Assessment and modelling of chiropractic and allied healthcare in Australia: Background and need for a formal investigation

There is need for a detailed investigation on the availability and impact of chiropractic and allied healthcare services, on healthcare choice and healthcare costs, as well as the delivery and spatial distribution of chiropractors in Australia. The goal of this paper is to discuss the background and to propose our intent to conduct an interdisciplinary assessment and modelling of the determinant factors of adoption of healthcare choices in Australia. Due to the highly complex nature of selecting a healthcare choice amongst available alternatives in today's world, it has been decided to design a research project using a new and innovative approach to the study of knowledge and knowledge systems in a social group. It was determined that the theory base of social interpretation of knowledge and knowledge implementation and change will drive this study. the study design will entail mixed methods including surveys, extensive document review, and a series of interviews of key stakeholders in the allied health professions within Australia. Studies such as this have potential to guide the planning process for federal and state governance bodies in chiropractic, in facilitating consumer choice between alternatives in healthcare. the knowledge gained through this study can drive healthcare change into the 21st century with chiropractic as a potential change agent

Chiropractic in Australia: A survey of the general public

Background: An increase in the use of complementary and alternative medicine was identified in several countries including Australia. There is a need to assess the current position of chiropractic within the Australian health system. Objectives: To estimate the lifetime prevalence of the use of chiropractic in Australia; to investigate the perceptions and attitudes of Australian general public about: their health status, the chiropractic profession, chiropractic and health services in general. Methods: A survey was carried out in which a novel 21-item questionnaire was utilised. To obtain a sample whose opinions would be representative of the Australian general population with a 95% level of significance and 4% margin of error, 600 respondents were required. Descriptive statistics, the chi-squared test and logistic regression were used to present and analyse the data. Results: 757 respondents completed the survey. A high prevalence of pain and discomfort relating to the musculoskeletal system were found, particularly in the lower back (71.1 % of the respondents) and neck (55.6%). The first contact with respect to therapy for the greatest proportion of respondents was general medicine (35.5%), followed by chiropractic (16%), physiotherapy (13.8%) and massage (10.2%). Physiotherapy was rated highest in its ability to relieve the symptoms (18%) followed by chiropractic (15.9%), massage (15.5%) and medicine (14%). In our sample 302 (39.9%) participants used chiropractic before and 75.9% of these consumers were satisfied or highly satisfied with the services provided. No significant differences in income, age and gender were found with regards to those individuals who reported a previous use of chiropractic services. The main reasons for not using chiropractic were: that there was no perceived need for a chiropractic intervention, associated cost, lack of information about chiropractic, lack of referral, being attended by another health professional, and concern about the safety and efficacy of the treatment. Most of the respondents considered that attending to general health and well-being was more important than simply alleviating symptoms and their personal philosophy was a major determinant when it came to the choice of health services. Conclusions: This study suggests that chiropractic is a thriving profession in Australia. It would appear that there is a need for chiropractic services in Australia, particularly in attending to the highly prevalent realm of musculoskeletal disorders. A considerable number of Australians already utilise chiropractic services. Encouragingly, the vast majority of these consumers are satisfied with the service provided. Chiropractic could play an even greater role within the Australian health if better integrated with the mainstream and allied medicine. A more active approach should be taken by chiropractic practitioners and institutions to improve the general public's knowledge about chiropractic

First observation of 54Zn and its decay by two-proton emission

The nucleus 54Zn has been observed for the first time in an experiment at the SISSI/LISE3 facility of GANIL in the quasi-fragmentation of a 58Ni beam at 74.5 MeV/nucleon in a natNi target. The fragments were analysed by means of the ALPHA-LISE3 separator and implanted in a silicon-strip detector where correlations in space and time between implantation and subsequent decay events allowed us to generate almost background free decay spectra for about 25 different nuclei at the same time. Eight 54Zn implantation events were observed. From the correlated decay events, the half-life of 54Zn is determined to be 3.2 +1.8/-0.8 ms. Seven of the eight implantations are followed by two-proton emission with a decay energy of 1.48(2) MeV. The decay energy and the partial half-life are compared to model predictions and allow for a test of these two-proton decay models.Comment: 4 pages, 4 figures, accepted for publication in PR

Measurement of two-halo neutron transfer reaction p(11^{11}Li,9^{9}Li)t at 3AA MeV

The p(\nuc{11}{Li},\nuc{9}{Li})t reaction has been studied for the first time at an incident energy of 3$A$ MeV delivered by the new ISAC-2 facility at TRIUMF. An active target detector MAYA, build at GANIL, was used for the measurement. The differential cross sectionshave been determined for transitions to the \nuc{9}{Li} ground andthe first excited states in a wide range of scattering angles. Multistep transfer calculations using different \nuc{11}{Li} model wave functions, shows that wave functions with strong correlations between the halo neutrons are the most successful in reproducing the observation.Comment: 6 pages, 3 figures, submitted to Physical Review Letter

Measurement of the Ge 70 (n,γ) cross section up to 300 keV at the CERN n-TOF facility

©2019 American Physical Society.Neutron capture data on intermediate mass nuclei are of key importance to nucleosynthesis in the weak component of the slow neutron capture processes, which occurs in massive stars. The (n,γ) cross section on Ge70, which is mainly produced in the s process, was measured at the neutron time-of-flight facility n-TOF at CERN. Resonance capture kernels were determined up to 40 keV neutron energy and average cross sections up to 300 keV. Stellar cross sections were calculated from kT=5 keV to kT=100 keV and are in very good agreement with a previous measurement by Walter and Beer (1985) and recent evaluations. Average cross sections are in agreement with Walter and Beer (1985) over most of the neutron energy range covered, while they are systematically smaller for neutron energies above 150 keV. We have calculated isotopic abundances produced in s-process environments in a 25 solar mass star for two initial metallicities (below solar and close to solar). While the low metallicity model reproduces best the solar system germanium isotopic abundances, the close to solar model shows a good global match to solar system abundances in the range of mass numbers A=60-80.Peer reviewedFinal Published versio

Cross section measurements of 155,157Gd(n, γ) induced by thermal and epithermal neutrons

© SIF, Springer-Verlag GmbH Germany, part of Springer Nature 2019Neutron capture cross section measurements on 155Gd and 157Gd were performed using the time-of-flight technique at the n_TOF facility at CERN on isotopically enriched samples. The measurements were carried out in the n_TOF experimental area EAR1, at 185 m from the neutron source, with an array of 4 C6D6 liquid scintillation detectors. At a neutron kinetic energy of 0.0253 eV, capture cross sections of 62.2(2.2) and 239.8(8.4) kilobarn have been derived for 155Gd and 157Gd, respectively, with up to 6% deviation relative to values presently reported in nuclear data libraries, but consistent with those values within 1.6 standard deviations. A resonance shape analysis has been performed in the resolved resonance region up to 181 eV and 307 eV, respectively for 155Gd and 157Gd, where on average, resonance parameters have been found in good agreement with evaluations. Above these energies and up to 1 keV, the observed resonance-like structure of the cross section has been analysed and characterised. From a statistical analysis of the observed neutron resonances we deduced: neutron strength function of 2. 01 (28) × 10 - 4 and 2. 17 (41) × 10 - 4; average total radiative width of 106.8(14) meV and 101.1(20) meV and s-wave resonance spacing 1.6(2) eV and 4.8(5) eV for n + 155Gd and n + 157Gd systems, respectively.Peer reviewedFinal Accepted Versio

Educating Health Professionals about Drug and Device Promotion: Advocates' Recommendations

Mansfield and colleagues outline the recommendations from four advocacy groups for improving the education of health professionals on promotion of drugs and devices

A stromal cell niche sustains ILC2-mediated type-2 conditioning in adipose tissue.

Group-2 innate lymphoid cells (ILC2), type-2 cytokines, and eosinophils have all been implicated in sustaining adipose tissue homeostasis. However, the interplay between the stroma and adipose-resident immune cells is less well understood. We identify that white adipose tissue-resident multipotent stromal cells (WAT-MSCs) can act as a reservoir for IL-33, especially after cell stress, but also provide additional signals for sustaining ILC2. Indeed, we demonstrate that WAT-MSCs also support ICAM-1-mediated proliferation and activation of LFA-1-expressing ILC2s. Consequently, ILC2-derived IL-4 and IL-13 feed back to induce eotaxin secretion from WAT-MSCs, supporting eosinophil recruitment. Thus, MSCs provide a niche for multifaceted dialogue with ILC2 to sustain a type-2 immune environment in WAT

NF-κB2 signalling in enteroids modulates enterocyte responses to secreted factors from bone marrow-derived dendritic cells

Alternative pathway NF-κB signalling regulates susceptibility towards developing inflammatory bowel disease (IBD), colitis-associated cancer and sepsis-associated intestinal epithelial cell apoptosis and shedding. However, the cell populations responsible for the perturbed alternative pathway NF-κB signalling in intestinal mucosal pathology remain unclear. In order to investigate the contribution of the epithelial compartment, we have tested whether NF-κB2 regulated transcription in intestinal epithelial cells controls the intestinal epithelial response to cytokines that are known to disrupt intestinal barrier permeability. Enteroids were generated from the proximal, middle and distal regions of small intestine (SI) from C57BL/6J wild-type mice and displayed region-specific morphology that was maintained during sub-culture. Enteroids treated with 100 ng/mL TNF were compared with corresponding regions of SI from C57BL/6J mice treated systemically with 0.33 mg/kg TNF for 1.5 h. TNF-induced apoptosis in all regions of the intestine in vitro and in vivo but resulted in Paneth cell degranulation only in proximal tissue-derived SI and enteroids. TNF also resulted in increased enteroid sphericity (quantified as circularity from two-dimensional bright field images). This response was dose and time-dependent and correlated with active caspase-3 immunopositivity. Proximal tissue-derived enteroids generated from Nfκb2−/− mice showed a significantly blunted circularity response following the addition of TNF, IFNγ, lipopolysaccharide (LPS) activated C57BL/6J-derived bone marrow-derived dendritic cells (BMDC) and secreted factors from LPS-activated BMDCs. However, Nfκb1−/− mouse-derived enteroids showed no significant changes in response to these stimuli. In conclusion, the selection of SI region is important when designing enteroid studies as region-specific identity and response to stimuli such as TNF are maintained in culture. Intestinal epithelial cells are at least partially responsible for regulating their own fate by modulating NF-κB2 signalling in response to stimuli known to be involved in multiple intestinal and systemic diseases. Future studies are warranted to investigate the therapeutic potential of intestinal epithelial NF-κB2 inhibition