Review article: Methodology for the ‘rapid review’ series on musculoskeletal injuries in the emergency department The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. The effectiveness of exercise on recovery and clinical outcomes of soft tissue injuries of the leg, ankle, and foot: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Urban emergency department overcrowding: defining the problem and eliminating misconceptions. Application of Platelet-Rich Plasma to Disorders of the Knee Joint Treatment of borderline personality disorder in youth. Pectoral stretching program for women undergoing radiotherapy for breast cancer Characteristics of Randomized Controlled Trials Designed for Elderly: A Systematic Review ASGE guideline: colorectal cancer screening and surveillance. Practice parameter: Thymectomy for autoimmune myasthenia gravis (an evidence-based review) Videogames and Health Improvement: A Literature Review of Randomized Controlled Trials. Improving quality of depression care using organized systems of care: a review of the literature. Neuropathic pain post spinal cord injury part 1: systematic review of physical and behavioral treatment. European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence based assessment and treatment of mentally disordered offenders. Chiropractic care for patients with asthma: A systematic review of the literature. A Review of Vilazodone, Serotonin, and Major Depressive Disorder Engaging medical librarians to improve the quality of review articles. The role of endoscopy in Barrett's esophagus and other premalignant conditions of the esophagus. The Integration of Electromyography (SEMG) at the Workstation: Assessment, Treatment, and Prevention of Repetitive Strain Injury (RSI) The role of endoscopy in the management of acute non-variceal upper GI bleeding. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report Changes in the prosthodontic literature 1966 to 2042. An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers.
Musculoskeletal injuries are a common presentation to the ED , with significant costs involved in the management of these injuries , variances in care within the ED and associated morbidity . A series of rapid review papers were completed to guide best practice for the assessment and management of common musculoskeletal injuries presenting to the ED . This paper presents the methodology used across the rapid review s. PubMed , CINAHL , EMBASE , TRIP and the grey literature , including relevant organisational websites , were search ed in 2015 . The search was repeated consistently for each topic area ( injuries of the foot and ankle , knee , h and and wrist , elbow , shoulder , lumbar spine and cervical spine ) . English- language primary studies , systematic review s and guidelines that were published in the last 10 years and addressed acute musculoskeletal injury management were considered for inclusion . Data extraction of each included article was conducted , followed by a quality appraisal . The extracted data from each article was synthesis ed to group similar evidence together . For each rapid review , the evidence has been organised in a way that a clinician can direct their attention to a specific component of the clinical cycle of care in the ED , such as the assessment , diagnostic tests , management and follow-up considerations from ED . The series of rapid review s are design ed to foster evidence -based practice within the ED , targeting the injuries most commonly presenting . The review s provide clinicians in EDs with rapid access to the best current evidence , which has been synthesis ed and organised to assist decision-making STUDY DESIGN Systematic review and best evidence synthesis . OBJECTIVES To describe the prevalence and incidence of  neck pain and disability in workers ; to identify risk factors for neck pain in workers ; to propose an etiological diagram ; and to make recommendations for future research . SUMMARY OF BACKGROUND DATA Previous review s of the etiology of neck pain in workers relied on cross-sectional evidence . Recently published cohorts and r and omized trials warrant a re- analysis of this body of research . METHODS We systematic ally search ed Medline for literature published from 1980 - 2006 . Retrieved articles were review ed for relevance . Relevant articles were critically appraised . Articles judged to have adequate internal validity were included in our best evidence synthesis . RESULTS One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible . The annual prevalence of neck pain varied from 27.1 % in Norway to 47.8 % in Québec , Canada . Each year , between 11 % and 14.1 % of workers were limited in their activities because of neck pain . Risk factors associated with neck pain in workers include age , previous musculoskeletal pain , high quantitative job dem and s , low social support at work , job insecurity , low physical capacity , poor computer workstation design and work posture , sedentary work position , repetitive work and precision work . We found preliminary evidence that gender , occupation , headaches , emotional problems , smoking , poor job satisfaction , awkward work postures , poor physical work environment , and workers ' ethnicity may be associated with neck pain . There is evidence that interventions aim ed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers . CONCLUSION Neck disorders are a significant source of pain and activity limitations in workers . Most neck pain results from complex relationships between individual and workplace risk factors . No prevention strategies have been shown to reduce the incidence of neck pain in workers INTRODUCTION Soft tissue injuries of the leg , ankle , or foot are common and often treated by exercise . The purpose of this study was to determine the effectiveness of  exercise  for the management of soft tissue injuries of the leg , ankle , or foot . METHODS A systematic review of the literature was conducted . We search ed five data bases from 1990 to 2015 . Relevant articles were critically appraised using Scottish Intercollegiate Guidelines Network ( SIGN ) criteria . The evidence from studies with low risk of bias was synthesized using the best- evidence synthesis methodology . RESULTS We screened 7946 articles . We critically appraised ten r and omized trials and six had a low risk of bias . The evidence suggests that for recent lateral ankle sprain : 1 ) rehabilitation exercises initiated immediately post-injury are as effective as a similar program initiated one week post-injury ; and 2 ) supervised progressive exercise plus education/advice and home exercise lead to similar outcomes as education/advice and home exercise . Eccentric exercises may be more effective than an AirHeel brace but less effective than acupuncture for Achilles tendinopathy of more than two months duration . Finally , for plantar heel pain , static stretching of the calf muscles and sham ultrasound lead to similar outcomes , while static plantar fascia stretching provides short-term benefits compared to shockwave therapy . CONCLUSIONS We found little evidence to support the use of early or supervised exercise interventions for lateral ankle sprains . Eccentric exercises may provide short-term benefits over a brace for persistent Achilles tendinopathy and plantar fascia stretching provides short-term benefits for plantar heel pain STUDY OBJECTIVE To develop an operational definition and a parsimonious list of postulated determinants for urban emergency department ( ED ) overcrowding .  METHODS A panel was formed from clinical and administrative experts in pre-hospital , ED and hospital domains . Key studies and reports were review ed in advance by panel members , an experienced health services research er facilitated the panel 's discussion s , and a formal content analysis of audiotaped recordings was conducted . RESULTS The panel considered community , patient , ED and hospital determinants of overcrowding . Of 46 factors postulated in the literature , 21 were not retained by the experts as potentially important determinants of overcrowding . Factors not retained included access to primary care services and seasonal influenza outbreaks . Key determinants retained included admitted patients awaiting beds and patient characteristics .  Ambulance diversion was considered to be an appropriate operational definition and proxy measure of ED overcrowding . CONCLUSION These results help to clarify the conceptual framework around ED overcrowding , and may provide a guide for future research . The relative importance of the determinants must be assessed by prospect i ve studies Importance : The promising therapeutic potential and regenerative properties of platelet-rich plasma ( PRP ) have rapidly led to its widespread clinical use in musculoskeletal injury and disease . Although the basic scientific rationale surrounding PRP products is compelling , the clinical application has outpaced the research . Objective : The purpose of this article is to examine the current concepts around the basic science of PRP application , different preparation systems , and clinical application of PRP in disorders in the knee . Evidence Acquisition : A systematic search of PubMed for studies that evaluated the basic science , preparation and clinical application of platelet concentrates was performed . The search used terms , including platelet-rich plasma or PRP preparation , activation , use in the knee , cartilage , ligament , and meniscus . Studies found in the initial search and related studies were review ed . Results : A comprehensive review of the literature supports the potential use of PRP  both nonoperatively and intraoperatively , but highlights the absence of large clinical studies and the lack of st and ardization between method , product , and clinical efficacy . Conclusions and Relevance . In addition to the call for more r and omized , controlled clinical studies to assess the clinical effect of PRP , at this point , it is necessary to investigate PRP product composition and eventually have the ability to tailor the therapeutic product for specific indications OBJECTIVES Borderline personality disorder ( BPD ) is frequently encountered in both adult and youth population s. There is a robust literature supporting psychotherapy for adults with BPD , but the literature supporting its use for BPD in youth is more limited . METHODS A literature review was conducted using the keywords " borderline personality disorders " and " adolescence . " Relevant articles were review ed for inclusion . RESULTS Several specialized treatments have been studied with mixed results . Dialectical behaviour therapy has no r and omized controlled trials in adolescents ,  emotion regulation training  has not demonstrated superiority of treatment as usual , and  cognitive analytic therapy has demonstrated more rapid recovery but little difference at follow-up .  Mentalization-based treatment  has one study supporting its use in self-harming adolescents . Pharmacotherapy has no evidence supporting its use in this population . CONCLUSIONS Structured therapy may be the most important therapeutic component in this population Surgery and radiotherapy commonly cause adverse musculoskeletal problems , particularly loss of strength and range of motion , in the upper quadrant of breast cancer patients . Few well- design ed studies have investigated whether these impairments can be prevented . Stretching is an effective technique for increasing range of motion , hence the aim of this study was to investigate whether a stretching program reduced acute musculoskeletal impairments in patients undergoing radiotherapy for breast cancer . Sixty-four women were recruited prior to commencement of radiotherapy following breast cancer surgery . Participants were r and omised to either a control or stretch group . Participants in both groups were review ed by the physical therapist on a weekly basis for approximately 6 weeks , and were given general information about skin care and lymphedema . The control group received no advice about exercise . The stretch group received instruction on low-load , prolonged pectoral stretches , which were to be performed daily and were checked at weekly visits . Shoulder range of motion , strength , arm circumference , and quality of life measurements were taken prior to , and at completion of radiotherapy , and at 7 months after radiotherapy . There was no difference in any outcome between groups . Breast symptoms increased for both groups during radiotherapy , without loss of strength or range of movement . The incidence of lymphedema during the study was low for both groups and did not differ between groups . The pectoral stretching program did not influence the outcomes measured because the symptoms reported by patients were not a consequence of contracture Objectives To quantify the proportion of r and omized controlled trials ( RCTs ) specifically design ed for elderly , and to assess their characteristics , as compared to RCTs not specifically design ed for elderly . Design Review and synthesis of published literature . Measurements We search ed PubMed for articles published in the year 2012 . We included RCTs . Articles were excluded if not conducted with human subjects or if findings of secondary analyses were reported . A r and om sample of 10 % was drawn and of this selection the following trial characteristics were extracted : sample size , disease category , age of sample , and age-related inclusion criteria . Clinical trials were defined to be specifically design ed for elderly if a lower age cut-off of ≥ 55 years was used , or when participants had an average age of ≥ 70 years . Results The search strategy yielded 26,740 articles , from which a r and om sample was drawn , result ing in 2375 articles . After exclusion , data was extracted from 1369 publications . Of these 1369 RCTs , 96 ( 7 % ) were specifically design ed for elderly . In comparison with trials not design ed for older adults , trials design ed for elderly contained a significantly larger median number of participants  ( 125 vs. 80 , p = 0.008 ) significantly more trials design ed for elderly fell into the disease categories eye ( 6 % vs. 2 % , p = 0.005 ) , musculoskeletal ( 13 % vs. 7 % , p = 0.023 ) and circulatory system ( 16 % vs. 9 % , p = 0.039 ) . No significant difference was observed with regard to the other disease categories . Conclusion There is a low proportion of RCTs specifically design ed for elderly . As older patients will increasingly form the majority in medical practice , there is an urgent need for stronger evidence for the formulation of treatment guidelines specifically for older adults This article is one of a series of statements discussing the use of gastrointestinal endoscopy in common clinical situations . The St and ards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text . In preparing this guideline , a MEDLINE literature search was performed , and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants . When little or no data exist from well design ed prospect i ve trials , emphasis is given to results from large series and reports from recognized experts . Guidelines for appropriate use of endoscopy  are based on a critical review of the available data and expert consensus . Further controlled clinical studies are needed to clarify aspects of this statement , and revision may be necessary as new data appear . Clinical consideration may justify a course of action at variance to these recommendations . This guideline replaces and supplements our previous document on colorectal cancer screening and surveillance The Quality St and ards Subcommittee of the American Academy of Neurology is charged with developing practice parameters for neurologists for diagnostic procedures , treatment modalities , and clinical disorders . The selection of topics for which practice parameters are used is based on prevalence , frequency of use , economic impact , membership involvement , controversy , urgency , external constraints , and re sources required . This paper addresses the role of thymectomy in the treatment of nonthymomatous autoimmune MG . In 1939 , Blalock et al.1 reported the remission of generalized MG in a 21-year-old woman after removal of a cystic thymic tumor . Subsequently , Blalock et al.2,3 performed thymectomy  on MG patients without thymoma , found hyperplasia in the thymus gl and s , and reported improvement in at least half of their patients . Since these reports , thymectomy , with or without the presence of thymoma , has gained widespread acceptance as a form of treatment for MG . Because a definitive study of the effectiveness of thymectomy has never been done,4,5 the role of thymectomy in the management of MG remains uncertain . Nevertheless , physicians have to advise their patients regarding the benefits of thymectomy based on the existing literature . Our goal is to develop evidence -based recommendations for clinicians considering  thymectomy for patients with nonthymomatous autoimmune MG by performing a systematic review and analysis of the literature . # # # Identification and selection of studies . We search ed the National Library of Medicine ’s Medline data base from 1966 to February 1998 using the medical subject headings “ myasthenia gravis ” ( restricted to the surgery subheading ) and “ thymectomy . ” To identify articles published before 1966 , or missed by our original search strategy , we review ed the references of the identified articles . We classified the result ing articles into the following categories : Class II , controlled but nonr and omized studies describing outcomes in MG patients with and without thymectomy ; and Class III , uncontrolled case series describing outcomes in patients with or without OBJECTIVE There are potential benefits of playing videogames for health improvement such as increasing knowledge about health-related issues by playing educational games and fighting a sedentary lifestyle by playing exergames . The number of systematic review articles about " videogames " and " health improvement " is limited . Therefore , the purpose of this study is to review those r and omized controlled trials ( RCTs ) with the topic of " videogames " and " health improvement . " MATERIAL S AND METHODS Several electronic data bases were search ed for RCTs testing  videogames on health outcomes that were published in English between January 2000 and April 2012 . RESULTS Forty-five articles met the eligibility criteria and were categorized into five groups : ( 1 ) videogames and patient pain and stress reduction ( nine articles ) , ( 2 ) videogames and  patient behavioral change  ( 19 articles ) , ( 3 ) videogames and patient rehabilitation  ( eight articles ) , ( 4 ) videogames as diagnostic tools ( three articles ) , and ( 5 ) videogames and cognitive ability ( six articles ) . CONCLUSIONS Most of the articles have shown promising results in using videogames within various fields of healthcare . Although exergames are the most prominent choice regarding health improvement , videogames have the potential to be used as a pain management tool , diagnostic tool , or educational tool . They also can be used as a facilitator in physical rehabilitation or cognitive loss prevention . More RCTs are needed to fully uncover the benefits of using videogames for improving patients ' health OBJECTIVE To establish the need for a chronic disease management strategy for major depressive disorder ( MDD ) , discuss the challenges involved in implementing guideline -level treatment for MDD , and provide examples of successful implementation of collaborative care programs . DATA SOURCES A systematic literature search of MEDLINE and the US National Library of Medicine was performed . STUDY SELECTION We review ed clinical studies evaluating the effectiveness of collaborative care interventions for the treatment of depression in the primary care setting using the keywords collaborative care , depression , and MDD . This review includes 45 articles relevant to MDD and collaborative care published through May 2010 and excludes all non-English- language articles . RESULTS Collaborative care interventions include a greater role for nonmedical specialists and a supervising psychiatrist with the major goal of improving quality of depression care in primary care systems . Collaborative care programs restructure clinical practice to include a patient care strategy with specific goals and an implementation plan , support for self-management training , sustained patient follow-up , and decision support for medication changes . Key components associated with the most effective collaborative care programs were improvement in antidepressant adherence , use of depression case managers , and regular case load supervision by a psychiatrist . Across studies , primary care patients r and omized to collaborative care interventions  experienced enhanced treatment outcomes compared with those r and omized to usual care , with overall outcome differences approaching 30 % . CONCLUSIONS Collaborative care interventions may help to achieve successful , guideline -level treatment outcomes for primary care patients with MDD . Potential benefits of collaborative care strategies include reduced financial burden of illness , increased treatment adherence , and long-term improvement in depression symptoms and functional outcomes BACKGROUND Neuropathic pain has various physiologic and psychosocial aspects . Hence , there is a growing use of adjunct nonpharmacological therapy with traditional pharmacotherapy to reduce neuropathic pain post spinal cord injury ( SCI ) . OBJECTIVE The purpose of this study was to conduct a systematic review of published research on nonpharmacological treatment of neuropathic pain after SCI . METHODS MEDLINE , CINAHL , EMBASE , and PsycINFO data bases were search ed for articles addressing nonpharmacological treatment of pain post SCI . Articles were restricted to the English language . Article selection was conducted by 2 independent review ers with the following inclusion criteria : the subjects participated in a treatment or intervention for neuropathic pain ; at least 50 % of the subjects had an SCI ; at least 3 subjects had an SCI ; and a definable intervention was being studied . Data extracted included study design , study type , subject demographics , inclusion and exclusion criteria , sample size , outcome measures , and study results . R and omized controlled trials ( RCTs ) were assessed for quality using the Physiotherapy Evidence Data base ( PEDro ) assessment scale . Levels of evidence were assigned to each intervention using a modified Sackett scale . RESULTS The 16 articles selected for this review fell into 1 of 2 categories of nonpharmacological management of pain after SCI : physical and behavioral treatments . The pooled sample size of all studies included 433 participants . Of the 16 studies included , 7 were level 1 , 3 were level 2 , and 6 were level 4 studies . CONCLUSIONS Physical interventions demonstrated the strongest evidence based on quality of studies and numbers of RCTs in the nonpharmacological treatment of post-SCI pain . Of these interventions , transcranial electrical stimulation had the strongest evidence of reducing pain . Despite a growing body of literature , there is still a significant lack of research on the use of nonpharmacological therapies for SCI pain Forensic psychiatry in Europe is a specialty primarily concerned with individuals who have either offended or present a risk of doing so , and who also suffer from a psychiatric condition . These mentally disordered offenders ( MDOs ) are often cared for in secure psychiatric environments or prisons . In this guidance paper we first present an overview of the field of forensic psychiatry from a European perspective . We then present a review of the literature summarising the evidence on the assessment and treatment of MDOs under the following headings : The forensic psychiatrist as expert witness , risk , treatment setting s for mentally disordered offenders , and what works for MDOs . We undertook a rapid review of the literature with search terms related to : forensic psychiatry , review articles , r and omised controlled trials and best practice . We search ed the Medline , Embase , PsycINFO , and Cochrane library data bases from 2000 onwards for adult groups only . We scrutinised publications for additional relevant literature , and search ed the websites of relevant professional organisations for policies , statements or guidance of interest . We present the findings of the scientific literature as well as recommendations for best practice drawing additionally from the guidance documents identified . We found that the evidence base for forensic-psychiatric practice is weak though there is some evidence to suggest that psychiatric care produces better outcomes than criminal justice detention only . Practitioners need to follow general psychiatric guidance as well as that for offenders , adapted for the complex needs of this patient group , paying particular attention to long-term detention and ethical issues OBJECTIVE To provide a review of the literature and rate the quality of published studies regarding chiropractic care , including spinal manipulation , for asthmatic patients . METHODS A multimodal search strategy was conducted , including multiple data base search es , along with reference and journal h and - search ing . Studies were limited to those published in English and in peer- review ed journals or conference proceedings between January 1980 and March 2009 . All study design s were considered except personal narratives or review s. Retrieved articles that met the inclusion criteria were rated for quality by using the Downs and Black checklist . A brief summary was also written for each retrieved study . RESULTS Eight articles met the inclusion criteria of this review in the form of one case series , one case study , one survey , two r and omized controlled trials ( RCTs ) , one r and omized patient and observer blinded cross-over trial , one single blind cross study design , and one self-reported impairment question naire . Their quality scores ranged from 5 to 22 out of 27 . CONCLUSION Results of the eight retrieved studies indicated that chiropractic care showed improvements in subjective measures and , to a lesser degree objective measures , none of which were statistically significant . It is evident that some asthmatic patients may benefit from this treatment approach ; however , at this time , the evidence suggests chiropractic care should be used as an adjunct , not a replacement , to traditional medical therapy Objective : To review the mechanism of selective serotonin reuptake inhibitor (SSRI)–mediated serotonergic neurotransmission , focusing on serotonin 1A ( 5-HT1A ) autoreceptors , which are proposed to be involved in delaying therapeutic efficacy . Vilazodone was specifically design ed to function both as an SSRI and a partial agonist at 5-HT1A receptors . This combined mechanism is proposed to decrease time to efficacy , minimize sexual side effects , and provide concomitant anxiolytic properties . Data Sources : A PubMed search of all English- language articles from January 1990 to January 2013 was conducted using the search terms depression and 5-HT1A , depression and buspirone , depression and pindolol , and vilazodone . Study Selection : We found 47 articles and abstract s that were selected for inclusion on the basis of information about the pharmacology of 5-HT1A receptors and the clinical data on pindolol , buspirone , and vilazodone in depression . Data Extraction : This review summarizes current literature involving antidepressant activity , the role of 5-HT1A autoreceptors , and clinical trials involving serotonin reuptake inhibition in conjunction with 5-HT1A agonists and partial agonists , with a focus on vilazodone . Results : Vilazodone has demonstrated efficacy in 2 large , r and omized , double-blind , placebo-controlled trials in major depressive disorder . Results suggest that vilazodone has a low incidence of sexual side effects and is effective in patients with high levels of anxiety . A pooled analysis shows evidence of significant symptom reduction after only 1 week of therapy . Conclusions : If future studies corroborate the clinical benefits attributed to its mechanism of action , vilazodone may show potential advantages in terms of onset of action , sexual side effects , and anxiolytic activity in patients with major depressive disorder Review articles published in JAMA summarize various aspects of medical practice and are written by known authorities . An expert ’s opinion about a topic has value , but often more can be learned by that expert ’s assessment of all the pertinent literature . When reading individual research articles , readers could miss subtle features of the studies that are more apparent to an expert clinician research er . Readers benefit from the expert ’s explanation of the validity and applicability of individual studies . When authors summarize the literature , a natural tendency is to select articles supporting their views . To minimize this potential for bias , JAMA editors ask authors to systematic ally review the literature and comment on as much of it as is practical . Extensive literature search es can be difficult to perform , given the complexity of the search process and authors ’ time constraints . It is also unlikely that a content expert will be familiar with the intricacies of more than one data base . Empirical evidence provides a strong rationale for search ing multiple data bases . 1,2 For this reason , collaborating with medical librarians is recommended when writing review articles . A general approach for this collaboration is presented in the Box . Preliminary search es conducted by a librarian can help refine the question and determine its feasibility and scope . These initial screening search es can also inform the development of the review ’s prospect i ve inclusion and exclusion criteria . The choice of data base depends on several factors . Most important is the content ( topic ) i ( n d m e This is one of a series of statements discussing the use of GI endoscopy in common clinical situations . The St and ards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text . In preparing this guideline , a search of the medical literature was performed using PubMed . Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants . When limited or no data exist from well- design ed prospect i ve trials , emphasis is given to results of large series and reports from recognized experts . Guidelines for appropriate use of endoscopy are based on a critical review of the available data and expert consensus at the time the guidelines are drafted . Further controlled clinical studies may be needed to clarify aspects of this guideline . This guideline may be revised as necessary to account for changes in technology , new data , or other aspects of clinical practice . The recommendations were based on review ed studies and were grade d on the strength of the supporting evidence ( Table 1).1 The strength of individual recommendations is based on both the aggregate evidence quality and an assessment of the anticipated benefits and harms . Weaker recommendations are indicated by phrases such as “ we suggest , ” whereas stronger recommendations are typically stated as “ we recommend . ” This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients . This guideline is not a rule and should not be construed as establishing a legal st and ard of care or as encouraging , advocating , requiring , or discouraging any particular treatment . Clinical decisions in any particular case involve a complex analysis of the patient ’s condition and available courses of action . Therefore , clinical considerations may lead an endoscopist to take a course of action that varies from these guidelines This paper review s the ergonomic and psychosocial factors that affect musculoskeletal disorders at the workstation . First is a model of a physiological assessment protocol that incorporated SEMG monitoring while working at the computer . Next is a study that showed that participants lack awareness of their muscle tension as compared to the actual SEMG levels . The final study illustrated how an intervention program can reduce RSI symptoms , decrease respiration rate , and lower SEMG activity . Recommendations include suggestions that successful safety and prevention programs need multiple components and that participants should to be trained to control physiological responses with respiration and SEMG biofeedback . All participants should master these physiological skills just as they learn how to use the computer d c p B s i R This is one of a series of statements discussing the use of GI endoscopy in common clinical situations . The St and ards of Practice Committee of the American Society for Gastrointestinal Endoscopy ( ASGE ) prepared this text . In preparing this guideline , a search of the medical literature was performed by using PubMed . Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants . When few or no data exist from well- design ed prospect i ve trials , emphasis is given to results from large series and reports from recognized experts . Guidelines for appropriate use of endoscopy are based on a critical review of the available data and expert consensus at the time that the guidelines are drafted . Further controlled clinical studies may be needed to clarify aspects of this guideline . This guideline may be revised as necessary to account for changes in technology , new data , or other aspects of clinical practice . The recommendations are based on review ed studies and are grade d on the strength of the supporting evidence 1 ( Table 1 ) . he strength of individual recommendations is based on oth the aggregate evidence quality and an assessment of the nticipated benefits and harms . Weaker recommendations re indicated by phrases such as “ We suggest . . . , ” whereas tronger recommendations are typically stated as “ We recmmend . . . . ” This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients . This guideline is not a rule and should not be construed as establishing a legal st and ard of care or as encouraging , advocating , requiring , or discouraging any particular treatment . Clinical decisions in any particular case involve a complex analysis of the patient ’s condition and available courses of action . Therefore , clinical considerations may lead an endoscopist to take a course of action that varies from these guidelines Background This systematic review up date d and extended the " UK evidence report " by Bronfort et al. ( Chiropr Osteopath 18:3 , 2010 ) with respect to conditions/ interventions that received an ' inconclusive ’ or ' negative ’ evidence rating or were not covered in the report . Methods A literature search of more than 10 general medical and specialised data bases was conducted in August 2011 and up date d in March 2013 . Systematic review s , primary comparative studies and qualitative studies of patients with musculoskeletal or non-musculoskeletal conditions treated with manual therapy and reporting clinical outcomes were included . Study quality was assessed using st and ardised instruments , studies were summarised , and the results were compared against the evidence ratings of Bronfort . These were either confirmed , up date d , or new categories not assessed by Bronfort were added . Results 25,539 records were found ; 178 new and additional studies were identified , of which 72 were systematic review s , 96 were r and omised controlled trials , and 10 were non-r and omised primary studies . Most ' inconclusive ’ or ' moderate ’ evidence ratings of the UK evidence report were confirmed . Evidence ratings changed in a positive direction from inconclusive to moderate evidence ratings in only three cases ( manipulation/mobilisation [ with exercise ] for rotator cuff disorder ; spinal mobilisation for cervicogenic headache ; and mobilisation for miscellaneous headache ) . In addition , evidence was identified on a large number of non-musculoskeletal conditions not previously considered ; most of this evidence was rated as inconclusive . Conclusions Overall , there was limited high quality evidence for the effectiveness of manual therapy . Most review ed evidence was of low to moderate quality and inconsistent due to substantial method ological and clinical diversity . Areas requiring further research are highlighted PURPOSE To describe the growth and content of the  prosthodontic  literature over the last 4 decades , to make a prognosis on its probable development in the coming 4 decades and to discuss changes in the content of the International Journal of Prosthodontics ( IJP ) from its start in 1988 to 2004 . METHODS MEDLINE was search ed for articles on prosthodontics published between 1966 and April 2004 . All volumes of IJP were examined with respect to type , subject area and geographic origin of articles . RESULTS Using the term " prosthodontics , " the MEDLINE search produced 66,600 hits . The proportion of clinical studies increased from 1 % during the first 10-year period to 13 % since 2001 . Articles on removable dentures decreased during the period review ed , whereas those on implant prosthodontics increased . R and omized controlled trials were rare and often of inadequate quality . Literature review s have become popular , but many do not follow current guidelines for systematic review s. A marked change in geographic origin of articles in IJP has occurred , with a decrease in material from North America and an increase in that from Europe and Asia . The Internet and open-access publishing will probably have a great impact on the future development of the prosthodontic literature . CONCLUSIONS Substantial changes have occurred in the prosthodontic literature between 1966 and 2004 , and they can be expected to continue with the rapid development of information technology and increased use of the Internet Scutellaria lateriflora is an herbal medicine with long-st and ing traditional use as a relaxing nervine . There has been controversy in the literature with regards to its efficacy , and this study was design ed to clarify its effectiveness in reducing anxiety , one of the phytotherapeutic indications . A double blind , placebo-controlled study of healthy subjects demonstrated noteworthy anxiolytic effects . The use of phytomedicines for the treatment of anxiety is review ed , as is the published literature on S. lateriflora and its putative toxicity
RESULTS The physiological effects of stretches may contribute to reducing discomfort and pain .
However , if other measures are not in place to remediate their causes , stretches may suppress awareness of risks , result ing in more debilitating injuries .
If inadequately performed , stretches may also cause or aggravate injuries .
The studies provided mixed findings , but demonstrated some beneficial effect of stretching in preventing work-related musculoskeletal disorders .
OBJECTIVE This article review ed the literature to clarify the physiological effects and benefits of , and misconceptions about , stretches used to reduce musculoskeletal disorders .