Search

News about violations of academic freedom have increased with the erosion of civil liberties and the decline of democratization. However, there is little empirical research on the political effects of academic freedom. There is also no consensus on the exact definition of the term. In this article, the meanings of academic freedom are approached through literature and practical advocacy work, and by presenting the indicator published in 2020 by the Varieties of Democracy database. As an example, we examine research results on the link between academic freedom and democracy in Africa, where the university institution has developed in the midst of rapid political changes. Based on interview material, we will focus on the experiences of scholars in Ghana, Cameroon, Kenya and Zimbabwe. Research data shows that academic freedom and higher education support democratic development far into the future. That is why they deserve long-term support through development cooperation.

To examine workload, thermal discomfort, and heat-related symptoms among healthcare workers (HCWs) in an Australian emergency department during the COVID-19 pandemic.A cross-sectional study design was employed among HCWs in an emergency department at a metropolitan hospital in Brisbane, Australia. Respondents provided demographic information including their self-reported age, sex, height, weight, role (e.g., doctor, nurse), and whether they wore PPE during their shift, rated as either Full PPE, Partial PPE, or usual uniform or scrubs. The workload of HCWs was assessed with the National Aeronautics and Space Administration's task load index (NASA-TLX). Thermal discomfort was evaluated using scales from the International Organisation for Standardisation. Responders rated their subjective heat illness using the Environmental Symptoms Questionnaire (ESQ-SHI).Fifty-nine HCWs completed the survey (27 male, 31 female). Overall workload from the NASA-TLX was 64.6 (IQR: 56.5-73.3) for doctors, 72.5 (IQR: 63.3-83.3) for nurses, and 66.7 (IQR: 58.3-74.17) for other staff, representing moderate to high ratings. Eighty-one percent reported thermal sensation to be slightly warm, warm, or hot, and 88% reported being uncomfortable, ranging from slightly to extremely. Ninety-seven percent reported at least one heat-strain symptom. More than 50% reported light-headedness or headache and approximately 30% reported feeling dizzy, faint, or weak.Emergency department HCWs experience thermal discomfort when wearing PPE. Combined with their workloads, HCWs experienced symptoms related to heat strain. Therefore, careful consideration should be given to managing heat strain among HCWs when wearing PPE in an Emergency Department. This article is protected by copyright. All rights reserved.

Increasingly, there is an attempt to minimize expression lines through esthetic procedures, and radiofrequency (RF) is one of the therapeutic modalities. This article aims to systematically review the literature on the different types of RF treatment in clinical trials and in variables related to the aging process. This systematic review included 21 articles that treated 354 people with different physical characteristics. The most used RF was the fractional followed by the non-ablative RF. There was a large discrepancy in relation to the types and parameters. A parameter that did not show so much divergence was the temperature, which was between 38°C and 44°C. The main temporary adverse reactions reported by the authors were as follows: discomfort, pain, erythema, hyperpigmentation, crusting, swelling, edema, and purple and acneic appearance of the skin. Finally, our study concluded that non-ablative and ablative RF was reported to rejuvenate and improve the features of skin in all skin types.

The analgesic role of PBMT for breastfeeding women with nipple pain is inconclusive. This study aimed to determine the efficacy of PBMT at 660 nm in postnatal women with nipple pain planning to exclusively breastfeed. A randomised, placebo-controlled clinical study was initiated at a tertiary hospital in Brisbane, Australia on the inpatient maternity wards from May 2020 to September 2020. Eligible participants were randomised into two groups, an intervention group receiving usual care and PBMT (Group A) and a control group receiving usual care and sham PBMT (Group B). Usual care involved consultation with a midwife and/or lactation consultant to assist with infant latching and breastfeeding positioning. PBMT (660 nm; 250 Hz; 17 mW; 0.5 cm2 spot size) was administered three times within 24 hours. Nipple pain was the primary outcome measure analysed using a Visual Analogue Scale (VAS). Quality of life (QoL) and the participants’ perceived efficacy of treatment were secondary outcome measures evaluated using the PROMIS Global Short Form and a combined 5-point Likert scale and thematic analysis, respectively. Due to the impact of COVID-19, only 10 participants were recruited. Compared to sham, three applications of PBMT at 660 nm provided no significant difference to participants’ nipple pain, QoL or perceived efficacy of treatment. Three key themes of PBMT treatment were simplicity, safety and support. This study was unable to demonstrate the impact of PBMT at 660 nm on relieving nipple pain due to low participant numbers. An adequately powered RCT with COVID-19 modifications, is recommended.

Aleysha K Martin,1 Theresa L Green,2 Alexandra L McCarthy,3 P Marcin Sowa,4 E-Liisa Laakso5,6 1Faculty of Medicine, Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia; 2School of Nursing, Midwifery and Social Work, The University of Queensland – MNHHS Surgical Treatment and Rehabilitation Service, Brisbane, QLD, Australia; 3School of Nursing, Midwifery and Social Work,  Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia; 4Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia; 5Allied Health, Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia; 6Menzies Health Institute Queensland, Gold Coast, AustraliaCorrespondence: Aleysha K Martin, Faculty of Medicine, Mater Research Institute – The University of Queensland, Level 2 Aubigny Place, Raymond Terrace, South Brisbane, QLD, 4101, Australia, Tel +61 457 993 248 ; +61 7 3163 2550, Email aleysha.martin@uq.net.auAbstract: One strategy to meet increasing consumer demand for healthcare services in the pandemic era has been to reorganize the healthcare workforce. This can be achieved by reorganizing healthcare teams, which are associated with improved workforce productivity and better patient outcomes. However, healthcare teams are described using numerous terminologies and labels, which has led to conceptual confusion for researchers and research users. In this paper, we explore the disparate nature of healthcare team terminology, ramifications of conceptual confusion, and we propose standardized terminology with synthesized definitions focused on characteristics of clinically based healthcare teams including unidisciplinary, multidisciplinary, interprofessional, and transdisciplinary teams.Keywords: teamwork, unidisciplinary, multidisciplinary, interprofessional, transdisciplinary

Objective: To assess whether remote application of photobiomodulation (PBM) is effective in reducing clinical signs of Parkinson's disease (PD). Background: PD is a progressive neurodegenerative disease for which there is no cure and few treatment options. There is a strong link between the microbiome-gut-brain axis and PD. PBM in animal models can reduce the signs of PD and protect the neurons from damage when applied directly to the head or to remote parts of the body. In a clinical study, PBM has been shown to improve clinical signs of PD for up to 1 year. Methods: Seven participants were treated with PBM to the abdomen and neck three times per week for 12 weeks. Participants were assessed for mobility, balance, cognition, fine motor skill, and sense of smell on enrolment, after 12 weeks of treatment in a clinic and after 33 weeks of home treatment. Results: A number of clinical signs of PD were shown to be improved by remote PBM treatment, including mobility, cognition, dynamic balance, spiral test, and sense of smell. Improvements were individual to the participant. Some improvements were lost for certain participants during at-home treatment, which coincided with a number of enforced coronavirus disease 2019 (COVID-19) pandemic lockdown periods. Conclusions: Remote application of PBM was shown to be an effective treatment for a number of clinical signs of PD, with some being maintained for 45 weeks, despite lockdown restrictions. Improvements in clinical signs were similar to those seen with the application of remote plus transcranial PBM treatment in a previous study. Clinical Trial Registration number: U1111-1205-2035.

This paper analyses faculty experiences tackling global knowledge asymmetries by examining the decolonisation of higher education in Africa in the aftermath of the 2015 ‘Rhodes Must Fall’ student uprising. An overview of the literature reveals a rich debate on defining ‘decolonisation’, starting from a critique of Eurocentrism to propositions of alternate epistemologies. These debates are dominated by the Global North and South Africa and their experiences of curriculum reform. Our focus is on the experiences of political scientists in Botswana, Ghana, Kenya, and Zimbabwe. These countries share the same Anglophone political science traditions but represent different political trajectories that constitute a significant condition for the discipline. The 26 political scientists we interviewed acted toward increasing local content and perspectives in their teaching, as promoted in the official strategies of the universities. They noted that what was happening in lecture halls was most important. The academic decolonisation debate appeared overambitious or even as patronising to them in their own political context. National politics affected the thematic focus of the discipline both as far as research topics and students’ employment opportunities were concerned. Although university bureaucracies were slow to respond to proposed curricula changes, new programmes were approved if there was a market-based demand for them. International programs tended to be approved fastest. Political economy of higher education plays a role: dependency on foreign funding, limited national resources to conduct research and produce publications vis-à-vis international competition, and national quality assurance standards appeared to be most critical constraints for decolonising the curriculum.

Parkinson’s disease is a progressive neurodegenerative disease with clinical signs and symptoms that deteriorate over time. We have previously demonstrated that a combination of transcranial and remote photobiomodulation treatment has the potential to improve some clinical signs of Parkinson’s disease for up to one-year. The objective of the current study was to assess the effectiveness of continued home photobiomodulation treatment over a three-year period. Eight of the original twelve participants returned for reassessment at 2 years and six at 3 years. Participants were assessed for mobility, fine motor control, balance, and cognition. Median values for mobility and cognition continued to improve to 2 years and slightly declined to 3-years although not to pre-treatment levels. Individual participants typically improved in some outcome measures to 2-years and some participants continued to improve to 3-years. Cognition was the most sustained outcome improvement and static balance the least. Two participants who discontinued treatment after 1 year showed a decline in outcome measures. No negative side-effects of the treatment were reported. In conclusion, results suggested that at-home photobiomodulation treatment was effective to maintain improvements in clinical signs and symptoms of Parkinson’s disease for as long as treatment continued. The results of this study warrant a larger prospective randomized trial.

A significant element in the EU co-operation with Eastern Africa relates to the EU’s aspirations to support democracy worldwide. The Treaty of Nice of the EU (2001) explicitly stipulated that promoting human rights and freedoms should be part of all EU development and other co-operation with developing countries. This principle gained prominence and an explicit codification in the Cotonou Agreement between the EU and the African, Caribbean and Pacific states (ACP) between 2000 and 2022. The year 2022, when a new agreement is to be signed, is a good time to look back at the application of these principles. Has the EU been able to support democracy in Eastern Africa? To this end, this chapter pays attention to both positive and negative democratisation instruments. The positive instruments like the election observation missions (EOM) appear to be the public image of EU democracy support before everything else. Economic sanctions, particularly smart sanctions and suspension of development aid, are the most important negative instruments. Together, these instruments have become an increasingly important part of the AU and EU’s attempts to prevent the erosion of democratic institutions in its Eastern African partner countries.

Background Transdisciplinary approaches can streamline processes and build workforce capacity by blurring traditional responsibilities and integrating aspects of care. Emerging evidence shows transdisciplinary approaches can improve time-efficiency, quality of care and cost-effectiveness across various healthcare settings, however no empirical study is based on an acute stroke unit. Methods The SPIRIT checklist was used to guide the content of the research protocol. The study is a pragmatic pre−/post- mixed methods four-phase study with a 3-month follow up, based at the Mater Hospital Brisbane. Participants experiencing stroke symptoms will be recruited as they are admitted to the acute stroke unit. Patients presenting with mild stroke symptoms or Transient Ischaemic Attack will be allocated to Phase 1 (baseline) or Phase 2 (implementation), while patients presenting with moderate to severe stroke symptoms will be allocated to Phase 3 (baseline) or Phase 4 (implementation). Participants in baseline Phases 1 and 3 will receive standard allied health assessment, while participants in implementation Phases 2 and 4 will receive the novel transdisciplinary assessment. For the primary aim, allied health professionals will time their assessments to evaluate time taken to administer a novel transdisciplinary assessment, compared to usual discipline-specific assessments. Non-inferiority of the novel transdisciplinary assessment will also be explored in terms of patient safety, compliance to national standards, use of the assessment, and stakeholder perceptions. A retrospective medical record audit, staff focus group, patient/staff surveys, and patient phone interviews at 3-months will be completed. Quantitative results will be estimated using general linear and logistic regression models in Stata 15.1. Qualitative results will be analysed using frequency counts and NVivo software. An economic evaluation will be performed using three scopes including the allied health assessment, hospital admission, and patient outcomes at 3-months. Discussion When designing the study, pragmatic factors related to staff willingness to be involved, patient safety, and existing clinical pathways/processes were considered. To address those factors, a co-design approach was taken, resulting in staff buy-in, clinically relevant outcome measures, and the pre−/post- four-phase study design. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12621000380897. Registered 06 April 2021 - retrospectively registered, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381339&isReview=true

Background: Intravenous blood irradiation with light is purported to reduce blood sugar levels in people with diabetes mellitus (DM). Transcutaneous light emitting devices are marketed for use in m...

The objectives of this work were to (i) describe upper-body symptoms post-breast cancer; (ii) explore the relationship between symptoms and upper-body function, breast cancer-related lymphoedema (BCRL), physical activity levels, and quality of life; and (iii) determine whether the presence of upper-body symptoms predicts BCRL. Nine symptoms, upper-body function, lymphoedema, physical activity, and quality of life were assessed in women with invasive breast cancer at baseline (2- to 9-months post-diagnosis; n = 2442), and at 2- and 7-years post-diagnosis. Mann–Whitney tests, unpaired t-tests, and chi-squared analyses were used to assess cross-sectional relationships, while regression analyses were used to assess the predictive relationships between symptoms at baseline, and BCRL at 2- and 7-years post-diagnosis. Symptoms are common post-breast cancer and persist at 2- and 7-years post-diagnosis. Approximately two in three women, and one in three women, reported >2 symptoms of at least mild severity, and of at least moderate severity, respectively. The presence of symptoms is associated with poorer upper-body function, and lower physical activity levels and quality of life. One or more symptoms of at least moderate severity increases the odds of developing BCRL by 2- and 7-years post-diagnosis (p < 0.05). Consequently, improved monitoring and management of symptoms following breast cancer have the potential to improve health outcomes.

Background Parkinson’s disease (PD) is a progressive neurodegenerative disease with no cure and few treatment options. Its incidence is increasing due to aging populations, longer disease duration and potentially as a COVID-19 sequela. Photobiomodulation (PBM) has been successfully used in animal models to reduce the signs of PD and to protect dopaminergic neurons. Objective To assess the effectiveness of PBM to mitigate clinical signs of PD in a prospective proof-of-concept study, using a combination of transcranial and remote treatment, in order to inform on best practice for a larger randomized placebo-controlled trial (RCT). Methods Twelve participants with idiopathic PD were recruited. Six were randomly chosen to begin 12 weeks of transcranial, intranasal, neck and abdominal PBM. The remaining 6 were waitlisted for 14 weeks before commencing the same treatment. After the 12-week treatment period, all participants were supplied with PBM devices to continue home treatment. Participants were assessed for mobility, fine motor skills, balance and cognition before treatment began, after 4 weeks of treatment, after 12 weeks of treatment and the end of the home treatment period. A Wilcoxon Signed Ranks test was used to assess treatment effectiveness at a significance level of 5%. Results Measures of mobility, cognition, dynamic balance and fine motor skill were significantly improved (p Conclusions PBM was shown to be a safe and potentially effective treatment for a range of clinical signs and symptoms of PD. Improvements were maintained for as long as treatment continued, for up to one year in a neurodegenerative disease where decline is typically expected. Home treatment of PD by the person themselves or with the help of a carer might be an effective therapy option. The results of this study indicate that a large RCT is warranted. Trial registration Australian New Zealand Clinical Trials Registry, registration number: ACTRN12618000038291p, registered on 12/01/2018.

Brain cancer and leukemia are the most common cancers diagnosed in the pediatric population and are often treated with lifesaving chemotherapy. However, chemotherapy causes severe adverse effects and chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting and debilitating side effect. CIPN can greatly impair quality of life and increases morbidity of pediatric patients with cancer, with the accompanying symptoms frequently remaining underdiagnosed. Little is known about the incidence of CIPN, its impact on the pediatric population, and the underlying pathophysiological mechanisms, as most existing information stems from studies in animal models or adult cancer patients. Herein, we aim to provide an understanding of CIPN in the pediatric population and focus on the 6 main substance groups that frequently cause CIPN, namely the vinca alkaloids (vincristine), platinum-based antineoplastics (cisplatin, carboplatin and oxaliplatin), taxanes (paclitaxel and docetaxel), epothilones (ixabepilone), proteasome inhibitors (bortezomib) and immunomodulatory drugs (thalidomide). We discuss the clinical manifestations, assessments and diagnostic tools, as well as risk factors, pathophysiological processes and current pharmacological and non-pharmacological approaches for the prevention and treatment of CIPN.

Background: Numerous mechanisms, mostly molecular, have been tested and proposed for photobiomodulation. Photobiomodulation is finding a niche in the treatment of conditions that have no gold-standard treatment or only partially effective pharmacological treatment. Many chronic conditions are characterised by symptoms for which there is no cure or control and for which pharmaceuticals may add to the disease burden through side effects. To add quality to life, alternate methods of symptom management need to be identified. Objective: To demonstrate how photobiomodulation, through its numerous mechanisms, may offer an adjunctive therapy in inflammatory bowel disease. Rather than considering only molecular mechanisms, we take an overarching biopsychosocial approach to propose how existing evidence gleaned from other studies may underpin a treatment strategy of potential benefit to people with Crohn’s disease and ulcerative colitis. Main findings: In this paper, the authors have proposed the perspective that photobiomodulation, through an integrated effect on the neuroimmune and microbiome–gut–brain axis, has the potential to be effective in managing the fatigue, pain, and depressive symptoms of people with inflammatory bowel disease.

In this article, complexities in the relationship between academic mobility and freedom evident in Africa showing high levels of mobility but frustrations with the realisation of academic freedom a...

Introduction: High-intensity laser therapy (HILT) has been used more recently in the therapeutic protocols of pain managements. Adding therapeutic interventions to laser therapy is usual in clinical practice. This study aimed to evaluate the efficacy of HILT and beneficial effects of adding cointerventions to HILT in musculoskeletal pain management. Methods: The following databases were searched up to August 2018: Medline, PubMed, EMBASE, Cochrane, Google Scholar, Springer and ISI. The keywords of pain, HILT, high power laser therapy, laser therapy, photobiomodulation, physical therapy and rehabilitation were searched. The quality of the articles was assessed using the PEDro scale. The primary measure was pain severity expected to be reported in all studies. Effect size was calculated as standardized mean differences divided by the standard deviation of either the treatment or other group. Results: Initially 52 potential studies were found. Eighteen of these studies were excluded based on title and abstract. The full text of 34 remaining articles was screened and 15 of the studies were excluded. All included studies had high quality (PEDro ≥7). Approximately, 94% of included articles (n=18) revealed positive effects of HILT on pain. The effect sizes for HILT and placebo/comparator groups were 0.9-9.11 and 0.21-11.22 respectively. Also, the differences of effect size between two groups were between 0.03 to 5.85. Conclusion: It is early to determine that HILT may be an effective non-invasive agent in the management of musculoskeletal pain, as few studies have shown its clinical efficacy. Adding related co-interventions to HILT may enhance the beneficial effects of laser therapy. The variability of the study methods and outcomes suggests that further long-term follow-up, randomized controlled clinical trials with appropriate methodological design are needed regarding the effectiveness of HILT on pain.

Parkinson's disease (PD) is one of the most common neurodegenerative disorders, and is associated with prominent motor deficits. However, neurocognitive impairment is also a common clinical feature that can contribute greatly to the overall disease burden. In the current study, a meta-analysis was conducted to gain a clearer understanding of how PD affects one of the most functionally important domains of cognition: prospection. The results indicate that, relative to controls, PD is associated with a large deficit in the capacity to engage in planning (g = -0.81, K = 25) and a moderate-sized deficit in prospective memory (g = -0.57, K = 16). Sub-analyses indicated that these deficits are evident for both time and event-based prospective memory, as well as for prospective memory tasks that have relatively limited ecological validity. Significant impairment was also evident for both medicated and non-medicated PD sub-groups, but for planning, these deficits were substantially greater in the unmedicated sub-group. The theoretical and practical implications of these findings are discussed.

Public policy is a window into social sciences’ evolution and the multidisciplinary foundation of policy studies globally, particularly in African universities and research organisations. Training in policymaking was useful for the colonial rule, but specific degree programs became popular only after independence and, more recently, with acute needs in public service delivery. In research, the disciplinary scope of social sciences has widened from anthropology to political economy, development and political science. While the increasing local research competence diversified knowledge production, the underlying academic traditions were not monolithic either. Pluralism of the approaches and links to policymaking-built capacity for ambitious theoretical and critical research. Governments and international development cooperation agencies’ active role in public policy research’s institutionalisation has facilitated besides conditioning its content. The participatory approach has brought the voice of intended target communities to the social research work, enhancing policy planning and implementation. Although freedom of research remains a concern, the instrumental value of public policy education for the governments has remained central.

Palpation remains essential for evaluating lymphoedema to detect subtle changes that may indicate progression. As palpation sense is not quantifiable, this study investigates the utility of ultrasound elastography to quantify stiffness of lymphoedema tissue and explore the influence of the pitting test on tissue stiffness. Fifteen women with unilateral arm lymphoedema were scanned using a Siemens S3000 Acuson ultrasound (Siemens, Germany) with 18 MHz and 9 MHz linear transducers to assess tissue structure and tissue stiffness with Acoustic Radiation Force Impulse elastography. Ninety sites were assessed, three on each of the lymphoedema-affected and contralateral unaffected arms. A subgroup of seven lymphoedema-affected sites included additional elastography imaging after a 60-s pitting test. Dermal tissue stiffness was greater than subcutaneous tissue stiffness regardless of the presence of pathology (p < 0.001). Lymphoedematous tissue exhibited a higher dermal to subcutaneous tissue stiffness ratio than contralateral sites (p = 0.005). Subgroup analysis indicated that the pitting test reduces dermal tissue stiffness (p = 0.018) and may alter the stiffness of the subcutaneous tissue layer. Elastography demonstrates potential as a complement to lymphoedema palpation assessment. The novel pre-test and post-pitting elastography imaging protocol yielded information representative of lymphoedema tissue characteristics that could not be ascertained from pre-test elastography images alone.

Objective: Stroke-related social cognitive impairment is now well established, but studies vary considerably in the nature and magnitude of the deficits reported, as well as whether there are potential areas of preservation. Because these discrepancies may reflect clinical heterogeneity between the contributing research participants, this study provides the first concurrent assessment of all four core social cognitive domains (theory of mind, emotion perception, social behavior, and affective empathy) in the same stroke cohort. A secondary goal was to test whether the degree of social cognitive impairment varied as a function of the tasks’ ecological validity, on the basis that tasks with greater realism may provide a better indication of the implications of any stroke-related difficulties for everyday social interactions. Method: Participants included 35 people with first-time, ischemic or hemorrhagic stroke (as confirmed via MRI or CT) aged between 29 and 87 years (M = 64.69; SD = 12.92), and 35 controls matched for age, sex, and years of education. All participants completed a comprehensive social cognitive test battery as well as measures to broadly characterize neurocognitive function and well-being. Results: Relative to controls, affective empathy was selectively preserved (d = 0.02), but stroke-related deficits were identified for theory of mind (d = –0.42), emotion perception (d = –0.48), and social behavior (d = –0.59). The degree of social cognitive impairment did not vary as a function of the tasks’ ecological validity. Conclusions: These data enhance understanding of stroke-related social cognitive impairment and inform the development of tailored, evidence-based rehabilitation efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Key Points—Question: The primary aim of the present study was to investigate the sensitivity of four core domains of social cognitive function (theory of mind, emotion perception, social behavior, and affective empathy) to stroke. Findings: People with stroke exhibited significant difficulties with theory of mind, emotion perception, and social behavior but the capacity for affective empathy was intact. Importance: Given the critical role that social cognitive function plays in social functioning and broader well-being, these results reinforce the importance of assessing social cognition in survivors of stroke to guide rehabilitative efforts. Next Steps: Future work should examine the nature and real-world implications of social behavioral impairment in stroke survivors, and supplement self-report measures of affective empathy with proxy-rated and objective performance-based measures. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Shared experiences but diversified developments make Africa an interesting region in which to investigate the impact of education on democracy, and the role of academic freedom in this impact. As building expertise takes time, we focus on the causality between past experience of academic freedom and electoral democracy. Our theory is that independent experts advocating free and fair elections are acclaimed, which makes rigging elections a costly strategy for rulers. Using the Varieties of Democracy (V-Dem) index of Academic Freedom, and the Generalized method of moments (GMM) technique to estimate a dynamic panel model, we find a positive impact of preceding academic freedom on the quality of elections after the Post-Cold war democratic transitions. The result is robust when we check reverse causality and country-specific effects such as the initial level of democracy or dependence on oil exportation. The analysis is robust to indicators measuring democracy by accountability of the executive and Polity2 and Freedom House Indices as alternatives to V-Dem measures of democracy. We discuss the observed heterogeneity of countries showing a counterintuitive relationship. The study highlights the significance of scholars as a channel through which education supports democracy.

This narrative review analyses the Australian Guideline (2018) for the treatment of knee osteoarthritis (KOA) developed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The Guideline recommended against the use low-level laser therapy (LLLT). Why this conclusion was reached is discussed in this review in the context of evidence provided in other systematic reviews, the latest of which was published in 2019 and which provided strong support for LLLT for knee OA. We evaluated the reference list cited for the recommendation “against” LLLT and compared this with reference lists of systematic reviews and studies published before and after the publication date of the Guideline. Eight randomised controlled trials (RCTs) of LLLT were cited in the Guideline the latest of which was published in 2012. There were seventeen additional RCTs, five of which together with one systematic review were located in the year of publication, 2018. The most recent systematic review in 2019 included 22 RCTs in its analysis. Discordance with the levels of evidence and recommendations was identified. Although GRADE methodology is said to be robust for systematically evaluating evidence and developing recommendations, many studies were not identified in the Guideline. In contrast, the latest systematic review and meta-analysis provides robust evidence for supporting the use of LLLT in knee OA. The conflict between guidelines based on opinion and evidence based on meta-analysis is highlighted. Given the totality of the evidence, we recommend that the Australian Guideline should be updated immediately to reflect a “for” recommendation.

Objective: To determine the potential efficacy and feasibility of photobiomodulation therapy (PBMT) before and after knee arthroplasty (KA) surgery. Background: Total knee replacements (total knee ...

The pandemic spread of coronavirus disease 2019 (COVID-19) has driven efforts to address the global threat to public health and there is increasing pressure to exploit interventions to manage the pneumonic inflammation manifested in this disease. Ultra-shortwave diathermy (USWD) is proposed by some rehabilitation professions in China, purportedly to minimise pneumonic inflammation. However, treatment of any symptomatic pneumonia should be evidence-based. There is no valid evidence, published in English, which establishes any benefit of USWD in pulmonary conditions, let alone COVID-19. The need for rigorous research and evidence-based practice is discussed in this article. Novel interventions require a solid physiological basis and must undergo rigorous testing prior to clinical adoption even during a pandemic. We are of the view that deployment of USWD in patients with COVID-19 must be prudent and supported by a logical scientific basis.

Objective: Individuals with traumatic brain injury (TBI) recover functional independence to varying degrees due to numerous factors. However, plateaued recovery often initiates between 6-12 months. We investigated whether introducing slacklining, a whole-body interactive balance approach, would provide further improvement in a chronic severe-TBI patient. Methods: A retrospective pragmatic single case-report on a 40-year-old woman two-years post severe-TBI working part-time. Global-functional status had plateaued with ongoing affected balance, left-sided weakness, and fatigue. Slacklining was added to an existing daily multi-disciplinary, self-managed rehabilitation program initially ‘ad-hoc’ and self-managed over nine weeks (Phase-1); then formalized therapist-directed over four weeks (Phase-2). The primary outcome was global-functional status; secondary was the 4-stage 20-step slackline graded-progression, and fatigue; tertiary was balance. All outcomes were reported at slacklining initiation (baseline) and Phase-1 and Phase-2 completion. Findings/ Results: Improvements were found from baseline till Phase-1 completion, and subsequently Phase-2 completion. Global-functional status increased 15% in Phase-1 (baseline=22% to completion=37%); and 18% in Phase-2 (completion=55%); slackline ability from baseline=step-1 to Phase-1 completion=step-6 then Phase-2 completion=step-10; balance duration increased 1.5-fold in Phase-1 and 3-6-fold in Phase-2; and fatigue reduced 22% overall baseline=63% to Phase-2=41% (no Phase-1 measure). Balance, confidence, and function were all self-reported as improved from baseline to program completion. Conclusions: The findings provide evidence for using slacklining to overcome plateaued recovery during rehabilitation of a severe-TBI patient; and imply that supervised programs have greater impact than un-supervised. Further research is required to determine slacklining’s efficacy for TBI, and potentially concussion, through dose, frequency, and intensity.

Muscle fatigue is a process influenced by several mechanisms such as concentration of metabolic substrates, changes in blood flow, and increases in reactive oxygen species that impair contractile muscle function. In this context, photobiomodulation has been investigated for preventing muscle fatigue, with reports of positive effects on muscle performance. This study aimed to investigate the effects of 904-nm LASER photobiomodulation on rectus femoris muscle performance in young women. Eighteen young women participated in a randomized, participant and assessor-blinded crossover trial with placebo control. Active LASER (904 nm, 60 mW, 250 Hz, 3.6 J per diode, total dose of 129.6 J) intervention was applied prior to an isokinetic fatigue protocol consisting of a set of 60 concentric quadricep contractions at a constant dynamometer angular velocity of 180°/s. Compared to placebo, LASER photobiomodulation significantly reduced muscle fatigue across a range of indicators including reduced ratings of perceived exertion (P = 0.0139), and increased electromyographic fatigue index (EFI) (P = 0.005). The isokinetic dynamometer performance analysis demonstrated that LASER photobiomodulation increased peak torque (P = 0.04), time to peak torque (P = 0.042), total work (P = 0.032), average power (P = 0.0007), and average peak torque (P = 0.019) between both experimental conditions. No significant difference was observed for work fatigue index (P = 0.29) or for lactate concentration (P > 0.05). Photobiomodulation at 904 nm was effective in reducing fatigue levels and increasing muscle performance in young active women but had no effect on lactate levels.

To investigate the effect of "breathing control" on sonographic diaphragmatic excursion.A prospective, randomized, assessor-blinded study design involving 20 physiotherapy students; ten with knowledge of the breathing control technique (Group BC) and ten without (Group CON). All participants were asked to perform a Chester step test. Group BC performed BC, while Group CON adopted their own breathing pattern during recovery after the step test. Respiratory rate and sonographic parameters of the diaphragm including diaphragmatic excursion, speed of diaphragmatic contraction (slope of contraction), and inspiratory time were recorded before and after the step test.All baseline data were similar for both groups except age. Respiratory rate at 1 min post-step test was higher in Group CON (24.6±4.9 bpm) compared to Group BC (15.6 ± 3.8 bpm) (p0.001). Post-step test sonographic evaluation demonstrated an increase in diaphragmatic excursion with a significant time and group interaction (FPost-exercise diaphragmatic excursion was higher in participants applying BC. Non-invasive ultrasonography is able to promote objective evaluation of the relationship between breathing techniques and diaphragmatic function.

Carpal tunnel syndrome (CTS) is a common peripheral nerve disorder of the wrist. Nonsurgical treatments e.g. laser therapy may cause potential beneficial effects.To compare the dose dependent effects of low level laser therapy (LLLT) and high intensity laser therapy (HILT) on pain and electrophysiology studies in patients with CTS.Double-blind randomized controlled trial.Outpatient physiotherapy clinic.Ninety-eight participants with CTS, aged between 20 to 60 years, were randomly assigned to five groups.All participants undertook four standard exercises, with one group serving as exercise-only controls. Patients were randomly allocated to either high or low fluence LLLT or high or low fluence HILT received over 5 sessions. All patients were assessed by visual analogue scale, median compound muscle action potential (CMAP) and sensory nerve conduction studies before and 3 weeks after the interventions.VAS was significantly lower in all groups after 3 weeks (P0.05). CMAP latency decreased in all groups. The interaction of group and time (5×2) was significant for pain (P0.001), the latency of CMAP (P=0.001) and CMAP amplitude (P=0.02). The interaction of group and time was not significant for the CMAP conduction velocity, sensory nerve latency and amplitude (P0.05).HILT with a power of 1.6 W and low fluence of 8 J/cmLLLT and HILT in conjunction with exercise program are effective in reducing pain and improving median motor nerve conduction studies of the patients with CTS. It seems that high power and low fluence laser therapy is better than LLLT and exercise interventions to treat these patients.

Electoral violence in Africa has garnered a lot of attention in research on African politics. Violence can be the result of manipulation of the electoral process or a reaction to that manipulation. While there is an agreement to distinguish it from the wider political violence by its timing with elections and motivation to influence their outcome, the analysis of its types, content, and impacts varies. There are different assessments of whether repetition of elections reduces violence or not. Elections in Africa are more often marred with violence than elections in other continents, but there is lots of variation between African countries, within countries, and even from one election to another. In addition to well-judged use and development of the existing datasets, qualitative methods and case studies are also needed. Much of the literature combines both approaches. In the analysis of the factors, causes, and contexts of electoral violence, researchers utilize distinct frameworks: emphasizing historical experiences of violence, patrimonial rule and the role of the “big man,” political economy of greed and grievance, as well as weak institutions and rule of law. All of them point to intensive competition for state power. Preelection violence often relates to the strategies of the government forces and their supporters using their powers to manipulate the process, while post-election riots typically follow in the form of spontaneous reactions among the ranks of the losing opposition. Elections are not a cause of the intensive power competition but a way to organize it. Thus, electoral violence is not an anomaly but rather a manifestation of the ongoing struggle for free and fair elections. It will be an issue for researchers and practitioners alike in the future as well.

Graduate employability is important to students, employers and universities. Typically, personal and professional attributes that enhance employability are addressed directly throughout the curriculum through a variety of learning activities from the classroom to clinical placements. Employability, however, also includes an ability to communicate those attributes to potential employers. In this chapter, we describe an approach to assist students to more effectively communicate their graduate attributes through the written and interview components of applying for employment. The aim of this project was to develop and evaluate a series of post-placement activities, including mock job applications and simulated interviews designed to enhance the employability of physiotherapy graduates. In brief, 47 final-year physiotherapy students were recruited to participate in a series of voluntary learning activities. Each student wrote an application for a hypothetical new graduate position in one of four employment sectors. A sector representative evaluated each application and provided written feedback to the applicant and a score to the investigators. Students then underwent training to improve the content and presentation of their applications, before subsequently applying for another position in a different sector and undergoing a mock interview. Sector representatives scored the written application and interviews and provided further feedback to the students.

Students commencing clinical placements often have difficulty applying their knowledge to produce meaningful clinical interactions. Patient-centred simulation can provide a bridge to clinical practice but can be expensive. This chapter describes the development and evaluation of a simulated environment integrating patient-centred simulation with an online adaptive learning platform to assist students to transition from classroom to placement. Student confidence increased significantly from pre- to post-simulation in all 12 areas that were surveyed from 3.4/6 (2.9–4.2) to 3.9/6 (3.7-4.5). Ninety-one percent of students felt better prepared for placement. The activity was not assessable and students rated this aspect highly for engagement and efficacy of learning. Student marks on their subsequent clinical placement were significantly higher for professional behavior, communication, and evidence-based practice compared with previous cohorts of students who had not undertaken a similar program.