Use of complementary alternative medicine for low back pain consulting in general practice: a cohort study

<p>Abstract</p> <p>Background</p> <p>Although back pain is considered one of the most frequent reasons why patients seek complementary and alternative medical (CAM) therapies little is known on the extent patients are actually using CAM for back pain.</p> <p>Methods</p> <p>This is a post hoc analysis of a longitudinal prospective cohort study embedded in a RCT. General practitioners (GPs) recruited consecutively adult patients presenting with LBP. Data on physical function, on subjective mood, and on utilization of health services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months</p> <p>Results</p> <p>A total of 691 (51%) respectively 928 (69%) out of 1,342 patients received one form of CAM depending on the definition. Local heat, massage, and spinal manipulation were the forms of CAM most commonly offered. Using CAM was associated with specialist care, chronic LBP and treatment in a rehabilitation facility. Receiving spinal manipulation, acupuncture or TENS was associated with consulting a GP providing these services. Apart from chronicity disease related factors like functional capacity or pain only showed weak or no association with receiving CAM.</p> <p>Conclusion</p> <p>The frequent use of CAM for LBP demonstrates that CAM is popular in patients and doctors alike. The observed association with a treatment in a rehabilitation facility or with specialist consultations rather reflects professional preferences of the physicians than a clear medical indication. The observed dependence on providers and provider related services, as well as a significant proportion receiving CAM that did not meet the so far established selection criteria suggests some arbitrary use of CAM.</p

Teaching: Natural or Cultural?

In this chapter I argue that teaching, as we now understand the term, is historically and cross-culturally very rare. It appears to be unnecessary to transmit culture or to socialize children. Children are, on the other hand, primed by evolution to be avid observers, imitators, players and helpers—roles that reveal the profoundly autonomous and self-directed nature of culture acquisition (Lancy in press a). And yet, teaching is ubiquitous throughout the modern world—at least among the middle to upper class segment of the population. This ubiquity has led numerous scholars to argue for the universality and uniqueness of teaching as a characteristically human behavior. The theme of this chapter is that this proposition is unsustainable. Teaching is largely a result of recent cultural changes and the emergence of modern economies, not evolution

Probabilistic SMF Tsunami Hazard Assessment for the upper East Coast of the United States

The level of tsunami hazard to the east coast of the United States is not well understood. This information is critical for the population, emergency services, and industry of the region. Assessing this hazard is particularly difficult because of the lack of tsunamis in the historical record and the uncertainty regarding the return periods of large-scale events that have been proposed, such as a large transoceanic tsunami possibly caused by a collapse of the Cumbre Vieja volcano in the Canary Islands, or a large coseismic tsunami initiated in the Puerto Rican subduction zone. The most significant tsunami hazard in this region, however, may be due to local submarine mass failures (SMF), which could cause concentrated damage in coastal communities located near the failures. This paper presents results of a probabilistic analysis that estimates the hazard, expressed in terms of runup (at a given probability of occurrence), of SMF tsunamis triggered by earthquakes, on the upper northeast coast of the United States. A Monte Carlo approach is employed, in which distributions of relevant parameters (seismicity, sediment properties, type and location of slide, volume of slide, water depth, etc.) are used to perform large numbers of stochastic stability analyses of underwater slopes, based on standard geotechnical methods. When slope failure occurs, initial tsunami characteristic height and runup are estimated, based on earlier numerical work, for specified return periods of seismic events. The overall hazard associated with SMF tsunamis along the coast is found to be quite low at most locations as compared, e.g., to the typical 100 year hurricane storm surge in the region (5 m). Two sites, however, located off of Long Island, New York and Atlantic City, New Jersey, show an elevated risk of higher tsunami runup (5.0-7.5 m). These two sites should be the focus of more detailed studies

Erythrocyte band 3 protein strongly interacts with phosphoinositides.

Abstract85% of the phosphorus coisolated with band 3 protein during separation of the intrinsic proteins of the human erythrocyte membrane by zonal electrophoresis in high concentrations of acetic acid was found to be derived from phosphoinositides, mainly phosphatidylinositol 4,5-bisphosphate. When native band 3 protein and pyrene-labelled phospholipids were present in micelles of the nonionic detergent nonaethyleneglycol lauryl ether, strong resonance energy transfer was observed between the tryptophan residues and phosphatidylinositol 4,5-bisphosphate and, to a smaller degree, phosphatidylinositol 4-phosphate. We conclude that band 3 protein strongly interacts with phosphoinositides, in particular with phosphatidylinositol 4,5-bisphosphate