CRD 42014009964. [Synnott A, O'Keeffe M, Bunzli S, Dankaerts W, O'Sullivan P, O'Sullivan K (2015) Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery: a systematic review.Journal of Physiotherapy61: 68-76].

Physiotherapists expressed confidence in their capacity and skill set to manage the biopsychosocial dimensions of chronic low back pain after CFT training, and identified a clear role for including these skills within the physiotherapy profession. Despite this, further clinical trials are needed to justify the time and cost of training, so that intensive CFT training may be made more readily accessible to clinicians, which to date has not been the case. [Synnott A, O'Keeffe M, Bunzli S, Dankaerts W, O'Sullivan P, Robinson K, O'Sullivan K (2016) Physiotherapists report improved understanding of and attitude toward the cognitive, psychological and social dimensions of chronic low back pain after Cognitive Functional Therapy training: a qualitative study.Journal of Physiotherapy62: 215-221].

Dynamic sitting approaches have been advocated to increase seated energy expenditure with the view of lessening the sedentary nature of the task. This study compared energy expenditure (EE) and overall body discomfort on a novel dynamic chair with a standard office chair. Fifteen pain-free participants completed a DVD viewing task on both chairs in a randomised order. Energy expenditure and discomfort were collected simultaneously. Linear mixed models were used to analyse steady-state EE recorded on each of the chairs. Differences in discomfort were analysed using Wilkoxon Signed Rank Tests. Sitting on the novel dynamic chair significantly (p = 0.005) increased energy expenditure compared to a standard office chair. The discomfort experienced was mild overall, but was significantly greater on the dynamic chair (p = 0.004). Whilst the EE was seen to be significantly higher on the dynamic chair, the MET values are still below 1.5 METS. Thus, the use of a dynamic chair does not seem to be the most effective measure to prevent sedentary behaviour. Practitioner Summary: Sitting on a dynamic chair increased energy expenditure compared to sitting on a standard office chair among pain-free participants. Whilst the EE was seen to be significantly higher on the dynamic chair, the MET values are still below 1.5 METS (low level EE).

The effect of changing the composition of the carrier gas from 66% nitrous oxide in oxygen to 100% oxygen was examined in three halothane vaporizers (Fluotec Mk 3, Drager Vapor 19 and Abingdon halothane vaporizer). All showed a transient increase in output following the discontinuation of the nitrous oxide. The effect was minor (2-8% of indicated output) and short-lived (1-4 min) at the fresh gas flows used. The steady-state output of the vaporizers, once the transient response was over, was found to be lower with 100% oxygen as carrier gas than it had been with 66% nitrous oxide in oxygen. The difference was minor in the case of the Drager Vapor 19 (1% of indicated output) and Fluotec Mk 3 (5% of indicated output), but greater in the case of the Abingdon (15% of indicated output).

SummaryThe mathematical relationship between peak ventilator breathing system pressure displayed on the digital meter of

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The ventilatory effects of halothane in eight children were compared with those of isoflurane in eight children and enflurane in six children. All studies were completed before surgery commenced, and the children received no preoperative medication. The depression of ventilation produced by the three agents increased in a dose-related fashion as the alveolar concentrations were increased, and the depression of ventilation that they produced in oxygen was greater than that produced by equipotent concentrations in nitrous oxide. While the increase in ventilatory frequency and the decrease in TE associated with increasing concentrations of halothane were statistically significant (P less than 0.05), the increase in frequency associated with isoflurane was not, although it was sufficient to maintain the end-tidal and arterialized venous PCO2 in the isoflurane group at a value which did not differ significantly from that in the halothane group. Profound depression of ventilation was produced in the children by enflurane, clearly because no increase in ventilatory frequency was associated with its use. It was evident that the ventilatory effects of the three volatile agents in unstimulated children are very similar to those described elsewhere in the adult. There was no difference of any clinical significance between the degree of depression of ventilation produced by halothane and isoflurane in children.

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