Exploring the Influence of Patient-Professional Partnerships on the Self-Management of Chronic Back Pain: A Qualitative Study

Patients are encouraged to take an active role in self-managing their chronic back pain and functional problems. However, research suggests that patients do not self-manage, and they expect health professionals to fulfill a comprehensive role in managing pain. A partnership between patients and health professionals is called for, and self-management works best when they share knowledge and work together toward optimal goals. To explore how patients' partnerships with health professionals may influence their ability to self-manage pain by exploring patients' experiences. A grounded theory approach with in-depth, semistructured interviews was undertaken. Each interview was analyzed using constant comparative analysis. This study was nested within a larger study on patient-professional partnerships and the self-management of chronic back pain. Twenty-six patients with chronic back pain were recruited in a community-based pain management service in Northern England, United Kingdom. Three themes emerged: building partnerships with health professionals; being supported by health professionals to self-manage the pain; and experiencing a change in self-management. Five approaches that underpinned health professionals' self-management support were identified. Facilitators of and barriers to a good partnership were reported. This study suggests that a good patient-professional partnership has a positive effect on patients’ self-management ability. A theoretical model explaining how such partnership may influence self-management was developed. It is necessary for both patients and health professionals to be aware of their partnerships, which may enhance the effect of pain management services

SEASONAL, HABITAT AND SEX-SPECIFIC PATTERNS OF FOOD UTILIZATION BY RED-WINGED BLACKBIRDS (Agelaius phoeniceous) IN EASTERN ONTARIO AND THEIR ECONOMIC IMPORTANCE

Crop depredation by red-winged blackbirds (Agelaius phoeniceus) causes serious economic losses to agricultural crops each year in both Canada and the United States. The concentration of vulnerable, monocultural crops, particularly corn, during periods when large flocks of blackbirds congregate in roosting areas prior to migration has invariably led to heavy feeding pressure (Stone et al., 1972; Wiens and Dyer, 1975; Tyler et al., 1978). Efforts to reduce damage levels by mechanical and chemical dispersal agents have been largely unsuccessful, at least in terms of a long-term solution to the problem. Recently, the lethal control of blackbird populations using surfactants has been proposed. However, the potential repercussions of the removal of substantial numbers of birds from northern breeding areas are virtually unknown (Robertson et al., 1978). Much of the research dealing with the feeding ecology of red-winged blackbirds has been limited to fall and winter periods when large aggregations of birds are actively involved in crop depredation (Goddad, 1969; Williams, 1976; Dolbeer et al., 1978) or pose a potential health hazard (Monroe and Cronholm, 1976). However, what is not known is the degree to which the removal of deleterious weed seed and insect pests cited in several studies (Bird and Smith, 1964; Mott et al., 1972; Robertson et al., 1978) might be of potential value to agriculture. The issue of whether the benefits derived from redwing foraging compensate for the negative aspects associated with crop depredation and health hazards remains largely unresolved. The present study attempted to evaluate the pest status of this species using diet information derived from food habits analysis conducted during the residency of red- winged blackbirds in a northern breeding area. By determining how the feeding ecology of red-winged blackbirds varies on a seasonal basis, among different breeding habitats and between sexes, we hoped to determine more realistically which segments of the population might be responsible for the greatest benefits or detriments and, thereby, more accurately evaluate the economic impact of the species as a whole. To achieve this aim, the study provides an accurate description of the common insects and weed pests utilized by redwings. By determining the relative proportions of those items known to be detrimental, we hoped to illustrate, at least qualitatively, the degree to which redwing foraging is comprised of both beneficial and harmful components

Radiocarbon content of dissolved organic carbon in the South Indian Ocean

Author Posting. © American Geophysical Union, 2018. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geophysical Research Letters 45 (2018): 872–879, doi:10.1002/2017GL076295.We report four profiles of the radiocarbon content of dissolved organic carbon (DOC) spanning the South Indian Ocean (SIO), ranging from the Polar Front (56°S) to the subtropics (29°S). Surface waters held mean DOC Δ14C values of −426 ± 6‰ (~4,400 14C years) at the Polar Front and DOC Δ14C values of −252 ± 22‰ (~2,000 14C years) in the subtropics. At depth, Circumpolar Deep Waters held DOC Δ14C values of −491 ± 13‰ (~5,400 years), while values in Indian Deep Water were more depleted, holding DOC Δ14C values of −503 ± 8‰ (~5,600 14C years). High-salinity North Atlantic Deep Water intruding into the deep SIO had a distinctly less depleted DOC Δ14C value of −481 ± 8‰ (~5,100 14C years). We use multiple linear regression to assess the dynamics of DOC Δ14C values in the deep Indian Ocean, finding that their distribution is characteristic of water masses in that region.National Science Foundation (NSF) Grant Numbers: OPP-1142117, OCE-14367482018-07-2

A patient-led approach to product innovation in patient education and wound management

This paper reports results from a multi-disciplinary industry-academia research partnership whose goal was to conceive, design and prototype solutions for older adults with chronic wounds. Aim: The aim of the project was to explore the potential enhanced benefits of extended patient involvement in an entire live product development process, from understanding the wound care environment, through needs identification, to solution generation and iteration. Methods: An action-design research methodology was used to engage with 47 target users and develop design ideas and prototypes. The research was built around a theoretical framework that integrates aspirations and needs of target users with socio-technical systems thinking and innovation management processes. Results: The design component of the research methodology resulted in the concept design of a wound management education and information system for use by patients and their caregivers. This concept was developed based on observations of and interaction with patients and caregivers. A prototype solution was built and used as a vehicle to gain an understanding of opportunities, issues, and challenges to be addressed in supporting older adults with chronic wounds and enabling them to maintain and improve their personal wellbeing. This led to the identification of the need for readily available, current wound care information, advice, and support for older people and caregivers. The design concept was a response to this need. From early evaluations of a prototype implementation, age was identified as not necessarily being a barrier to the use of a technology-based solution; IT skills, confidence, and access to the internet were identified as more important factors. Outcomes: A prototypical wound care information system was developed that has been evaluated with target users using deliberative panels and home-based evaluations of a prototype implemented on a tablet platform. Wound care solutions focussed on the need to support people in maintaining their personal wellbeing lead to different requirements from those that support wound treatment. By considering wider perspectives, solution providers have opportunities to utilise fewer or re-allocate resources whilst improving user wellbeing by creating user-focussed outcomes that are effective, efficient, and valued by both patient and provider

Single cell genomics-based analysis of gene content and expression of prophages in a diffuse-flow deep-sea hydrothermal system

© The Author(s), 2019. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Labonte, J. M., Pachiadaki, M., Fergusson, E., McNichol, J., Grosche, A., Gulmann, L. K., Vetriani, C., Sievert, S. M., & Stepanauskas, R. Single cell genomics-based analysis of gene content and expression of prophages in a diffuse-flow deep-sea hydrothermal system. Frontiers in Microbiology, 10, (2019): 1262, doi:10.3389/fmicb.2019.01262.Phage–host interactions likely play a major role in the composition and functioning of many microbiomes, yet remain poorly understood. Here, we employed single cell genomics to investigate phage–host interactions in a diffuse-flow, low-temperature hydrothermal vent that may be reflective of a broadly distributed biosphere in the subseafloor. We identified putative prophages in 13 of 126 sequenced single amplified genomes (SAGs), with no evidence for lytic infections, which is in stark contrast to findings in the surface ocean. Most were distantly related to known prophages, while their hosts included bacterial phyla Campylobacterota, Bacteroidetes, Chlorobi, Proteobacteria, Lentisphaerae, Spirochaetes, and Thermotogae. Our results suggest the predominance of lysogeny over lytic interaction in diffuse-flow, deep-sea hydrothermal vents, despite the high activity of the dominant Campylobacteria that would favor lytic infections. We show that some of the identified lysogens have co-evolved with their host over geological time scales and that their genes are transcribed in the environment. Functional annotations of lysogeny-related genes suggest involvement in horizontal gene transfer enabling host’s protection against toxic metals and antibacterial compounds.This work was supported by the U.S. National Science Foundation’s Dimensions of Biodiversity Program [OCE-1136488 (to RS), OCE-1136727 (to SMS) and OCE-1136451 (to CV)], as well as DEB-1441717 and OCE-1335810 (to RS), and the DOE JGI CSP project 1477

Natural-abundance radiocarbon as a tracer of assimilation of petroleum carbon by bacteria in salt marsh sediments

Author Posting. © The Authors, 2005. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Geochimica et Cosmochimica Acta 70 (2006): 1761-1771, doi:10.1016/j.gca.2005.12.020.The natural abundance of radiocarbon (14C) provides unique insight into the source and cycling of sedimentary organic matter. Radiocarbon analysis of bacterial phospholipid lipid fatty acids (PLFAs) in salt-marsh sediments of southeast Georgia (USA) – one heavily contaminated by petroleum residues – was used to assess the fate of petroleum-derived carbon in sediments and incorporation of fossil carbon into microbial biomass. PLFAs that are common components of eubacterial cell membranes (e.g., branched C15 and C17, 10-methyl-C16) were depleted in 14C in the contaminated sediment (mean Δ14C value of +25 ± 19 ‰ for bacterial PLFAs) relative to PLFAs in uncontaminated “control” sediment (Δ14C = +101 ± 12‰). We suggest that the 14C-depletion in bacterial PLFAs at the contaminated site results from microbial metabolism of petroleum and subsequent incorporation of petroleum-derived carbon into bacterial membrane lipids. A mass balance calculation indicates that 6-10% of the carbon in bacterial PLFAs at the oiled site could derive from petroleum residues. These results demonstrate that even weathered petroleum may contain components of sufficient lability to be a carbon source for biomass production by marsh sediment microorganisms. Furthermore, a small but significant fraction of fossil carbon is assimilated even in the presence of a much larger pool of presumably more-labile and faster-cycling carbon substrates.This study was supported by Georgia Sea Grant (RR100-221/926784), the National Science Foundation (OCE-9911678) and NOSAMS (thanks to J. M. Hayes)

Massive Peatland Carbon Banks Vulnerable to Rising Temperatures

Peatlands contain one-third of the world’s soil carbon (C). If destabilized, decomposition of this vast C bank could accelerate climate warming; however, the likelihood of this outcome remains unknown. Here, we examine peatland C stability through five years of whole-ecosystem warming and two years of elevated atmospheric carbon dioxide concentrations (eCO2). Warming exponentially increased methane (CH4) emissions and enhanced CH4 production rates throughout the entire soil profile; although surface CH4 production rates remain much greater than those at depth. Additionally, older deeper C sources played a larger role in decomposition following prolonged warming. Most troubling, decreases in CO2:CH4 ratios in gas production, porewater concentrations, and emissions, indicate that the peatland is becoming more methanogenic with warming. We observed limited evidence of eCO2 effects. Our results suggest that ecosystem responses are largely driven by surface peat, but that the vast C bank at depth in peatlands is responsive to prolonged warming

Direct application of compound-specific radiocarbon analysis of leaf waxes to establish lacustrine sediment chronology

Author Posting. © Springer, 2007. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in Journal of Paleolimnology 39 (2008): 43-60, doi:10.1007/s10933-007-9094-1.This study demonstrates use of compound-specific radiocarbon analysis (CSRA) for dating Holocene lacustrine sediments from carbonate-hosted Ordy Pond, Oahu, Hawaii. Long-chain odd-numbered normal alkanes (n-alkanes), biomarkers characteristic of terrestrial higher plants, were ubiquitous in Ordy Pond sediments. The δ13C of individual n-alkanes ranged from −29.9 to −25.5‰, within the expected range for n-alkanes synthesized by land plants using the C3 or C4 carbon fixation pathway. The 14C ages of n-alkanes determined by CSRA showed remarkably good agreement with 14C dates of rare plant macrofossils obtained from nearby sedimentary horizons. In general, CSRA of n-alkanes successfully refined the age-control of the sediments. The sum of n-alkanes in each sample produced 70–170 μg of carbon (C), however, greater age errors were confirmed for samples containing less than 80 μg of C. The 14C age of n-alkanes from one particular sedimentary horizon was 4,155 years older than the value expected from the refined age-control, resulting in an apparent and arguable age discrepancy. Several lines of evidence suggest that this particular sample was contaminated by introduction of 14C-free C during preparative capillary gas chromatography. This study simultaneously highlighted the promising potential of CSRA for paleo-applications and the risks of contamination associated with micro-scale 14C measurement of individual organic compounds.This project was funded by Petroleum Research Fund (PRF #40088-ACS) and in part by Sigma Xi, The Scientific Research Society (Grants in aid of research, 2003)

Ibrutinib for Relapsed / Refractory CLL: A UK and Ireland Analysis of Outcomes in 315 patients

In 2014, ibrutinib was made available for relapsed/refractory chronic lymphocytic leukaemia (CLL) patients. The UK CLL Forum collected data from UK/Ireland patients with a minimum of 1 year follow-up with pre-planned primary endpoints; the number of patients still on therapy at 1 year (Discontinuation Free Survival; DFS) and 1 year overall survival (OS). With a median 16 months follow-up, data on 315 patients demonstrated 1 year DFS of 73.7% and 1 year OS of 83.8%. Patients with better pre-treatment performance status (PS 0/1 vs 2+) had superior DFS (77.5% vs 61.3%;p14 days and had OS of 89.7%, while 26% of patients had dose reductions and 13% had temporary treatment breaks >14 days. We could not demonstrate a detrimental effect of dose reductions alone (1 year OS: 91.7%), but patients who had first year treatment breaks > 14 days, particularly permanent cessation of ibrutinib had both reduced 1 year OS (68.5%) and also a statistically significant excess mortality rate beyond one year. Although outcomes appear inferior to the RESONATE trial (1 year OS;90%: PFS;84%), this may partly reflect the inclusion of PS 2+ patients and that 17.5% of patients permanently discontinued ibrutinib due to an event other than disease progression