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Background: Despite the well-known benefits of physical activity, physical inactivity is presently a global health pandemic. Allied healthcare providers, such as chiropractors, knowingly recognise the importance of physical activity and are prepared to routinely discuss and/or counsel patients on this topic; however, little is known about Australian chiropractors in the physical activity setting. Our aim was to explore and identify factors associated with physical activity promotion among Australian chiropractors, including their knowledge of the physical activity and sedentary behaviour guidelines and their own levels of physical activity. Methods: From February to May 2021, a convenience sample of Australian chiropractors completed an online survey. Items assessed by Likert scale included: physical activity promotion frequency, with the type, quantity, barriers, perceptions, and feasibility. We asked questions about their familiarity with, and knowledge of, Australian Physical Activity and Sedentary Behaviour Guidelines, chiropractors' own physical activity, and whether the chiropractors met activity guidelines. Survey responses were descriptively reported. Univariable logistic regression models explored factors explaining frequent physical activity promotion. Results: Of 217 respondents, 64% reported that they frequently (≥ 70%) recommended a more physically active lifestyle. Only 15% often performed pre-exercise screening, 73% frequently prescribed resistance exercise, 19% reported time as the most frequent barrier, while 37% reported being not at all familiar with the guidelines. Univariable logistic regression models found male chiropractors were more likely to promote physical activity, [odds ratio (OR) = 2.33; 95% confidence interval (CI): 1.32–4.12)], while chiropractors who frequently treat children 0–3 years (OR = 0.5; 95% CI: 0.28–0.87), children 4–18 years (OR = 0.42; 95% CI: 0.21–0.86), and pregnant women (OR = 0.5; 95% CI: 0.26–0.94) were less likely. Chiropractors were more likely to promote physical activity if they were familiar with the activity guidelines (OR = 2.9; 95% CI: 1.32–6.41), were confident promoting (OR = 11.6; 95% CI: 1.37–98.71) and prescribing physical activity programs (OR = 4.5; 95% CI: 2.03–9.99). Conclusion: Most chiropractors confidently and regularly integrate physical activity into practice. Yet, despite acknowledging its importance, one third of chiropractors reported poor knowledge of the Physical Activity and Sedentary Behaviour Guidelines. Identifying barriers to the awareness, and implementation of physical activity guidelines should be further explored within chiropractic clinical settings. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to evaluate the effectiveness of a three‐month physiotherapist‐delivered eHealth physical activity program compared with usual care to improve function in adults with low back pain or knee osteoarthritis in rural Australia. Methods: This was a parallel, two‐group, pragmatic, superiority, randomized controlled trial involving three‐ and six‐month posttreatment follow‐ups. There was a total of 156 adults with chronic nonspecific low back pain (n = 97) or knee osteoarthritis (n = 59) from rural Australia. The intervention involved an eHealth physical activity and an exercise program that included five to eight teleconsultations with a physiotherapist (primary time point three months) or usual care (eg, general practitioner, physiotherapy, and pain medication). The primary outcome was the Patient‐Specific Functional Scale (0–30), with a three‐point difference between groups being considered the minimum clinically important difference. Results: Participants receiving the eHealth intervention (n = 78) reported significantly greater and clinically worthwhile improvements in function (mean between‐group difference 3.6; 95% confidence interval [CI] 1.3–5.9) compared to participants receiving usual care (n = 78). Small but statistically significantly greater improvements in disability (7.2 of 100; 95% CI 2.1–12.3) and quality of life (4.5 of 100; 95% CI 0.0–9.0) also favored the eHealth group. No clinical or statistical differences between groups were found for the secondary outcomes of pain, coping skills, and physical activity levels. Conclusion: A physiotherapist‐delivered eHealth intervention is effective and provides clinically meaningful improvements in function compared to usual care for people with musculoskeletal pain in rural communities. These findings highlight the potential for eHealth‐based programs to improve access to evidence‐based exercise interventions for people with musculoskeletal pain in rural communities. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-related low back and/or pelvic girdle pain is common, with a prevalence rate of up to 86% in pregnant women. Although 19.5% of Australian pregnant women visit a chiropractor for pelvic girdle pain, little is known about the experience of pregnant women who seek this care. The aim of this study was to describe and explore the experiences of Australian pregnant women who seek chiropractic care for their current pregnancy-related low back and/or pelvic girdle pain. Methods: A qualitative case study approach with purposive sampling from 27 chiropractic practices was used. A grounded theory approach was informed by a constructivist and interpretivist stance, which provided understanding and meaning to the pregnant women's experiences. Online unstructured interviews were recorded, transcribed, and anonymised. A thematic analysis was subsequently conducted on the primary data. Codes and major themes were developed with the use of critical self- reflection (memos), survey finding triangulation and respondent validation. Results: Sixteen potential respondents expressed interest in participating. After eligibility screening and data saturation, nine interviews were undertaken. Four key themes were identified: "Care drivers: what drives care seeking?", "Care barriers: what barriers are encountered?", "Chiropractic treatment: what does treatment consist of?" and "Response to care: what response was there to care?". Conclusion: Four key themes: care drivers, care barriers, chiropractic treatment, and response to care support an emergent substantive-level theory in women's care seeking experiences for pregnancy-related back pain and chiropractic care. This theory is that chiropractic care for pregnant women experiencing low back pain and pelvic girdle pain may improve pain and function, while reducing pregnancy-related biopsychosocial concerns. The findings may inform antenatal health providers and the chiropractic profession about pregnant women's experience seeking chiropractic care as well as directing future research. [ABSTRACT FROM AUTHOR]

This article reviews 37 empirical studies, selected from 363 articles and 20 journals, on assessment feedback published between 2000 and 2011. The reviewed articles, many of which came out of studies in the UK and Australia, reflect the most current issues and developments in the area of assessing disciplinary writing. The article aims to outline current studies on assessment feedback. These studies have explored undergraduate students' wide-ranging perspectives on the effectiveness and utility of assessment feedback, the divergent styles of assessment feedback of lecturers and tutors in various disciplines, teachers' divergent interpretations of assessment criteria and confusion about the dual roles of assessment feedback, and the divergences between teachers' beliefs and practices. The review includes analysis and comparison of the research methods and findings of the studies. It identifies a research space for assessment feedback and outlines implications for further studies.

Background: To report the national prevalence, years lived with disability (YLDs) and attributable risk factors for all musculoskeletal conditions and separately for low back pain (LBP), as well as compare the disability burden related to musculoskeletal with other health conditions in Australia in 2019. Methods: Global Burden of Disease (GBD) 2019 study meta-data on all musculoskeletal conditions and LBP specifically were accessed and aggregated. Counts and age-standardised rates, for both sexes and across all ages, for prevalence, YLDs and attributable risk factors are reported. Results: In 2019, musculoskeletal conditions were estimated to be the leading cause of YLDs in Australia (20.1%). There were 7,219,894.5 (95% UI: 6,847,113–7,616,567) prevalent cases of musculoskeletal conditions and 685,363 (95% UI: 487,722–921,471) YLDs due to musculoskeletal conditions. There were 2,676,192 (95% UI: 2,339,327–3,061,066) prevalent cases of LBP and 298,624 (95% UI: 209,364–402,395) YLDs due to LBP. LBP was attributed to 44% of YLDs due to musculoskeletal conditions. In 2019, 22.3% and 39.8% of YLDs due to musculoskeletal conditions and LBP, respectively, were attributed to modifiable GBD risk factors. Conclusions: The ongoing high burden due to musculoskeletal conditions impacts Australians across the life course, and in particular females and older Australians. Strategies for integrative and organisational interventions in the Australian healthcare system should support high-value care and address key modifiable risk factors for disability such as smoking, occupational ergonomic factors and obesity. [ABSTRACT FROM AUTHOR]

An otherwise healthy 72-year-old Chinese patient diagnosed with exudative age-related macular degeneration and decreased vision in left eye was fully investigated. The retrospective analysis of past multimodal imaging revealed bilateral severe choroidal neovascularization and choroiditis associated with a positive tuberculin skin testing and interferon-gamma release assay (QuantiFERON-TB Gold – Cellestis®, Chadstone, VIC, Australia) suggestive of latent ocular tuberculosis. The variable presentation and tests' results interpretation represent the greatest limitations in understanding and treating intraocular TB (IOTB). This may present without any other systemic symptoms, the intraocular tissues are of limited access to biopsies and other tests, including imaging and immunological tests, are of relative value. This case highlights how variable may be the presentation of IOTB, which can be easily misdiagnosed leading to a delayed treatment and worse prognosis. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal conditions are the primary reason older adults seek general medical care, resulting in older adults as the highest consumers of health care services. While there is high use of chiropractic care by older adults, there is no recent, specific data on why older adults seek chiropractic care and how chiropractors manage conditions. Therefore, the purpose of this study was to describe the demographic characteristics of older adults seeking chiropractic care, and to report problems diagnosed by chiropractors and the treatment provided to older adults who seek chiropractic care.Methods: A secondary data analysis from two, large cross-sectional observational studies conducted in Australia (COAST) and Canada (O-COAST). Patient encounter and diagnoses were classified using the International Classification of Primary Care, 2nd edition (ICPC-2), using the Australian ICPC-2 PLUS general practice terminology and the ICPC-2 PLUS Chiro terminology. Descriptive statistics were used to summarize chiropractor, patient and encounter characteristics. Encounter and patient characteristics were compared between younger (< 65 years old) and older (≥65 years old) adults using χ2 tests or t-tests, accounting for the clustering of patients and encounters within chiropractors.Results: A total of 6781 chiropractor-adult patient encounters were recorded. Of these, 1067 encounters were for persons aged > 65 years (16%), from 897 unique older patients. The most common diagnosis within older adult encounters was a back problem (56%), followed by neck problems (10%). Soft tissue techniques were most frequently used for older patients (85 in every 100 encounters) and in 29 of every 100 encounters, chiropractors recommended exercise to older patients as a part of their treatment.Conclusions: From 6781 chiropractor-adult patient encounters across two countries, one in seven adult chiropractic patients were > 65 years. Of these, nearly 60% presented with a back problem, with neck pain and lower limb problems the next most common presentation to chiropractors. Musculoskeletal conditions have a significant burden in terms of disability in older adults and are the most commonly treated conditions in chiropractic practice. Future research should explore the clinical course of back pain in older patients seeking chiropractic care and compare the provision of care to older adults across healthcare professions. [ABSTRACT FROM AUTHOR]

Multi-hazard events can be associated with larger socio-economic impacts than single-hazard events. Understanding the spatio-temporal interactions characterising the former is, therefore, of relevance to disaster risk reduction measures. Here, we consider two high-impact hazards, namely wet and dry hydrological extremes, and quantify their global co-occurrence. We define these using the monthly self-calibrated Palmer Drought Severity Index based on the Penman-Monteith model (sc_PDSI_pm) covering the period 1950–2014, at 2.5° horizontal resolution. We find that the land areas affected by extreme wet, dry and wet-dry events (i.e. geographically remote, yet temporally co-occurring wet or dry extremes) all display increasing trends with time, of which changes in dry and wet-dry episodes are significant (p-value << 0.01). The most geographically widespread wet-dry event covered a combined land area of 21 million km2, with documented high-impact flooding and drought episodes spanning diverse regions. To further elucidate the interplay of wet and dry extremes at a grid-point scale, we introduce two new metrics: the wet-dry (WD) ratio and the extreme transition (ET) time interval. The WD-ratio measures the relative occurrence of extreme wet or dry events, whereas ET quantifies the average separation time of hydrological extremes with opposite signs. The WD-ratio shows that the incidence of extreme wet episodes dominates over dry episodes in the USA, northern and southern south America, northern Europe, north Africa, western China and most of Australia. Conversely, extreme dry events are more prominent in most of the remaining regions. The median ET for wet to dry is ~ 27 months, while the dry to wet median ET is 21 months. We also evaluate correlations between wet-dry hydrological extremes and leading modes of large-scale variability, namely the: El Niño–Southern Oscillation (ENSO), Pacific Decadal Oscillation (PDO) and American Multi-decadal Oscillation (AMO). We find that ENSO and PDO have a similar influence globally, with the former significantly impacting (p-value < 0.05) a larger area compared to the latter, whereas the AMO shows an almost inverse pattern, and significantly impacts a larger overall area. Our analysis brings new insights on hydrological multi-hazards and are of direct relevance to governments and organisations with globally distributed interests, such as (re)insurance companies. Specifically, the multi-hazard maps may be used to evaluate worst-case disaster scenarios considering the potential co-occurrence of wet and dry hydrological extremes. [ABSTRACT FROM AUTHOR]

Objective: To evaluate Australian and New Zealand chiropractic students' opinions regarding the identity, role setting, and future of chiropractic practice. Methods: An online, cross-sectional survey was administered to chiropractic students in all chiropractic programs in Australia and New Zealand. The survey explored student viewpoints about the identity, role/scope, setting, and future of chiropractic practice as it relates to chiropractic education and health promotion. Associations between the number of years in the program, highest degree preceding chiropractic education, institution, and opinion summary scores were evaluated by multivariate analysis of variance tests. Results: A total of 347 chiropractic students participated in the study. For identity, most students (51.3%) hold strongly to the traditional chiropractic theory but also agree (94.5%) it is important that chiropractors are educated in evidence-based practice. The main predictor of student viewpoints was a student's chiropractic institution (Pillai's trace = 638, ij/16, 1368] = 16.237, p < .001). Chiropractic institution explained over 50% of the variance around student opinions about role/scope of practice and approximately 25% for identity and future practice. Conclusions: Chiropractic students in Australia and New Zealand seem to hold both traditional and mainstream viewpoints toward chiropractic practice. However, students from different chiropractic institutions have divergent opinions about the identity, role, setting, and future of chiropractic practice, which is most strongly predicted by the institution. Chiropractic education may be a potential determinant of chiropractic professional identity, raising concerns about heterogeneity between chiropractic schools. [ABSTRACT FROM AUTHOR]

Objective: To explore qualitative insights into the pain experience of older women with quantitatively derived pain profiles. Methods: The sequential mixed methods design involved applying quantitative pain profiles, derived from an earlier latent class analysis, to qualitative comments by a sample of older Australian women with arthritis. Data from a substudy of the Australian Longitudinal Study on Women's Health, mid‐aged cohort, born 1946–1951, were used. Inductive content analysis was conducted to explore qualitative insights into the experience of pain. Results: The average age of women was 64.6 years (±1.4). Within each derived pain profile, themes generated from the qualitative comments of women were concordant with the profile descriptors: ‘I manage my pain’ for the uni‐dimensional, mild pain profile (comments from 56 women); ‘I live with pain every day’ and ‘I rely on medication regularly’ for the moderate multidimensional pain profile (comments from 39 women); and ‘multiple pains’, ‘I suffer with pain’ and ‘I am unable and adjust’ for the severe multidimensional pain profile (comments from 31 women). Conclusion: Women with different pain profiles used different language and strategies in managing their pain experience, information which can guide clinicians to provide more tailored support for self‐management and care of arthritis pain. [ABSTRACT FROM AUTHOR]

Objectives The aims of this study were to (1) report the prevalence and explore the influence of spinal pain on quality of life and (2) assess the relationship between spinal pain and the type and number of comorbidities. Methods This cross-sectional study comprised 579 community-dwelling, older Australian women. Women had “spinal pain” if they marked “yes” to neck pain, upper back pain, mid-back pain, and/or lower back pain. Descriptive statistics and binary logistic regression were performed to report the prevalence and explore the relationship between spinal pain and the type and number of comorbidities. Results A majority of women (55.8%) who returned surveys had spinal pain. Women with spinal pain had significantly lower physical and mental quality of life scores than women without spinal pain (Medical Outcomes Study: 36 Item Short Form Survey [SF-36] physical component summary: 40.1 ± 11.1 vs 49.0 ± 9.0, and SF-36 mental component summary: 50.0 ± 10.5 vs 53.9 ± 8.2, respectively). Having spinal pain was significantly associated with overweight and obesity (odds ratio 1.98 [95% confidence interval 1.3-2.96] and 2.12 [1.37-3.28]), diabetes (1.93 [1.01-3.67]), pulmonary comorbidity (1.66 [1.04-2.65]), and cardiovascular comorbidity (1.57 [1.07-2.28]). More than half of the women with spinal pain reported 2 or more comorbidities, with comorbidities significantly more common among women with spinal pain than among women without spinal pain. The odds of having spinal pain increased with an increasing number of comorbidities (2 comorbidities: 2.44 [1.47-4.04], 3 comorbidities: 3.07 [1.66-5.67], 4 comorbidities: 5.05 [1.64-15.54]). Conclusions Spinal pain is common in community-dwelling, older Australian women and is associated with greater disability and poorer quality of life. Diabetes, cardiovascular disease, pulmonary disease, and obesity appear to have a relationship with spinal pain. There was an incremental increase in the risk of spinal pain associated with increasing comorbidity count. [ABSTRACT FROM AUTHOR]

Objective. To estimate the prevalence and examine the associations of neuropathic-like pain in a community-based sample of older Australian women with arthritis. Design. Population based cross-sectional survey. Setting. Participants were recruited from the 1946-1951 cohort of the Australian Longitudinal Study of Women's Health. Subjects. Women with self-reported arthritis (n = 147). Methods. Primary outcome measure was self-reported neuropathic-like pain, defined as scores ≥12 via the pain DETECT screening tool. Descriptive statistics summarized health and socio-demographic characteristics, and comparisons made using student's t-test or Wilcoxon Rank Sum test, and Chi-square tests. Independent health and demographic variables were examined by univariable logistic regression, and significant variables included in multiple variable logistic regression modelling. Results. Thirty-nine women (26.5%) were screened as having neuropathic-like pain. Women with neuropathic-like pain were more likely to have poorer health, worse pain, higher pain catastrophizing, more fatigue, and more depression than women with nociceptive pain. Neuropathic-like pain was significantly associated with higher scores on the SF-MPQ sensory scale and pain catastrophizing scale, and with more medication use. Conclusions. Neuropathic-like pain in women with arthritis was common and is associated with greater disability and poorer quality of life. [ABSTRACT FROM AUTHOR]

The article presents a sermon given by Reverend John de Luca of the Parish of St. Mary and St Joseph Maroubra Bay Beach, Australia. He mentions the advice given to him on his ordination day in 1966 at St Mary's Cathedral, Sydney. He considers the relation to the biblical teaching of Christian hope in the Resurrection of Jesus Christ.

This article reviews 37 empirical studies, selected from 363 articles and 20 journals, on assessment feedback published between 2000 and 2011. The reviewed articles, many of which came out of studies in the UK and Australia, reflect the most current issues and developments in the area of assessing disciplinary writing. The article aims to outline current studies on assessment feedback. These studies have explored undergraduate students' wide-ranging perspectives on the effectiveness and utility of assessment feedback, the divergent styles of assessment feedback of lecturers and tutors in various disciplines, teachers' divergent interpretations of assessment criteria and confusion about the dual roles of assessment feedback, and the divergences between teachers' beliefs and practices. The review includes analysis and comparison of the research methods and findings of the studies. It identifies a research space for assessment feedback and outlines implications for further studies. [ABSTRACT FROM AUTHOR]

Objective: Chemotherapy treatment for acute lymphoblastic leukaemia (ALL) may disrupt motor development, with suggestions that gross and fine motor deficits are different depending on time since treatment. Methods: Thirty-seven participants aged between 2.5 to 5 years at the time of diagnosis were assessed using the Movement Assessment Battery for Children, 2nd Edition (MABC-2) and the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition, Short Form (BOT-2 SF), and divided into groups (i.e. months-off-treatment): (1) 0-12, (2) 13-24, and (3) 25-60 for comparison. Results: MABC-2 and BOT-2 SF mean total scores fell within the average range. Twenty-six percent of the sample performed in the impaired range on the MABC-2. Group 2 had significantly lower Manual Dexterity scores than the normative population and lower BOT-2 SF scores than Group 1. Conclusion: Most children treated for ALL display appropriate motor skills, yet around a quarter experience general motor difficulties. Time-off-treatment did not affect the prevalence of motor impairments on any measure. [ABSTRACT FROM AUTHOR]

Objective: Osteoarthritis is the most common musculoskeletal disorder, estimated to affect 3 million Australians. Previous studies support structured exercise programs and manipulation for hip osteoarthritis; however, no trials have examined treatment of the lower limb kinetic chain. The purpose of this case series was to report hip range of motion and pain scale outcomes in 4 patients diagnosed with hip osteoarthritis who were treated with chiropractic management of the lower limb kinetic chain. Methods: Four subjects (mean age 59.5; SD ± 6.7) were provided with 9 sessions of chiropractic treatment. This included long-axis traction pulls and pre/post adjustment stretching of the symptomatic hip, with additional manipulation and mobilization of the lumbar spine, sacroiliac, knee, and ankle joints. Outcome measures included range of motion as measured and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: All 4 subjects had improvements in WOMAC scores, with a mean group reduction of 382.5 (SD ± 115.8) and overall improvement of 68.1%. As a group, there were improvements in internal rotation (51.7%, mean 7.3°; SD ± 6.2°), adduction (26.7%, mean 5.3°; SD ± 5.0°), abduction (21.1%, mean 6.8°; SD ± 5.4°), flexion (15.3%, mean 15°; SD ± 4.8°) and external rotation (8.5%, mean 8.5°; SD ± 6.0°). Conclusions: Four patients diagnosed with hip osteoarthritis had decreases in WOMAC scores and increases in hip range of motion after chiropractic management. Further research in the form of large scale randomized controlled trials is needed to investigate the effectiveness and clinical significance of chiropractic management for hip osteoarthritis. [Copyright &y& Elsevier]

Background: Approximately 60% of people with low back pain also have associated leg pain symptoms. Guidelines for low back pain recommend non-pharmacological approaches, including spinal manipulation - a therapy provided by chiropractors. However, limited empirical data has examined the characteristics of chiropractors managing patients with low back-related leg pain (LBRLP). Our objective is to describe the prevalence, profile and practice characteristics of Australian chiropractors who often treat LBRLP, compared to those who do not often treat LBRLP. Methods: This is a cross-sectional analysis of a nationally representative sample from the Australian Chiropractic Research Network (ACORN). This study investigated the demographic and practice characteristics as well as clinical management of chiropractors who 'often' treated patients with LBRLP compared to those who treated LBRLP 'never/rarely/sometimes'. Multiple logistic regression models identified independent factors associated with chiropractors who 'often' treated patients with LBRLP. Results: A total of 1907 chiropractors reported treating patients experiencing LBRLP, with 80.9% of them 'often' treating LBRLP. Chiropractors who 'often' treated LBRLP were more likely to manage patients with multi-site pain including axial low back pain (OR = 21.1), referred/radicular neck pain (OR = 10.8) and referred/radicular thoracic pain (OR = 3.1). While no specific management strategies were identified, chiropractors who 'often' treated LBRLP were more likely to discuss medication (OR = 1.8), manage migraine (OR = 1.7) and degenerative spine conditions (OR = 1.5), and treat women during pregnancy (OR = 1.6) and people with work-related injuries (OR = 1.5), compared to those not treating LBRLP frequently. Conclusions: Australian chiropractors frequently manage LBRLP, although the nature of specific management approaches for this condition remains unclear. Further research on the management of LBRLP can better inform policy makers and educators interested in upskilling chiropractors to deliver safe and effective treatment of LBRLP. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal pain frequently occurs in more than one body region, with up to 80% of adults reporting more than one joint pain site in the last 12 months. Older people and females are known to be more susceptible to multiple joint pain sites, however the association of multisite joint pain with physical and psychosocial functions in this population are unknown. Methods: Cross-sectional data from 579 women were analyzed. Women were asked "Which of your joints have been troublesome on most days of the past month?" Pain qualities were measured using the McGill Pain Questionnaire (Short Form) and PainDETECT, and health was assessed using the SF-36 and sociodemographic variables. Statistical analysis using generalized ordinal logistic regression included comparison of three joint pain groups: no joint pain, 1–4 sites of joint pain and ≥ 5 sites of joint pain. Results: Two thirds of respondents had multisite pain (>1 site), and one third had ≥5 joint pain sites. Compared to women with fewer joint pain sites, women with >5 joint pain sites (multisite joint pain) had significantly poorer physical and emotional health-related quality of life, more severe pain, a higher probability of neuropathic pain, and a longer duration of pain. More than half of women in the multisite joint pain group were still employed, statistically significantly more than women with no joint pain. In the final model, pain duration, the number of medications, pain intensity (discomforting and distressing) and the physical component of health-related quality of life were significantly associated with increased number of joint pain sites. Conclusions: Over one-third of older women in our sample had >5 painful joints in the last month. These women demonstrated significantly poorer psychosocial health, and increased medication use, than women with no or fewer sites of joint pain. Many women with multisite joint pain were still in the workforce, even when nearing retirement age. This study has important implications for future research into musculoskeletal pain, particularly in regards to womens health and wellbeing, and for clinical practice where there should be increased awareness of the implications of concurrent, multisite joint pain. [ABSTRACT FROM AUTHOR]

Background: Whilst half of all Australian chiropractors report often treating athletes, there is insufficient evidence to characterise the sports chiropractor in Australia. Objective: To perform a workforce survey of Sports Chiropractic Australia (SCA) members. Methods: A 74-item web-based questionnaire collected information about practitioner and practice characteristics. Descriptive statistics summarised practitioner and patient characteristics, caseload and management approaches. Results: SCA members were predominantly male (74%) with 11.3 (±8.4) years of clinical experience. Amateur or semi-professional sportspeople comprised 67% of SCA members' caseload. Athletes were most likely to present with a lower limb musculoskeletal condition (44%), followed by low back pain (34%). Nearly half (43%) of musculoskeletal conditions were co-managed with another healthcare practitioner. Conclusions: SCA members provided care for people of all sporting abilities, ranging from recreational to elite athletes, but most typically at the non-elite level. SCA members almost exclusively treat musculoskeletal conditions and apply various modalities in the management of athletes and sportspeople. [ABSTRACT FROM AUTHOR]

Objective: Treatment guidelines recommend initiation of therapy for individuals experiencing rapid CD4 cell decline. It is not known, however, whether the rate of CD4 cell decline before combination antiretroviral therapy (cART) is related to immunological response following cART., Methods: We estimated precART and postcART CD4 cell slopes by mixed models and categorized patients into two groups according to whether estimated precART slopes were above or below the 75th percentile. We compared immunological responses of the two groups through both mixed models and survival techniques. Models were stratified by CD4 cell at baseline, adjusted for HIV RNA, age, sex, HIV transmission group, year of seroconversion, initiation during primary infection, hepatitis C virus and hepatitis B virus serostatus, and cART class., Results: Of 2038 eligible patients, 1531 and 507 experienced median (interquartile range) precART CD4 cell slope of −105 (−471 to −61) and −42 (−62 to −80) cells/μl, respectively, over 2 years. After adjusting for potential confounders, individuals with shallower decline experienced a slower rate of CD4 cell recovery following cART initiation of +9.5 [95% confidence interval (CI) +6.6 to +12.2] compared to +13.9 (+13.0 to +14.8) cells/μl per month among those with steeper precART decline (P < 0.001). After stratifying by the baseline CD4 cell count, the adjusted relative hazard of an increase from baseline of more than 50 cells/μl was 0.70 (95% CI 0.62−0.79) for those with a shallower vs. steeper precART decline., Conclusion: Findings highlight the existence of a subgroup of individuals with shallower precART CD4 cell decline who experience poorer CD4 cell increases after cART; new studies in this group may provide information to optimize responses to therapy.