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Your dashboard is a one-stop shop for accessing various NCCMT resources, tracking your progress as you work through available training opportunities, saving evidence syntheses and publications, and building your own toolkit to match your evidence-informed decision making needs.
According to evidence-based guidelines, conservative management strategies for OA include education, exercise and weight management (if needed) as well as appropriate and timely pharmacological intervention (Bannuru et al. 2019; Kolasinski et al. 2020; National Clinical Guideline Centre 2014; Rausch Osthoff, et al. 2018; The Royal Australian College of General Practitioners 2018). With more advanced disease progression, and when conservative management fails to provide the individual with effective pain relief, joint replacement surgery is advised (Bannuru et al. 2019; Jette et al. 2020; Kolasinski et al. 2020). Because of the elective nature of this surgery, individuals are often placed on a waiting list. The waiting time for joint surgery could range from 4 to 18 months, with some countries having waiting times of up to 9 years (Cronström et al. 2020; Desmeules et al. 2009; Johnson, Horwood & Gooberman-Hill 2014; Tsui & Fong 2018).
Prolonged waiting times for joint replacement surgery can lead to further progression of OA, increased pain, anxiety, deterioration in function and a further reduction in quality of life (Desmeules et al. 2009; Scott, MacDonald & Howie 2019). These effects are shown to be amplified in women from lower socio-economic backgrounds (Ackerman et al. 2005).
The knee is the most affected joint in the body with a prevalence rate of 22% for individuals aged over 40 years (Cui et al. 2020). The diagnosis of knee OA typically falls within two distinct categories, namely primary and secondary OA. Primary OA is when articular degeneration has no clear underlying reason compared with secondary OA that is linked to joint injury (previous fractures, ligament and meniscus injuries) as well as inflammatory conditions such as rheumatoid arthritis (RA) (Hsu & Siwiec 2021). Risk factors for the development of primary knee OA include age, gender, genetics, increased BMI, physical activity levels and occupational demands (Silverwood et al. 2015). In addition, risk factors impacting the clinical progression (i.e. level of pain experienced and functional ability) and structural progression of knee OA include socio-economic variables (i.e. level of education, social class), psychological factors (i.e. coping strategies, anxiety and depression) and the presence of comorbidities (Bastick et al. 2016; Deveza et al. 2017). Most of these risk factors are linked to the social context of the individual and alongside the personal factors, community perceptions and psychological influences have an impact on the health-related outcomes of individuals with OA (Luong et al. 2012). Therefore, an additional aspect in the management of individuals with primary knee OA should be the identification of modifiable risk factors, targeted with an appropriate intervention (Georgiev & Angelov 2019).
For over 20 years, VinylPlus has been acting as a frontrunner in sustainability and the circular economy.
Recognizing that progress towards sustainable development is a journey of continuous improvements, the European PVC industry reconfirmed its strong commitment in 2021 by launching an even more ambitious programme for the next 10 years.
The VinylPlus 2030 Commitment has been developed bottom-up through industry workshops and with an outside-in approach to goal setting through an open process of stakeholder consultation.