The development and validation of a measurement instrument to investigate determinants of health care utilisation for low back pain in Ethiopia

Introduction and Objections: Low back pain (LBP) is a highly prevalent and disabling public health problem globally. However, little is known about factors affecting health care utilisation for optimal management of the pain, and there is no validated instrument to derive epidemiological data for a better understanding of these factors. The aim of this study was to develop and validate an instrument used to measure determinants of health care utilisation for LBP in Ethiopia.Methods: The relevant domains of potential determinants of health care utilisation for LBP were identified following a comprehensive review of the literature. Items relating to each domain were then generated by considering the context of Ethiopia, and where necessary, existing items were adapted. The instrument was then translated, and an expert panel reviewed the instrument for content validity, clarity and any other suggestions. Using the data collected from 1303 adults with LBP, factorial validity was assessed by conducting principal component and parallel analyses. Internal consistency reliability was also assessed using Cronbach's alpha. Intraclass correlation coefficient (ICC) and Cohen Kappa statistic were calculated to evaluate temporal stability of the instrument.Results: Parallel analysis showed that there were six components with Eigenvalues (obtained from principal component analysis) exceeding the corresponding criterion values for a randomly generated data matrix of the same size. Cronbach's alpha for the internal consistency reliability ranged from 0.65 to 0.82. In assessing temporal stability, ICC ranged from 0.60, 95% CI: 0.23-0.98 to 0.95, 95% CI: 0.81-1.00 while Cohen Kappa ranged from 0.72, 95% CI: 0.49-0.94 to 0.93, 95% CI: 0.85-1.00.Conclusions: This study demonstrated that the newly developed instrument has an overall good level of content and factorial validity, internal consistency reliability, and temporal stability. In this way, this instrument is appropriate for measuring determinants of health care utilisation among people with LBP in Ethiopia

Determinants of healthcare utilisation for low back pain: a population-based study in Ethiopia

Low back pain (LBP) remains one of the major public health problems worldwide. However, in low-income countries, such as those in Africa, the epidemiological data on healthcare utilisation for LBP are lacking due to more pressing problems such as infectious diseases, to which the majority of health resources are channelled. Therefore, this study aimed at investigating the determinants of healthcare utilisation for LBP in the general population of Ethiopia. A population-based cross-sectional study was conducted in South-West Shewa zone of Ethiopia from June to November 2018. The data were collected by interviewing adults with LBP (n = 1812, randomly selected) using a psychometrically tested and validated instrument, analysed using R version 3.5.1. A log-binomial regression model was used to determine the prevalence ratio with a 95% confidence interval (CI) in identifying factors associated with healthcare utilisation for LBP. Estimates of population parameters were also presented with 95% CIs and p values. For all applications of inferential statistics, a p value of ≤.05 was taken as the significance level. The lifetime prevalence of healthcare utilisation for LBP was 36.1%, 95% CI: 33.9-38.1, while the annual prevalence rate was 30%, 95% CI: 27.9-32.2. Of those with a 1-year history of healthcare utilisation, while 7.4%, 95% CI: 4.9-10.3 rural and 36.6%, 95% CI: 29.5-44 urban populations utilised healthcare from general hospitals, 1.4%, 95% CI: 0.3-2.7 rural and 6.8%, 95% CI: 3.1-10.8 urban populations utilised healthcare from specialised hospitals. Several sociodemographic factors, modifiable health behaviours/lifestyle habits, pain interrelated factors, and specific factors such as beliefs about the pain, depressive symptoms and insomnia were associated with healthcare utilisation for LBP. The implications of this research are that it may be prudent for the Ethiopian healthcare policy makers to develop the necessary strategies to meet the health needs of both urban and rural populations with LBP

Current research into brain barriers and the delivery of therapeutics for neurological diseases: a report on CNS barrier congress London, UK, 2017.

This is a report on the CNS barrier congress held in London, UK, March 22-23rd 2017 and sponsored by Kisaco Research Ltd. The two 1-day sessions were chaired by John Greenwood and Margareta Hammarlund-Udenaes, respectively, and each session ended with a discussion led by the chair. Speakers consisted of invited academic researchers studying the brain barriers in relation to neurological diseases and industry researchers studying new methods to deliver therapeutics to treat neurological diseases. We include here brief reports from the speakers

Participant recruitment to FiCTION, a primary dental care trial – survey of facilitators and barriers

Objective To identify reasons behind a lower than expected participant recruitment rate within the FiCTION trial, a multi-centre paediatric primary dental care randomised controlled trial (RCT). Subjects (materials) and methods An online survey, based on a previously published tool, consisting of both quantitative and qualitative responses, completed by staff in dental practices recruiting to FiCTION. Ratings from quantitative responses were aggregated to give overall scores for factors related to participant recruitment. Qualitative responses were independently grouped into themes. Results Thirty-nine anonymous responses were received. Main facilitators related to the support received from the central research team and importance of the research question. The main barriers related to low child eligibility rates and the integration of trial processes within routine workloads. Conclusions These findings have directed strategies for enhancing participant recruitment at existing practices and informed recruitment of further practices. The results help provide a profile of the features required of practices to successfully screen and recruit participants. Future trials in this setting should consider the level of interest in the research question within practices, and ensure trial processes are as streamlined as possible. Research teams should actively support practices with participant recruitment and maintain enthusiasm among the entire practice team

Probing quantum phases of ultracold atoms in optical lattices by transmission spectra in cavity QED

Studies of ultracold atoms in optical lattices link various disciplines, providing a playground where fundamental quantum many-body concepts, formulated in condensed-matter physics, can be tested in much better controllable atomic systems, e.g., strongly correlated phases, quantum information processing. Standard methods to measure quantum properties of Bose-Einstein condensates (BECs) are based on matter-wave interference between atoms released from traps which destroys the system. Here we propose a nondestructive method based on optical measurements, and prove that atomic statistics can be mapped on transmission spectra of a high-Q cavity. This can be extremely useful for studying phase transitions between Mott insulator and superfluid states, since various phases show qualitatively distinct light scattering. Joining the paradigms of cavity quantum electrodynamics (QED) and ultracold gases will enable conceptually new investigations of both light and matter at ultimate quantum levels, which only recently became experimentally possible. Here we predict effects accessible in such novel setups.Comment: 6 pages, 3 figure

Development of a chemically defined medium and discovery of new mitogenic growth factors for mouse hepatocytes: Mitogenic effects of FGF1/2 and PDGF

Chemically defined serum-free media for rat hepatocytes have been useful in identifying EGFR ligands and HGF/MET signaling as direct mitogenic factors for rat hepatocytes. The absence of such media for mouse hepatocytes has prevented screening for discovery of such mitogens for mouse hepatocytes. We present results obtained by designing such a chemically defined medium for mouse hepatocytes and demonstrate that in addition to EGFR ligands and HGF, the growth factors FGF1 and FGF2 are also important mitogenic factors for mouse hepatocytes. Smaller mitogenic response was also noticed for PDGF AB. Mouse hepatocytes are more likely to enter into spontaneous proliferation in primary culture due to activation of cell cycle pathways resulting from collagenase perfusion. These results demonstrate unanticipated fundamental differences in growth biology of hepatocytes between the two rodent species. Copyright: © 2014 Reekie et al

Single-Atom Resolved Fluorescence Imaging of an Atomic Mott Insulator

The reliable detection of single quantum particles has revolutionized the field of quantum optics and quantum information processing. For several years, researchers have aspired to extend such detection possibilities to larger scale strongly correlated quantum systems, in order to record in-situ images of a quantum fluid in which each underlying quantum particle is detected. Here we report on fluorescence imaging of strongly interacting bosonic Mott insulators in an optical lattice with single-atom and single-site resolution. From our images, we fully reconstruct the atom distribution on the lattice and identify individual excitations with high fidelity. A comparison of the radial density and variance distributions with theory provides a precise in-situ temperature and entropy measurement from single images. We observe Mott-insulating plateaus with near zero entropy and clearly resolve the high entropy rings separating them although their width is of the order of only a single lattice site. Furthermore, we show how a Mott insulator melts for increasing temperatures due to a proliferation of local defects. Our experiments open a new avenue for the manipulation and analysis of strongly interacting quantum gases on a lattice, as well as for quantum information processing with ultracold atoms. Using the high spatial resolution, it is now possible to directly address individual lattice sites. One could, e.g., introduce local perturbations or access regions of high entropy, a crucial requirement for the implementation of novel cooling schemes for atoms on a lattice

Using PIV to measure granular temperature in saturated unsteady polydisperse granular flows

The motion of debris flows, gravity-driven fast moving mixtures of rock, soil and water can be interpreted using the theories developed to describe the shearing motion of highly concentrated granular fluid flows. Frictional, collisional and viscous stress transfer between particles and fluid characterizes the mechanics of debris flows. To quantify the influence of collisional stress transfer, kinetic models have been proposed. Collisions among particles result in random fluctuations in their velocity that can be represented by their granular temperature, T. In this paper particle image velocimetry, PIV, is used to measure the instantaneous velocity field found internally to a physical model of an unsteady debris flow created by using “transparent soil”—i.e. a mixture of graded glass particles and a refractively matched fluid. The ensemble possesses bulk properties similar to that of real soil-pore fluid mixtures, but has the advantage of giving optical access to the interior of the flow by use of plane laser induced fluorescence, PLIF. The relationship between PIV patch size and particle size distribution for the front and tail of the flows is examined in order to assess their influences on the measured granular temperature of the system. We find that while PIV can be used to ascertain values of granular temperature in dense granular flows, due to increasing spatial correlation with widening gradation, a technique proposed to infer the true granular temperature may be limited to flows of relatively uniform particle size or large bulk

Interaction and filling induced quantum phases of dual Mott insulators of bosons and fermions

Many-body effects are at the very heart of diverse phenomena found in condensed-matter physics. One striking example is the Mott insulator phase where conductivity is suppressed as a result of a strong repulsive interaction. Advances in cold atom physics have led to the realization of the Mott insulating phases of atoms in an optical lattice, mimicking the corresponding condensed matter systems. Here, we explore an exotic strongly-correlated system of Interacting Dual Mott Insulators of bosons and fermions. We reveal that an inter-species interaction between bosons and fermions drastically modifies each Mott insulator, causing effects that include melting, generation of composite particles, an anti-correlated phase, and complete phase-separation. Comparisons between the experimental results and numerical simulations indicate intrinsic adiabatic heating and cooling for the attractively and repulsively interacting dual Mott Insulators, respectively

Quantum Acoustics with Surface Acoustic Waves

It has recently been demonstrated that surface acoustic waves (SAWs) can interact with superconducting qubits at the quantum level. SAW resonators in the GHz frequency range have also been found to have low loss at temperatures compatible with superconducting quantum circuits. These advances open up new possibilities to use the phonon degree of freedom to carry quantum information. In this paper, we give a description of the basic SAW components needed to develop quantum circuits, where propagating or localized SAW-phonons are used both to study basic physics and to manipulate quantum information. Using phonons instead of photons offers new possibilities which make these quantum acoustic circuits very interesting. We discuss general considerations for SAW experiments at the quantum level and describe experiments both with SAW resonators and with interaction between SAWs and a qubit. We also discuss several potential future developments.Comment: 14 pages, 12 figure