Coping and Management Techniques Used by Chronic Low Back Pain Patients Receiving Treatment From Chiropractors.

OBJECTIVES:The purpose of this study was to describe coping strategies (eg, mechanisms, including self-treatment) that a person uses to reduce pain and its impact on functioning as reported by patients with chronic low back pain who were seen by doctors of chiropractic and how these coping strategies vary by patient characteristics. METHODS:Data were collected from a national sample of US chiropractic patients recruited from chiropractic practices in 6 states from major geographical regions of the United States using a multistage stratified sampling strategy. Reports of coping behaviors used to manage pain during the past 6 months were used to create counts across 6 domains: cognitive, self-care, environmental, medical care, social activities, and work. Exploratory analyses examined counts in domains and frequencies of individual items by levels of patient characteristics. RESULTS:A total of 1677 respondents with chronic low back pain reported using an average of 9 coping behaviors in the prior 6 months. Use of more types of behaviors were reported among those with more severe back pain, who rated their health as fair or poor and who had daily occurrences of pain. Exercise was more frequent among the healthy and those with less pain. Female respondents tended to report using more coping behaviors than men, and Hispanics more than non-Hispanics. CONCLUSION:Persons with chronic back pain were proactive in their coping strategies and frequently used self-care coping strategies like those provided by chiropractors in patient education. In alignment with patients' beliefs that their condition was chronic and lifelong, many patients attempted a wide range of coping strategies to relieve their pain

Experiences With Chiropractic Care for Patients With Low Back or Neck Pain.

BackgroundMusculoskeletal disorders are the second leading cause of disability worldwide.ObjectiveExamine experiences of chiropractic patients in the United States with chronic low back or neck pain.MethodObservational study of 1853 chronic low back pain and neck pain patients (74% female) who completed an online questionnaire at the 3-month follow-up that included Consumer Assessment of Healthcare Providers and Systems (CAHPS) items assessing their experiences with care.ResultsWe found similar reports of communication for the chiropractic sample and patients in the 2016 CAHPS National Database, but 85% in the database versus 79% in the chiropractic sample gave the most positive response to the time spent with provider item. More patients in the CAHPS database rated their provider at the top of the scale (8 percentage points). More chiropractic patients reported always getting answers to questions the same day (16 percentage points) and always being seen within 15 minutes of their appointment time (29 percentage points).ConclusionsThe positive experiences of patients with chronic back and neck pain are supportive of their use of chiropractic care

Solution to the problem of the poor cyclic fatigue resistance of bulk metallic glasses

The recent development of metallic glass-matrix composites represents a particular milestone in engineering materials for structural applications owing to their remarkable combination of strength and toughness. However, metallic glasses are highly susceptible to cyclic fatigue damage, and previous attempts to solve this problem have been largely disappointing. Here, we propose and demonstrate a microstructural design strategy to overcome this limitation by matching the microstructural length scales (of the second phase) to mechanical crack-length scales. Specifically, semisolid processing is used to optimize the volume fraction, morphology, and size of second-phase dendrites to confine any initial deformation (shear banding) to the glassy regions separating dendrite arms having length scales of ≈2 μm, i.e., to less than the critical crack size for failure. Confinement of the damage to such interdendritic regions results in enhancement of fatigue lifetimes and increases the fatigue limit by an order of magnitude, making these “designed” composites as resistant to fatigue damage as high-strength steels and aluminum alloys. These design strategies can be universally applied to any other metallic glass systems

The implications of lung-regulated buoyancy control for dive depth and duration

Among air-breathing divers, control of buoyancy through lung volume regulation may be most highly developed in marine turtles. In short, the turtle lung may serve a dual role as both an oxygen store and in buoyancy control. A simple model is developed to show that, for turtles diving up to the maximum depth at which they can still use their lungs to attain neutral buoyancy, the total oxygen store will increase greatly with dive depth, and hence a corresponding increase in dive duration is predicted. Time–depth recorders attached to free-living green turtles (Chelonia mydas) at Ascension Island confirmed a marked increase in dive duration with depth, with the gradient of this relationship being >10 times that seen in diving birds and mammals. Consistent with the prediction that the lungs serve a dual role, we found that, when lead weights were added to some turtles to increase their specific gravity, the mean depth of dives decreased, but for dives to the same depth, weighted animals dived for longer. The depth distribution of green turtles seems to be generally constrained by the maximum depth at which they can still attain close to neutral buoyancy

Observations of the 5‐day wave in the mesosphere and lower thermosphere

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94851/1/grl7954.pd

TIMED Doppler Interferometer on the Thermosphere Ionosphere Mesosphere Energetics and Dynamics satellite: Data product overview

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94699/1/jgra18252.pd

Computerized adaptive testing and short form development for child and adolescent oral health patient-reported outcomes measurement.

ObjectivesTo develop computerized adaptive testing (CAT) and short forms of self-report oral health measures that are predictive of both the children's oral health status index (COHSI) and the children's oral health referral recommendation (COHRR) scales, for children and adolescents, ages 8-17.Material and methodsUsing final item calibration parameters (discrimination and difficulty parameters) from the item response theory analysis, we performed post hoc CAT simulation. Items most frequently administered in the simulation were incorporated for possible inclusion in final oral health assessment toolkits, to select the best performing eight items for COHSI and COHRR.ResultsTwo previously identified unidimensional sets of self-report items consisting of 19 items for the COHSI and 22 items for the COHRR were administered through CAT resulting in eight-item short forms for both the COHSI and COHRR. Correlations between the simulated CAT scores and the full item bank representing the latent trait are r = .94 for COHSI and r = .96 for COHRR, respectively, which demonstrated high reliability of the CAT and short form.ConclusionsUsing established rigorous measurement development standards, the CAT and corresponding eight-item short form items for COHSI and COHRR were developed to assess the oral health status of children and adolescents, ages 8-17. These measures demonstrated good psychometric properties and can have clinical utility in oral health screening and evaluation and clinical referral recommendations

Increasing Pregnancy Rate in Beef Cattle by Clitoral Massage During Artificial Insemination

Clitoral massage (stimulation) at the time of artificial insemination (AI) has been reported to increase pregnancy rate in lactating beef cows, but not to increase pregnancy rate in heifers. These reports have been limited to studies conducted at one location in the U.S. (Miles City, Montana), and the efficacy of clitoral massage on AI pregnancy rates of beef cattle at other geographic locations has not been reported. To our knowledge, there are no reports in the literature indicating a negative effect of clitoral stimulation on pregnancy rate of cows. The following experiment was conducted to test the effects of clitoral massage on pregnancy rate to artificial insemination in beef cattle and to define the effects of age, postpartum interval, and technician on pregnancy responses to clitoral massage performed at the time of artificial inseminatio

Targeted vagus nerve stimulation for rehabilitation after stroke

No abstract available