A mixed-methods feasibility study of a comorbidity-adapted exercise program for low back pain in older adults (COMEBACK):a protocol

BACKGROUND: The prevalence of low back pain increases with age and has a profound impact on physical and psychosocial health. With increasing age comes increasing comorbidity, and this also has pronounced health consequences. Whilst exercise is beneficial for a range of health conditions, trials of exercise for low back pain management often exclude older adults. It is currently unknown whether an exercise program for older adults with low back pain, tailored for the presence of comorbidities, is acceptable for participants and primary healthcare providers (PHCPs). Therefore, this mixed-methods study will assess the feasibility of an 8-week comorbidity-adapted exercise program for older people with low back pain and comorbid conditions. METHODS: The 3-phased feasibility study will be performed in a primary healthcare setting. PHCPs will be trained to deliver a comorbidity-adapted exercise program for older people with low back pain and comorbidities. Healthcare-seeking adults > 65 will be screened for eligibility over telephone, with a recruitment target of 24 participants. Eligible participants will attend an initial appointment (diagnostic phase). During this initial appointment, a research assistant will collect patient demographics, self-reported outcome measurement data, and perform a physical and functional examination to determine contraindications and restrictions to an exercise program. During the development phase, PHCPs will adapt the exercise program to the individual and provide patient education. During the intervention phase, there will be two supervised exercise sessions per week, over 8 weeks (total of 16 exercise sessions). Each exercise session will be approximately 60 min in duration. A qualitative evaluation after the last exercise program session will explore the feasibility of the exercise program for participants and PHCPs. Progression criteria will determine the suitability for a fully powered randomised controlled trial. DISCUSSION: This mixed-methods feasibility study will assess an exercise program for older adults with low back pain and comorbidities. Once assessed for feasibility, the exercise program may be tested for effectiveness in a larger, fully powered randomised controlled trial. This information will add to the sparse evidence base on appropriate options for managing back pain in older adults. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry registration number: ACTRN12621000379819p (06/04/2021; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621000379819p). TRIAL SPONSOR: Macquarie University, Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40814-022-01097-x

Distance Estimation in Cosmology

In this paper we outline the framework of mathematical statistics with which one may study the properties of galaxy distance estimators. We describe, within this framework, how one may formulate the problem of distance estimation as a Bayesian inference problem, and highlight the crucial question of how one incorporates prior information in this approach. We contrast the Bayesian approach with the classical `frequentist' treatment of parameter estimation, and illustrate -- with the simple example of estimating the distance to a single galaxy in a redshift survey -- how one can obtain a significantly different result in the two cases. We also examine some examples of a Bayesian treatment of distance estimation -- involving the definition of Malmquist corrections -- which have been applied in recent literature, and discuss the validity of the assumptions on which such treatments have been based.Comment: Plain Latex version 3.1, 18 pages + 2 figures, `Vistas in Astronomy' in pres

Children’s and parents’ involvement in care order proceedings: a cross-national comparison of judicial decision-makers’ views and experiences

This paper presents the views of judicial decision-makers (n= 1794) in four child protection jurisdictions (England, Finland, Norway, and the USA (California)), about whether parents and children are provided with appropriate opportunities to participate in proceedings in their countries. Overall, the study found a high degree of agreement within and between the countries as regards the important conditions for parents and children´s involvement, although the four systems themselves are very different. There was less agreement about children’s involvement than parents’, and the court decision-makers from Norway and Finland were more likely to express doubts about this. Nevertheless, the main message from the judicial decision-makers is that they are relatively satisfied as to how parents and children´s involvement is handled in their countries. Whether or not this confidence is justified, the emphasis on achieving effective involvement of children and parents in court proceedings is likely to grow, with major implications for the workers, decision-makers and agencies involved

Distribution of sedimentary rock types through time in a back-arc basin: A case study from the Jurassic of the Greater Caucasus (Northern Neotethys)

Abstract The evolution of sedimentary basins can be explored by analyzing the changes in their lithologies and lithofacies (i.e. predominant lithologies). The Greater Caucasus Basin, which was located at the northern margin of the Neotethys Ocean, represents a complete Sinemurian-Tithonian succession. A quantitative analysis of compiled datasets suggests that principal lithologies and lithofacies are represented by siliciclastics, shale and carbonates. The relative abundance of siliciclastics and shale decreased throughout the Jurassic, whereas that of carbonates increased. Evaporites are known from the Upper Jurassic, while volcaniclastics and volcanics, as well as coals, are known only in the Lower to Middle Jurassic. Siliceous rocks are extremely rare. Lithology and lithofacies proportions change accordingly. The Sinemurian-Bathonian sedimentary complex is siliciclastic-and-shale-dominated, whereas the Callovian-Tithonian sedimentary complex is carbonate-dominated. A major change in the character of sedimentation occurred during the Aalenian-Callovian time interval. Regional transgressions and regressions were more important controls of changes in the sedimentary rock proportions than average basin depth. Landward shoreline shifts were especially favorable for carbonate accumulation, whereas siliciclastics and shale were deposited preferentially in regressive settings. An extended area of the marine basin, its lower average depth, and a sharp bathymetric gradient favored a higher diversity of sedimentation. An orogeny at the Triassic-Jurassic transition was responsible for a large proportion of siliciclastics and extensive conglomerate deposition. An arcarc collision in the Middle Jurassic also enhanced the siliciclastic deposition. Both phases of tectonic activity were linked with an increase in volcanics and volcaniclastics. Volcanism itself might have been an important control on sedimentation. A transition to carbonate-dominated sedimentation occurred in the Late Jurassic, reflecting a tectonically calm period

Genuine Correlations of Like-Sign Particles in Hadronic Z0 Decays

Correlations among hadrons with the same electric charge produced in Z0 decays are studied using the high statistics data collected from 1991 through 1995 with the OPAL detector at LEP. Normalized factorial cumulants up to fourth order are used to measure genuine particle correlations as a function of the size of phase space domains in rapidity, azimuthal angle and transverse momentum. Both all-charge and like-sign particle combinations show strong positive genuine correlations. One-dimensional cumulants initially increase rapidly with decreasing size of the phase space cells but saturate quickly. In contrast, cumulants in two- and three-dimensional domains continue to increase. The strong rise of the cumulants for all-charge multiplets is increasingly driven by that of like-sign multiplets. This points to the likely influence of Bose-Einstein correlations. Some of the recently proposed algorithms to simulate Bose-Einstein effects, implemented in the Monte Carlo model PYTHIA, are found to reproduce reasonably well the measured second- and higher-order correlations between particles with the same charge as well as those in all-charge particle multiplets.Comment: 26 pages, 6 figures, Submitted to Phys. Lett.

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types

Diversity of hard-bottom fauna relative to environmental gradients in Kongsfjorden, Svalbard

A baseline study of hard-bottom zoobenthos in relation to environmental gradients in Kongsfjorden, a glacial fjord in Svalbard, is presented, based on collections from 1996 to 1998. The total species richness in 62 samples from 0 to 30 m depth along five transects was 403 species. Because 32 taxa could not be identified to species level and because 11 species are probably new to science, the total number of identified species was 360. Of these, 47 species are new for Svalbard waters. Bryozoa was the most diverse group. Biogeographic composition revealed features of both Arctic and sub-Arctic properties of the fauna. Species richness, frequency of species occurrence, mean abundance and biomass generally decreased towards the tidal glaciers in inner Kongsfjorden. Among eight environmental factors, depth was most important for explaining variance in the composition of the zoobenthos. The diversity was consistently low at shallow depths, whereas the non-linear patterns of species composition of deeper samples indicated a transitional zone between surface and deeper water masses at 15–20 m depth. Groups of “colonial” and “non-colonial” species differed in diversity, biogeographic composition and distribution by location and depth as well as in relation to other environmental factors. “Non-colonial” species made a greater contribution than “colonial” species to total species richness, total occurrence and biomass in samples, and were more influenced by the depth gradient. Biogeographic composition was sensitive to variation of zoobenthic characteristics over the studied depth range. A list of recorded species and a description of sampling sites are presented