Best practice care for acute low back pain: A new clinical standard to assist general practitioners.

Background: Low back pain is one of the most common presentations in general practice. Although there is excellent evidence regarding best management of the condition, in primary care there is often overuse of less effective and expensive options, whereas effective, inexpensive options are underused. After broad consultation and evidence review, the Australian Commission on Safety and Quality in Health Care has developed a clinical care standard in response to this identified gap between best and actual practice.

Finale: impact of the ORCHESTRA/ENCORE programmes on Southern Ocean heat and carbon understanding.

The 5-year Ocean Regulation of Climate by Heat and Carbon Sequestration and Transports (ORCHESTRA) programme and its 1-year extension ENCORE (ENCORE is the National Capability ORCHESTRA Extension) was an approximately 11-million-pound programme involving seven UK research centres that finished in March 2022. The project sought to radically improve our ability to measure, understand and predict the exchange, storage and export of heat and carbon by the Southern Ocean. It achieved this through a series of milestone observational campaigns in combination with model development and analysis.

Novel use of social media to assess and improve coastal flood forecasts and hazard alerts.

Coastal communities and infrastructure need protection from flooding and wave overtopping events. Assessment of hazard prediction methods, used in sea defence design, defence performance inspections and forecasting services, requires observations at the land-sea interface but these are rarely collected. Here we show how a database of hindcast overtopping events, and the conditions that cause them, can be built using qualitative overtopping information obtained from social media.

Natural variability in air-sea gas transfer efficiency of CO.

The flux of CO between the atmosphere and the ocean is often estimated as the air-sea gas concentration difference multiplied by the gas transfer velocity (K). The first order driver for K over the ocean is wind through its influence on near surface hydrodynamics. However, field observations have shown substantial variability in the wind speed dependencies of K.

Prolotherapy injections and physiotherapy used singly and in combination for lateral epicondylalgia: a single-blinded randomised clinical trial.

Background: Lateral epicondylalgia (tennis elbow) is a common, debilitating and often treatment-resistant condition. Two treatments thought to address the pathology of lateral epicondylalgia are hypertonic glucose plus lignocaine injections (prolotherapy) and a physiotherapist guided manual therapy/exercise program (physiotherapy). This trial aimed to compare the short- and long-term clinical effectiveness, cost effectiveness, and safety of prolotherapy used singly and in combination with physiotherapy.

Relationship between ultrasound detected tendon abnormalities, and sensory and clinical characteristics in people with chronic lateral epicondylalgia.

Objective: To investigate the relationship between tendon structural changes determined by static ultrasound images (US) and sensory changes using quantitative sensory testing (QST), and clinical measures in lateral epicondylalgia.

Materials And Methods: Both elbows of 66 adult participants with a clinical diagnosis of lateral epicondylalgia were investigated. Using a standardised ultrasound image rating scale, common extensor hypoechogenicity, heterogenicity, neovascularity, and bony abnormalities at the enthesis were scored, and tendon thickness (longitudinal and transverse plane) was measured by a trained assessor.

Management of Whiplash Associated Disorders in Australian general practice.

Background: Whiplash Associated Disorders (WAD) are common and costly, and are usually managed initially by general practitioners (GPs). How GPs manage WAD is largely unstudied, though there are clinical guidelines. Our aim was to ascertain the rate of management (percentage of encounters) of WAD among patients attending Australian general practice, and to review management of these problems, including imaging, medications and other treatments.

Low-level laser therapy for chronic non-specific low back pain: a meta-analysis of randomised controlled trials.

Objective: The efficacy of low-level laser treatment (LLLT) for chronic back pain remains controversial due to insufficient trial data. We aimed to conduct an updated review to determine if LLLT (including laser acupuncture) has specific benefits in chronic non-specific low back pain (CNLBP).

Methods: Electronic databases were searched for randomised trials using sham controls and blinded assessment examining the intervention of LLLT in adults with CNLBP.

The challenges and opportunities in medical education for digital 'natives' and 'immigrants' in Scotland and abroad.

Although the digital revolution only started towards the end of the twentieth century, it has already dramatically shifted our world away from traditional industries and ushered in a new age of information. Virtually every aspect of our modern lives has either been transformed or challenged, including medical education. This article describes three of the important factors that are causing seismic changes in medical education in Scotland and abroad.

Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy.

Background: Recurrent chest pain in the absence of coronary artery disease is a common problem which sometimes leads to excess use of medical care. Although many studies have examined the causes of pain in these patients, few clinical trials have evaluated treatment. This is an update of a Cochrane review originally published in 2005 and last updated in 2010.

Direct observation of the nutrition care practices of Australian general practitioners.

Introduction: Nutrition care refers to nutrition-related advice or counselling provided by health professionals in an attempt to improve the nutrition behaviour of patients.

Aim: The aim of this study was to describe the practices of a sample of Australian general practitioners (GPs) when providing nutrition care to adult patients.

Methods: Eighteen GPs (13 male, 5 female) were observed by fourth-year medical students during their general practice rotation.

Low-dose laser acupuncture for non-specific chronic low back pain: a double-blind randomised controlled trial.

Objective: To determine if infrared laser acupuncture (LA) may have a specific effect in reducing pain and disability in treatment of chronic low back pain (LBP).

Methods: This was a double-blind sham laser controlled trial performed in general practices in Perth, Western Australia. The participants were 144 adults with chronic non-specific LBP.

Using aggregated single patient (N-of-1) trials to determine the effectiveness of psychostimulants to reduce fatigue in advanced cancer patients: a rationale and protocol.

Background: It is estimated that 29% of deaths in Australia are caused by malignant disease each year and can be expected to increase with population ageing. In advanced cancer, the prevalence of fatigue is high at 70-90%, and can be related to the disease and/or the treatment. The negative impact of fatigue on function (physical, mental, social and spiritual) and quality of life is substantial for many palliative patients as well as their families/carers.

The Örebro Musculoskeletal Screening Questionnaire: validation of a modified primary care musculoskeletal screening tool in an acute work injured population.

The original Örebro Musculoskeletal Pain Questionnaire (original-ÖMPQ) was developed to identify patients at risk of developing persistent back pain problems and is also advocated for musculoskeletal work injured populations. It is critiqued for its informal non-clinimetric development process and narrow focus. A modified version, the Örebro Musculoskeletal Screening Questionnaire (ÖMSQ), evolved and progressed the original-ÖMPQ to broaden application and improve practicality.

Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy.

Background: Recurrent chest pain in the absence of coronary artery disease is a common problem that sometimes leads to excess use of medical care. Although many studies examine the causes of pain in these patients, few clinical trials have evaluated treatment. The studies reviewed in this paper provide an insight into the effectiveness of psychological interventions for this group of patients.