The Fear Reduction Exercised Early (FREE) approach to low back pain: study protocol for a randomised controlled trial

This is the final version of the article. Available from BioMed Central via the DOI in this record.BACKGROUND: Low back pain (LBP) is a major health issue associated with considerable health loss and societal costs. General practitioners (GPs) play an important role in the management of LBP; however, GP care has not been shown to be the most cost-effective approach unless exercise and behavioural counselling are added to usual care. The Fear Reduction Exercised Early (FREE) approach to LBP has been developed to assist GPs to manage LBP by empowering exploration and management of psychosocial barriers to recovery and provision of evidence-based care and information. The aim of the Low Back Pain in General Practice (LBPinGP) trial is to explore whether patients with LBP who receive care from GPs trained in the FREE approach have better outcomes than those who receive usual care. METHODS/DESIGN: This is a cluster randomised controlled superiority trial comparing the FREE approach with usual care for LBP management with investigator-blinded assessment of outcomes. GPs will be recruited and then cluster randomised (in practice groups) to the intervention or control arm. Intervention arm GPs will receive training in the FREE approach, and control arm GPs will continue to practice as usual. Patients presenting to their GP with a primary complaint of LBP will be allocated on the basis of allocation of the GP they consult. We aim to recruit 60 GPs and 275 patients (assuming patients are recruited from 75% of GPs and an average of 5 patients per GP complete the study, accounting for 20% patient participant dropout). Patient participants and the trial statistician will be blind to group allocation throughout the study. Analyses will be undertaken on an intention-to-treat basis. The primary outcome will be back-related functional impairment 6 months post-initial LBP consultation (interim data at 2 weeks, 6 weeks and 3 months), measured with the Roland-Morris Disability Questionnaire. Secondary patient outcomes include pain, satisfaction, quality of life, days off from work and costs of care. Secondary GP outcomes include beliefs about pain and impairment, GP confidence, and actual and reported clinical behaviour. Health economic and process evaluations will be conducted. DISCUSSION: In the LBPinGP trial, we will investigate providing an intervention during the first interaction a person with back pain has with their GP. Because the FREE approach is used within a normal GP consultation, if effective, it may be a cost-effective means of improving LBP care. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12616000888460 . Registered on 6 July 2016.This study is funded and supported by the Accident Compensation Corporation (ACC), Wellington, New Zealand. The study funder has not been involved with study design. The study funder will not be involved with or have ultimate authority over the collection, management, analysis and interpretation of data; the writing of the report; or the decision to submit the report for publication. The funder will have the opportunity to comment on draft reports before publication. SD’s work was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health

Ruddlesden Popper 2D perovskites as Li-ion battery electrodes

The electrochemical performance of 2-dimensional hybrid perovskite electrodes for Li-ion batteries are investigated using a high-molarity electrolyte. The effect of changing the halide content and layering structure is systematically explored.</p

KAJIAN KEDUDUKAN DAN NILAI PEMBUKTIAN SAKSI MAHKOTA SEBAGAI ALAT BUKTI DALAM PEMBUKTIAN TINDAK PIDANA KORUPSI (STUDI KASUS NO.REG.PERK : PDS-01/SKRTA/Ft.1/03/2010 BERKAIT KORUPSI DI RUMAH SAKIT JIWA DAERAH SURAKARTA)

Penulisan penelitian hukum ini bertujuan untuk mengetahui dasar hukum menurut jaksa penuntut umum digunakannya saksi mahkota serta kedudukan dan nilai pembuktian saksi mahkota dalam pandangan hakim sebagai alat bukti dalam kasus perkara No. Reg. Perk : PDS-01/SKRTA/Ft.1/03/2010. Pengertian saksi mahkota dalam putusan Mahkamah Agung RI No.1986 K/Pid/1989 adalah teman terdakwa yang dilakukan secara bersama-sama yang diajukan sebagai saksi untuk membuktikan dakwaan penuntut umum dalam hal ini perkaranya dipisah dikarenakan kurangnya alat bukti. Tetapi dalam perkembangannya di dalam Putusan Mahkamah Agung RI No. 1174/K/Pid/1994 tanggal 3 Mei 1995, Putusan Mahkamah Agung RI No. 1590/K/Pid/1995 tanggal 3 Mei 1995 dan Putusan Mahkamah Agung RI No. 1592/K/Pid/1995 tanggal 3 Mei 1995 tidak membenarkan adanya penggunaan saksi mahkota. Menurut putusan ini saksi mahkota juga pelaku yang diajukan sebagai terdakwa dalam dakwaan yang terpisah sehingga hal ini dianggap sebagai pelanggaran hak asasi terdakwa. Pada kenyataannya dalam praktek peradilan di Indonesia masih sering digunakannya saksi mahkota dalam mengatasi masalah kurangnya alat bukti saksi. P e n u lisa n H u k u m ini term asu k dala m je nis p en elitia n h u k u m e m p iris ata u non doctrinal y a itu pe n elitia n ya n g d ilak u ka n se ca ra la n gsu n g de n ga n m e m b a n d in gk a n h u k u m da la m ha l te o ritis de n ga n m e n ga m ati pe rila k u ya n g te rjad i d idala m m a sya rak at. Penulisan hukum ini bersifat deskriptif dengan pendekatan kualitatif. Hasil yang diperoleh dari penelitian ini yaitu bahwa selain dari Putusan Mahkamah Agung RI tidak ada dasar hukum mengenai saksi mahkota dan penggunaan saksi mahkota dalam perkara No.Reg.Perk : PDS- 01/SKRTA/Ft.1/03/2010 berkait korupsi di Rumah Sakit Jiwa Daerah Surakarta dibenarkan didasarkan pada prinsip-prinsip tertentu yaitu terdapat kekurangan alat bukti, dalam perkara delik penyertaan (Deelneming), diperiksa dengan mekanisme pemisahan (Splitsing). S aksi mahkota dalam kasus ini berkedudukan murni sebagai saksi karena memenuhi syarat sebagai saksi sesuai Pasal 1 angka 26 KUHAP maka sah untuk dapat diperiksa sebagai saksi, sehingga majelis hakim akan menerima dan mengakui kesaksian dari saksi mahkota ini dan akan digunakan sebagai pertimbangkan dalam menyusun putusan. Kata kunci : saksi mahkota

Some properties of nucleic acids extracted with phenol

Preparations of nucleic acids obtained by extraction of mouse liver, HeLa cells and cell fractions with phenol and deoxycholate have been characterized with regard to the differential solubility of ribonucleic acid and deoxyribonucleic acid in ethanol, density-gradient centrifugation and the presence of high-molecular-weight contaminants. Ribonucleic acid obtained by this method is less soluble than deoxyribonucleic acid. It was precipitable with 20 % ethanol, nearly free of deoxyribonucleic acid, but containing 4-5 times its weight of polysaccharide which is not removed by repeated fractional precipitation nor entirely by [alpha]-amylase (EC 3.2.1.1) digestion, but is removed by density-gradient centrifugation. Deoxyribonucleic acid could be subsequently precipitated with 50 % ethanol free of ribonucleic acid but contaminated with polysaccharide. The buoyant density of the latter is identical with deoxyribonucleic acid and they are not separated by density-gradient centrifugation. The contaminating polysaccharide appears to be a single entity, the [beta]-subunit of glycogen granules. Its isolation and some of its properties are described. Its effect upon the properties of the nucleic acids is discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32046/1/0000089.pd

Fixed-Parameter Tractable Distances to Sparse Graph Classes

We show that for various classes $\mathcal{C}$ of sparse graphs, and several measures of distance to such classes (such as edit distance and elimination distance), the problem of determining the distance of a given graph $\small{G}$ to $\mathcal{C}$ is fixed-parameter tractable. The results are based on two general techniques. The first of these, building on recent work of Grohe et al. establishes that any class of graphs that is slicewise nowhere dense and slicewise first-order definable is FPT. The second shows that determining the elimination distance of a graph $\small{G}$ to a minor-closed class $\mathcal{C}$ is FPT. We demonstrate that several prior results (of Golovach, Moser and Thilikos and Mathieson) on the fixed-parameter tractability of distance measures are special cases of our first method