Terms Of Adults Research Articles

Efficacy of physiotherapy treatment in medium and long term in adults with fibromyalgia: an umbrella of systematic reviews.

To summarise the available evidence and assess the effectiveness of medium and long-term physiotherapy treatment in adults with fibromyalgia (FM). This systematic review was registered in PROSPERO: CRD42023388356. The databases searched were MEDLINE, PEDro, Scopus, Cinhal, LatinIndex, and Cochrane, using the following keywords: "fibromyalgia", "physiotherapy", "treatment", "therapeutic exercise", "TENS", "laser therapy" and "manual therapy." The included articles analysed treatments with active or passive physiotherapy approaches in patients with FM. The variables included structural characteristics, such as: author, publication year, research question, and main outcome variables. The data on the findings of the articles comprised the following aspects: number of participants, intervention, follow-up, results, and principal conclusions. Thirty-three articles were analysed, with an overall PRISMA score of 18.63±3.36. The active treatment methods analysed were: movement and body awareness therapies (stretching, tai chi, yoga and Pilates); hydrotherapy; physical or aerobic exercise; and multidisciplinary therapy. The passive therapies analysed were: manual therapy; repetitive transcranial magnetic stimulation (rTMS); and other therapies (hyperbaric oxygen therapy, vibration therapy, virtual reality, transcutaneous electric nervous stimulation (TENS), pain neuroscience education, and acupuncture). Evidence was found on the positive effect of physiotherapy treatment on the signs and symptoms of fibromyalgia, such as pain, impairment of physical capacity and worse quality of life. The effectiveness of the active and passive therapies analysed in the management of the symptoms and signs of the disease was positive in most of the studies. However, more specific descriptions of the treatment protocol, frequency, intensity and treatment dose are required to reach a consensus, as well as primary studies for a more extended follow-up period to better evaluate long-term effects.

Spaces for play: listening to children’s voices

ABSTRACT This paper explores young children’s voices about their play spaces in one Scottish primary school. 45 children (ages 5–7 years) participated, choosing from a range of creative methods (e.g. InPhoTours, drawing, mapping) to share their voices. Using a ‘Playful Research Ethics Framework’, a developmentally appropriate framework which involved the use of visual aids, puppets, songs, Makaton symbols and discussions as well as attention to any cues of disengagement, this research aimed at achieving children’s ongoing informed assent. Four themes were identified: (a) the ‘whole child’ in the space, (b) space and relationships, (c) function of space, and (d) impact (or lack) of children’s voices about space. Children expressed differences in ownership, creativity and imagination in indoor and outdoor spaces. Further, despite perceiving there to be a lack of agency, children were willing to share their voices. There are implications for both practice and research in terms of adults willing to effectively listen to children’s voices and acting on them. This study makes original and significant contributions which have the potential to impact research and practice with young children internationally.

Symmetric bicuspidizing repair for patients with congenital aortic or truncal valve disease

ObjectiveSymmetric bicuspidizing repair has been shown to be safe and effective in the short term in adults and children with unicuspid aortic valve. Outcomes of extending this technique to patients with other forms of aortic and truncal valve disease have not been reported. MethodsWe performed a retrospective review of patients who underwent the symmetric bicuspidizing repair at Boston Children's Hospital between December 2019 and June 2022 with a contemporary comparator group of patients who underwent other forms of bicuspidization. Survival, valve-related reoperation, and the development of moderate or greater aortic or truncal valve regurgitation were assessed. ResultsThere were 23 patients who underwent symmetric bicuspidizing repair and 18 who underwent another form of bicuspidization. Preoperative aortic regurgitation was present in 87.0%. Patients who underwent symmetric bicuspidizing repair more commonly underwent suture annuloplasty (100% vs 55.6%; P = .002) and ascending aortoplasty (78.3% vs 27.8%; P = .004). There was 1 operative mortality (2.4%) in the entire cohort and 1 late mortality. Freedom from moderate aortic regurgitation was 87.5% at 21 months after symmetric bicuspidizing repair compared with 43.5% for patients who underwent other types of bicuspidization; P = .03. Freedom from valve-related reoperation was 100% in the symmetric bicuspidizing repair group compared with 64.4%; P = .02. ConclusionsThe symmetric bicuspidizing repair may be safely extended to patients with various forms of congenital aortic and truncal valve disease. Longer term follow-up will be necessary to determine the comparative effectiveness of this technique compared with neocuspidization and the Ross procedure.

Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk

There are concerns that low- and no-calorie sweetened beverages (LNCSBs) do not have established benefits, with major dietary guidelines recommending the use of water and not LNCSBs to replace sugar-sweetened beverages (SSBs). Whether LNCSB as a substitute can yield similar improvements in cardiometabolic risk factors vs water in their intended substitution for SSBs is unclear. To assess the association of LNCSBs (using 3 prespecified substitutions of LNCSBs for SSBs, water for SSBs, and LNCSBs for water) with body weight and cardiometabolic risk factors in adults with and without diabetes. Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception through December 26, 2021. Randomized clinical trials (RCTs) with at least 2 weeks of interventions comparing LNCSBs, SSBs, and/or water were included. Data were extracted and risk of bias was assessed by 2 independent reviewers. A network meta-analysis was performed with data expressed as mean difference (MD) or standardized mean difference (SMD) with 95% CIs. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to assess the certainty of the evidence. The primary outcome was body weight. Secondary outcomes were other measures of adiposity, glycemic control, blood lipids, blood pressure, measures of nonalcoholic fatty liver disease, and uric acid. A total of 17 RCTs with 24 trial comparisons were included, involving 1733 adults (mean [SD] age, 33.1 [6.6] years; 1341 women [77.4%]) with overweight or obesity who were at risk for or had diabetes. Overall, LNCSBs were a substitute for SSBs in 12 RCTs (n = 601 participants), water was a substitute for SSBs in 3 RCTs (n = 429), and LNCSBs were a substitute for water in 9 RCTs (n = 974). Substitution of LNCSBs for SSBs was associated with reduced body weight (MD, -1.06 kg; 95% CI, -1.71 to -0.41 kg), body mass index (MD, -0.32; 95% CI, -0.58 to -0.07), percentage of body fat (MD, -0.60%; 95% CI, -1.03% to -0.18%), and intrahepatocellular lipid (SMD, -0.42; 95% CI, -0.70 to -0.14). Substituting water for SSBs was not associated with any outcome. There was also no association found between substituting LNCSBs for water with any outcome except glycated hemoglobin A1c (MD, 0.21%; 95% CI, 0.02% to 0.40%) and systolic blood pressure (MD, -2.63 mm Hg; 95% CI, -4.71 to -0.55 mm Hg). The certainty of the evidence was moderate (substitution of LNCSBs for SSBs) and low (substitutions of water for SSBs and LNCSBs for water) for body weight and was generally moderate for all other outcomes across all substitutions. This systematic review and meta-analysis found that using LNCSBs as an intended substitute for SSBs was associated with small improvements in body weight and cardiometabolic risk factors without evidence of harm and had a similar direction of benefit as water substitution. The evidence supports the use of LNCSBs as an alternative replacement strategy for SSBs over the moderate term in adults with overweight or obesity who are at risk for or have diabetes.

Whose ‘voice’ is it anyway? The paradoxes of the participatory narrative

This study discusses some of the paradoxes found in the rhetoric of participatory research. Research‐with‐children views them as competent and agentic and as social actors, as citizens with opinions that must be listened to and given due weight. This image of the child as a social actor fails to acknowledge the structural, contextual and relational conditions that can afford or restrict opportunities for children’s agentic action. It conceals the multi‐faceted, multi‐dimensional properties of power that shape children’s (and adults’) contributions and ‘voices’. Our research took place in a primary school and aimed at training Year 6 children to carry out their own research on their chosen topic of interest. The participatory research ‘space’ was informed by the participants’ different intentionalities and agendas. The children were invited to take initiatives and make decisions, to be agentic. However, their agency, or what counts as ‘proper’ agency, was framed and defined in our adult terms. Tensions arose when the children’s agendas conflicted with and threatened ours. As we argue here, this participatory space should rather be seen as a political arena, where different and often competing agendas are at play, where the roles and relationships between children and adults are far from fixed, and where the capacity for agentic action is always socially mediated and shaped by social structure.

Stories of becoming: implications of future‐oriented theories for a vital literacy education

AbstractDrawing on a multi‐year qualitative study of immigrant and non‐immigrant youth storytelling, I describe youth's imaginative labour as they constructed and moved into one another's worlds. I argue that although multicultural literature is vital for affirming and expanding youth perspectives on their own and others' worlds, the publishing industry lags behind the immediate needs of immigrant youth to be understood and heard as fully human. Storytelling, in the form of co‐narration, creates an imaginative space of uncertainty and playfulness for inviting possible futures into mutual awareness and interpretation. Using two storytelling episodes as illustrations and drawing on contemporary sociocultural and decolonizing theories, I outline four ways future‐oriented teaching and research may be realized: (1) rename the world, by considering ‘what if’, (2) reframe narratives of damage so that narratives of desire may be foregrounded, (3) contribute to a more just and equal world rather than merely participate in existing practices and (4) reclaim childhoods for freedom and exploration, especially in our relations with Black and Brown youth who are perceived in adult terms much earlier than their White peers. I argue, overall, that we must understand and develop a contemporary theory of imagination in order to meet the challenges of future‐oriented literacy teaching and research.

Working Memory Training for Adults With ADHD

Objective: The aim of this study was to examine the effects of Cogmed training on working memory in adults with ADHD, including the generalization of effects to nonverbal reasoning, executive function in daily life, and ADHD symptoms. Method: Adults of ages 18 to 63 with ADHD were randomly assigned to an experimental group that received the working memory training or to a placebo group that received a low-intensity comparison version of the training. Results: participants in the experimental group showed greater improvement in verbal and visuospatial working memory capacity. Effects persisted 6 months after intervention completion. However, effects did not generalize elsewhere. Conclusion: The results challenge the claims made by Cogmed to the effect that the program is effective in treating attention problems and improving performance in daily life over the long term in adults with ADHD.

Spirituality in Rehabilitation Counseling of Adults With Physical Disabilities: Views of Practitioners Across Countries

The purpose of the study is to understand the views of practitioners across countries, on spirituality for rehabilitation counseling of adults with congenital and acquired disabilities. A survey of 1,269 practitioners in the field of disability across 15 countries was conducted. Results showed that practitioners had a favorable view of spirituality. Logistic regression results highlight several cross-country nuances in practitioners’ views toward spirituality for rehabilitation counseling, and more so, differentials in terms of adults with congenital and acquired physical disabilities. Practitioners who focused on a client-centered approach vis-à-vis those who diversified also into macro-level work of networking and advocacy, and specifically those who had high self-reported spirituality, proposed that for adults with congenital physical disabilities, spirituality enabled living with disabilities, as against a rationalization and justification of the disability. They favored mindfulness techniques as the modes of working with the clients and reported that by cultivating relational consciousness, spirituality enabled meeting the social goal of rehabilitation counseling. Furthermore, practitioners from affluent nations placed a premium on the deconstructing potential of spirituality and its facilitative role in enabling the clients themselves, and significant others, to transcend the ability/disability binary. The study foregrounds the importance of spiritually sensitive approaches in rehabilitation counseling.

Handbook for Student Affairs in Community Colleges ed. by Ashley Tull, Linda Kuk, and Paulette Dalpes (review)

Reviewed by: Handbook for Student Affairs in Community Colleges ed. by Ashley Tull, Linda Kuk, and Paulette Dalpes Case Willoughby Handbook for Student Affairs in Community Colleges Ashley Tull, Linda Kuk, and Paulette Dalpes (Editors) Sterling, VA: Stylus Publishing, LLC, 2014, 351 pages, $95.00 (softcover) Community Colleges are somewhat used to getting short shrift compared to their four year counterparts: fewer resources; less respect; and less scholarship about their institutions, personnel, and students. This volume makes great strides in increasing awareness of the issues, concerns, programs and services of community colleges student affairs organizations and personnel. These long-standing needs are now highlighted as community colleges ascend into the national spotlight. As the "completion agenda" aims to return the United States to preeminence in terms of adults with college credentials, as 4-year institutions' tuitions rate soar, and as student debt levels are deemed a national crisis, a renewed focus on the large numbers of students attending community college makes increasing sense. The content of the Handbook for Student Affairs in Community Colleges prepares student affairs to be a major contributor in addressing these issues. As an edited book organized in four parts, it covers a broad range of topics from history and research to programs and structures to future directions. Part 1, "Historical and contemporary developments" contains two chapters. The first, titled "Introduction to student affairs in the community college," by Tull, provides an excellent backdrop for the book. It deftly weaves together community college history philosophy, and evolving purposes. These themes are well-supported by rafts of data in narrative format. Some form of chart for all the numerical information might have made the presentation clearer. Floyd, Felscher, and Mulder authored chapter 2, "The contemporary student and student development theory." The explicit application of student development theory in the community college is extremely welcome, even more so as the authors link student learning and development to retention and graduation rates. The next eight chapters comprise part 2, “Organizing and leading student affairs in community college settings.” Kuk’s chapter 3, “Organization and administration of community college student affairs” provides a useful 30,000 foot view of student affairs, including how states organize community colleges (as part of state systems, districts, or stand-alone entities). She discusses the impact on funding and administration of student affairs and the disproportionate resources that 4-year institutions enjoy. The focus then becomes internal, covering various reporting models for student affairs organizations in community colleges. Chapter 4, "The challenging and unique role of a community college senior student affairs officer," highlights similarities and differences of the senior student affairs officer (SSAO) role between 2-year and 4-year institutions, and between different types of community colleges. In the latter part of the chapter, authors Garber and Wills provide two illuminating perspectives on the SSAO role, one by an SSAO and one by a president. Chapter 5, "Partnering with academic affairs in the community college setting," was authored by Cohen, Gomez, Peruggi, Schlesinger, and Suss. The topic and content [End Page 882] of this worthwhile chapter are of paramount importance, although the title is somewhat misleading. Rather than a review of literature on academic and student affairs partnerships that is implied by the title, the chapter is actually an excellent case study of such a partnership at Kingsborough Community College. Regardless, the chapter offers much to the reader that can be transferred to other institutions. "Financing student affairs in community colleges," by Kuk and Ash, is the sixth chapter and serves as a good primer on the topic. It reviews community college revenue sources, financial aid, funding formulas, decreasing public support, increasing loan debt, budgeting processes and specific ways that student affairs organizations are funded. In chapter 7, Lowery accomplishes the near impossible. "Legal and policy issues for student affairs in the community college" strikes a balance between breadth and precision, making complex legal concepts both clear and compelling for the reader. Topics include various sources of law that impact community colleges, the importance of institutional policies and procedures to clarify student rights and responsibilities as well as institutional obligations. This chapter is a must read for student affairs professionals. With a strong...

Spinal manipulation and home exercise with advice for subacute and chronic back-related leg pain: a trial with adaptive allocation.

Back-related leg pain (BRLP) is often disabling and costly, and there is a paucity of research to guide its management. To determine whether spinal manipulative therapy (SMT) plus home exercise and advice (HEA) compared with HEA alone reduces leg pain in the short and long term in adults with BRLP. Controlled pragmatic trial with allocation by minimization conducted from 2007 to 2011. (ClinicalTrials.gov: NCT00494065). 2 research centers (Minnesota and Iowa). Persons aged 21 years or older with BRLP for least 4 weeks. 12 weeks of SMT plus HEA or HEA alone. The primary outcome was patient-rated BRLP at 12 and 52 weeks. Secondary outcomes were self-reported low back pain, disability, global improvement, satisfaction, medication use, and general health status at 12 and 52 weeks. Blinded objective tests were done at 12 weeks. Of the 192 enrolled patients, 191 (99%) provided follow-up data at 12 weeks and 179 (93%) at 52 weeks. For leg pain, SMT plus HEA had a clinically important advantage over HEA (difference, 10 percentage points [95% CI, 2 to 19]; P=0.008) at 12 weeks but not at 52 weeks (difference, 7 percentage points [CI, -2 to 15]; P=0.146). Nearly all secondary outcomes improved more with SMT plus HEA at 12 weeks, but only global improvement, satisfaction, and medication use had sustained improvements at 52 weeks. No serious treatment-related adverse events or deaths occurred. Patients and providers could not be blinded. For patients with BRLP, SMT plus HEA was more effective than HEA alone after 12 weeks, but the benefit was sustained only for some secondary outcomes at 52 weeks. U.S. Department of Health and Human Services.

Oral health‐related behaviours among dentate adults in Finland: findings from the Finnish Health 2000 Survey

The aim of this study was to assess oral health-related behaviours among dentate adults. As part of the comprehensive Finnish Health 2000 Survey, this study included dentate subjects, 30-64 yr of age (n = 4,417). Based on interview and questionnaire data, information on nine oral health-related habits was elicited. On average, study subjects reported 4.4 (SD = 1.5) oral health-promoting behaviours among the nine behaviours investigated, the mean number differing according to subjects' gender, educational level, marital status, and employment status. Older age, higher level of education, cohabiting, and being employed were indications of higher numbers of oral health-promoting habits than were younger age, lower levels of education, being single, or being unemployed. Oral health-promotion activities should be tailored and targeted in terms of adults' socio-economic and demographic characteristics, and directed especially towards men, those with lower education, and those who are single or unemployed.

Active, healthy cities – how does population physical activity vary between Australian cities?

Despite recognition that urban infrastructure influences physical activity, there have been no comparisons between Australian city-level patterns of physical activity. This study ranked Australian cities in terms of adults' participation in leisure-time physical activity and examined city-level variations in activity trends between 2001 and 2009. Data on participation in leisure-time physical activity in adults (≥15 years) between 2001 and 2009 were obtained from the Exercise Recreation and Sport Survey (ERASS), a computer-assisted telephone interview conducted to collect population-level sport participation information by the Australian Sports Commission. Data were analysed for respondents residing in the eight capital cities of Australia. The prevalence of meeting recommended 'health-enhancing physical activity' (HEPA) and levels of walking were calculated by age, gender and survey year. Multiple linear logistic regression analyses were used to compare cities. Pooled data from 174,323 adults across years showed that Melbourne, Brisbane, Perth and Canberra residents were significantly more active than Sydney, Adelaide and Hobart residents in terms of HEPA. Hobart, Perth and Melbourne residents were significantly more likely to walk ≥5 sessions a week compared with their counterparts in other cities. HEPA and walking increased across most cities between 2001 and 2009. There are significant differences between Australian cities in physical activity and walking levels, over and above differences attributable to age, gender or educational levels. While this may be due to infrastructure differences, comparative information on indicators of the built environment and transport infrastructure are not available.

Review: a single dose of nasal decongestant reduces congestion in the short term in adults with the common cold; insufficient evidence exists on the effectiveness of repeated doses

Taverner D, Latte J, Draper M. Nasal decongestants for the common cold. Cochrane Database Syst Rev 2004;(3):CD001953. Q Are nasal decongestants effective for reducing the symptom of nasal congestion in...

Exploring the role of children in adults' adoption and use of computers

Although we now know much about children's use of information and communications technologies, researchers have yet to consider adequately the roles that children play in shaping adults' computer use. Via household survey data from a randomised sample of 1,001 adults and in‐depth interview data from 100 of these initial respondents, this paper explores the meditating roles of children in: the purchasing/acquisition of computers by adults; adults' access to computers; the level and nature of adults' use (and non‐use) of computers; how adults learn to use computers; and how adults are supported when using computers. The paper concludes that while children play a variety of roles in adults' (non)adoption and (non)use of computers this influence is often tempered by a range of other factors and, indeed, should not be overstated. For example, while children appear to be a significant “official” factor in parents' and grandparents' adoption of computers they were rarely the sole reason for adults investing time and money in ICT – with a range of other self‐orientated reasons usually in attendance. In terms of adults' access to and use of ICT, the demands of children to use computers were a mitigating but not always dominant factor to be considered by parents. Similarly, children appear to play a peripheral role in supporting adults' use of ICT. The paper concludes by considering how the role of children in adults' use of ICT would appear to be often more symbolic than practical;, e.g. as an official justification for buying/adopting a computer rather than as a strong and sustained guiding force.

Acute paediatric pain — Assessment and management

Paediatric pain is under-recognised and under-treated in Emergency Departments. Children of different ages react to pain in different ways, therefore the aim of this article is to provide guidelines for the assessment of acute pain in children presenting to the ED. Common indicators and assessment methods are described, including the parents' role. Methods of pain management are discussed, both pharmacological and non-pharmacological. There are many agents used today for treating pain; I have attempted to provide an overview of those most commonly used in ED's today. We have a duty of care to all patients, regardless of age, to appropriately assess and manage acute pain. Despite advances in pain management, acute pain in children is still a significantly under-treated problem within the Emergency Department. It is important to have an understanding of children's cognition and their developmental levels to understand and recognise a child's response to pain. This article will discuss these, and include options for pain management, both pharmacological and non-pharmacological. Pain is “…whatever the experiencing person says itis…” 1Children who are pre-verbal or uncommunicative make it difficult to elicit a response in adult terms. Without intervention, children stressed during painful procedures will show an increase in distress behaviours over time. The positive results from teaching children to cope with painful procedures are well documented 2.

SPATIAL PATTERN AND DENSITY OFCTENICERA DESTRUCTORANDHYPOLITHUS BICOLOR(COLEOPTERA: ELATERIDAE) IN SOIL IN SPRING WHEAT

AbstractDetermination of the spatial pattern and estimation of the density of egg, larval, and adult populations ofCtenicera destructor(Brown) andHypolithus bicolorEschscholtz were made by soil sampling, and forC.destructoradults, also by cages that collected the emerging adults in the spring. Eggs of both the above species and also those ofAeolus mellillus(Say), which were also found in the samples, were highly aggregated. SmallC.destructorlarvae were most highly aggregated and medium larvae less so; large larvae were usually randomly distributed. UnlikeC.destructor, largeH.bicolorlarvae were more highly aggregated than either the small or mediumbicolorlarvae. Sampling by emergence cages showed thatC.destructoradults were aggregated while sampling by soil cores showed them to be randomly distributed. The different result obtained by the two methods was attributed to the difference in the size of the sampling unit. Aggregation was detected in 29% of theH.bicoloradult population sampled by soil cores only.Larval densities ofC.destructorranged from a low of 0.25 to a high of 1.46 per sample unit (81 cm2) over the 14-year period that samples were taken; densities ofH.bicolorranged from 0.16 to 0.64. Densities ofC.destructorandH.bicoloradults averaged about 6 (range 1–16) % and 12 (0–27) % of the total population of larvae and adults for each respective species. Population composition, in terms of adults and larvae of different sizes, and population fluctuations are discussed.The relation between density and the number of sampling units required to achieve four levels of margin of error at four levels of statistical significance was determined.No satisfactory transformation was found for data of individual samples with a mean less than 1. Several common transformations, including Taylor’s power transformation, were satisfactory for stabilizing the variance of pooled samples.

ANXIETY IN THE DYING CHILD

Twenty-five leukemic children aged 6 to 10 years related significantly more stories that contained elements of preoccupation with threat to their body integrity and functioning than did 25 control children with nonfatal chronic illnesses. Although they made no overt reference to the concept of death, the children with fatal illness showed an awareness of intrusion into their body integrity and functioning, and expressed a greater degree of both hospital-related and nonhospital- related anxiety than did the children in the control sample. The fatally ill child of 6 to 10 years appears to be aware of the seriousness of his illness, even though he may not yet be capable of talking about this awareness in adult terms.

Undernutrition and the developing brain. The relevance of animal models to the human problem.

The possibility that undernutrition in early life may permanently reduce the intellectual capacity of men and women has become increasingly recognized in recent years.¹Attempts to investigate a causal relationship are in progress in many parts of the privileged and underprivileged world, and there can be few more important problems in the fields of human nutrition and preventive pediatrics. For our own species, unlike pigs, sheep, and cattle, carcass weight and even athletic prowess are considerably less important than achieving our full intellectual potential. Undernutrition has for too long been considered in adult terms as a series of deficiency diseases whose main consequences can be reversed on restoration of the deficient component. In pediatrics, we must now be much more concerned about undernutrition at certain vulnerable stages of development having long-term sequelae which may be irreversible in spite of the most strenuous