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DEPARTMENT OF HEALTH AND HUMAN SERVICES
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Public Health Service
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INDIAN HEALTH SERVICE
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AGREEMENT TO ASSIGN CLAIM UPON REQUEST
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PUBLIC LAW 87-693, (42 U S.C. §§ 2651-2653)
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In accordance with the provisions of Public Law 87-693 (42 U.S.C. §§ 2651-2653), I hereby agree to assign to the United States of America, upon request, any claim, demand, entitlement, or cause of action which I now have or which I may hereafter have against a third person for the reasonable value of hospital, medical, surgical, or dental care and treatment (including prostheses and medical appliances) furnished or to be furnished to me by or at the expense of the United States as the result of an injury or disease suffered by me on or about (mm/dd/yyyy) ___ under circumstances creating a tort liability upon such third person to pay damages to me.
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It is understood and agreed that I may assert a personal injury claim in my own behalf against such third person, and may include as a part thereof the reasonable value of the hospital and medical care and treatment furnished to me by or at the expense of the Unites States. If I assert a personal injury claim in my own behalf and make a recovery therein, whether by judgment, compromise settlement, or otherwise, I agree to hold in trust for the United States out of the proceeds thereof the full amount of its claim for the reasonable value of the medical care and treatment furnished to me by or at the expense of the United States and to pay over such amount as directed by the United States.
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THIS AGREEMENT IS NOT AN ASSIGNMENT AND DOES NOT CONSTITUTE A TRANSFER OF ANY PRESENT INTEREST IN ANY CLAIM OR CAUSE OF ACTION WHICH I NOW HAVE OR MAY HEREAFTER HAVE AGAINST A THIRD PERSON.
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Any assignment demanded by the United States in accordance with the above cited statute shall be in writing, and the cause of action thereby assigned shall not vest in the United States unless and until the assignment is accepted in writing by the department or agency concerned, or by the Attorney General of the United States.
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DATED THIS DAY
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14
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MONTH
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3
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YEAR (yyyy)
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2025
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SIGNATURE
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WITNESS
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IHS-961 (11/21)
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PSC Publishing Services (301) 443-6740 EF
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Int. J. Environ. Res. Public Health 2022, 19, 825
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8 of 24
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Table 1. Cont.
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Study Study Design Setting Follow-Up N° of Subjects Included in the Analysis Age (Years) ¹ Intervention/s in the Experimental Group/s (EG) Intervention/s in the Control Group (CG) Statistical Analysis Comments
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Rodríguez-García et al., 2013 [50] Cluster randomized trial School 8 months N = 84 EG = 44 CG = 40 M(SD) ¹ Children = 10.27 (0.31) Teenagers: 13.46 (0.68)
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Education on physical exercise, in two 13 min sessions of exercise per week, during 32 weeks The exercises included hamstring stretching, endurance strength of abdominal and lumbar muscles, and anterior and posterior pelvic tilt
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No intervention Chi-square and Mann–Whitney U tests
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Vidal et al., 2013 [51] Cluster randomized trial School 3 months N = 137 EG = 63 CG = 74 M(SD) ¹ 10.72 (0.672) EG = 10.83 (0.64) CG = 10.64(0.70)
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6, one-hour sessions on postural hygiene 4 talks on anatomy and physiology of the spine, pathophysiology of low back pain, risk factors, ergonomics, and postural hygiene + 2 “practical sessions”; postural analysis, carrying objects, balance, analysis of the content and way to carry schoolbags, breathing and relaxation
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No intervention One-way analysis of variance (ANOVA) or chi-square tests, to compare baseline values. Repeated-measures analysis of co-variance (ANCOVA), to to examine the effect of the intervention
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Bodes Pardo et al., 2018 [46] RCT Physical therapy practices 3 months N = 56 EG = 28 EG = 28 M(SD) EG = 44.9(9.6); CG = 49.2(10.5)
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Usual care + exercise (motor control exercises, stretching, and aerobic exercise): • Session 1: exercises were demonstrated and performed by participants under supervision of a physiotherapist • Session 2 (one month later). Same as session 1, confirming proper execution of exercises • Patients instructed to complete the exercise program on their own, daily for 3 months. Compliance assessed + education on neurophysiology of pain (www.paininmotion.be) (accessed date: 29 September 2021). Two 30–50 min educational sessions on neurophysiology of pain, provided to groups of 4–6 participants • Session 1: verbal explanation + visual presentation + leaflet reinforcing contents. • Session 2, one month later: content of session 1 was reinforced, and questions answered
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Usual care + exercise (motor control exercises, stretching, and aerobic exercise): • Session 1: exercises were demonstrated and performed by participants under supervision of a physiotherapist. • Session 2 (one month later). Same as session 1, confirming proper execution of exercises • Patients instructed to complete the exercise program on their own, daily for 3 months. Compliance assessed
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Pearson chi-square test and Student t test. Effect sizes were calculated by Hedges’ g
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RCT, randomized clinical trial; I, intervention; EG, experimental group; CG, control group; M(R): mean (range). M(IQR): mean (IQR: interquartile range). M(SD): Mean (Standard Deviation). ¹ As per the Spanish law, children are grouped in class based on year of birth (e.g., all the children born between 1 January 2015 and 31 December 2015, are grouped in the same class). Therefore, the age of all the students in a school class is homogenous.
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Int. J. Environ. Res. Public Health 2022, 19, 825
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20 of 24
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# 3 49.686 AK = (back pain) OR AK = (back) OR AK = (musculoskeletal pain) OR AK = (musculoskeletal disorder) OR AK = (musculoeskeletal diseases) Bases de datos= WOS, CCC, DIIDW, KJD, MEDLINE, RSCI, SCIELO Periodo de tiempo = Todos los años Idioma de búsqueda = Auto
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# 2 1.182.747 AB = (back pain) OR AB = (back) OR AB = (musculoskeletal pain) OR AB = (musculoskeletal disorder) OR AB = (musculoeskeletal diseases) Bases de datos= WOS, CCC, DIIDW, KJD, MEDLINE, RSCI, SCIELO Periodo de tiempo = Todos los años Idioma de búsqueda = Auto
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# 1 332.322 TI= (back pain) OR TI = (back) OR TI = (musculoskeletal pain) OR TI = (musculoskeletal disorder) OR TI = (musculoeskeletal diseases) Bases de datos= WOS, CCC, DIIDW, KJD, MEDLINE, RSCI, SCIELO Periodo de tiempo = Todos los años Idioma de búsqueda = Auto
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#8 AND #4
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