Lived experiences of informal caregivers of people with chronic musculoskeletal pain: a systematic review and meta-ethnography

BACKGROUND: People with chronic pain often seek support from friends and family for everyday tasks. These individuals are termed informal caregivers. There remains uncertainty regarding the lived experiences of these people who care for individuals with chronic musculoskeletal pain. The aim of this paper is to synthase the evidence on the lived experiences of informal caregivers providing care to people with chronic musculoskeletal pain. METHODS: A systematic literature review was undertaken of published and unpublished literature databases including: EMBASE, MEDLINE, CINAHL, PubMed, the WHO International Clinical Trial Registry and ClinicalTrials.gov registry (to September 2019). Qualitative studies exploring the lived experiences of informal caregivers of people with chronic musculoskeletal pain were included. Data were synthesised using a meta-ethnography approach. Evidence was evaluated using the Critical Appraisal Skills Programme (CASP) qualitative appraisal tool. RESULTS: From 534 citations, 10 studies were eligible (360 participants: 171 informal caregivers of 189 care recipients). The evidence was moderate quality. Seven themes arose: the relationship of caregivers to healthcare professionals, role reversal with care recipients; acting the confidant to the care recipient; a constant burden in caregiving; legitimising care recipient’s condition; knowledge and skills to provide caregiving; and the perception of other family members and wider-society to the caregiver/care recipient dyad. CONCLUSIONS: The lived experiences of caregivers of people with chronic musculoskeletal pain is complex and dynamic. There is an inter-connected relationship between caregivers, care recipients and healthcare professionals. Exploring how these experiences can be modified to improve a caregiving dyad’s lived experience is now warranted

Linear Paul trap design for an optical clock with Coulomb crystals

We report on the design of a segmented linear Paul trap for optical clock applications using trapped ion Coulomb crystals. For an optical clock with an improved short-term stability and a fractional frequency uncertainty of 10^-18, we propose 115In+ ions sympathetically cooled by 172Yb+. We discuss the systematic frequency shifts of such a frequency standard. In particular, we elaborate on high precision calculations of the electric radiofrequency field of the ion trap using the finite element method. These calculations are used to find a scalable design with minimized excess micromotion of the ions at a level at which the corresponding second- order Doppler shift contributes less than 10^-18 to the relative uncertainty of the frequency standard

Integrins as therapeutic targets: lessons and opportunities.

The integrins are a large family of cell adhesion molecules that are essential for the regulation of cell growth and function. The identification of key roles for integrins in a diverse range of diseases, including cancer, infection, thrombosis and autoimmune disorders, has revealed their substantial potential as therapeutic targets. However, so far, pharmacological inhibitors for only three integrins have received marketing approval. This article discusses the structure and function of integrins, their roles in disease and the chequered history of the approved integrin antagonists. Recent advances in the understanding of integrin function, ligand interaction and signalling pathways suggest novel strategies for inhibiting integrin function that could help harness their full potential as therapeutic targets

Movement and habitat use of the snapping turtle in an urban landscape

In order to effectively manage urban habitats, it is important to incorporate the spatial ecology and habitat use of the species utilizing them. Our previous studies have shown that the distribution of upland habitats surrounding a highly urbanized wetland habitat, the Central Canal (Indianapolis, IN, USA) influences the distribution of map turtles (Graptemys geographica) and red-eared sliders (Trachemys scripta) during both the active season and hibernation. In this study we detail the movements and habitat use of another prominent member of the Central Canal turtle assemblage, the common snapping turtle, Chelydra serpentina. We find the same major upland habitat associations for C. serpentina as for G. geographica and T. scripta, despite major differences in their activity (e.g., C. serpentina do not regularly engage in aerial basking). These results reinforce the importance of recognizing the connection between aquatic and surrounding terrestrial habitats, especially in urban ecosystems

Multifaceted roles of GSK-3 and Wnt/β-catenin in hematopoiesis and leukemogenesis: opportunities for therapeutic intervention

Glycogen synthase kinase-3 (GSK-3) is well documented to participate in a complex array of critical cellular processes. It was initially identified in rat skeletal muscle as a serine/threonine kinase that phosphorylated and inactivated glycogen synthase. This versatile protein is involved in numerous signaling pathways that influence metabolism, embryogenesis, differentiation, migration, cell cycle progression and survival. Recently, GSK-3 has been implicated in leukemia stem cell pathophysiology and may be an appropriate target for its eradication. In this review, we will discuss the roles that GSK-3 plays in hematopoiesis and leukemogenesis as how this pivotal kinase can interact with multiple signaling pathways such as: Wnt/β-catenin, phosphoinositide 3-kinase (PI3K)/phosphatase and tensin homolog (PTEN)/Akt/mammalian target of rapamycin (mTOR), Ras/Raf/MEK/extracellular signal-regulated kinase (ERK), Notch and others. Moreover, we will discuss how targeting GSK-3 and these other pathways can improve leukemia therapy and may overcome therapeutic resistance. In summary, GSK-3 is a crucial regulatory kinase interacting with multiple pathways to control various physiological processes, as well as leukemia stem cells, leukemia progression and therapeutic resistance. GSK-3 and Wnt are clearly intriguing therapeutic targets

Multi-Phase Sputtered TiO2-Induced Current–Voltage Distortion in Sb2Se3 Solar Cells

Despite the recent success of CdS/Sb2Se3 heterojunction devices, cadmium toxicity, parasitic absorption from the relatively narrow CdS band gap (2.4 eV) and multiple reports of inter-diffusion at the interface forming Cd(S,Se) and Sb2(S,Se)3 phases, present significant limitations to this device architecture. Among the options for alternative partner layers in antimony chalcogenide solar cells, the wide band gap, non-toxic titanium dioxide (TiO2) has demonstrated the most promise. It is generally accepted that the anatase phase of the polymorphic TiO2 is preferred, although there is currently an absence of analysis with regard to phase influence on device performance. This work reports approaches to distinguish between TiO2 phases using both surface and bulk characterization methods. A device fabricated with a radio frequency (RF) magnetron sputtered rutile-TiO2 window layer (FTO/TiO2/Sb2Se3/P3HT/Au) achieved an efficiency of 6.88% and near-record short–circuit current density (Jsc) of 32.44 mA cm−2, which is comparable to established solution based TiO2 fabrication methods that produced a highly anatase-TiO2 partner layer and a 6.91% efficiency device. The sputtered method introduces reproducibility challenges via the enhancement of interfacial charge barriers in multi-phase TiO2 films with a rutile surface and anatase bulk. This is shown to introduce severe S-shaped current–voltage (J–V) distortion and a drastic fill–factor (FF reduction in these devices

Stein's method on Wiener chaos

We combine Malliavin calculus with Stein's method, in order to derive explicit bounds in the Gaussian and Gamma approximations of random variables in a fixed Wiener chaos of a general Gaussian process. We also prove results concerning random variables admitting a possibly infinite Wiener chaotic decomposition. Our approach generalizes, refines and unifies the central and non-central limit theorems for multiple Wiener-It\^o integrals recently proved (in several papers, from 2005 to 2007) by Nourdin, Nualart, Ortiz-Latorre, Peccati and Tudor. We apply our techniques to prove Berry-Ess\'een bounds in the Breuer-Major CLT for subordinated functionals of fractional Brownian motion. By using the well-known Mehler's formula for Ornstein-Uhlenbeck semigroups, we also recover a technical result recently proved by Chatterjee, concerning the Gaussian approximation of functionals of finite-dimensional Gaussian vectors.Comment: 39 pages; Two sections added; To appear in PTR