Factors associated with physical activity participation in adults with chronic cervical spine pain: a systematic review

Objective: To determine the factors associated with physical activity participation in adults with chronic cervical spine pain. Methods: A systematic review was conducted including searches of PubMed (MEDLINE), EMBASE and CINAHL from inception to June 12th, 2016. Grey literature and reference checking was also undertaken. Quantitative studies including factors related to physical activity participation in adults with chronic cervical spine pain were included. Two independent authors conducted the searches, extracted data and completed methodological quality assessment. Results: A total of seven studies met the selection criteria, however, four papers were finally included in the final review. A modified Downs and Black criteria was used to assess methodological quality, each study included was classed as moderate quality. A total of six factors were assessed against physical activity participation for people with chronic neck pain. These included: pain, fear of movement, smoking habits, socioeconomic status, gender, leisure and work time habits. A significant relationship was demonstrated between pain, leisure and work time habits and physical activity. Subjects were less likely to participate in physical activity if they were in pain. Subjects with neck pain were less likely to participate in physical activity in their leisure and work time. Conclusion: This review, based on a small number of heterogeneous studies demonstrated key factors that are likely to affect physical activity in people with chronic neck pain, most notably, pain levels, leisure and work habits. This review suggests that more in-depth, high quality studies are required to fully understand the impact of chronic pain on physical activity

Randomized sham controlled trial of cranial microcurrent stimulation for symptoms of depression, anxiety, pain, fatigue and sleep disturbances in women receiving chemotherapy for early-stage breast cancer

Purpose Women with breast cancer may experience symptoms of depression, anxiety, pain, fatigue and sleep disturbances during chemotherapy. However, there are few modalities that address multiple, commonly occurring symptoms that may occur in individuals receiving cancer treatment. Cranial electrical stimulation (CES) is a treatment that is FDA cleared for depression, anxiety and insomnia. CES is applied via electrodes placed on the ear that deliver pulsed, low amplitude electrical current to the head. Methods This phase III randomized, sham-controlled study aimed to examine the effects of cranial microcurrent stimulation on symptoms of depression, anxiety, pain, fatigue, and sleep disturbances in women receiving chemotherapy for early-stage breast cancer. Patients were randomly assigned to either an actual or sham device and used the device daily for 1 h. The study was registered at clinicaltrials.gov, NCT00902330. Results The sample included N = 167 women with early-stage breast cancer. Symptom severity of depression, anxiety, and fatigue and sleep disturbances were generally mild to moderate. Levels of pain were low. Anxiety was highest prior to the initial chemotherapy and decreased over time. The primary outcome assessment (symptoms of depression, anxiety, fatigue, pain, sleep disturbances) revealed no statistically significant differences between the two groups, actual CES vs. sham. Conclusion In this study, women receiving chemotherapy for breast cancer experienced multiple symptoms in the mild to moderate range. Although there is no evidence for the routine use of CES during the chemotherapy period for symptom management in women with breast cancer, further symptom management modalities should be evaluated to mitigate symptoms of depression, anxiety, fatigue, pain and sleep disturbances over the course of chemotherapy

Coherent Topological Charge Structure in CPN−1CP^{N-1} Models and QCD

In an effort to clarify the significance of the recent observation of long-range topological charge coherence in QCD gauge configurations, we study the local topological charge distributions in two-dimensional $CP^{N-1}$ sigma models, using the overlap Dirac operator to construct the lattice topological charge. We find long-range sign coherence of topological charge along extended one-dimensional structures in two-dimensional spacetime. We discuss the connection between the long range topological structure found in $CP^{N-1}$ and the observed sign coherence along three-dimensional sheets in four-dimensional QCD gauge configurations. In both cases, coherent regions of topological charge form along membrane-like surfaces of codimension one. We show that the Monte Carlo results, for both two-dimensional and four-dimensional gauge theory, support a view of topological charge fluctuations suggested by Luscher and Witten. In this framework, the observed membranes are associated with boundaries between ``k-vacua,'' characterized by an effective local value of $\theta$ which jumps by $\pm 2\pi$ across the boundary.Comment: 26 page

Smoothed Particle Hydrodynamics in cosmology: a comparative study of implementations

We analyse the performance of twelve different implementations of Smoothed Particle Hydrodynamics (SPH) using seven tests designed to isolate key hydrodynamic elements of cosmological simulations which are known to cause the SPH algorithm problems. In order, we consider a shock tube, spherical adiabatic collapse, cooling flow model, drag, a cosmological simulation, rotating cloud-collapse and disc stability. In the implementations special attention is given to the way in which force symmetry is enforced in the equations of motion. We study in detail how the hydrodynamics are affected by different implementations of the artificial viscosity including those with a shear-correction modification. We present an improved first-order smoothing-length update algorithm that is designed to remove instabilities that are present in the Hernquist and Katz (1989) algorithm. For all tests we find that the artificial viscosity is the most important factor distinguishing the results from the various implementations. The second most important factor is the way force symmetry is achieved in the equation of motion. Most results favour a kernel symmetrization approach. The exact method by which SPH pressure forces are included has comparatively little effect on the results. Combining the equation of motion presented in Thomas and Couchman (1992) with a modification of the Monaghan and Gingold (1983) artificial viscosity leads to an SPH scheme that is both fast and reliable.Comment: 30 pages, 26 figures and 9 tables included. Submitted to MNRAS. Postscript version available at ftp://phobos.astro.uwo.ca/pub/etittley/papers/sphtest.ps.g