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Biomedical subjects

Steve Milanese

Publications and source records attributed to Steve Milanese.

4 recordsLinked to original sources

Longitudinal investigation of low back pain in Australian adolescents: a five-year study.

BACKGROUND AND PURPOSE: Adolescent spinal pain is a worldwide concern, with few longitudinal studies to validate concerns that an increasing number of adolescents report pain with age. The aim of the present study was to track reports of low back pain (LBP) in adolescents each year over a five-year period (between the ages of 13 and 17 years). METHOD: A longitudinal, observational, repeated-measures study, commencing in 1999. We followed a group of South Australian students throughout five years of high schooling, reporting on prevalence of recent low back pain each year. RESULTS: In 1999, data were collected from 434 13-year-olds (82.5% eligible students). In the subsequent four years, the response rate from the 1999 sample was, respectively, 72.2%, 69.1%, 56.2% and 40.1%. A significant increasing prevalence of recent LBP was reported for girls and boys. The odds of girls reporting recent LBP in the final study year (fifth year) compared with the first year was 4.4 (95% CI 1.9-10.1),for boys 1.6 (95% CI 0.7-3.7). New cases of girls' recent LBP decreased consistently over the study (90% in 2000, 46.1% in 2001, 42.1% in 2002 and 33% in 2003). New boys' cases decreased in the second and third study years (85% in 2000, 45% in 2001) then increased (45.8% in 2002, 63.6% in 2003), suggesting less established patterns of occurrence. CONCLUSIONS: New cases of LBP reflected a decreasing percentage of total LBP reports over each study year for girls (suggesting increasing consistency of LBP occurrence with age). A different pattern was observed for boys, with a reversal of the downward trend after age 15 years, showing an increased percentage of LBP reports that reflected new cases in the final two study years.

Adolescent↗

Teaching Filipino physiotherapists on-shore: an Australian-Filipino collaborative postgraduate health education initiative.

INTRODUCTION: This paper outlines a collaborative, cross-national educational initiative, commenced in 2001, in which an Australian university provided clinical and research education assistance to a Filipino University. The aim was to establish the first Filipino Master of Science in Physical Therapy program that would train physiotherapists in their home country using best available content and teaching expertise. PROCESS: Principles of quality transnational education underpinned the program design and contractual agreements. Australian educational input was tailored to local constraints to ensure efficient and effective delivery of high quality, relevant material. Approximately 60% of the inaugural program was delivered by Australian educators in one-week intensive courses on-shore in the Philippines, using local facilities and case-scenarios. Follow-up support and evaluation were provided by video, email, written workbooks and assignments once these educators returned to Australia. Filipino graduates, who were competent with course content, taught the remaining subjects. In line with an aim of empowering Filipino graduates to assume responsibility for teaching all aspects of the program by 2006, the Australian educators are now teaching less than 25% of the course content to subsequent student cohorts. After 2006, they will provide mentorship only to the program. RESULTS: In 2003, 12 students in the first cohort graduated with Master of Science in Physical Therapy from the University of Santo Tomas (UST). Twenty-four students subsequently enrolled in the second cohort (commenced 2003) and 21 students into the third cohort (commenced 2004). Six of the inaugural graduate cohort are currently acting as tutors for the Australian educators and will assume full teaching roles in 2006. Comparison of feedback from student evaluations at UST indicates significant improvements in teaching quality for the graduates from the inaugural program. Research activity and publications have also increased as a result of completion of the program. DISCUSSION: Such a cross-institutional, cross-national program has not been described previously for physiotherapy, and no other similar health program (for nursing) evaluated the educational processes in the manner used in this program. The program met its aims and has produced sustainable educational outcomes and outputs. CONCLUSION: Future scholarly activities between the two institutions include extension of postgraduate training to other health disciplines, cross-institutional PhD student enrollments and collaborative research.

Australia↗

Adolescent standing postural response to backpack loads: a randomised controlled experimental study.

BACKGROUND: Backpack loads produce changes in standing posture when compared with unloaded posture. Although 'poor' unloaded standing posture has been related to spinal pain, there is little evidence of whether, and how much, exposure to posterior load produces injurious effects on spinal tissue. The objective of this study was to describe the effect on adolescent sagittal plane standing posture of different loads and positions of a common design of school backpack. The underlying study aim was to test the appropriateness of two adult 'rules-of-thumb'-that for postural efficiency, backpacks should be worn high on the spine, and loads should be limited to 10% of body weight. METHOD: A randomised controlled experimental study was conducted on 250 adolescents (12-18 years), randomly selected from five South Australian metropolitan high schools. Sagittal view anatomical points were marked on head, neck, shoulder, hip, thigh, knee and ankle. There were nine experimental conditions: combinations of backpack loads (3, 5 or 10% of body weight) and positions (backpack centred at T7, T12 or L3). Sagittal plane photographs were taken of unloaded standing posture (baseline), and standing posture under the experimental conditions. Posture was quantified from the x (horizontal) coordinate of each anatomical point under each experimental condition. Differences in postural response were described, and differences between conditions were determined using Analysis of Variance models. RESULTS: Neither age nor gender was a significant factor when comparing postural response to backpack loads or conditions. Backpacks positioned at T7 produced the largest forward (horizontal) displacement at all the anatomical points. The horizontal position of all anatomical points increased linearly with load. CONCLUSION: There is evidence refuting the 'rule-of-thumb' to carry the backpack high on the back. Typical school backpacks should be positioned with the centre at waist or hip level. There is no evidence for the 10% body weight limit.

Clinical Trial↗

Non-steroidal anti-inflammatory drugs (NSAIDs): physiotherapists' use, knowledge and attitudes.

This paper reports on a survey regarding physiotherapists' knowledge, use and attitudes to non-steroidal anti-inflammatory drugs (NSAIDs), some of which have recently been re-scheduled to non-prescription dispensing. A written survey instrument was developed and administered to 750 physiotherapists in South Australia, Tasmania and the Australian Capital Territory (50% of the registered physiotherapists). Responses were received from 285 physiotherapists. The survey identified opportunities for patient misuse and misadventures with NSAIDs in conjunction with physiotherapy management. Differences in physiotherapist understanding of the dosage and actions of oral and topic administrations of NSAIDs were highlighted, as were the moral and ethical responsibilities of physiotherapists to patients considering taking NSAIDs. The study identified the need for regular professional updates on quality use of NSAIDs.

Anti-Inflammatory Agents, Non-Steroidal↗