Characteristics and health outcomes associated with activation for self-management in patients with non-specific low back pain: A cross-sectional study.

BACKGROUND: Research has shown that the course of non-specific low back pain (LBP) is influenced by, among other factors, patients' self-management abilities. Therefore, clinical guidelines recommend stimulation of self-management. Enhancing patients' self-management potentially can improve patients' health outcomes and reduce future healthcare costs for non-specific LBP. OBJECTIVES: Which characteristics and health outcomes are associated with activation for self-management in patients with non-specific LBP? DESIGN: Cross-sectional study. METHOD: Patients with non-specific LBP applying for primary care physiotherapy were asked to participate. Multivariable linear regression analysis was performed to analyze the multivariable relationship between activation for self-management (Patient Activation Measure, range 0-100) and a range of characteristics, e.g., age, gender, and health outcomes, e.g., self-efficacy, pain catastrophizing. RESULTS: The median activation for self-management score of the patients with non-specific LBP (N = 208) was 63.10 (IQR = 19.30) points. The multivariable linear regression analysis revealed that higher self-efficacy scores (B = 0.54), female gender (B = 3.64), and a middle educational level compared with a high educational level (B = -5.47) were associated with better activation for self-management in patients with non-specific LBP. The goodness-of-fit of the model was 17.24% (R2 = 0.17). CONCLUSIONS: Patients with better activation for self-management had better self-efficacy, had a higher educational level, and were more often female. However, given the explained variance better understanding of the factors that influence the complex construct of self-management behaviour in patients who are not doing well might be needed to identify possible barriers to engage in self-management.

A comparative study of the optical characteristics of intact cells of photosynthetic green sulfur bacteria containing bacteriochlorophyll c, d or e.

Energy transfer and pigment arrangement in intact cells of the green sulfur bacteria Prosthecochloris aestuarii, Chlorobium vibrioforme and chlorobium phaeovibrioides, containing bacteriochlorophyll (BChl) c, d or e as main light harvesting pigment, respectively, were studied by means of absorption, fluorescence, circular dichroism and linear dichroism spectroscopy at low temperature. The results indicate a very similar composition of the antenna in the three species and a very similar structure of main light harvesting components, the chlorosome and the membrane-bound BChl a protein. In all three species the Qy transition dipoles of BChl c, d or e are oriented approximately parallel to the long axis of the chlorosome. Absorption and fluorescence excitation spectra demonstrate the presence of at least two BChl c-e pools in the chlorosomes of all three species, long-wavelength absorbing BChls being closest to the membrane. In C. phaeovibrioides, energy from BChl e is transferred with an efficiency of 25% to the chlorosomal BChl a at 6 K, whereas the efficiency of transfer from BChl e to the BChl a protein is 10%. These numbers are compatible with the hypothesis that the chlorosomal BChl a is an intermediary in the energy transfer from the chlorosome to the membrane.