SYNOPSIS: Vascular serious adverse events can occur after examining, manipulating, mobilizing, and prescribing exercise for the cervical spine. Patients presenting with neck pain and headache who develop a vascular serious adverse event during or after treatment may have vascular flow limitations that go unrecognized and are aggravated by treatment. Patients with neck pain and headache-the first nonischemic symptoms of arterial dissection-frequently access physical therapists as first-point providers, not all of whom have specialist training in orthopaedic manual physical therapy. All physical therapists, irrespective of their training, who are helping patients manage neck pain, headache, and/or facial symptoms must feel confident to identify potential vascular flow limitations of the neck prior to providing treatment. J Orthop Sports Phys Ther 2021;51(9):418-421. Epub 10 May 2021. doi:10.2519/jospt.2021.10408.
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Studies about clinical pain in schizophrenia are rare. Conclusions on pain sensitivity in people with schizophrenia are primarily based on experimental pain studies. This review attempts to assess clinical pain, that is, everyday pain without experimental manipulation, in people with schizophrenia. PubMed, PsycINFO, Embase.com, and Cochrane were searched with terms related to schizophrenia and pain. Methodological quality was assessed with the Mixed Methods Appraisal Tool. Fourteen studies were included. Persons with schizophrenia appear to have a diminished prevalence of pain, as well as a lower intensity of pain when compared to persons with other psychiatric diseases. When compared to healthy controls, both prevalence and intensity of pain appear to be diminished for persons with schizophrenia. However, it was found that this effect only applies to pain with an apparent medical cause, such as headache after lumbar puncture. For less severe situations, prevalence and intensity of pain appears to be comparable between people with schizophrenia and controls. Possible underlying mechanisms are discussed. Knowledge about pain in schizophrenia is important for adequate pain treatment in clinical practice. Perspective This review presents a valuable insight into clinical pain in people with schizophrenia
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Pain in critically ill adults with burns should be assessed using structured pain behavioural observation measures. This study tested the clinimetric qualities and usability of the behaviour pain scale (BPS) and the critical-care pain observation tool (CPOT) in this population. This prospective observational cohort study included 132 nurses who rated pain behaviour in 75 patients. The majority of nurses indicated that BPS and CPOT reflect background and procedural pain-specific features (63–72 and 87–80%, respectively). All BPS and CPOT items loaded on one latent variable (≥0.70), except for compliance ventilator and vocalisation for CPOT (0.69 and 0.64, respectively). Internal consistency also met the criterion of ≥0.70 in ventilated and non-ventilated patients for both scales, except for non-ventilated patients observed by BPS (0.67). Intraclass correlation coefficients (ICCs) of total scores were sufficient (≥0.70), but decreased when patients had facial burns. In general, the scales were fast to administer and easy to understand. Cut-off scores for BPS and CPOT were 4 and 1, respectively. In conclusion, both scales seem valid, reliable, and useful for the measurement of acute pain in ICU patients with burns, including patients with facial burns. Cut-off scores associated with BPS and CPOT for the burn population allow professionals to connect total scores to person-centred treatment protocols.
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Background: Previous systematic reviews revealed poor reliability and validity for sacroiliac joint (SIJ) mobility tests. However, these reviews were published nearly 20 years ago and recent evidence has not yet been summarised. Objectives: To conduct an up-to-date systematic review to verify whether recommendations regarding the clinical use of SIJ mobility tests should be revised. Study design: Systematic review. Method: The literature was searched for relevant articles via 5 electronic databases. The review was conducted according to the PRISMA guidelines. COSMIN checklists were used to appraise the methodological quality. Studies were included if they had at least fair methodology and reported clinimetric properties of SIJ mobility tests performed in adult patients with non-specific low back pain, pelvic (girdle) pain and/or SIJ pain. Only tests that can be performed in a clinical setting were considered. Results: Twelve relevant articles were identified, of which three were of sufficient methodological quality. These three studies evaluated the reliability of eight SIJ mobility tests and one test cluster. For the majority of individual tests, the intertester reliability showed slight to fair agreement. Although some tests and one test cluster had higher reliability, the confidence intervals around most reliability estimates were large. Furthermore, there were no validity studies of sufficient methodological quality. Conclusion: Considering the low and/or imprecise reliability estimates, the absence of high-quality diagnostic accuracy studies, and the uncertainty regarding the construct these tests aim to measure, this review supports the previous recommendations that the use of SIJ mobility tests in clinical practice is problematic.
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In daily interaction with horses, humans primarily rely on facial expression as a non-verbal equine cue for emotional information. Difficulties in correctly recognizing these signals might arise due to the species-specificity of facial cues, possibly leading to diminished equine welfare and health. This study aimed to explore human visual search patterns when assessing equine facial expressions indicative of various pain levels, utilizing eye-tracking technology. Hundred and eight individuals (N = 108), classified into three groups (affinity with horses (N = 60), pet owners with no affinity with horses (N = 32), and individuals with no affinity with animals (N = 16)) participated in the study; with their eye movements recorded using eye tracking glasses they evaluated four photos of horses with different levels of pain. Error score, calculated by comparing participant scores to Gold Standard Visual Analogue Score levels and fixation metrics (number of fixations and duration of fixations) were analysed across the four photos, participant group and Areas of Interest (AOIs): eyes, ears, nostrils, and mouth. Statistical analysis utilized linear mixed models. Highlighting the critical role of the eyes as key indicators of pain, findings showed that the eyes played a significant role in assessing equine emotional states, as all groups focused on them for a longer time and more frequently compared to other facial features. Also, participants showed a consistent pattern in how they looked at a horse's face, first focusing on the eyes, then the ears, and finally the nose/mouth region, indicating a horse-specific pattern. Moderate pain was assessed with similar accuracy across all groups, indicating that these signals are broadly recognizable. Nevertheless, non-equestrians faced challenges with recognizing the absence of pain, possibly highlighting the role of experience in interpreting subtle equine expressions. The study's limitations, such as variability in assessment conditions may have impacted findings. Future work could further investigate why humans follow this visual search pattern and whether they recognize the significance of a horse's ears. Additionally, emphasis should be placed on developing targeted training interventions to improve equine pain recognition, possibly benefiting equine welfare and health.
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Aims: To assess the effectiveness of a variety of physical treatments in the management of tension-type headache (TTH) in children. Methods: This review is reported in accordance with the PRISMA guidelines and was registered in the PROSPERO database (CRD42014015290). Randomized and nonrandomized controlled trials that examined the effects of all treatments with a physical component in the management of TTH in children and compared these treatments to a placebo intervention, no intervention, or a controlled comparison intervention were included. The Physiotherapy Evidence Database (PEDro) criteria for bias assessment and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Working Group criteria were used to assess the quality of the body of evidence. The outcome measures were pain, functioning, and quality of life. Only RCTs were included in the meta-analyses. Results: An initial search produced 10,464 published articles. Of these, 17 were relevant trials, including 1,815 participants. The overall GRADE rating of the included studies was moderate, and 11 of the 17 studies could be used in the meta-analyses. The effectiveness of physical treatments in terms of a reduction of pain of 50% or more showed a risk ratio (RR) of 2.37 (95% CI: 1.69 to 3.33). Relaxation training was the most evaluated intervention and proved to be significantly effective (RR: 3.00 [95% CI: 1.94 to 4.63]). In children having TTH combined with temporomandibular disorders, occlusal appliances were effective (RR: 2.58 [95% CI: 1.37 to 4.85]). Conclusion: This review supports the use of physical treatments to reduce pain in children with TTH.
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Background: Acne vulgaris is a multifaceted skin disorder, affecting more than 85% of young individuals worldwide. Pharmacological therapy is not always desirable because of the development of antibiotic resistance or the potential risk of adverse effects. Non‐pharmacological therapies can be viable alternatives for conventional therapies. However, sufficient evidence‐based support in the efficacy and safety of non‐pharmacological therapies is lacking. Objective: To assess the efficacy and safety of several non‐pharmacological therapies in the treatment of acne vulgaris. Methods: A systematic literature review, including a best‐evidence synthesis, was performed to identify literature. Three electronic databases were accessed and searched for studies published between January 2000 and May 2017. Results: Thirty‐three eligible studies were included in our systematic review. Three main types of non‐pharmacological therapies were identified laser‐ and light‐based therapies, chemical peels and fractional microneedling radiofrequency. The majority of the included studies demonstrated a significant reduction in acne lesions. However, only seven studies had a high methodologic quality. Based on these seven trials, a best‐evidence synthesis was conducted. Strong evidence was found for glycolic acid (10–40%). Moderate evidence was found for amino fruit acid (20–60%), intense pulsed light (400–700 and 870–1200 nm) and the diode laser (1450 nm). Initially, conflicting evidence was found for pulsed dye laser (585–595 nm). The most frequently reported side‐effects for non‐pharmacological therapies included erythema, tolerable pain, purpura, oedema and a few cases of hyperpigmentation, which were in most cases mild and transient. Conclusion: Circumstantial evidence was found for non‐pharmacological therapies in the treatment of acne vulgaris. However, the lack of high methodological quality among included studies prevented us to draw clear conclusions, regarding a stepwise approach. Nevertheless, our systematic review including a best‐evidence synthesis did create order and structure in resulting outcomes in which a first step towards future research is generated.
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Inaugurele rede uitgesproken bij de aanvaarding van het ambt van lector aan Hogeschool van Hall Larenstein, 16 juni 2023. Partners uit verschillende sectoren werken samen met het lectoraat Duurzame Paardenhouderij en Paardensport om bruggen te slaan tussen wetenschap, praktijk en diverse stakeholders. De focus ligt op het ontwikkelen van transitietrajecten naar een duurzame paardensector en het laten zien van de bijdrage die de sector kan leveren aan een duurzaam en diervriendelijk Nederland. Het lectoraat richt zich op drie onderzoekslijnen: - duurzame omgang met paarden - duurzaam ondernemen - een duurzame omgeving voor paard en mens Door de integrale benadering van kennisdeling en samenwerking met nationale en internationale kennispartners, praktijkorganisaties, ondernemers en paardensporters, streeft het lectoraat naar blijvende gedragsverandering en duurzame ontwikkeling. Het lectoraat sluit bovendien aan bij de transities van Hogeschool Van Hall Larenstein, waarbij onder andere de mogelijkheden voor biodiversiteit, natuurinclusie en klimaatadaptatie op paardenbedrijven worden verkend. Daarnaast worden nieuwe inzichten omtrent de welzijnsgerichte omgang met paarden toegepast, waarbij het paardenerf dienst kan doen als natuurlijke overgang tussen bebouwde omgeving en natuur, met positieve gevolgen voor biodiversiteit en (dieren)welzijn.
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Surviving a burn can dramatically alter a child’s life, yet few studies examined long-term health-related quality of life (HRQL). This study assessed HRQL 5–7 years post-burn in children with mild/intermediate and severe burns and identified associated factors. Parents of children (5− < 18 years) who were hospitalized or had burn surgery between 08/2011 and 09/2012 completed the Burn Outcomes Questionnaire (BOQ). Outcomes were compared between two subgroups: children with mild/intermediate burns (10% (TBSA) burned; (2) aged ≥10 years with >20% TBSA burned; or (3) >5% full-thickness burns). A total of 102 children were included (mean age at survey: 8.4 (3.0) years; mean former TBSA: 7.1%). At a mean of 5.7 years post-burn, many parents rated their child’s health as excellent (46.1%) or very good (35.3%), with few reporting issues with ‘pain’ (2.3%), ‘physical function and sports’ (1.6%), and ‘upper extremity function’ (0.9%). Parents of children with severe burns indicated significantly more problems with ‘appearance’ (89.2% versus 71.5%; p = 0.014) and ‘parental concern’ (94.1% versus 84.8%; p = 0.021). Upper limb burns, facial burns, burn size, length of hospital stay, full-thickness burns, and the number of surgeries predicted poorer outcomes. In general, these findings indicate positive long-term HRQL, though especially children with full-thickness burns and/or surgical interventions face a higher risk of reduced HRQL. The results can be used to inform children and their families about the long-term implications. Furthermore, healthcare professionals can use these insights to identify children at higher risk of poorer long-term HRQL.
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Een belangrijk deel van onze interesse in de wereld om ons heen is gericht op dieren. Niet alleen voor de voedselproductie of het transport, maar ook vanwege onze empathie voor hen en onze fascinatie voor wat ze voor ons in veel andere rollen(kunnen) betekenen. Paarden, honden, katten en andere gezelschapsdieren maar ook veel landbouwhuisdieren worden als metgezel behandeld en met genegenheid verzorgd. Deze belangstelling voor de band tussen mens en dier is sinds eind vorige eeuw enorm toegenomen door onder andere de berichtgeving in de populaire pers over de positieve impact van dieren op het leven van mensen. Hierdoor is de nieuwsgierigheid van professionals en de samenleving gewekt om deze unieke relatie tussen mens en dier tot meerwaarde te brengen. Met de toenemende inzet van dieren in ons leven, rijst vanzelfsprekend de vraag of die mens-dier interactie wederzijds positief uitpakt. In 2019 is de zienswijze Dierbare Hulpverleners: welzijn voor mens en dier? van De Raad voor Dierenaangelegenheden (RDA) (Raad voor Dierenaangelegenheden, 2019) verschenen waarbij de vraag gesteld werd of, en op welke wijze, dieren bij interventies op verantwoorde wijze kunnen worden ingezet. Zowel in de dagelijkse omgang met, als de inzet van dieren, maar zeker ook in de wetenschappelijke literatuur, is veel vaker aandacht voor hoe dieren de kwaliteit van leven van de mens kunnen bevorderen in vergelijking met hoe de mens de kwaliteit van leven van dieren zouden kunnen verbeteren. Alhoewel deze thematiek het meest herkenbaar is bij sectoren waar dieren ingezet worden bij dierondersteunde interventies (zoals therapie) of hulp (blindengeleidehonden), moet het effect van de mens-dier interactie op het dier veel breder gezien worden. Ook bij de inzet van dieren in opsporing, beveiliging, sport, recreatie en vermaak is er sprake van een intensieve interactie tussen mens en dier. In sommige gevallen is de mens in het partnerschap met het dier zelfs geheel of gedeeltelijk afhankelijk van het dier. De mens-dier interactie is ook (indirect) zichtbaar in het management, en dan met name in de houderij en fokkerij van dieren. Daar waar mensen beslissen over huisvesting, voeding en fokdoelen van dieren, kan de kwaliteit van leven van dieren in gevaar komen wanneer onvoldoende rekening wordt gehouden met de behoeften en aanpassingsmogelijkheden van het dier. Gek genoeg is onderzoek naar het effect van de mens-dier interactie pas aan het einde van de vorige eeuw als een onderzoeksgebied opgekomen. Sindsdien is het onderzoek explosief gegroeid met multidisciplinaire onderzoeksgroepen over de hele wereld. Ook in Nederland wordt voornamelijk op universiteiten onderzoek gedaan naar de interactie tussen dieren, mensen en maatschappij. De thematiek wordt vanuit verschillende disciplines benaderd, waaronder ook vanuit het diergedrag en dierenwelzijn. Op het hbo wordt onderzoek gedaan naar diergedrag, dierenwelzijn en diermanagement; het effect van de mens-dier interactie op het dier heeft daar echter nog een ondergeschikte rol. Het lectoraat Human-Animal Interactions draagt bij aan het verder ontrafelen van wat zich af speelt in de mens-dier interactie en vooral ook wat het voor het dier betekent. De focus ligt bij twee diersoorten: paarden en honden. In de publicatie wordt verder ingegaan op hoede mens-dier interactie tot stand komt, hoe dierenwelzijn een rol speelt in de mens-dier interactie en in welke sectoren mensen met paarden en honden samenwerken.
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