Academic literature on the topic 'Shoulder pain Victoria'

IntroductionPersistent musculoskeletal conditions can impact profoundly on younger people’s quality of life, psychological distress and capacity to work, as shown by previous research involving younger people with osteoarthritis. The personal impacts, in particular, work and parenting impacts, of other musculoskeletal conditions (such as persistent shoulder pain) on younger patient groups remain poorly understood. Furthermore, the personal financial burden associated with managing musculoskeletal conditions is rarely documented. This study aims to investigate well-being, work participation and productivity, shoulder-related parenting disability and out-of-pocket healthcare expenditure among younger people with shoulder pain and evaluate changes over 12 months.Methods and analysisOne hundred and fifty people aged 20–55 years with shoulder pain of more than 6 weeks’ duration (excluding those with recent history of fracture or dislocation) will be recruited for this cohort study. Participants will be recruited from three major public hospitals in Victoria, Australia, following screening of orthopaedic outpatient clinics lists and referrals. Participants will be asked to complete a baseline questionnaire and 2-week healthcare costs diary, with follow-up data collected at 12 months. Patient-reported outcomes will be collected, including health-related quality of life (HRQoL), shoulder pain and function, psychological distress, shoulder-related parenting disability and work productivity. Information on sociodemographics, employment, health services utilisation and shoulder-related healthcare expenditure will also be collected. Descriptive analysis of baseline data will provide a comprehensive snapshot of the personal burden of shoulder pain. Baseline HRQoL and psychological distress data will be compared with Australian population norms to provide context around well-being. Associations between sociodemographic factors and patient-reported outcomes will be evaluated using univariate and multivariate analyses. Changes in patient-reported outcomes from baseline to 12 months will be analysed using paired t-tests.Ethics and disseminationEthics approval has been obtained. The study findings will be submitted to peer-reviewed journals and presented at relevant scientific meetings.

Objective: To determine outcomes of intra-articular corticosteroids injection versus physiotherapy for the treatment of adhesive capsulitis using mean pain score on the visual analogue scale. Study Design: Comparative prospective study. Place and Duration of Study: Orthopedic outpatient department, Bahawal Victoria Hospital Bahawalpur from Jan to Jun 2021. Methodology: A total of 120 cases having adhesive capsulitis (frozen shoulder) were included in the study according to inclusion criteria. Non-probability consecutive sampling technique was used for the selection of cases. Patients were divided into two groups, group-A and group B, each containing 60 cases. Patients in group-A were given intra-articular steroid injection (2ml triamcinolone 40mg ± 2ml of bupivacaine). Patients in group B received ten sessions of physiotherapy by a welltrained physiotherapist under the supervision of an orthopaedic surgeon on alternate days. After six weeks, outcomes were measured in terms of pain score using a visual analogue pain scale. Results: Significant improvement was seen among patients in group-A with mean pain score from 7.32 ± 0.89 measured initially to 5.44 ± 1.37 measured after six weeks (p<0.001). No significant improvement was found among patients in group B with a mean pain score of 7.58 ± 0.94 measured initially to 7.12 ± 0.88 measured after six weeks (p>0.05). Conclusion: Significant improvement in pain relief can be achieved using intra-articular steroid injection administered in the shoulder as compared to supervised sessions of physiotherapy among patients with adhesive capsulitis.

IntroductionGeneral practice is integral to the Australian healthcare system. Outcome Health’s POpulation Level Analysis and Reporting (POLAR) database uses de-identified electronic health records to analyse general practice data in Australia. Previous studies using routinely collected health data for research have not consistently reported the codes and algorithms used to describe the population, exposures, interventions and outcomes in sufficient detail to allow replication. This paper reports a study protocol investigating patterns of care for people presenting with musculoskeletal conditions to general practice in Victoria, Australia. Its focus is on the systematic approach used to classify and select eligible records from the POLAR database to facilitate replication. This will be useful for other researchers using routinely collected health data for research.Methods and analysisThis is a retrospective cohort study. Patient-related data will be obtained through electronic health records from a subset of general practices across three primary health networks (PHN) in southeastern Victoria. Data for patients with a low back, neck, shoulder and/or knee condition and who received at least one general practitioner (GP) face-to-face consultation between 1 January 2014 and 31 December 2018 will be included. Data quality checks will be conducted to exclude patients with poor data recording and/or non-continuous follow-up. Relational data files with eligible and valid records will be merged to select the study cohort and the GP care received (consultations, imaging requests, prescriptions and referrals) between diagnosis and 31 December 2018. Number and characteristics of patients and GPs, and number, type and timing of imaging requests, prescriptions for pain relief and referrals to other health providers will be investigated.Ethics and disseminationEthics approval was obtained from the Cabrini and Monash University Human Research Ethics Committees (Reference Numbers 02-21-01-19 and 16975, respectively). Study findings will be reported to Outcome Health, participating PHNs, disseminated in academic journals and presented in conferences.

ObjectivesTo investigate the impacts, on mental and physical health, of a mandatory shift to working from home during the COVID-19 pandemic.DesignCross sectional, online survey.SettingOnline survey was conducted from September 2020 to November 2020 in the general population.ParticipantsAustralian residents working from home for at least 2 days a week at some time in 2020 during the COVID-19 pandemic.Main outcome measuresDemographics, caring responsibilities, working from home arrangements, work-related technology, work–family interface, psychosocial and physical working conditions, and reported stress and musculoskeletal pain.Results924 Australians responded to the online questionnaire. Respondents were mostly women (75.5%) based in Victoria (83.7%) and employed in the education and training and healthcare sectors. Approximately 70% of respondents worked five or more days from home, with only 60% having a dedicated workstation in an uninterrupted space. Over 70% of all respondents reported experiencing musculoskeletal pain or discomfort. Gendered differences were observed; men reported higher levels of family to work conflict (3.16±1.52 to 2.94±1.59, p=0.031), and lower levels of recognition for their work (3.75±1.03 to 3.96±1.06, p=0.004), compared with women. For women, stress (2.94±0.92 to 2.66±0.88, p<0.001) and neck/shoulder pain (4.50±2.90 to 3.51±2.84, p<0.001) were higher than men and they also reported more concerns about their job security than men (3.01±1.33 to 2.78±1.40, p=0.043).ConclusionsPreliminary evidence from the current study suggests that working from home may impact employees’ physical and mental health, and that this impact is likely to be gendered. Although further analysis is required, these data provide insights into further research opportunities needed to assist employers in optimising working from home conditions and reduce the potential negative physical and mental health impacts on their employees.

Background: Assisted dying remains an emotive topic globally with a number of countries initiating legislation to allow individuals access to assisted dying measures. Victoria will become the first Australian state in over 13 years to pass Assisted Dying Legislation, set to come into effect in 2019. Objectives: This article sought to evaluate the impact of Victorian Assisted Dying Legislation via narrative view and case study presentation. Research design: Narrative review and case study. Participants and research context: case study. Ethical considerations: This legislation will provide eligible Victorian residents with the option to request access to assisted dying measures as a viable alternative to a potentially painful, protracted death. Findings: This legislation, while conservative and inclusive of many safeguards at present, will form the basis for further discussion and debate on assisted dying across Australia in time to come. Discussion: The passing of this legislation by the Victorian parliament was prolonged, emotive and divided not only the parliament but Australian society. Conclusion: Many advocates for this legislation proclaimed it was well overdue and will finally meet the needs of contemporary society. Protagonists claim that medical treatment should not provide a means of ending life, despite palliative care reportedly often failing to relieve the pain and suffering of individuals living with a terminal illness.

Family provision legislation was introduced in Victoria in 1906 to allow the court to order provision from the estate of a deceased person whose will did not make adequate provision for the proper maintenance and support of a person for whom the deceased had a moral duty to provide. The first version of the legislation allowed only widows and children to claim; it underwent little reform until 1997 when a major amendment to the Administration and Probate Act 1958 (Vic) removed the statutory list of eligible applicants, and replaced it with the jurisdictional question, ‘Did the deceased have a responsibility to provide?’ This in theory means that ‘anyone’ can make a claim, including those without a close family relationship with the deceased. This article examines a selection of judgments handed down under the new provisions, with the aim of showing the range of applicants who are now eligible to apply and examining the particular features of their relationship with the deceased that determined the success of their claims. This is in light of the current Victorian Law Reform Commission Inquiry into Succession Law that questions whether eligibility should be limited to certain types of relationship, and whether costs should continue to be paid out of the estate.

Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P=0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P=0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

ObjectivesGreater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain. Limited evidence exists for the effectiveness of exercise for GTPS. This study aimed to compare the effectiveness of isometric and isotonic exercise for individuals with GTPS.MethodsThis randomised controlled pilot trial recruited 30 participants with GTPS. Both programmes consisted of daily, progressive home exercise for 12 weeks with 8 individual physiotherapy sessions over the trial period. The primary outcome measure was the Victorian Institute of Sport Assessment-Gluteal (VISA-G) and secondary outcome measures included the Numeric Pain Rating Scale (0–10) and an 11-point Global Rating of Change Scale. Outcome measures were assessed at baseline, 4 and 12 weeks.ResultsTwenty-three participants completed the trial. After 12 weeks, mean VISA-G scores improved in both groups; 55–65 in the isometric group and 62–72 in the isotonic group. 55% of the isometric group and 58% of the isotonic group achieved a reduction in pain of at least 2 points (minimally clinically important difference (MCID)) on the Numeric Pain Rating Scale. 64% of the isometric group and 75% of the isotonic group had improved by at least 2 points (MCID) on the Global Rating of Change Scale.ConclusionIsometric and isotonic exercise programmes appear to be effective for individuals with GTPS and should be considered in the loading management of patients with this condition.

Introduction. Australian medical speciality colleges have adapted and integrated the CanMEDS Physician Competency Framework into their training programs. The role as manager is one of the competencies and is presently thought to receive little attention during training. The objective of our study was to investigate the perceptions of Australian junior doctors regarding their management skills and their perceived need for management education. Methods. In November and December 2011, 1376 junior doctors from eight Victorian metropolitan health services were invited via email to participate in this study. Participating junior doctors received a questionnaire regarding their self- perceived management skills and knowledge and a medical management training needs assessment. Results. The response rate of one of the health centres was too low (6%) and therefore insufficient for credible conclusions to be drawn. Of the other health services, 194 (16%) out of 1213 junior doctors responded to the survey. Overall, the junior doctors rated their perceived competency on a 1–5 Likert scale as moderate (mean 3.45; s.d. 0.42). Of the 194 residents who responded, 71.3% (n = 139) reported a need for management training. Discussion. The junior doctors of Victoria, Australia perceived their knowledge on medical management as moderate. The results of this study showed that there is a perceived need among junior doctors for more management training. This need seems to confirm that management skills are thought to be valuable in medical practice. Our study also suggests that before the development of specific interventions, there is a need for a gap analysis between the perceived and actual management skills desired in medical residents. The attention paid to the role ‘as manager’ should therefore be embedded in training of all junior doctors. What is known about the topic? The CanMEDS 2005 Framework describes the seven key competencies physicians should possess to meet the needs of patients and society, and was developed by The Royal College of Physicians and Surgeons of Canada. One of these competencies is the role as manager. Published studies have shown that medical residents have a need for education in healthcare management in basic and postgraduate medical training. What does this paper add? In this study we discovered that junior doctors in Victorian metropolitan health services have a moderate perception of their competencies as managers. Previous management experience influenced the perceived competence in a positive way. What are the implications for practitioners? We believe that it is necessary that junior doctors continue to build on existing opportunities to develop their management skills. In order to achieve this, awareness of the importance of management competencies and the possibilities to obtain management experience must be raised among junior doctors. Furthermore, they need to be given the opportunity to obtain experience.

Design: A retrospective study of 40 cases of Trigeminal Neuralgia who were treated surgically ( by MVD, micro-vasculardecompression). Place & Duration: Department of Neurosurgery Quaid-I-Azam Medical College/Bahawal Victoria Hospital Bahawalpur duringfour (4) year period from January 2003 to December 2006.These patients were resistant to medical treatment so MVD was performed. MethodsTotal number of patients is (40) forty. In 10 patients CT scan brain and especially for posterior fossa was performed before surgery to rule outany suspected tumour pathology. In the remaining 30 cases no MRI or CT scanning of brain was done before surgery and diagnosis ofTrigeminal Neuralgia was made on clinical grounds. Results: Posterior fossa was opened by standard right or left retro-mastoid approachdepending upon the side of pain. In 27 out of 40 cases the superior cerebellar artery (SCA) was the offending vessel. In 5 cases, only the veinwas the cause of pain. In 2 cases, vein and artery, both were the offending vessels. In 2 cases, only arachnoidal adhesions were the causeof pain. And in 4 cases, after opening the posterior fossa it was found that cause of pain is a tumour of trigeminal nerve (3 cases) or meningioma(1 case) of cerebellopontine angle. C o n c l u s i o n : From these operative findings of tumours in the posterior fossa in cases of TrigeminalNeuralgia, it is concluded that all the patients suffering from Trigeminal Neuralgia should be screened with MRI prior to surgery to rule out anytumour pathology as a cause of Trigeminal Neuralgia, so that proper preparations be made before surgical intervention.

Abstract Chapter 2 tells how the Roosevelt administration, members of Congress, the media, and much of the public reached a breaking point with the five justices after they invalidated minimum wage legislation in 1936, and how the court “problem” suffused both the Democratic and Republican presidential campaigns. Then Roosevelt won every state but Maine and Vermont and nearly 61% of the popular vote. Thanks to his coattails, the new Senate included a paltry sixteen Republicans, the House just eighty-nine. The chapter then addresses how the administration ignored signals that the justices were “falling into line” after FDR’s triumph to develop a legislative program to add up to six new justices to the Supreme Court and why it chose a statutory remedy over constitutional amendment. Perhaps the president and his attorney general should have paid more attention to the change in mood they had detected at the court before deciding to move ahead. Yet the beginning of FDR’s second term, after he had proven his popularity and had won greater control of Congress, was also an ideal time to throw down the gauntlet before the court.

In the months leading up to the Christmas of 1877, a series of rumours began to gain traction in political society. At their heart, they all had the same kernel—that details of cabinet discussions were being made known to the Russian Government in St Petersburg—and they implicated and involved a wide range of political society, from the Prime Minister to civil servants, ambassadors to the press. By Boxing Day, the rumours had morphed into something more damaging. The Queen, through her chaplain, the Dean of Windsor, accused Mary of leaking government secrets to her friend the Russian Ambassador. While little scholarly attention has been paid to the role rumour and gossip played in political society, public men, as Trollope warned, ‘felt horror at the thought of being made the subject of common gossip and public criticism’. This chapter charts the origins of and journeys these rumours took through political society and considers their implications for Mary’s political reputation.

Israel security remained a pawn of the superpowers’ rivalry even after its military victory in the campaign. However, if it had not won either political or a diplomatic victory. The Eisenhower administration was haunted by the nightmare of losing the middle East to the Soviets which would deny the west vital Arab oil. Consequently, the US pressed Israel to withdraw from Sinai, to the extent of threatening economic sanctions. The Soviet Union could punish Israel by trying to expel it from the UN. Israel’s government, particularly Ben-Gurion, said that the withdrawal from the Sinai peninsula, the straits of Tiran and the Gaza strips should be conditioned on a strong security arrangement. Israel had no choice but to succumb to the pressures of the superpowers.

This chapter probes why French migrants in Britain, British Francophiles, and transnational actors began to judge that the French language, and to some extent culture, were relevant means of establishing outward-looking connections with diverse British audiences. In the late nineteenth century, French migrants wanted to promote specific national ideas, but this process was, at the time, distinct from a conscious reflection on how such efforts may serve the French state. Indeed, diplomats were remarkably indifferent or unable to comprehend what their attitude should be regarding the growing number of private French cultural institutions that emerged in Britain in the late nineteenth century. The French government was certainly no novice in formulating and implementing cultural policies outside mainland France. At the same time, it was developing an intense ‘civilising mission’ that relied on French culture and the French language in the Empire. By focusing on the activities of exiles, migrants, and transnational agents, this chapter considers early attempts at French cultural diplomacy in Britain at a time when the French government paid little attention to these questions in non-imperial spaces.

Chapter 6 explores tensions surrounding the mentoring of trainee physicians. Victory odes articulate an ideal of mentoring as an enduring, influential, and even transformational relationship focused on building character and moral judgment rather than technical skill. At the same time, the odes expose concerns that actual mentoring can fail to achieve this ideal, and instead prove to be elitist or more focused on obtaining immediate results than fostering independent agents. Mentorship has re-emerged as a key factor in the development of modern physicians as increased attention is paid to measuring the outcomes of medical education and humanistic competencies within medicine are revalued. Mentorship should certainly be fostered, but care must be taken to design mentorship programs that are inclusive and that develop independent agents.

This chapter defines a framework for the crosscultural communication process, including efficiency and cost. The framework provides some directions for dialogue among civilizations, which is one of the main routes toward creation of the universal civilization. A developed architectural design of the cross-cultural communication process is based on a universal system approach that not only considers the complexities of the various cultural hierarchies and their corresponding communication climates, but also compares and quantifies the cultural-specific attributes with the intention of increasing efficiency levels in crosscultural communication. The attributes for two selected cultures (Western-West and Egyptian) are estimated in a normative way using expert opinions, measuring on a scale from 1 to 5 with 5 as the best value. Quantifying cultural richness (R), cultural efficiency (?), modified cultural differences (DMC, and cultural ability (B) reflects how a given culture’s strength can overcome cultural differences and enhance its competitive advantage (V). Two components of the culture factor cost, explicit (CE) and implicit (CI), are defined, examined and quantified for the purposes not only of controlling the cost of doing business across cultures, but also to determine the amount of investment needed to overcome cultural differences in a global economy. In this new millennium, global organizations will increasingly focus on the critical value of the cross-cultural communication process, its efficiency, its competence, its cost of doing business. In order to successfully communicate crossculturally, knowledge and understanding of such cultural factors as values, attitudes, beliefs and behaviors should be acquired. Because culture is a powerful force that strongly influences communication behavior, culture and communication are inseparably linked. Worldwide, in the last 20 years, countries have experienced a phenomenal growth in international trade and foreign direct investment. Similarly, they have discovered the importance of crosscultural communication. As a result, practitioners and scholars are paying attention to the fact that cultural dimensions influence management practices (Hofstede, 1980; Child, 1981; Triandis, 1982; Adler, 1983; Laurent, 1983; Maruyama, 1984). In recent years, empirical work in the crosscultural arena has focused on the role of culture on employee behavior in communicating within business organizations (Tayeb, 1988). But current 346 Asymmetric Communication work on cross-cultural business communication has paid little attention to either (a) how to adapt these seminal works on general communication to the needs of intercultural business or (b) how to create new models more relevant to cross-cultural business exchanges (Limaye & Victor, 1991, p. 283). There are many focused empirical studies on cross-cultural communication between two specific cultures (e.g., Wong & Hildebrandt, 1983; Halpern, 1983; Victor, 1987; Eiler & Victor, 1988; Varner, 1988; Victor & Danak, 1990), but such results must be arguable when extrapolated across multiple cultures. The prevailing western classical linear and process models of communication (Shannon & Weaver, 1949; Berlo, 1960) neglect the complexity of cross-cultural communication. Targowski and Bowman (1988) developed a layer-based pragmatic communication process model which covered more variables than any previous model and indirectly addressed the role of cultural factors among their layer-based variables. In a similar manner, the channel ratio model for intercultural communication developed by Haworth and Savage (1989) has also failed to account completely for the multiple communication variables in cross-cultural environments. So far, there is no adequate model that can explain the cross-cultural communication process and efficiency, let alone estimate the cost of doing business with other cultures worldwide.