Objective: The purpose of this study was to assess the effects of the Mulligan Concept (MC) 'squeeze' technique compared to a sham technique in participants with a clinically diagnosed meniscal tear. Methods: A multi-site randomized sham-controlled trial of participants (n = 23), aged 24.91 ± 12.09 years, with a clinically diagnosed meniscal tear were equally and randomly divided into two groups. Groups received a maximum of six treatments over 14 days. Patient outcomes included the numeric pain rating scale (NRS), patient-specific functional scale (PSFS), the disablement in the physically active (DPA) scale and the knee injury osteoarthritis outcome score. Data were analysed using univariate ANOVA, univariate ANCOVA, and descriptive statistics. Results: All participants in the MC 'squeeze' group met the discharge criteria of ≤2 points on the NRS, ≥9 points on the PSFS, and ≤34 points or ≤23 on the DPA Scale for chronic or acute injuries, respectively within the treatment intervention timeframe. A significant difference was found in favor of the MC 'squeeze' technique in PSFS scores (F(1, 21) = 4.40, p = .048, partial eta squared = .17, observed power = .52) and in DPA Scale scores (F(1, 21) = 7.46, p = .013, partial eta squared = .27, observed power = .74). Discussion: The results indicate the MC 'squeeze' technique had positive effects on patient function and health-related quality of life over a period of 14 days and was clinically and statistically superior to the sham treatment. Further investigation of the MC 'squeeze' technique is warranted.

Purpose -The purpose of this paper is to discuss the reasons and drivers for academic libraries affecting university strategy with regards to shaping and developing learning spaces in response to changing pedagogic behaviours. Design/methodology/approach -A review of available literature within the context of academic libraries and their position to influence and lead institutional strategic change. This theory and practice is addressed and evidenced by four case studies of university libraries in the UK. Findings -Many UK academic libraries find themselves able to lead on and influence their institution's strategic direction with regards to teaching, learning and research. This is particularly the case in the design and development of learning spaces within the university. Academic libraries are in a unique position within a university with a view to observing student behaviours, being responsive to ever changing demands from academics and students, spotting trends and benchmarking against comparative institutions. These practices make it possible for academic libraries to advise, guide and lead on teaching and learning strategy and lead on learning spaces developments within their institutions. Practical implications -Academic libraries can use existing quality assurance, responsiveness and benchmarking frameworks to influence university strategy and decision making. Originality/value -This paper focuses on the concept of academic libraries influencing change, rather than responding to change, within their university. The case studies provide examples of where this has been the case, and suggest ways and frameworks which can be adopted by other academic libraries.

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Purpose -The purpose of this paper is to demonstrate how the DigiTool software has been used to create a university digital repository. Design/methodology/approach -The paper outlines the project team's experience of using the DigiTool software and evaluates its potential for the creation of academic digital libraries. Findings -The initial trials and first live projects demonstrate that DigiTool is a proprietary software solution with all the capabilities required to create an open access digital repository. The test work described in this paper will contribute to future enhancements to the software. Practical applications -The paper will be of interest to project managers involved in the evaluation and selection of digital library software Originality/value -DigiTool is relatively new to the UK market and this is a report of the first UK digital repository created using it.

Background and Purpose: The nervous system plays a significant role in groin/hip flexor pain which is a common complaint in the active population. Patient examinations that lack consideration of the nervous system's involvement may result in chronic pain and dysfunctional breathing patterns due to continuously excited (also known as "uprelated") primal reflexes. Primal Reflex Release Technique™ (PRRT™) is a novel treatment paradigm that was designed to calm primal reflexes from their excitatory state. The purpose of this case series was to describe the effects of downregulating primal reflexes using PRRT™ on pain, function, and breathing pattern dysfunction in subjects who presented with groin and hip flexor pain and exhibited hyperesthesia to TriggerRegions™ in areas of respiration. Case Descriptions: Six subjects with acute groin and/or hip flexor pain were examined using a battery of tests including muscle integrity strength and range-of-motion (ROM) measurements, special orthopedic tests, breathing functionality and PRRT™ rib palpation assessments. If subjects were determined to be potential PRRT™ responders through PRRT™ rib palpation assessments, the technique was performed according to PRRT™ guidelines. Outcome measures including the Numeric Pain Rating Scale (NPRS), Patient Specific Functional Scale (PSFS), the Global Rating of Change (GRoC) Scale, and the Disability in the Physically Active (DPA) Scale were collected to determine the effects of the treatment. Outcomes: All subjects demonstrated full resolution of pain as reported on the Numeric Pain Rating Scale, and the change was statistically (p = 0.001) and clinically significant. All subjects returned to optimal function as reported on the Patient Specific Functional Scale, and the change was both clinically (minimal detectable change) and statistically significant (p = 0.001). All subjects returned to normal breathing function as observed through the seated assessment of lateral expansion test. The number of treatments (mean = 1.83 ± 1.16) and time to the resolution of symptoms was minimal (mean = 2.833 ± 2.56 days). Discussion: By assessing and treating abnormal breathing patterns, postulated to be a result of a sustained excitatory nervous system, subjects returned to full activity, without pain, in less than three days. After a two-week follow-up, subjects remained functionally pain free. Considering the state of the nervous system in the presentation of musculoskeletal pain and not focusing all treatment on local muscle structures may be beneficial. A multifaceted assessment approach is needed to determine other pain factors.