CHILDREN FIRST COUNCILS

Every county in Ohio has a Family and Children First Council. Each council includes public and private agencies, as well as parents.

OFCFCA COUNCILS DO

WHAT DO FAMILY AND CHILDREN FIRST COUNCILS

Local Family and Children First Councils identify and address the ongoing needs of children and families through planning, implementing effective strategies, monitoring.

Local Family and Children First Councils recruit and support parents encouraging them to be active contributing members of the council, to be involved in key decision-making efforts.

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Local Family and Children First Councils streamline and coordinate existing government services for families seeking services for their children (micro). FCFCs also annually evaluate and prioritize services.

Local Family and Children First Councils provide a collaborative infrastructure that allows for creative and innovative solutions that will streamline and strengthen the local service delivery system for children and families.

Happy Kids, Happy You

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Non-Profit Organization: Moving From Volunteers to Paid Staff

April 16, 2021
Moving From Volunteers to Paid Staff

A sensitive issue for a non-profit board to resolve is moving to a staffing model that includes replacing some volunteers with paid staff.

Many small non-profit service organizations operate with a significant number of volunteers, usually under the direction of a paid coordinator or Executive Director (ED), and other paid staff. Over the years, the board comes to realize that it is time to reassess the role of volunteers in delivering services to clients, find more info.

Deciding to Move Beyond Volunteers

Deciding to Move Beyond Volunteers

It is a always difficult to determine the appropriate role of volunteers in any community-based service organization, whether it organizes sports in a social housing project or runs a multi-service center for the homeless. Many of these organizations started life with a few people concerned about social issues, deciding what needed to be done, and actually doing it.

There have been changes in the environment in which volunteers have traditionally helped the poor and disadvantaged.

  • Trend towards ‘professionalizing’ services
  • Government or foundation funding requirements
  • Increased expectations of the recipients of the services
  • Increased demand and competition for volunteer time

Recognizing these changes, the board might want to look at a different staffing model for the organization for which they are accountable.

Assessing the Service Needs

Although the paid ED determines operational needs, the board has to be involved and provide direction if there is the possibility of a substantial move from volunteers to paid staff.

Assessing the role of volunteers in providing client service is best begun with a fresh look at the work being done in the organization. Over the years, it is all too easy to provide more and different kinds of service without really formalizing the service and the staffing model. Everyone is too intent on providing the service to analyze the infrastructure.

It would be useful to review the following areas.

  • Categories of job. For example, workers are needed for case management, meal preparation, healthcare assessment, recreation activities, computer training, sorting donations, and administrative support.
  • Qualifications needed. These qualifications can range from simple friendliness, to experience in pastoral care, training in addiction assessment, or handyman skills. There might be levels of education, training and skills required by funders.
  • Number of hours of work required. There are few volunteers prepared to work full-time hours. Review each job in terms of the need for continuity and commitment of full time or even substantial part-time hours.

Assessing the Culture of the Non-Profit Organization

The board and management can also assess the culture of the organization in using volunteers.

  • Tradition. Consider the role and expectations of current volunteers. If the organization has always been proud of the number and commitment of its volunteers, if that is part of its public face and communication to the community, the board will naturally be hesitant to upset the status quo.
  • Turnover rate of volunteers. If the turnover rate is high, that makes for unstable service delivery and considerable effort at continually training volunteers. If the turnover rate is low, check on age and commitment to see if a significant number will be leaving in the next year or so.
  • Acceptance standards. Some organizations believe that it is important to find work for everyone who wants to volunteer. This can lead to ‘make work’ jobs and/or unsuitable volunteers. This means that effort to sustain those unhealthy situations is being diverted from client service.

Making a Decision about the Role of Volunteers

Putting all this information on paper in an organized manner will help the board and management identify the following.

  • Work that should be done by paid staff in order to meet funding requirements, comply with health and safety regulations or with a risk management plan, or simply to sustain the quality of client service.
  • Volunteer services. These might require certain training or experience but are not essential to the primary service mandate of the organization. They could include jobs like organizing social activities, pastoral visiting, filling grocery bags, or driving clients to appointments.
  • Work that could be done either be paid staff or volunteers. There is significant research that explores the idea of interchangeability and substitution between paid staff and volunteers. The main determination here is whether or not it makes a difference who does the work. There will probably be considerable discussion around this category as one common, but controversial principle is that core services are provided by paid staff and value-added services can be provided by volunteers.

The board and management have to make a decision about the right mix of paid staff and volunteers for their particular organization, providing their kind of service, to an identified population.

Next Steps in Moving from Volunteers to Paid Staff

Next Steps in Moving from Volunteers to Paid Staff

Once the board has made a decision to use more paid staff for work traditionally done by volunteers, management will proceed with implementation.

  • Develop the new staffing model, identifying paid and volunteer positions with appropriate job descriptions. It is typical that the description of work currently done by volunteers will require specific qualifications and/or increased time. There might also be new volunteer positions.
  • Identify the ‘new’ jobs for which people will have to be hired. Any volunteer will be free to apply for the job.
  • Develop a training plan to ensure that all staff and volunteers will be adequately equipped to handle the work.
  • Develop a transition plan to implement the changes over the following months.
  • Develop a communication plan that explains clearly and succinctly the changes, the reasons for them, and the transition plan to move forward. The board chair and Executive Director should present this information in person with written handouts so there are no misunderstandings about the intent and the plan. Everything will, of course, be interlaced with appreciation of the volunteer work currently being done and confirmation of opportunities to come, although perhaps reorganized differently. Make it clear that everyone is affected, all for the sake of better client service.

If this is a unionized environment the Executive Director should work through this process with a labor relations consultant or labor lawyer.

The Balance Ball: Office Furniture that Firms Your Abs

April 12, 2021
Office Furniture that Firms Your Abs

For once I'm cutting edge. I'm sitting on a ball as I write this, something I've been doing for a couple of years when I got tired of folding my body into a chair. At the time, I didn't realize I was in the vanguard of a trend. But yesterday, I became a confirmed avante-gardist when I saw a story in the Wall Street Journal detailing that the use of exercise or 'stability' balls as office furniture was becoming popular with forward looking office trendies in technology companies like Google.

The Journal article displays a photo of employees in the New York City office of Naked Communications intently studying their laptop computers while astride the same size stability ball that I'm riding. From the photos, I can see that the mood of Naked Communication is rather somber, for the balls are either the color of pearl like my own or they are navy blue. I don't wonder why there are no red ones. Obviously, only the most sedate choices in balance balls would be in keeping with the conservative image politics of Naked Communication. Yes, I have noticed an irony in the choice of 'Naked Communication' for that company.

Office Furniture

Stability balls come in a variety of sizes and colors. The Wall Street Journal article states that $25 is the average amount for a full-size ball, the type you can sit on almost without fear of falling off. If that is true, I will hurry right down to Wal-Mart where I bought my second balance ball (my wife uses my first one-for exercise) for $7.25 and offer to sell as many as I can for $20.00.

I mentioned a fear of falling off my ball. Actually, that's never happened to me, although I can see it happening to the inexperienced and recently graduated youngsters of Naked Communication. In the picture, they seem perplexed, a bit unstable, almost as if they didn't know how to sit on a stability ball. I wonder if they are properly licensed.

An industrial designer interviewed in the Journal article advises 'novices' to start out using the ball in thirty minute increments. In the article, the reporter struck another cautionary note, quoting a physical therapist who mentioned that the balls have an ability to roll. Roll? Hello? My biggest fear is that some day my ball will burst and I will have only a nano-second to recover before I hit the floor. There's a degree of irony in the degree of my worry about that, inasmuch as I work part-time in a boxing gym where the occupational hazards are significantly greater. But this is to digress. Stability balls are soft and comfortable. They do tend to shift a bit but that's the point.

https://www.youtube.com/watch?v=Y6tv2Rxdmnk

You must use your stomach and lateral muscles to keep your balance. It's also fun to bounce a bit since that relieves anxiety and stress. My stability ball is of such a size that it is on eye-level with the computer screen. I prefer this arrangement to buying one of those elevating platforms for computer monitors which take up desk space and are expensive besides. The industrial ergonomist warns against fatigue followed by slouching, but there is something about a balance ball that makes you want to sit up and take notice, more helpful hints. I have more inclination to slump when I'm fatigued and sitting in a chair. I do have a chair in my little office. I use it as a rolling coffee table. I can raise and lower it by pressing on the little bar underneath, a technological innovation my stability ball doesn't have.

How Blower Door Test Can Help in Fire Protection

April 11, 2021
How Blower Door Test Can Help in Fire Protection

Why you should perform the blower door tests? Well there are several reasons. The number one reason for a blower door test is to find out if the room is perfectly airtight or not.

Airtightness = fire protection

Blower Door Test Can Help in Fire Protection

Fire protection includes all measures that prevent the development of a fire and the spread of fire and smoke and, in the event of a fire, enable people and animals to be saved and effective extinguishing work possible. The air tightness of the space-enclosing components plays an important role here. Sufficient tightness of these components is an essential requirement for the function of classified fire protection structures. In the event of a fire, leaks quickly lead to the transmission of heat and harmful smoke gases, e.g. B. in neighboring residential units.

When component tests are carried out to determine fire resistance classes according to DIN 4102, the tightness of the construction to be tested is also evaluated; Due to the rapid flue gas and temperature transmission, leaks are often the cause of the often "early" failure of room-enclosing components in the test. The function of complex, fire-resistant component constructions falls by the wayside if - without any other impairment of the stability of the fire protection structure - the fire or smoke gas transmission via cracks, e.g. B. takes place in the area of the connections to flanking components.

The partition wall to be classified in terms of its fire resistance class is checked for leaks using the “cotton ball test”. The cotton ball is held for 30 seconds at a distance of 20 mm from the specimen in the area of gaps, cracks or connecting joints. The test should always be carried out if hot gases escape from the side facing away from the fire or if there are doubts as to whether the room is still sealed. The room closure is no longer observed if the cotton ball is ignited, i.e. H. it ignites or glows.

Door Test

The transmission of harmful smoke gases through leaks endangers the function of escape and rescue routes: For this reason, the model building regulations (MBO) for floors with more than four residential units require the arrangement of generally accessible corridors, which must be sealed off from the stairwell in a "smoke-tight" manner. The required partitioning is achieved by installing special "smoke protection doors" in accordance with DIN 18095. The use of these sufficiently airtight and smoke-tight doors ensures that the stairwell, in its function as an escape and rescue route, remains passable even without breathing protection.

Walking to Lose Weight – the Safe Way

April 10, 2021
Walking to Lose Weight

Believe it or not, you can lose weight just by walking. You don't have to train like an Olympic athlete for 2 hours a day to see a change in your waistline. Take a brisk walk 3-5 times a week to shed a few pounds.

It is suggested to have 30-60 minutes of activity each day. Depending on what the rest of your day is like, figure out how much time you should spend walking to lose weight. If you sit behind a desk for eight hours a day, it is important to allow yourself 60 minutes of activity a day. One of the best ways to work multiple muscle groups is walking. Try these simple rules to ensure you burn enough calories to lose weight by just walking.

Lose Weight

Frequent walks are better. Use your dog or alone time with your spouse as an excuse to take a walk around the neighborhood. The more times that you walk each week, the more calories you are burning, thus, walking to lose weight. However, it is not necessary to walk every day. Your body does need a rest after a few days of exercise, find more info.

Switch your routes. After you spend a few days walking around the neighborhood, drive yourself to a different location, such as a trail, for a change of scenery. It is important that you don't allow yourself to get bored. When you are on your way to the trails, pick up a friend so you can enjoy the walk with good company. Also, considering changing your paths around the neighborhood, not only for scenery, but for the incline. It is healthy to walk up and down hills because they target different muscles. Alternate the length of your walks. Your body will respond better if you walk for 30 minutes one night, then 60 minutes the next, and 45 minutes the third night and follow with a break.

Pull your own weight, and then some. Look into purchasing ankle weights if you want to focus on your leg muscles. Otherwise bring dumbbells with you on your stroll. If you don't own dumbbells, grab a couple of water bottles. As you get hot, alternate which bottle you drink from in attempts to keep both the same weight. By carrying extra weight, you have to work slightly harder and successfully walking to lose weight.

https://www.youtube.com/watch?v=amRD-peOHhw

Walk to the beat. If you want help speeding up your walking pace, bring a music player with upbeat music. It is vital to walk at a pace fast enough to get your heart rate high enough to start burning extra calories. Measure your pulse before you begin walking to lose weight. If you are 35 years old, your target heart rate is 93-157 beats per minute. If you are younger, you want higher heartbeats. If you are older, you are targeting lower heart rates; 50-year-old individuals want 85-145 heartbeats a minute. If you are able to have conversation comfortably during your entire walk, you are not walking hard enough. But be careful no to walk too fast, you want to be able to talk to your partner, just not able to have a conversation with no shortness of breath.

Try using these tips when walking as exercise and you can lose weight.

Family Vacation to PEI National Park: Put Anne of Green Gables and Cavendish Beach on an Island Itinerary

April 9, 2021
Family Vacation to PEI National Park

Prince Edward Island National Park is the lone national park in Canada's smallest province. But a visit to this protected, ocean side park delivers unequaled views, vibrant red sands, and a taste of the charming setting for the Anne of Green Gables books.

The park stretches for 40 km (25 miles) along the northern coast of Prince Edward Island, from Stanhope and Dalvay-by-the-Sea in the east to Cavendish Beach and the Green Gables House in the west. Cavendish Beach lies a convenient 40 minute drive from Charlottetown, the capital of the province, or about an hour from the Confederation Bridge, see more.

Things to Do Near Cavendish on a Vacation to PEI National Park

Things to Do Near Cavendish on a Vacation to PEI National Park

Families will benefit from the many things to do at the Cavendish region of Prince Edward Island National Park, such as:

  • Visiting the Anne of Green Gables house
  • Hiking along the shore near Cavendish and watching for bird life (such as the rare piping plover) in the sand dunes
  • Swimming in the ocean at Cavendish Beach
  • Playing a round of PEI golf on the Green Gables Golf Course
  • Biking the oceanfront trails from Cavendish West to Cavendish East
  • Camping near Cavendish Beach

Perfect for a family beach vacation, Cavendish Beach offers gorgeous sands in a stunning seaside setting. In addition to swimming in the ocean and relaxing on the beach, Cavendish Beach remains trumps for its many amenities. Washrooms, nearby camping, well-maintained boardwalks, and parking make this PEI vacation location appealing and convenient for families.

Anne of Green Gables House is Fun for a PEI Family Vacation

The Green Gables House sits atop a picturesque hill, welcoming visitors year-round to the house that inspired Lucy Maud Montgomery’s Anne of Green Gables books. In addition to rooms filled with historic items from an early 1900s farm, activities in the barns and grounds transport visitors back to old-time island life. For even more Anne, take the family to a showing of Anne of Green Gables: The Musical at the Charlottetown Festival.

Things to Do in PEI National Park near Stanhope and Greenwich

A visit to the eastern portion of PEI National Park also offers plenty of family vacation activities:

  • Hiking the trails near Stanhope
  • Dining at the lavish Dalvay-by-the-Sea Historic Site
  • Walking the length of the Greenwich boardwalk that protects the fragile dunes
  • Learning the history of the Mi’kmaq people who first lived on these shores
  • Swimming at Brackley, Ross Lane, or Stanhope beaches
  • Camping at Robinsons Island Campground

The facilities at Greenwich, the newest portion of the national park added to the eastern end in 1998, will keep everyone entertained on a family vacation—no matter the weather. The interpretive center offers activities for a rainy day while kilometers of trails are great for spring and fall vacations to the island. Taking advantage of the supervised swimming is best saved for the summer months when the ocean is warmest.

Other PEI Attractions for a Family Vacation

Other PEI Attractions for a Family Vacation

Overall, Prince Edward Island National Park remains an ideal destination for an outdoor-activity-based family vacation to PEI. With many activities like swimming, golfing, hiking, biking, camping, and exploring, families have no shortage of things to do during an island vacation.

Wristwatch Review: Casio Classic Calculator and Calendar Watch

April 7, 2021
Wristwatch Review

Long, long ago, when digital watches were new to our planet, the calculator watch was a stunning technical achievement. Now, it's a fondly nostalgic timepiece for retro nerds. Of course, when I walked into my apartment wearing the Casio Classic Calculator and Calendar Watch, I soon found out that not everyone is nostalgic about it.

"Is that your geek watch?"
"Yeah, it's my nerd watch."
"Did you wear that to work?"

Wristwatch

That quick conversation with my wife let me know that I wasn't getting any cool points for wearing a calculator on my wrist. My week of wearing the Casio Classic Calculator and Calendar Watch wasn't off to a great start. It's a digital watch that prepares wearers for an adventure in math. It's not a glamorous vision.

The watch itself (model CA53W-1) is functional and provides time, date, stopwatch and calculator functions. The display gives you the time and day of the week at a glance. A push of an exposed button on the right side of the watch activates the calculator. A second push shows you the time for the alarm. A third push displays a second timezone time and a fourth button push gets you to the 1/100 of a second stopwatch. A smaller recessed button is pressed when you want to set the time or alarms. The stop watch is started and stopped via buttons on the calculator.

The Casio Calculator watch is water resistant to 30 meters and survived when I got caught in a sudden rainstorm. However, with all the buttons on this watch, I'd prefer to keep it dry. The calculator works and is convenient to have on hand (or wrist). You can expect 5 years of battery life with this watch. The Casio Calculator watch itself works well, but has a few drawbacks. First, the numerals and markings on the calculator keypad are small. I need to use a a magnifier or reading glasses to see the numerals and functions. Second, this watch does not have the same button navigation pattern of most watches so there is a slight learning curve. Third, I was unable to find any light to illuminate the face of this watch at night.

While this Casio Classic Calculator and Calendar Watch is perfectly practical, the main reason to own this watch is nostalgia. When the digital watch first arrived on the scene in the 1970s, it was truly a marvel. It evolved from the LED digital watch to the LCD digital watch and then to the calculator watch. When the calculator watch was introduced, it was truly a marvel. However, the features of today's more expensive digital watches far surpass this humble Casio that sells for $19 at Walmart. You can get watches like the Casio Pathfinder Hunting Timer that tell you when to go hunting or fishing. Other watches provide compasses, altimeters, and Global Positioning System (GPS) functionality. But, all those wonders started with the calculator watch. For that reason alone, this Casio Calculator Watch is a worthy addition to any watch collection.

How Can the PC Muscle Enhance Male Sexual Performance?

April 4, 2021
How Can the PC Muscle Enhance Male Sexual Performance

The PC muscle is the muscle you contract when you need to stop urinating. It is also the muscle that pushes semen through the penis during ejaculation. According to www.fair-news.de/2821226/bolaxol-test-bringt-es-der-muskel-booster-wirklich, the editor of For-Men-Only-Magazine.com, "The PC muscle is the key to penile reformation. It's your ticket to enhanced sexual performance."

Premature Ejaculation

Voluntary contractions of the PC muscle can help prevent premature ejaculation. If you develop your PC muscle with exercise, your sexual stamina will increase dramatically.

Kegel Exercises

Kegel Exercises

Kegel exercises are the best way to develop and control your PC muscle. A Kegel exercise is simply contracting and releasing your PC muscle in small repetitions just like any other type of exercise.

Caution

As with all exercises, you should never overwork your PC muscle. Pace yourself when exercising. Straining your PC muscle can cause severe urination and bladder problems.

Other Benefits

A strong PC muscle also helps promote stronger erections and can be used to help treat erectile dysfunction. Control of your PC muscle also helps you experience stronger, longer-lasting and more frequent orgasms.

Five Tips to Becoming the Best Customer Support Agent

April 3, 2021
Tips to Becoming the Best Customer Support Agent

Have you ever chatted with customer support on the phone or online? Most people don't realize that there are lots of guidelines and protocols that customer support agents must follow and that they sometime have to talk to several people at once. I am going to show you five tips that I, an online customer support agent, use to solve the customer's problem as quick as possible with the least amount of questions.

Don't rush the customer

Don't rush the customer

Even though the customer might be talking forever to send their message, you have to always be kind and helpful to them. Don't be impatient and cut them off. You don't want the customer to get angry with you, because you are the face of the company. If you don't care about their problem, the entire company must not care, as it may seem in the customer's eyes.

The customer is always right -- even when they're wrong

If the customer is wrong, and it does not interfere with you solving the problem, just ignore it. If, however, the customer is incorrect and you cannot solve their problem with their mistake, kindly correct them. Avoid directly telling them that they are incorrect, just correct them and continue on with the subject as if it isn't that big of a deal.

If the customer is requesting, try to fulfill their request

If the customer's request is reasonable, try to fulfill it. If their request is, however, too large for you to fulfill, let them know another path they could take that could get them closer to them being happy. If you know that in the long run, their request could never be fulfilled, don't be rude, just try leading them to a representative who could then explain to them that their request could never be completed. Avoid making yourself tell the customer that it would never happen.

Make the customer feel cared for and special

You never want an angry customer. You could lose a long-time customer, but not only that, they could tell others that your company is uncaring, and lose even more customers. For all you know, the person you made angry could be a famous blogger, and post an article about your terrible customer support. Making a single customer mad could potentially lose several customers. You want the customer to feel cared for - You are, once again, the face of the company.

https://www.youtube.com/watch?v=La-ZJKa_8q0

Let the customer know who you are, and become temporary friends with the customer

Tell the customer your first name, give them a nice greeting, and ask kindly for their name. If they refuse, accept it and continue on with the conversation. Act as if you are their friends with the customer, even if you could care less about the person. Keeping the customer happy is the key in being successful in your job, as you don't want people to report you.

What are Monoculars and How do Yhey Work?

April 2, 2021
What are Monoculars and How do Yhey Work

A monocular is a single-barrel refractor viewing device for looking at objects in the distance. They are usually more portable and smaller than spotting scopes and are widely used by bird-watchers, airplane spotters, hikers and walkers, hunters and amateur astronomers.

Images of objects in the distance are magnified in a monocular by use of a series of lenses or prisms. A monocular products two dimensional images, unlike binoculars which produce three dimensional images.

Monoculars are relatively cheap to buy compared to most other viewing devices including the telescope, spotting scopes and top quality binoculars. There are plenty of monoculars under £20 but prices rise much higher for monoculars with stronger magnification and other features like night vision.

You can determine the magnification level of your monocular and any visual aid by looking at the first number of the mutual X-number equation which is present on any piece of optical equipment. For instance, if a certain monocular is 10x50, the magnification is 10.

This means that the magnification will show you a 10 times enlargement of the image which would be viewed with a naked eye. The object aperture of the monocular is the second number of the common equation. So, for instance, if this is 10x50, then the aperture is 50.

The aperture is the measurement of the diameter of your objective lens, and the objective lens depends on its size controls of how much light is apparent when viewing. The bigger the lens, the more light it reflects off the object, thereby making the image appear brighter, more helpful hints.

Lastly, the field of view of the monocular is the perceived width of the object image from 1000 yards away. It is important to note that the larger the field view, the lesser the magnification, and equally, the higher the magnification, the lesser the field view.

The lens in a monocular causes light entering it to bend. Light which enters the top of the objective lens will be bent downwards whereas the light at the bottom of the lens will be bent upwards. The crossing of the light beams causes a flipping of the image. This is counteracted to enable correct viewing by the eyepiece lens - light passes through this before hitting the eye to show the image right way up.

A monocular is a bit like a low powered mini telescope and more expensive models have night vision capability which is useful for studying nocturnal creatures. Night vision monoculars and spotting scopes are widely used by hunters and astronomers. Night vision devices are also widely used by the military and a night vision monocular can be mounted to a firearm and used as a night sight.

When you first use a monocular it is important to ensure you have a clear view of the object you are intending to watch. You should hold a monocular reasonably close to your eye, although not touching it, and if you wear glasses it is advised that you rest them gently against the rubber end of the monocular.

When you have lined the monocular up properly with the eye's pupil you will see light appear. A monocular can be focused by placing a hand on the device’s ridged section and turning it slowly to focus the image. If you notice that the image has become blurred this means that the ridge has been turned too far and should be turned in the opposite direction to correct the problem.

Magnification is an important aspect of a monocular or any other viewing device - the greater the magnification, the more you're likely to pay for a monocular or spotting scope.  You should carefully consider exactly what you intend using a monocular for - there's no point buying a very expensive one with a high magnification level if you intend to use it for viewing objects which are not particularly far away.  A cheap monocular with 8x or 10x magnification level may be ample for your needs.

You should also give consideration to the subject of eye relief when buying a monocular.  This relates to the distance that you can hold the monocular from your eye and still see the full field of view - some people will need to use a monocular at very short notice, for example if a bird or wild animal appears suddenly, so they will require a device which can be held up quickly a few centimetres from the eye.  If you wear glasses it is important to ensure you buy a monocular which has an eye relief distance of 14mm or more to allow for the fact glasses will not allow you to get your eye any closer to the device.

Lens coatings are another important aspect of a monocular and affect image brightness. The best monoculars available to buy are fully multi-coated, multi-coated being the next highest models, and fully coated the least.

Many monoculars are waterproof so that’s certainly worth bearing in mind if you plan to use one in a wet climate or on board a ship, boat or other river or sea vessel.

If you don’t need a very high-powered monocular, a small pocket-sized one will probably meet your needs. These are very light in weight and are not bulky for carrying around. Some are not much larger than a pen so they are great for fitting into a pocket, backpack or purse.

There are many occasions when a small monocular can come in really handy - and that’s not just for the uses normally associated with them such as bird watching, plane spotting, hunting and locating golf galls on a golf course.  A  monocular can also be very useful if you simply want to read street notices or shop and road traffic signage in the distance.

The opportunities for using a monocular are many - when you own a monocular you will amazed how often you use it to get a closer look at things you previously could not see clearly with the naked eye.

If you feel a monocular isn’t suitable for your needs, it may be worth buying a more powerful spotting scope - you can read more about spotting scopes here: What is a spotting scope?

Monocular - an optical viewing device which is very popular with bird watchers, walkers and hunters.

Treatment of Neck Pain

April 1, 2021
Treatment of Neck Pain

Neck and shoulder pain is a common complaint. Population studies have shown that 20-65% of women and 15-40% of men have experienced neck and shoulder pain at some point in their lives4. Headache is also a common ailment affecting humans with a point prevalence of 16% in the general population5. 

As neck pain or neck pain and headache is so common, the need for effective management is clear. Physiotherapy is one of many forms of treatment for neck disorders. Physiotherapy encompasses a variety of interventions such as manipulative therapy, therapeutic exercise and postural advice and education. The question of efficacy of these interventions is important to answer as evidence based practice becomes increasingly important. Therefore the purpose of this paper is to review the scientific evidence for the efficacy of physiotherapy in the management of neck pain.

The main body of literature in regards to treatment for spinal pain concerns the lumbar spine. Evidence of efficacy of treatments for the cervical spine is more recent and quality trials are now beginning to emerge. It has only been in the 1990's that systematic reviews are being introduced into the literature.

The Australian National Health and Medical Research Council (NHMRC) has issued guidelines which allow readers to judge the strength of the evidence on which recommendations are based. Level I evidence represents the desired standard on which to base clinical decision making. This evidence is 'that obtained from systematic reviews of relevant randomised trials (with meta-analysis where possible).' This level of evidence is therefore the strongest when considering treatment efficacy. Level II evidence is 'that obtained from one or more, well designed randomised controlled trial.' This position paper will only consider Level I and II evidence when examining the efficacy of treatment for cervical spine pain.

Manipulative Therapy

Manipulative Therapy

There is Level I and II evidence to support manipulative therapy as an effective form of treatment for mechanical neck pain. There has been three systemic reviews (Level I evidence) examining the efficacy of manipulative therapy for cervical spine pain. In regards to Level II evidence, eleven trials have examined spinal manipulative therapy for neck pain. Three of these have investigated acute pain, two finding manipulative therapy to be more effective than rest and analgesia and one having a negative outcome. On closer examination of this last trial with negative results, the treatment group received what was called mobilisation but appears to be more similar to hold-relax techniques. In the two trials with positive results the manipulative therapy was performed by physiotherapists.

Eight randomised controlled trials (RCT's) have examined the effectiveness of manipulative therapy for subacute or chronic neck pain with six having positive outcomes. In four of these RCT's with favourable reports of manipulative therapy, the treatment was performed by physiotherapists. Most of these RCT's only reported on short-term effects. In regard to headache, there have been six trials examining the effectiveness of manipulative therapy on headache. Of these, one has been on cervicogenic headache, one post traumatic headache, one migraine and three on tension headache, additional resources. All reported positive short term effects of manipulative therapy. In two trials the treatment was from physiotherapists, one from osteopaths and the others, treatment was from chiropractors.

A systematic review by Koes3 assessed the quality of 35 RCT's comparing manipulative therapy with other treatments for back and neck pain. Only five of these trials examined neck pain. All trials were scored according to their methodological quality. They found that most of the RCT's scored poorly, that is they showed major methodological flaws. Koes3 concluded that although there are some promising results, the efficacy of manipulation has not been convincingly shown.

More recent Level I evidence by Hurwitz2 assessed the evidence for the efficacy of cervical spine manipulation and mobilisation for the treatment of neck pain and headache. In doing this they divided the RCT's into acute, subacute or chronic neck pain and headache.

For acute neck pain, no RCT's were found that had assessed the efficacy of cervical manipulation. Three RCT's were found that examined mobilisation for acute neck pain. Hurwitz2 concluded that due to limited data no recommendations could be made for manipulation for acute neck pain and for mobilisation, the literature indicates that this form of treatment may be beneficial when used in conjunction with other treatments.

For subacute and chronic neck pain, Hurwitz2 reported on five RCT's on manipulation for this type of pain. Data from three of these was able to be statistically combined for outcomes measured at three weeks after initial treatment. The result of this did not quite reach statistical significance but Hurwitz2 did state that "it is more than 90% probable that the difference in means favours the groups treated with manipulation" (p 1752). Only one RCT examined mobilisation as treatment for subacute or chronic neck pain. Only one study reported on long term results therefore Hurwitz et al could not determine the long term effect of manipulation or mobilisation.

In regard to headache Hurwitz et al found five RCT's which examined the effectiveness of manipulation or mobilisation for headache. For muscle tension headache three RCT's were discussed in regards to cervical manipulation. As the data was not homogenous, no combination could be made for further statistical analysis. Hurwitz2 found only one study, which examined the efficacy of mobilisation for muscle tension headaches which did have positive results but had a poor methodological score. One study that examined manipulation for migraines was discussed. The conclusions made in regard to efficacy of manipulative therapy for headaches were that manipulation and/or mobilisation may be beneficial for muscle tension headache.

Gross1 have conducted a meta-analysis on conservative management of mechanical neck disorders. This review aimed to investigate the efficacy of various forms of conservative treatments in adults with neck pain without neurological deficit. Manual therapy was one of the treatments they investigated. Meta-analytical techniques were used aiming to synthesize the clinical evidence to allow for increased statistical power and to give a better indication of treatment effects. In examining manual therapy, this was done when it was used alone or in combination with drug therapy, education or physical medicine modalities. In regards to manual therapy alone four controlled trials were retrieved. Two of these examined the effectiveness of manipulation and one mobilisation, which was in the form of hold/relax techniques. These trials all report non-significant effects. They could not be combined quantitatively as raw data could not be obtained. In one trial by Vernon et al, the only outcome measure was pressure pain threshold, which did show significant results but due to the type of measure could not be combined with the other trials. Therefore although these trials report no benefit from manipulative therapy used alone, they do not have the statistical power to definitively state that manual therapy alone is not effective.

Gross1 identified six trials, which used manual therapies in combination with other forms of treatment. One study by Brodin et al found mobilisation significantly decreased pain compared with control and physical modality groups but because raw data could not be obtained this trial had to be excluded from meta-analysis. The other five studies examined the effects of various forms of manipulative therapy for neck pain all with positive outcomes. Therefore five studies could be combined and outcomes compared between one and four weeks. Even though each study examined different types of neck pain the authors felt they were similar enough to combine. This combination yielded a pooled effect size of -0.6, which indicates a moderate to large reduction in pain.

The effect size is a measure of change of perceived levels of pain reported in standard deviation units. A negative effect size indicates a reduction of pain. From this point three of the studies were combined at a time frame of 6-8 weeks of treatment. As the results again showed a moderate reduction of pain, with a pooled effect size of -0.5.

In summary, this meta-analysis provided evidence to support the short term benefit of manual therapy in combination with other treatments for the treatment of mechanical neck pain. As with the Hurwitz et al review, long term results were only reported on in one study so the long term effects of manual therapy could not be reported on.

Exercise

Exercise

No Level I evidence exists that adequately assesses the efficacy of exercise in the treatment of neck pain due to the lack of suitable trials in the literature. There are some recent Level II trials which show benefit of certain exercise protocols in decreasing neck pain.

There is no Level I or II evidence available on Pilates therapy, Feldenkrais therapy, Alexander techniques or bed rest.

Traction

The present Level I evidence available can not draw clear conclusions regarding the efficacy of traction for neck pain due to the poor quality and low statistical power of the available literature. Of five RCT's investigating cervical traction, three had negative outcomes and two positive.

Electro-Physical Agents

In regards to Level I evidence for electro-physical agents there is limited support for pulsed electromagnetic therapy. This has to be regarded with caution as it is based on results from only two trials and therefore has low statistical power. The only other Level I evidence is for laser therapy. Two reviews have stated poor effects of laser but again this must be regarded with caution due to low statistical power and poor quality of the trials on laser therapy. Level II evidence of various electrotherapy modalities has varied results and is detailed in the attached document.

Level I evidence on acupuncture can also not make firm conclusions regarding the efficacy of this treatment for neck pain due to limited data. Of seven RCT's on acupuncture, six report positive outcomes of using acupuncture for neck disorders.

No Level I evidence exists to comment on the use of biofeedback for neck pain but one RCT does report positive effects of EMG mediated muscle relaxation.

Collars

No Level I evidence comments on the efficacy of cervical collars. Three RCT's were located with only one showing positive outcomes of cervical collars. One study found subjects who were encouraged to engage in normal activity had a better outcome than those who used a collar.

Medications

Medications

No Level I or II evidence was found on the use of antidepressants for neck pain. No Level I evidence could draw firm conclusions regarding the efficacy of muscle relaxants, anti-inflammatory medication or analgesics due to the lack of literature and unsuitable trial design. There is some Level II evidence for muscle relaxants with varied results.

Conclusions

There is Level I and II evidence to support the short term benefit of manipulative therapy for neck pain. In regards to long term effects of manipulative therapy or other forms of physiotherapy there is insufficient literature to make firm conclusions. This is obviously an area open for further research.

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