Demographic characteristics and perceptions of supply and demand of chiropractic services in Australia: Results from stage 1 of the work force study survey

Objectives: The aim of this report is to describe the demographic characteristics including the age profile, gender differences, income and perceptions of supply and demand of the chiropractic profession in Australia. This workforce study (WFS) was divided into three components, Australian Chiropractors (Stage 1), their patients (Stage 2), and members of the general public (Stage 3). Methods: A web-based, 64-item, cross-sectional survey questionnaire was issued to registered chiropractors (CAA and non-CAA members) throughout Australia in 2010. At the time of the survey there were 3,892 registered chiropractors. Survey invitations were sent to those who were registered chiropractors, and had provided email addresses (n=1,917). Results: Demographic Characteristics: There is evidence to suggest that the profession may be becoming increasingly female over time. Income exclusively from chiropractic care included 27.9% who reported an annual pre-tax net income of $115,000 or less and 32.3$115,000. Of the latter group, 12% indicated that they were earning more than $215,000. Income was not related to the hours worked per week particularly for males. Supply and Demand: When considering their home state and their local region, more chiropractors thought that there was undersupply in their state, but an adequate supply in their local region. A large proportion (40%) of the sample felt that universities in Australia were graduating the correct number of chiropractors per year, and 32% reported that too many were being produced in Australia. Very few reported that the Universities were not graduating enough chiropractors. Conclusion: This paper reflects some of the findings from Stage 1 of the three stage Workforce study, showing a profession heading towards a more even gender balance and characterised by a higher than average annual income. Future research should include the impact on supply and demand of the possibility of an increasingly female profession. In addition to this, although there is a perception that there is under-utilisation of chiropractic services in inland, rural and remote areas, the extent of which should be further explored. Information from this study will assist with strategic decision making and planning. A strategic framework for the profession should not only consider the findings from this study but also explore other factors that may have an impact on supply and demand, for example general trends in health and aging from local and national government reports

Chiropractic in Australia: A survey of the general public

Background: An increase in the use of complementary and alternative medicine was identified in several countries including Australia. There is a need to assess the current position of chiropractic within the Australian health system. Objectives: To estimate the lifetime prevalence of the use of chiropractic in Australia; to investigate the perceptions and attitudes of Australian general public about: their health status, the chiropractic profession, chiropractic and health services in general. Methods: A survey was carried out in which a novel 21-item questionnaire was utilised. To obtain a sample whose opinions would be representative of the Australian general population with a 95% level of significance and 4% margin of error, 600 respondents were required. Descriptive statistics, the chi-squared test and logistic regression were used to present and analyse the data. Results: 757 respondents completed the survey. A high prevalence of pain and discomfort relating to the musculoskeletal system were found, particularly in the lower back (71.1 % of the respondents) and neck (55.6%). The first contact with respect to therapy for the greatest proportion of respondents was general medicine (35.5%), followed by chiropractic (16%), physiotherapy (13.8%) and massage (10.2%). Physiotherapy was rated highest in its ability to relieve the symptoms (18%) followed by chiropractic (15.9%), massage (15.5%) and medicine (14%). In our sample 302 (39.9%) participants used chiropractic before and 75.9% of these consumers were satisfied or highly satisfied with the services provided. No significant differences in income, age and gender were found with regards to those individuals who reported a previous use of chiropractic services. The main reasons for not using chiropractic were: that there was no perceived need for a chiropractic intervention, associated cost, lack of information about chiropractic, lack of referral, being attended by another health professional, and concern about the safety and efficacy of the treatment. Most of the respondents considered that attending to general health and well-being was more important than simply alleviating symptoms and their personal philosophy was a major determinant when it came to the choice of health services. Conclusions: This study suggests that chiropractic is a thriving profession in Australia. It would appear that there is a need for chiropractic services in Australia, particularly in attending to the highly prevalent realm of musculoskeletal disorders. A considerable number of Australians already utilise chiropractic services. Encouragingly, the vast majority of these consumers are satisfied with the service provided. Chiropractic could play an even greater role within the Australian health if better integrated with the mainstream and allied medicine. A more active approach should be taken by chiropractic practitioners and institutions to improve the general public's knowledge about chiropractic

Tracking linkage to HIV care for former prisoners: A public health priority

Improving testing and uptake to care among highly impacted populations is a critical element of Seek, Test, Treat and Retain strategies for reducing HIV incidence in the community. HIV disproportionately impacts prisoners. Though, incarceration provides an opportunity to diagnose and initiate therapy, treatment is frequently disrupted after release. Though model programs exist to support linkage to care on release, there is a lack of scalable metrics with which to assess adequacy of linkage to care after release. The linking data from Ryan White program Client Level Data (CLD) files reported to HRSA with corrections release data offers an attractive means of generating these metrics. Identified only by use of a confidential encrypted Unique Client Identifier (eUCI) these CLD files allow collection of key clinical indicators across the system of Ryan White funded providers. Using eUCIs generated from corrections release data sets as a linkage tool, the time to the first service at community providers along with key clinical indicators of patient status at entry into care can be determined as measures of linkage adequacy. Using this strategy, high and low performing sites can be identified and best practices can be identified to reproduce these successes in other settings

Probing the Role of Magnetic-Field Variations in NOAA AR 8038 in Producing Solar Flare and CME on 12 May 1997

We carried out a multi-wavelength study of a CME and a medium-size 1B/C1.3 flare occurring on 12 May 1997. We present the investigation of magnetic-field variations in the NOAA Active Region 8038 which was observed on the Sun during 7--16 May 1997. Analyses of H{\alpha} filtergrams and MDI/SOHO magnetograms revealed continual but discrete surge activity, and emergence and cancellation of flux in this active region. The movie of these magnetograms revealed two important results that the major opposite polarities of pre-existing region as well as in the emerging flux region (EFR) were approaching towards each other and moving magnetic features (MMF) were ejecting out from the major north polarity at a quasi-periodicity of about ten hrs during 10--13 May 1997. These activities were probably caused by the magnetic reconnection in the lower atmosphere driven by photospheric convergence motions, which were evident in magnetograms. The magnetic field variations such as flux, gradient, and sunspot rotation revealed that free energy was slowly being stored in the corona. The slow low-layer magnetic reconnection may be responsible for this storage and the formation of a sigmoidal core field or a flux rope leading to the eventual eruption. The occurrence of EUV brightenings in the sigmoidal core field prior to the rise of a flux rope suggests that the eruption was triggered by the inner tether-cutting reconnection, but not the external breakout reconnection. An impulsive acceleration revealed from fast separation of the H{\alpha} ribbons of the first 150 seconds suggests the CME accelerated in the inner corona, which is consistent with the temporal profile of the reconnection electric field. In conclusion, we propose a qualitative model in view of framework of a solar eruption involving, mass ejections, filament eruption, CME, and subsequent flare.Comment: 8 figures, accepted for publication in Solar Physic

Rapid clearance profile of plasma circulating tumor HPV type 16 DNA during chemoradiotherapy correlates with disease control in HPV-associated oropharyngeal cancer

Purpose: To identify a profile of circulating tumor human papilloma virus (HPV) DNA (ctHPVDNA) clearance kinetics that is associated with disease control after chemoradiotherapy (CRT) for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). Experimental Design: A multi-institutional prospective biomarker trial was conducted in 103 patients with (i) p16- positive OPSCC, (ii) M0 disease, and (iii) receipt of definitive CRT. Blood specimens were collected at baseline, weekly during CRT, and at follow-up visits. Optimized multianalyte digital PCR assays were used to quantify ctHPVDNA (types 16/18/31/33/35) in plasma. A control cohort of 55 healthy volunteers and 60 patients with non-HPV-associated malignancy was also analyzed. Results: Baseline plasma ctHPVDNA had high specificity (97%) and high sensitivity (89%) for detecting newly diagnosed HPV-associated OPSCC. Pretreatment ctHPV16DNA copy number correlated with disease burden, tumor HPV copy number, and HPV integration status. We define a ctHPV16DNA favorable clearance profile as having high baseline copy number (>200 copies/mL) and >95% clearance of ctHPV16DNA by day 28 of CRT. Nineteen of 67 evaluable patients had a ctHPV16DNA favorable clearance profile, and none had persistent or recurrent regional disease after CRT. In contrast, patients with adverse clinical risk factors (T4 or >10 pack years) and an unfavorable ctHPV16DNA clearance profile had a 35% actuarial rate of persistent or recurrent regional disease after CRT (P = 0.0049). Conclusions: A rapid clearance profile of ctHPVDNA may predict likelihood of disease control in patients with HPVassociated OPSCC patients treated with definitive CRT and may be useful in selecting patients for deintensified therapy

First Observation of Coherent π0\pi^0 Production in Neutrino Nucleus Interactions with Eν<E_{\nu}< 2 GeV

The MiniBooNE experiment at Fermilab has amassed the largest sample to date of $\pi^0$s produced in neutral current (NC) neutrino-nucleus interactions at low energy. This paper reports a measurement of the momentum distribution of $\pi^0$s produced in mineral oil (CH$_2$) and the first observation of coherent $\pi^0$ production below 2 GeV. In the forward direction, the yield of events observed above the expectation for resonant production is attributed primarily to coherent production off carbon, but may also include a small contribution from diffractive production on hydrogen. Integrated over the MiniBooNE neutrino flux, the sum of the NC coherent and diffractive modes is found to be (19.5 $\pm$1.1 (stat) $\pm$2.5 (sys))% of all exclusive NC $\pi^0$ production at MiniBooNE. These measurements are of immediate utility because they quantify an important background to MiniBooNE's search for $\nu_{\mu} \to \nu_e$ oscillations.Comment: Submitted to Phys. Lett.

Spectroscopic and photometric periods of six ultracompact accreting binaries

Ultracompact accreting binary systems each consist of a stellar remnant accreting helium-enriched material from a compact donor star. Such binaries include two related sub-classes, AM CVn-type binaries and helium cataclysmic variables, in both of which the central star is a white dwarf. We present a spectroscopic and photometric study of six accreting binaries with orbital periods in the range of 40--70 min, including phase-resolved VLT spectroscopy and high-speed ULTRACAM photometry. Four of these are AM CVn systems and two are helium cataclysmic variables. For four of these binaries we are able to identify orbital periods (of which three are spectroscopic). SDSS J1505+0659 has an orbital period of 67.8 min, significantly longer than previously believed, and longer than any other known AM CVn binary. We identify a WISE infrared excess in SDSS J1505+0659 that we believe to be the first direct detection of an AM CVn donor star in a non-direct impacting binary. The mass ratio of SDSS J1505+0659 is consistent with a white dwarf donor. CRTS J1028-0819 has an orbital period of 52.1 min, the shortest period of any helium cataclysmic variable. MOA 2010-BLG-087 is co-aligned with a K-class star that dominates its spectrum. ASASSN-14ei and ASASSN-14mv both show a remarkable number of echo outbursts following superoutbursts (13 and 10 echo outbursts respectively). ASASSN-14ei shows an increased outburst rate over the years following its superoutburst, perhaps resulting from an increased accretion rate

Anthropogenic Space Weather

Anthropogenic effects on the space environment started in the late 19th century and reached their peak in the 1960s when high-altitude nuclear explosions were carried out by the USA and the Soviet Union. These explosions created artificial radiation belts near Earth that resulted in major damages to several satellites. Another, unexpected impact of the high-altitude nuclear tests was the electromagnetic pulse (EMP) that can have devastating effects over a large geographic area (as large as the continental United States). Other anthropogenic impacts on the space environment include chemical release ex- periments, high-frequency wave heating of the ionosphere and the interaction of VLF waves with the radiation belts. This paper reviews the fundamental physical process behind these phenomena and discusses the observations of their impacts.Comment: 71 pages, 35 figure

Phenomenology of flavor-mediated supersymmetry breaking

The phenomenology of a new economical SUSY model that utilizes dynamical SUSY breaking and gauge-mediation (GM) for the generation of the sparticle spectrum and the hierarchy of fermion masses is discussed. Similarities between the communication of SUSY breaking through a messenger sector, and the generation of flavor using the Froggatt-Nielsen (FN) mechanism are exploited, leading to the identification of vector-like messenger fields with FN fields, and the messenger U(1) as a flavor symmetry. An immediate consequence is that the first and second generation scalars acquire flavor-dependent masses, but do not violate FCNC bounds since their mass scale, consistent with effective SUSY, is of order 10 TeV. We define and advocate a minimal flavor-mediated model (MFMM), recently introduced in the literature, that successfully accommodates the small flavor-breaking parameters of the standard model using order one couplings and ratios of flavon field vevs. The mediation of SUSY breaking occurs via two-loop log-enhanced GM contributions, as well as several one-loop and two-loop Yukawa-mediated contributions for which we provide analytical expressions. The MFMM is parameterized by a small set of masses and couplings, with values restricted by several model constraints and experimental data. The next-to-lightest sparticle (NLSP) always has a decay length that is larger than the scale of a detector, and is either the lightest stau or the lightest neutralino. Similar to ordinary GM models, the best collider search strategies are, respectively, inclusive production of at least one highly ionizing track, or events with many taus plus missing energy. In addition, D^0 - \bar{D}^0 mixing is also a generic low energy signal. Finally, the dynamical generation of the neutrino masses is briefly discussed.Comment: 54 pages, LaTeX, 8 figure

Grain Surface Models and Data for Astrochemistry

AbstractThe cross-disciplinary field of astrochemistry exists to understand the formation, destruction, and survival of molecules in astrophysical environments. Molecules in space are synthesized via a large variety of gas-phase reactions, and reactions on dust-grain surfaces, where the surface acts as a catalyst. A broad consensus has been reached in the astrochemistry community on how to suitably treat gas-phase processes in models, and also on how to present the necessary reaction data in databases; however, no such consensus has yet been reached for grain-surface processes. A team of ∼25 experts covering observational, laboratory and theoretical (astro)chemistry met in summer of 2014 at the Lorentz Center in Leiden with the aim to provide solutions for this problem and to review the current state-of-the-art of grain surface models, both in terms of technical implementation into models as well as the most up-to-date information available from experiments and chemical computations. This review builds on the results of this workshop and gives an outlook for future directions