Standardized screening of cognitive and affective tendencies in persons with low back pain: A knowledge translation project.

BACKGROUND: The use of screening questionnaires (SQ) to evaluate affective or cognitive tendencies (CAT) in persons with low back pain (LBP) is recommended by clinical practice guidelines (CPG) yet few physical therapists (PTs) have adopted these recommendations. OBJECTIVE: To develop and implement a tailored knowledge translation (KT) intervention in an outpatient rehabilitation practice to facilitate the uptake of SQ for CAT in persons with LBP. METHODS: In a mixed-methods study, using the knowledge to action framework, PTs (n = 12) collaborated with research clinicians to improve the use of three SQ: 1) Primary Care Evaluation of Mental Disorders for Depressive Symptoms; 2) Fear-Avoidance Beliefs Questionnaire; and 3) Pain Catastrophizing Scale. Success of the intervention was measured through questionnaires, focus groups and chart audit. RESULTS: A multimodal intervention to overcome specific identified barriers (i.e. time, forgetfulness, and lack of knowledge) was implemented. There was a 10% increase in the use of at least one SQ. PTs reported increased knowledge and use of the SQ but reported time and lack of confidence as barriers to implementation. CONCLUSION: It was concluded that SQ for CAT can be successfully implemented; however, PTs felt unprepared to use the screening results to evaluate persons with CAT and more extensive training is recommended to change this practice pattern.

Comparing Lumbar Lordosis in Functional Dance Positions in Collegiate Dancers With and Without Low Back Pain.

Limited research has explored the relationship between lumbar lordosis and incidence of low back pain in dancers. The purpose of this study was to investigate the relationship between lumbar lordosis in functional dance positions and low back pain (LBP). Thirty full-time undergraduate ballet and modern collegiate dancers (28 female, 2 male) from three university dance programs participated in this study. Functional lumbar lordosis, hip passive range of motion, and core endurance were measured in a single session. Dancers participated in weekly follow-up surveys over a 4-month period to track the presence and severity of LBP. Primary analysis was performed using independent t-tests between groups who did and did not develop pain. Secondary analyses were performed using Pearson's r correlation. Eleven dancers reported no pain during the follow-up period, 16 reported pain, and three did not respond to follow-up surveys. Lumbar lordosis in right developpé á la seconde and right retiré was significantly greater (p < 0.05) in the group who reported pain compared to the group who reported no pain. Increased hold times in the supine bridge position was shown to be fairly correlated (p < 0.05) to reduced lumbar lordosis in first position (Pearson's r = 0.381), left retiré (Pearson's r = 0.396), and right developpé á la seconde (Pearson's r = 0.365). The results of this study suggest a relationship between increased lumbar lordosis in the retiré and developpé á la seconde dance positions and development of LBP. Increased endurance of posterior core musculature and gluteal muscles was inversely related to the magnitude of lumbar lordosis in some dance-specific positions. The measurement of lumbar lordosis during functional dance positions, particularly those requiring single leg stances, may help identify collegiate dancers with increased risk of developing low back pain.

Applying a clinical decision-making model to a patient with severe shoulder pain ultimately diagnosed as neuralgic amyotrophy.

Objective and Purpose Shoulder symptoms are often encountered in physical therapy and a myriad of etiologies can cause these symptoms, either locally or remotely. The purpose of this case report is to describe the physical therapist's differential diagnostic process for a patient with acute and severe onset of shoulder pain. Case Description: The patient was a 37-year-old female with sudden onset of right shoulder pain that awakened her at night. Pain was associated with decreased range of motion and shoulder weakness. Faced with an uncertain diagnosis, the physical therapist followed a systematic approach to clinical decision-making. Outcomes: Neuralgic amyotrophy was the primary diagnostic hypothesis but other causes of shoulder pain could not be ruled out. Conclusion: The clinical decision-making process helped the physical therapist narrow down the differential diagnosis list and make a decision to send the patient for further testing. Magnetic resonance imaging and electromyogram confirmed the diagnosis of neuralgic amyotrophy.

Development of oriC-Based Plasmids for Mesoplasma florum.

The near-minimal bacterium Mesoplasma florum constitutes an attractive model for systems biology and for the development of a simplified cell chassis in synthetic biology. However, the lack of genetic engineering tools for this microorganism has limited our capacity to understand its basic biology and modify its genome. To address this issue, we have evaluated the susceptibility of M. florum to common antibiotics and developed the first generation of artificial plasmids able to replicate in this bacterium. Selected regions of the predicted M. florum chromosomal origin of replication (oriC) were used to create different plasmid versions that were tested for their transformation frequency and stability. Using polyethylene glycol-mediated transformation, we observed that plasmids harboring both rpmH-dnaA and dnaA-dnaN intergenic regions, interspaced or not with a copy of the dnaA gene, resulted in a frequency of ∼4.1 × 10-6 transformants per viable cell and were stably maintained throughout multiple generations. In contrast, plasmids containing only one M. florumoriC intergenic region or the heterologous oriC region of Mycoplasma capricolum, Mycoplasma mycoides, or Spiroplasma citri failed to produce any detectable transformants. We also developed alternative transformation procedures based on electroporation and conjugation from Escherichia coli, reaching frequencies up to 7.87 × 10-6 and 8.44 × 10-7 transformants per viable cell, respectively. Finally, we demonstrated the functionality of antibiotic resistance genes active against tetracycline, puromycin, and spectinomycin/streptomycin in M. florum Taken together, these valuable genetic tools will facilitate efforts toward building an M. florum-based near-minimal cellular chassis for synthetic biology.IMPORTANCEMesoplasma florum constitutes an attractive model for systems biology and for the development of a simplified cell chassis in synthetic biology. M. florum is closely related to the mycoides cluster of mycoplasmas, which has become a model for whole-genome cloning, genome transplantation, and genome minimization. However, M. florum shows higher growth rates than other Mollicutes, has no known pathogenic potential, and possesses a significantly smaller genome that positions this species among some of the simplest free-living organisms. So far, the lack of genetic engineering tools has limited our capacity to understand the basic biology of M. florum in order to modify its genome. To address this issue, we have evaluated the susceptibility of M. florum to common antibiotics and developed the first artificial plasmids and transformation methods for this bacterium. This represents a strong basis for ongoing genome engineering efforts using this near-minimal microorganism.