Constipation is a disorder of gastrointestinal motility characterized by difficult or decreased bowel movements, and is a common condition in Western countries. Laxatives are the most common strategy for managing constipation. However, long-term use of some laxatives may be associated with harmful side-effects including increased constipation and fecal impaction. Abdominal massage, once an accepted method of treating constipation, is no longer standard of care, but may be a desirable therapy for this condition because it is inexpensive, non-invasive, free of harmful side-effects, and can be performed by patients themselves. However, until recently, evidence for its effectiveness was not strong enough to make a recommendation for its use in constipated patients. In 1999, Ernst reviewed all available controlled clinical trials, and found that there was no sound evidence for the effectiveness of abdominal massage in the treatment of chronic constipation. This article reviews scientific evidence from 1999 to the present, regarding abdominal massage as an intervention for chronic constipation. Since that time, studies have demonstrated that abdominal massage can stimulate peristalsis, decrease colonic transit time, increase the frequency of bowel movements in constipated patients, and decrease the feelings of discomfort and pain that accompany it. There is also good evidence that massage can stimulate peristalsis in patients with post-surgical ileus. Individual case reports show that massage has been effective for patients with constipation due to a variety of diagnosed physiologic abnormalities, as well as in patients with long-term functional constipation.
12-month-old Y39C transgenic mice were divided into Exercise and Non-Exercise groups (n = 7 for each group) following pre-testing of all 14 animals in individual cages with running wheels. Animals were assigned to Exercise and Non-Exercise groups by alternating rank order following their week-long pre-test. Exercise mice had free access to individual cage-mounted running wheels and Non-Exercise mice had a locked, non-functioning running wheel in individual cages. Daily running distances of the Exercise animals were recorded and averaged for each week. (A) Data show that all animals continued running for 12 weeks with some reduction in running speed. Average distance in the first week was 3.76 ± 0.87 miles per day. Average distance in the 12th week was 2.71 ± 0.53 miles per day (no statistical difference between 1st and 12th week, n = 7, multi-variance ANOVA, p = 0.33). After 12-weeks of running wheel activity, all mice were tested for high intensity motor activity on the Rotarod (B) and cognitive function using a Morris water maze (C). (B) In the Rotarod test, the Exercise group could remain on the rod significantly longer at 26 rpm than the Non-Exercise group (n = 7, multi-variance ANOVA, **p = 0.001). (C) In the Morris water maze, the Exercise mice took significantly less time to find the hidden platform at Day 5 than Non-Exercise transgenic mice (n = 7, multi-variance ANOVA, *p = 0.02).
The strong points: As a follower of Shannon's initial column, and having read the 2011 version or rather the majority of articles from the 2011 version multiple times, having the follow up series in front of me makes me all happy and warm inside. I couldn't have possibly known back then, but I felt certain that that material, that book, had so much potential that it had to be redone in a better way than before. As I wrote on my 2012 review, books like this validate the existence of a hobby. De&D contains an unprecedented wealth of information about the English-speaking RPG industry that nobody could have possibly collected on his own, and which becomes increasingly harder to track down, amongst other due to the course of life. If one can't address the protagonists because they are no longer among us, by definition he can only consult secondary sources. Shannon himself acknowledges that in many occasions there were conflicting accounts even about hard facts as to when a product was printed. The writing is thus authoritative on the issues that have been verified, while it acknowledges the divergence of opinions on what wasn't. The honesty is appreciated: in some cases not only different accounts were given by different people, but even the same people told the story differently, with the time having passed and all. In that sense maybe the forth volume was slightly easier to research and compose, seeing how it is the most current. It also demonstrates however that even though the author does not take sides, he is opinionated about what occurred in numerous of the described companies' stories.
Last but not least: probably owing to the editorial support that Shannon received during/after the kickstarter, I actually noticed one single typo in this volume. I understand that all four volumes have received the same treatment, meaning that one can potentially ignore my commentary on typos on the reviews of the first two volumes of the series (volume three was as typo free as the present fourth volume).
Conclusion: This is it; the series is complete. It is as perfect as they get. There is nothing else to say than go buy these four books, yes, all four of them. We owe it to ourselves to know our history, to know who we are. Shannon continues his great work on a product level this time. It can be read under each listing at You can follow it more thoroughly however through the Designers & Dragons facebook page. Will this be the next generation of research into our hobby? An article per supplement, instead of an article per company? I can hardly wait! 2b1af7f3a8