of the formation of subdwarf B (sdB) stars and related objects (sdO, sdOB stars) using the latest version of the BPS code developed by Han and co-workers. We systematically investigate the importance of the five main evolutionary channels in which the sdB stars form after one or two common-envelope (CE) phases, one or two phases of stable Roche lobe overflow (RLOF) or as the result of the merger of two helium white dwarfs (WDs). Our best BPS model can satisfactorily explain the main observational characteristics of sdB stars, in particular their distributions in the orbital period-minimum companion mass (log P-M-comp) diagram and in the effective temperature-surface gravity (T-eff- log g) diagram, their distributions of orbital period, log (gtheta(4))(theta = 5040 K / T-eff) and mass function, their binary fraction and the fraction of sdB binaries with WD companions, their birth rates and their space density. We obtain a Galactic formation rate for sdB stars of 0.014- 0.063 yr(-1) with a best estimate of similar to0.05 yr(-1) and a total number in the Galaxy of 2.4-9.5 x 10(6) with a best estimate of similar to6 x 10(6); half of these may be missing in observational surveys owing to selection effects. The intrinsic binary fraction is 76-89 per cent, although the observed frequency may be substantially lower owing to the selection effects. The first CE ejection channel, the first stable RLOF channel and the merger channel are intrinsically the most important channels, although observational selection effects tend to increase the relative importance of the second CE ejection and merger channels. We also predict a distribution of masses for sdB stars that is wider than is commonly assumed and that some sdB stars have companions of spectral type as early as B. The percentage of A-type stars with sdB companions can in principle be used to constrain some of the important parameters in the binary evolution model. We conclude that (i) the first RLOF phase needs to be more stable than is commonly assumed, either because the critical mass ratio q(crit) for dynamical mass transfer is higher or because of tidally enhanced stellar wind mass loss; (ii) mass transfer in the first stable RLOF phase is non-conservative, and the mass lost from the system takes away a specific angular momentum similar to that of the system; and (iii) common-envelope ejection is very efficient.

Applications of digital technology in COVID-19 pandemic planning and response

Abstract: Summary With high transmissibility and no effective vaccine or therapy, COVID-19 is now a global pandemic Government-coordinated efforts across the globe have focused on containment and mitigation, with varying degrees of success Countries that have maintained low COVID-19 per-capita mortality rates appear to share strategies that include early surveillance, testing, contact tracing, and strict quarantine The scale of coordination and data management required for effective implementation of these strategies has—in most successful countries—relied on adopting digital technology and integrating it into policy and health care This Viewpoint provides a framework for the application of digital technologies in pandemic management and response, highlighting ways in which successful countries have adopted these technologies for pandemic planning, surveillance, testing, contact tracing, quarantine, and health care

Turning software into a service

Abstract: The software as a service model composes services dynamically, as needed, by binding several lower-level services-thus overcoming many limitations that constrain traditional software use, deployment, and evolution.