Unbased calculus for functors to chain complexes

Recently, the Johnson-McCarthy discrete calculus for homotopy functors was extended to include functors from an unbased simplicial model category to spectra. This paper completes the constructions needed to ensure that there exists a discrete calculus tower for functors from an unbased simplicial model category to chain complexes over a fixed commutative ring. Much of the construction of the Taylor tower for functors to spectra carries over to this context. However, one of the essential steps in the construction requires proving that a particular functor is part of a cotriple. For this, one needs to prove that certain identities involving homotopy limits hold up to isomorphism, rather than just up to weak equivalence. As the target category of chain complexes is not a simplicial model category, the arguments for functors to spectra need to be adjusted for chain complexes. In this paper, we take advantage of the fact that we can construct an explicit model for iterated fibers, and prove that the functor is a cotriple directly. We use related ideas to provide concrete infinite deloopings of the first terms in the resulting Taylor towers when evaluated at the initial object in the source category.Comment: 20 page

International Handbook of Health Literacy : Research, practice and policy across the lifespan

Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, eds. International Handbook of Health Literacy : Research, practice and policy across the lifespan. Bristol: Policy Press, University of Bristol; 2019

Measuring children’s health literacy. Current approaches and challenges

Bollweg TM, Okan O. Measuring children’s health literacy. Current approaches and challenges. In: Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, eds. International handbook of health literacy. Research, practice and policy across the life-span. Bristol: Policy Press; 2019: 83-97

Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of trial data

Objective: To assess the value of monitoring response to bisphosphonate treatment by means of measuring bone mineral density

Association of Osteocalcin and Abdominal Aortic Calcification in Older Women: The Study of Osteoporotic Fractures

Osteocalcin (OC) is produced by osteoblasts and vascular smooth muscle cells. In animal models, serum OC levels are strongly correlated with vascular calcium content, however, the association of OC with vascular calcification in humans is uncertain. The Study of Osteoporotic Fractures (SOF) enrolled community-living women, age ≥65 years. The present study included a subsample of 363 randomly selected SOF participants. Serum total OC was measured by ELISA, and abdominal aortic calcification (AAC) was evaluated on lateral lumbar radiographs. We examined the cross-sectional association between serum OC and AAC. The mean serum OC level was 24 ± 11 ng/ml and AAC was present in 188 subjects (52%). We observed no association of OC and AAC in either unadjusted or adjusted analyses. For example, each standard deviation higher OC level was associated with an odds ratio (OR) for AAC prevalence (AAC score >0) near unity (OR = 1.06; 95% CI, 0.82–1.36) in models adjusted for CVD risk factors. Further adjustment for intact parathyroid hormone, bone-specific alkaline phosphatase, 25-hydroxyvitamin D, and hip and spine bone mineral density did not materially change the results (OR = 1.22; 95% CI, 0.86–1.75). Similarly, higher OC levels were not associated with severity of AAC (P = 0.87). In conclusion, among community-living older women, serum OC is not associated with AAC. These findings suggest that serum OC levels may more closely reflect bone formation than vascular calcification in humans

Individualized chiropractic and integrative care for low back pain: the design of a randomized clinical trial using a mixed-methods approach

<p>Abstract</p> <p>Background</p> <p>Low back pain (LBP) is a prevalent and costly condition in the United States. Evidence suggests there is no one treatment which is best for all patients, but instead several viable treatment options. Additionally, multidisciplinary management of LBP may be more effective than monodisciplinary care. An integrative model that includes both complementary and alternative medicine (CAM) and conventional therapies, while also incorporating patient choice, has yet to be tested for chronic LBP.</p> <p>The primary aim of this study is to determine the relative clinical effectiveness of 1) monodisciplinary chiropractic care and 2) multidisciplinary integrative care in 200 adults with non-acute LBP, in both the short-term (after 12 weeks) and long-term (after 52 weeks). The primary outcome measure is patient-rated back pain. Secondary aims compare the treatment approaches in terms of frequency of symptoms, low back disability, fear avoidance, self-efficacy, general health status, improvement, satisfaction, work loss, medication use, lumbar dynamic motion, and torso muscle endurance. Patients' and providers' perceptions of treatment will be described using qualitative methods, and cost-effectiveness and cost utility will be assessed.</p> <p>Methods and Design</p> <p>This paper describes the design of a randomized clinical trial (RCT), with cost-effectiveness and qualitative studies conducted alongside the RCT. Two hundred participants ages 18 and older are being recruited and randomized to one of two 12-week treatment interventions. Patient-rated outcome measures are collected via self-report questionnaires at baseline, and at 4, 12, 26, and 52 weeks post-randomization. Objective outcome measures are assessed at baseline and 12 weeks by examiners blinded to treatment assignment. Health care cost data is collected by self-report questionnaires and treatment records during the intervention phase and by monthly phone interviews thereafter. Qualitative interviews, using a semi-structured format, are conducted with patients at the end of the 12-week treatment period and also with providers at the end of the trial.</p> <p>Discussion</p> <p>This mixed-methods randomized clinical trial assesses clinical effectiveness, cost-effectiveness, and patients' and providers' perceptions of care, in treating non-acute LBP through evidence-based individualized care delivered by monodisciplinary or multidisciplinary care teams.</p> <p>Trial registration</p> <p>ClinicalTrials.gov NCT00567333</p