Amount of health care and self-care following a randomized clinical trial comparing flexion-distraction with exercise program for chronic low back pain

BACKGROUND: Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program) or a form of chiropractic care (Flexion Distraction) for chronic low back pain. METHODS: In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD) or a form of physical therapy (EP). Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain. RESULTS: Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p < 0.05). No group differences were noted in the number of visits to a chiropractor or physical therapist. Self-care was initiated by nearly every participant in both groups. CONCLUSION: During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care

Understanding and addressing mathematics anxiety using perspectives from education, psychology and neuroscience

Mathematics anxiety is a significant barrier to mathematical learning. In this article, we propose that state or on-task mathematics anxiety impacts on performance, while trait mathematics anxiety leads to the avoidance of courses and careers involving mathematics. We also demonstrate that integrating perspectives from education, psychology and neuroscience contributes to a greater understanding of mathematics anxiety in its state and trait forms. Research from cognitive psychology and neuroscience illustrates the effect of state mathematics anxiety on performance and research from cognitive, social and clinical psychology, and education can be used to conceptualise the origins of trait mathematics anxiety and its impact on avoidant behaviour. We also show that using this transdisciplinary framework to consider state and trait mathematics anxiety separately makes it possible to identify strategies to reduce the negative effects of mathematics anxiety. Implementation of these strategies among particularly vulnerable groups, such as pre-service teachers, could be beneficial

AMM15: a new high-resolution NEMO configuration for operational simulation of the European north-west shelf

This paper describes the next-generation ocean forecast model for the European north-west shelf, which will become the basis of operational forecasts in 2018. This new system will provide a step change in resolution and therefore our ability to represent small-scale processes. The new model has a resolution of 1.5 km compared with a grid spacing of 7 km in the current operational system. AMM15 (Atlantic Margin Model, 1.5 km) is introduced as a new regional configuration of NEMO v3.6. Here we describe the technical details behind this configuration, with modifications appropriate for the new high-resolution domain. Results from a 30-year non-assimilative run using the AMM15 domain demonstrate the ability of this model to represent the mean state and variability of the region. Overall, there is an improvement in the representation of the mean state across the region, suggesting similar improvements may be seen in the future operational system. However, the reduction in seasonal bias is greater off-shelf than on-shelf. In the North Sea, biases are largely unchanged. Since there has been no change to the vertical resolution or parameterization schemes, performance improvements are not expected in regions where stratification is dominated by vertical processes rather than advection. This highlights the fact that increased horizontal resolution will not lead to domain-wide improvements. Further work is needed to target bias reduction across the north-west shelf region