Socioeconomic disparities in chronic low back pain

Chronic pain is a widespread public health problem that affects at least 37% of U.S. adults. Low back pain (LBP) is the most common type of pain and results in over $100 billion each year in total direct and indirect (e.g., lost wages, reduced productivity) costs in the U.S. Chronic LBP (cLBP) is associated with limitations in physical function, work or school activities, and social activities, resulting in substantial impacts on individuals and families. The prevalence of back pain is higher among women, older adults and those with lower levels of education and a lower annual income. Literature reviews often document racial/ethnic disparities in pain treatment due to issues within the medical system, attitudes and beliefs of health care providers, and patient factors that result from each individual's pain experience. The biopsychosocial model conceptualizes the individual experience of pain with interrelated causes and manifestations in physical (e.g., genetics, injuries), psychological (e.g., depression, pain beliefs), and social (e.g., social support, health behaviors) dimensions. Common of assessments of cLBP include measures of pain intensity and measures of functional limitations. This research aims to explore associations of the seriousness of LBP with multiple sociodemographic characteristics. Two clinical research trials enrolled a diverse population to participant in cLBP research. All 415 participants completed baseline questionnaires, including measures of LBP intensity and LBP-related dysfunction, before randomization and participation began. The majority of participants were female, non-Hispanic black, and had an annual income <$20,000. This study population had a high level of pain intensity and LBP-related dysfunction, although the two outcomes were only moderately correlated. Two multivariate logistic regression models, one for each outcome) revealed different sets of predictors, although race/ethnicity, education, and employment status were present in both final models. LBP is a complex condition that requires differences in seriousness to be considered in relation to the multiple facets of the biopsychosocial model. Differences in seriousness of pain can in part be attributed to variability in perceptions and reports of patients. Patient perceptions as a result of coping strategies, behaviors, and perceived racial discrimination are discussed. Pain intensity and related function are important and interacting measures of cLBP in both clinical and research settings. Assessment of functional limitation holds value for predicting important disability outcomes such as the ability to work. LBP intensity ratings may reflect the direct and indirect impact of LBP treatment on psychological and social experiences of chronic pain. Medical professionals must acquire comprehensive knowledge about health disparities, cultural influences, and the role of individual behavioral characteristics in order to adequately create patient-centered treatment plans

Effect of the Coriolis Force on the Hydrodynamics of Colliding Wind Binaries

Using fully three-dimensional hydrodynamic simulations, we investigate the effect of the Coriolis force on the hydrodynamic and observable properties of colliding wind binary systems. To make the calculations tractable, we assume adiabatic, constant velocity winds. The neglect of radiative driving, gravitational deceleration, and cooling limit the application of our models to real systems. However, these assumptions allow us to isolate the effect of the Coriolis force, and by simplifying the calculations, allow us to use a higher resolution (up to 640^3) and to conduct a larger survey of parameter space. We study the dynamics of collidng winds with equal mass loss rates and velocities emanating from equal mass stars on circular orbits, with a range of values for the ratio of the wind to orbital velocity. We also study the dynamics of winds from stars on elliptical orbits and with unequal strength winds. Orbital motion of the stars sweeps the shocked wind gas into an Archimedean spiral, with asymmetric shock strengths and therefore unequal postshock temperatures and densities in the leading and trailing edges of the spiral. We observe the Kelvin-Helmholtz instability at the contact surface between the shocked winds in systems with orbital motion even when the winds are identical. The change in shock strengths caused by orbital motion increases the volume of X-ray emitting post-shock gas with T > 0.59 keV by 63% for a typical system as the ratio of wind velocity to orbital velocity decreases to V_w/V_o = 2.5. This causes increased free-free emission from systems with shorter orbital periods and an altered time-dependence of the wind attenuation. We comment on the importance of the effects of orbital motion on the observable properties of colliding wind binaries.Comment: 12 pages, 17 figures, accepted for publication in Ap

Native American Weight Loss Movement: Pilot Test of a Culturally Tailored Weight Loss Program for American Indians

American Indians (AIs) have higher rates of obesity than other racial/ethnic groups, placing them at heightened risk for cardiovascular diseases, diabetes, and certain cancers. Culturally appropriate weight loss interventions may be the key to reducing risk. The most successful program used in AI communities has been the Diabetes Prevention Program (DPP), which limits enrollment to individuals with a clinical diagnosis of pre-diabetes. The purpose of this pilot project was to modify and culturally tailor a weight loss intervention to AI communities in Kansas to improve weight loss related behaviors among those who do not qualify for the DPP. The Native American Weight Loss Movement (NAWLM) was developed from 2012-2014 using an iterative process with 4 sequential modifications to the program. Group 1 received a slightly modified version of the DPP that was originally tailored to African Americans. Each group received an improved program based on modifications from the previous group. Our analysis shows 36.1% (95% CI: 25.7, 47.5) of all participants (n=72) lost weight; a majority (63.9%, 95% CI: 52.8-75.0) maintained weight, gained weight, or dropped out. Among individuals who completed the program (n=34), 76.5% lost weight (95% CI: 61.4, 91.5). These individuals lost an average of 2.98% body weight (95% CI: 1.58, 4.37), with 6 participants losing \u3e7% body weight. While most participants who completed the program lost weight, more research is needed to determine factors that discourage drop-out and promote behavioral changes. NAWLM shows promise as a weight loss program for AIs who do not qualify for the DPP

Developing and Researching PhET simulations for Teaching Quantum Mechanics

Quantum mechanics is difficult to learn because it is counterintuitive, hard to visualize, mathematically challenging, and abstract. The Physics Education Technology (PhET) Project, known for its interactive computer simulations for teaching and learning physics, now includes 18 simulations on quantum mechanics designed to improve learning of this difficult subject. Our simulations include several key features to help students build mental models and intuitions about quantum mechanics: visual representations of abstract concepts and microscopic processes that cannot be directly observed, interactive environments that directly couple students' actions to animations, connections to everyday life, and efficient calculations so students can focus on the concepts rather than the math. Like all PhET simulations, these are developed using the results of education research and feedback from educators, and are tested in student interviews and classroom studies. This article provides an overview of the PhET quantum simulations and their development. We also describe research demonstrating their effectiveness and share some insights about student thinking that we have gained from our research on quantum simulations.Comment: accepted by American Journal of Physics; v2 includes an additional study, more explanation of research behind claims, clearer wording, and more reference

Density Probability Distribution Functions in Supersonic Hydrodynamic and MHD Turbulence

We study the probability distribution function (PDF) of the mass density in simulations of supersonic turbulence with properties appropriate for molecular clouds. For this study we use Athena, a new higher-order Godunov code. We find there are surprisingly similar relationships between the mean of the time-averaged PDF and the turbulent Mach number for driven hydrodynamic and strong-field MHD turbulence. There is, however, a large scatter about these relations, indicating a high level of temporal and spatial variability in the PDF. Thus, the PDF of the mass density is unlikely to be a good measure of magnetic field strength. We also find the PDF of decaying MHD turbulence deviates from the mean-Mach relation found in the driven case. This implies that the instantaneous Mach number alone is not enough to determine the statistical properties of turbulence that is out of equilibrium. The scatter about the mean-Mach relation for driven turbulence, along with the large departure of decaying turbulence PDFs from those of driven turbulence, may illuminate one factor contributing to the large observed cloud-to-cloud variation in the star formation rate per solar mass.Comment: 4 pages, 2 figures, published in ApJL; corrected sign in eqn. (4

A Study of Educational Simulations Part I - Engagement and Learning

Interactive computer simulations with complex representations and sophisticated graphics are a relatively new addition to the classroom, and research in this area is limited. We have conducted over 200 individual student interviews during which the students described what they were thinking as they interacted with simulations. These interviews were conducted as part of the research and design of simulations for the Physics Education Technology (PhET) project. PhET is an ongoing project that has developed over 60 simulations for use in teaching physics, chemistry, and physical science. These interviews are a rich source of information about how students interact with computer simulations and what makes an educationally effective simulation. We have observed that simulations can be highly engaging and educationally effective, but only if the student's interaction with the simulation is directed by the student's own questioning. Here we describe our design process, what features are effective for engaging students in educationally productive interactions and the underlying principles which support our empirically developed guidelines. In a companion paper we describe in detail the design features used to create an intuitive simulation for students to use

The Magnetothermal Instability in the Intracluster Medium

The electron mean free path in the intracluster medium (ICM) of galaxy clusters is much larger than the gyroradius; thus, heat is transported anisotropically along magnetic field lines. We show that the intracluster medium is unstable to the magnetothermal instability (MTI) using MHD simulations with anisotropic thermal conduction. As a result of the MTI, we find that the temperature profile of the ICM can be substantially modified on timescales of several billion years while the magnetic field is amplified by dynamo action up to more than fifty times the original energy. We also show that the instability drives field lines to become preferentially radial leading to conduction that is a highly efficient fraction of the Spitzer conductivity. As such, we present the first self-consistent calculation of the effective thermal conductivity in the ICM.Comment: Submitted to Ap

Diabetes and Tooth Loss in a National Sample of Dentate Adults Reporting Annual Dental Visits

IntroductionPeriodontal disease has been associated with tooth loss and reported as more prevalent among people with diabetes than among those without diabetes. Having an annual dental examination is a national goal of Healthy People 2010. Our objective was to examine whether an association exists between diabetes and tooth loss among a population reporting an annual dental visit.MethodsWe used data from the 2004 Behavioral Risk Factor Surveillance System to examine the association between self-reported diabetes and tooth removal due to decay or periodontal disease among 155,280 respondents reporting a dental visit within the past year. We calculated prevalence estimates, odds ratios, and 95% confidence intervals. Multiple logistic regression allowed for adjustment.ResultsThe overall prevalence of tooth removal among the people in the study was 38.3%. People with diabetes had a significantly higher prevalence of tooth removal. In a multivariable model adjusting for selected covariates, respondents with diabetes were 1.46 times as likely (95% CI, 1.30–1.64) to have at least one tooth removed than respondents without diabetes. A stronger association between diabetes and tooth loss was observed among people in the younger age groups than among those in the older age groups.ConclusionEven among people reporting a recent dental visit, diabetes was independently associated with tooth loss. Multidisciplinary efforts are needed to raise awareness of the risk of tooth loss among younger people with diabetes. Good oral hygiene as well as annual dental examinations are important for preventing tooth loss

Electromyographical Assessments of Recommended Neck and Trunk Positions for Dental Hygienists

Purpose: Dental professionals are recommended to limit neck and trunk flexion to within 20° of a neutral (0°) body posture, however empirical support for the recommendations is lacking. The purpose of this study was to determine whether there are differences in muscle workload between a range of neck and trunk postures in a population of dental hygiene students. Methods: Fifteen first semester senior dental hygiene students with no history of neck and trunk injury volunteered to participate. Surface electromyography was used to record muscle activity from two neck extensors muscles, cervical erector spinae (CES) and upper trapezius (UT), and two trunk extensor muscles, thoracic erector spinae (TES) and iliocostalis lumboruni (IL). Participants performed ten conditions, including five neck flexion angles (0°, 10°, 20°, 30°, 40°) and five trunk flexion angles (0°,10°, 20°, 30°, 40°). For each trial, posture was checked with a goniometer and maintained for 20s. Muscle activity for each muscle was normalized to the individual\u27s maximum voluntary isometric contraction (MVIC). Results: Activity of the CES was significantly lower in the neutral position than all flexed neck positions. Activation of the UT increased with neck flexion but required 30° of flexion to differ significantly from the neutral position. Activity of the TES required 20° of trunk flexion to differ significantly from neutral and IL activity in the neutral position was significantly lower than all other trunk flexion conditions. Conclusion: Even small amounts of neck or trunk flexion (10°), within the recommended range (≤ 20°), can significantly increase the workload for some muscles in an oral health care provider

Witnesses to Inspiration

Introductory essays by Jennifer Abod, Eve Oishi, and Holly Smith, the editors of a Special Issue of the Journal of International Women’s Studies dedicated to pioneering Black Lesbian Feminist scholar, activist, artist, teacher Angela Bowen, Ph.D. (1936-2018.) Also included is a piece by Lore/tta LeMaster, a former student of Bowen’s and M. Jacqui Alexander, a close friend and co-conspirator. These essays describe the authors’ personal and professional connections with Bowen and situate the special issue in relation to their fields of expertise, including International Women’s and Gender Studies and Black Archival Feminist Practice