Feasibility of the STarT back screening tool in chiropractic clinics: a cross-sectional study of patients with low back pain

The STarT back screening tool (SBT) allocates low back pain (LBP) patients into three risk groups and is intended to assist clinicians in their decisions about choice of treatment. The tool consists of domains from larger questionnaires that previously have been shown to be predictive of non-recovery from LBP. This study was performed to describe the distribution of depression, fear avoidance and catastrophising in relation to the SBT risk groups. A total of 475 primary care patients were included from 19 chiropractic clinics. They completed the SBT, the Major Depression Inventory (MDI), the Fear Avoidance Beliefs Questionnaire (FABQ), and the Coping Strategies Questionnaire. Associations between the continuous scores of the psychological questionnaires and the SBT were tested by means of linear regression, and the diagnostic performance of the SBT in relation to the other questionnaires was described in terms of sensitivity, specificity and likelihood ratios

Deception in Research on the Placebo Effect

A common feature of research investigating the placebo effect is deception of research participants about the nature of the research. Miller and colleagues examine the ethical issues surrounding such deception

Conifer : a model of carbon and water flow through a coniferous forest : revised documentation

CONIFER simulates water, carbon, and energy dynamics of a coniferous forest. The model consists of 29 nonlinear difference equations. Measured driving variables include air temperature, dew point temperature, precipitation, solar radiation, and wind speed. Water and energy variables are updated daily; carbon variables are updated weekly. This report contains a detailed description of the model including all equations, parameter values, and initial conditions. Cross-reference tables list the equations in which each variable and parameter appear. Listings of the driving variable data, computer implementation, and corresponding output are also provided. Information sources and model behavior are discussed elsewhere

Documentation for a combined carbon-water flow stand level coniferous forest model

The following report Introduces a documentation scheme for flow oriented ecosystem models and shows its application to a carbon-water model developed within the coniferous biome. This documentation scheme has remained operative through revision of this model and expansion of It to include nutrient flows. This model and subsequent versions are operative simulations on the CDC 6400 at the University of Washington using SIMCOMP (Gustafson S Innis (1971)).and give reasonable output. The purpose of this report is mainly to introduce the reader to the documentation scheme which we have found so effective in maintaining a running history of the modeling process for large scale models. We hope that it will lead to the adoption of this or a similar documentation scheme as a standard for ecological modeling

Healthcare Worker Occupation and Immune Response to Pneumocystis jirovecii

Humans may be a reservoir for this pathogen and transmit it from person to person

Dihydropteroate synthase mutations in Pneumocystis pneumonia: impact of applying different definitions of prophylaxis, mortality endpoints and mutant in a single cohort

Pneumocystis jirovecii dihydropteroate synthase (DHPS) gene mutations are well-reported. Although sulfa prophylaxis generally is associated with DHPS mutant infection, whether mutant infection is associated with poorer clinical outcomes is less clear. The differing definitions of sulfa prophylaxis and the different mortality endpoints used in these studies may be one explanation for the conflicting study results. Applying different definitions of prophylaxis, mortality endpoints and DHPS mutant to 301 HIV-infected patients with Pneumocystis pneumonia, we demonstrate that prophylaxis, irrespective of definition, increased the risk of infection with pure mutant (any prophylaxis: AOR 4.00, 95% CI: 1.83–8.76, p0.05). Future studies should standardize key variables associated with DHPS mutant infection as well as examine DHPS mutant subtypes (pure mutant vs. mixed infections) – perhaps even individual DHPS mutant genotypes – so that data can be pooled to better address this issue

Effects of work ability and health promoting interventions for women with musculoskeletal symptoms: A 9-month prospective study

<p>Abstract</p> <p>Background</p> <p>Women working in the public human service sector in 'overstrained' situations run the risk of musculoskeletal symptoms and long-term sick leave. In order to maintain the level of health and work ability and strengthen the potential resources for health, it is important that employees gain greater control over decisions and actions affecting their health – a process associated with the concept of self-efficacy. The aim of this study was to describe the effects of a self-efficacy intervention and an ergonomic education intervention for women with musculoskeletal symptoms, employed in the public sector.</p> <p>Methods</p> <p>The design of the study was a 9-month prospective study describing the effects of two interventions, a comprehensive self-efficacy intervention (<it>n </it>= 21) and an ergonomic education intervention (<it>n </it>= 21). Data were obtained by a self-report questionnaire on health- and work ability-related factors at baseline, and at ten weeks and nine months follow-up. Within-group differences over time were analysed.</p> <p>Results</p> <p>Over the time period studied there were small magnitudes of improvements within each group. Within the self-efficacy intervention group positive effects in perceived work ability were shown. The ergonomic education group showed increased positive beliefs about future work ability and a more frequent use of pain coping strategies.</p> <p>Conclusion</p> <p>Both interventions showed positive effects on women with musculoskeletal symptoms, but in different ways. Future research in this area should tailor interventions to participants' motivation and readiness to change.</p

Physical and biological variables affecting seabird distributions during the upwelling season of the northern California Current

Author Posting. © The Authors, 2004. This is the author's version of the work. It is posted here by permission of Elsevier B. V. for personal use, not for redistribution. The definitive version was published in Deep Sea Research Part II: Topical Studies in Oceanography 52 (2005): 123-143, doi:10.1016/j.dsr2.2004.08.016.As a part of the GLOBEC-Northeast Pacific project, we investigated variation in the abundance of marine birds in the context of biological and physical habitat conditions in the northern portion of the California Current System (CCS) during cruises during the upwelling season 2000. Continuous surveys of seabirds were conducted simultaneously in June (onset of upwelling) and August (mature phase of upwelling) with ocean properties quantified using a towed, undulating vehicle and a multi-frequency bioacoustic instrument (38-420 kHz). Twelve species of seabirds contributed 99% of the total community density and biomass. Species composition and densities were similar to those recorded elsewhere in the CCS during earlier studies of the upwelling season. At a scale of 2-4 km, physical and biological oceanographic variables explained an average of 25% of the variation in the distributions and abundance of the 12 species. The most important explanatory variables (among 14 initially included in each multiple regression model) were distance to upwelling-derived frontal features (center and edge of coastal jet, and an abrupt, inshore temperature gradient), sea-surface salinity, acoustic backscatter representing various sizes of prey (smaller seabird species were associated with smaller prey and the reverse for larger seabird species), and chlorophyll concentration. We discuss the importance of these variables in the context of what factors may be that seabirds use to find food. The high seabird density in the Heceta Bank and Cape Blanco areas indicate them to be refuges contrasting the low seabird densities currently found in most other parts of the CCS, following decline during the recent warm regime of the Pacific Decadal Oscillation.Support from National Science Foundation Grant OCE-0001035, National Oceanic and Atmospheric Administration (NOAA)/Woods Hole Oceanographic Institution-CICOR Grant NA17RJ1223 is gratefully acknowledged

Oxygen: A Fundamental Property Regulating Pelagic Ecosystem Structure in the Coastal Southeastern Tropical Pacific

Background: In the southeastern tropical Pacific anchovy (Engraulis ringens) and sardine (Sardinops sagax) abundance have recently fluctuated on multidecadal scales and food and temperature have been proposed as the key parameters explaining these changes. However, ecological and paleoecological studies, and the fact that anchovies and sardines are favored differently in other regions, raise questions about the role of temperature. Here we investigate the role of oxygen in structuring fish populations in the Peruvian upwelling ecosystem that has evolved over anoxic conditions and is one of the world's most productive ecosystems in terms of forage fish. This study is particularly relevant given that the distribution of oxygen in the ocean is changing with uncertain consequences. Methodology/Principal Findings: A comprehensive data set is used to show how oxygen concentration and oxycline depth affect the abundance and distribution of pelagic fish. We show that the effects of oxygen on anchovy and sardine are opposite. Anchovy flourishes under relatively low oxygen conditions while sardine avoid periods/areas with low oxygen concentration and restricted habitat. Oxygen consumption, trophic structure and habitat compression play a fundamental role in fish dynamics in this important ecosystem. Conclusions/Significance: For the ocean off Peru we suggest that a key process, the need to breathe, has been neglected previously. Inclusion of this missing piece allows the development of a comprehensive conceptual model of pelagic fish populations and change in an ocean ecosystem impacted by low oxygen. Should current trends in oxygen in the ocean continue similar effects may be evident in other coastal upwelling ecosystems