Showing papers by "Ben-Gurion University of the Negev published in 1998"
TL;DR: In the tradition of political geography, boundary analysis has focused on the international scale, since international boundaries provide perhaps the... as discussed by the authors, and state boundaries have constituted a major topic in political geography.
Abstract: State boundaries have constituted a major topic in the tradition of political geography. Boundary analysis has focused on the international scale, since international boundaries provide perhaps the...
816 citations
TL;DR: In this paper, phase equilibrium studies were performed with the PEG 400phosphate system, obtaining equilibrium binodal lines, tie lines, and phase inversion points, and a method of calculation of the critical point on the binoderal curve is described.
703 citations
TL;DR: The results suggest a model in which robust cholinergic stimulation triggers rapid induction of the gene encoding the transcription factor c-Fos, which mediates selective regulatory effects on the long-lasting activities of genes involved in acetylcholine metabolism.
Abstract: Acute traumatic stress may lead to post-traumatic stress disorder (PTSD), which is characterized by delayed neuropsychiatric symptoms including depression, irritability, and impaired cognitive performance. Curiously, inhibitors of the acetylcholine-hydrolysing enzyme acetylcholinesterase may induce psychopathologies that are reminiscent of PTSD. It is unknown how a single stressful event mediates long-term neuronal plasticity. Moreover, no mechanism has been proposed to explain the convergent neuropsychological outcomes of stress and of acetylcholinesterase inhibition. However, acute stress elicits a transient increase in the amounts released of the neurotransmitter acetylcholine and a phase of enhanced neuronal excitability. Inhibitors of acetylcholinesterase also promote enhanced electrical brain activity, presumably by increasing the survival of acetylcholine at the synapse. Here we report that there is similar bidirectional modulation of genes that regulate acetylcholine availability after stress and blockade of acetylcholinesterase. These calcium-dependent changes in gene expression coincide with phases of rapid enhancement and delayed depression of neuronal excitability. Both of these phases are mediated by muscarinic acetylcholine receptors. Our results suggest a model in which robust cholinergic stimulation triggers rapid induction of the gene encoding the transcription factor c-Fos. This protein then mediates selective regulatory effects on the long-lasting activities of genes involved in acetylcholine metabolism.
597 citations
TL;DR: In this paper, the van der Waals energy between separated systems is calculated using density functional theory, and the asymptotic H-He and He--He interactions are calculated as a first illustration.
Abstract: In principle, density functional theory yields the correct ground-state densities and energies of electronic systems under the action of a static external potential. However, traditional approximations fail to include van der Waals energies between separated systems. This paper proposes a practical procedure for remedying this difficulty. Our method allows seamless calculations between small and large intersystem distances. The asymptotic H-He and He--He interactions are calculated as a first illustration, with very accurate results.
476 citations
TL;DR: It is suggested that prolonged low-grade oxidative stress impairs insulin-stimulated GLUT4 translocation, potentially by interfering with compartment-specific activation of PI 3-kinase.
Abstract: Prolonged exposure of 3T3-L1 adipocytes to micromolar concentrations of H2O2 results in an impaired response to the acute metabolic effects of insulin. In this study, we further characterized the mechanisms by which oxidative stress impairs insulin stimulation of glucose transport activity. Although insulin induced a 2.5-fold increase in plasma membrane GLUT4 content and a 50% reduction in its abundance in the low-density microsomal (LDM) fraction in control cells, oxidation completely prevented these responses. The net effect of insulin on 2-deoxyglucose uptake activity was reduced in oxidized cells and could be attributed to GLUT1 translocation. Insulin stimulation of insulin receptor substrate (IRS) 1 tyrosine phosphorylation and the association of IRS-1 with phosphatidylinositol (PI) 3-kinase were not impaired by oxidative stress. However, a 1.9-fold increase in the LDM content of the p85 subunit of PI 3-kinase after insulin stimulation was observed in control, but not in oxidized, cells. Moreover, although insulin induced an increase in IRS-1-associated PI 3-kinase activity in the LDM in control cells, this effect was prevented by oxidation. These findings suggest that prolonged low-grade oxidative stress impairs insulin-stimulated GLUT4 translocation, potentially by interfering with compartment-specific activation of PI 3-kinase.
458 citations
TL;DR: Theory of urban and regional planning have been deficient, neglecting to account sufficiently for its use as a tool of social control and oppression as mentioned in this paper, and planning's well-documented progressive potential should be understood as being structurally accompanied by a more sinister dark side.
Abstract: Theories of urban and regional planning have been deficient, neglecting to account sufficientlyfor its use as a tool of social control and oppression The article argues that planning's well-documented progressive potential should be understood as being structurally accompanied by a more sinister dark side It develops a conceptual framework within which the 'planning as control' can be theorized and studied, and by linking the public production of space to recent social science and Foucauldian debates on stateand nation-building The framework delineates four principal dimensions: territorial, procedural, socioeconomic, and cultural, each with a capacity to influence intergroup relations These dimensions should be understood as double-edged, with the influence of each potentially stretching between emancipatory reform and oppressive control This article concludes by offering some explanations for the neglect of the dark side by most theorists, and by sketching a future agenda for a revised critical the
432 citations
TL;DR: The results of these analyses suggest that the wild salt-tolerant Lpa plants are better protected against active oxygen species (AOS), inherently and under salt stress, than the relatively sensitive plants of the cultivated species.
Abstract: The possible involvement of the antioxidative system in the tolerance to salt stress was studied in the cultivated tomato Lycopersicon esculentum Mill. cv. M82 (M82) and its wild salt-tolerant relative L. pennellii (Corn) D'Arcy accession Atico (Lpa). All analyses, except that of monodehydroascorbate reductase (MDHAR), were performed of the youngest fully-expanded leaf of control and salt (100 mM NaCl) stressed plants, 4, 7, 10, 14, 18 and 22 days after completing the stress treatment. In Lpa, constitutive level of lipid peroxidation and activities of catalase (CAT) and glutathione reductase (GR) were lower while the activities of superoxide dismutase (SOD), ascorbate peroxidase (APX) and dehydroascorbate reductase (DHAR) were inherently higher than in M82. Relative to M82, lipid peroxidation was much lower and the activities of SOD, CAT and APX were higher in Lpa at 100 mM NaCl. The activity of DHAR decreased more in Lpa than in M82 under salt stress, and the activity of MDHAR, which was lower in Lpa than in M82 under control conditions, increased much more and to a higher level in salt-treated Lpa plants. GR activity decreased similarly in the two species under salt stress. The results of these analyses suggest that the wild salt-tolerant Lpa plants are better protected against active oxygen species (AOS), inherently and under salt stress, than the relatively sensitive plants of the cultivated species.
416 citations
TL;DR: Aggressive driving is defined in terms of the frustration-aggression model as mentioned in this paper, which is a syndrome of frustration-driven behaviors, enabled by the driver's environment, which can either take the form of instrumental aggression, that allows the frustrated driver to move ahead at the cost of infringing on other road users' rights (e.g., by weaving and running red lights), or hostile aggression which is directed at the object of frustration (e
Abstract: Aggressive driving is defined in terms of the frustration–aggression model. In that context aggressive driving is a syndrome of frustration-driven behaviors, enabled by the driver's environment. These behaviors can either take the form of instrumental aggression—that allows the frustrated driver to move ahead at the cost of infringing on other road users’ rights (e.g., by weaving and running red lights)—or hostile aggression which is directed at the object of frustration (e.g., cursing other drivers). While these behaviors may be reflective of individual differences in aggression, it is argued that the exclusive focus on the characteristics of the aggressive drivers and how to control them is short-sighted. Instead, this paper proposes a multi-factor approach to the problem. Five studies conducted so far tend to support this approach, by showing that specific aggressive behaviors—such as honking and running red lights—are associated with cultural norms, actual and perceived delays in travel, and congestion. Ergonomics-oriented approaches that involve environmental modifications are proposed.
329 citations
TL;DR: This article examined allocators' willingness to reward and punish their paired recipients in the ultimatum game and found that allocators reward skillful recipients but punish unskillful ones only modestly, while the punishment effect is mitigated by the belief held by some allocators that effort is the appropriate measure of deservingness.
310 citations
TL;DR: Irradiation parameters of a 780 nm low power CW diode laser leading to enhanced proliferation of cultured normal human keratinocytes (NHK) were determined and the possible role of reactive oxygen species (ROS) in this response was evaluated.
Abstract: Background and Objective
The purpose of this study was to determine irradiation parameters of a 780 nm low power CW diode laser (6.5 mW) leading to enhanced proliferation of cultured normal human keratinocytes (NHK). The possible role of reactive oxygen species (ROS) in this response was evaluated.
Study Design/Materials and Methods: NHK were exposed to a single dose of 0 to 3.6 J/cm2 (0–180 sec) of irradiation. Proliferation parameters studied were: incorporation of 3H-thymidine during 6–24 hr following irradiation; percentage of dividing cells and number of cells, 24 hr and 48 hr following irradiation, respectively.
Results
Proliferation of NHK exposed to 0.45–0.95 J/cm2 was significantly enhanced by 1.3–1.9-folds relative to sham-irradiated controls, as inferred from parameters studied. Exposure to other energy densities was considerably less affective in enhancing proliferation parameters. Added enzymatic antioxidants, superoxide dismutase or catalase, scavenging superoxide anions and H2O2, suppressed this enhanced proliferation. Added scavengers (α-tocopherol acetate, scavenging lipid peroxidation, or sodium azide, histidine, mannitol, scavenging singlet oxygen, superoxide anions, and hydroxyl radicals, respectively), or N-acetyl cysteine, the thiol-reducing agent, suppressed the response, but to different extents.
Conclusions
The results indicate that 780 nm low power diode laser irradiation enhanced keratinocytes proliferation in vitro, with an apparent involvement of ROS in this response, and comparably, might be used to promote their proliferation in vivo to enhance wound healing. Lasers Surg. Med. 22:212–218, 1998. © 1998 Wiley-Liss, Inc.
300 citations
TL;DR: In this article, a solvent exchange method was used to obtain nanosized hydrophobic, oleate stabilized silver organosols in various organic solvents, with a transfer efficiency of 50−70%.
Abstract: Nanosized hydrophobic, oleate stabilized silver organosols in various organic solvents are obtained using a solvent exchange method. The silver particles are initially prepared as a hydrosol in the presence of sodium oleate (surfactant). Then a transfer of the colloid to an organic phase is induced by a low concentration of several agents such as orthophosphoric acid, with a transfer efficiency of 50−70%. The hydrophobic colloid is stable and the particles retain their integrity even after the solvent is evaporated and the dried deposit is resuspended in a variety of other solvents. We present the preparation method in detail and characterize the hydrosol and organosol particles by electron microscopy, electrophoresis, and UV−visible extinction spectroscopy. On the basis of IR spectroscopy we discuss the conformation of the surfactant adsorbed on the silver cores and the changes in it as the particles transfer into the organic environment.
TL;DR: The science, technology and applications of magnesium alloys are reviewed in this paper, where the very low density of magnesium in combination with excellent castability is leading to increased use, despite poor galvanic corrosion resistance and a higher cost than aluminum, especially in automotive applications.
Abstract: The science, technology and applications of magnesium alloys are reviewed. The very low density of magnesium in combination with excellent castability is leading to increased use, despite poor galvanic corrosion resistance and a higher cost than aluminum, especially in automotive applications. Even further expansion of the magnesium market should come from an expanded design base, a better understanding of the scientific “underpinning” of magnesium alloys, and development of cost-affordable cast and wrought products.
TL;DR: An extensive overview of the different technologies used to produce tunable optical filters is presented and it is shown that fiber filters are the most commercialized, yet inherently limited in their dynamic speeds.
Abstract: WDM is currently taking over as the leading technology in point-to-point transmission links. For optical implementation of WDM networks, logical functionalities such as wavelength (channel) selection should be carried out in the wavelength domain; thus, the development of dynamic optical devices is required. One key device is a tunable optical filter. Important features of such a filter include low insertion loss, narrow bandwidth, high sidelobe suppression, large dynamic range, fast tuning speed, a simple control mechanism, small size, and cost effectiveness. Here, an extensive overview of the different technologies used to produce tunable optical filters is presented. Among them, fiber filters such as fiber Bragg gratings and fiber Fabry Perot are the most commercialized, yet inherently limited in their dynamic speeds. For high demanding dynamics, micro-machined and acousto-optic filters can offer a good solution for microsecond tuning speeds. Faster tunable devices, in nanosecond tuning speeds, might emerge out of microresonators, electrooptic filters, and active DBR filters.
TL;DR: A single stranded conformational polymorphism (SSCP) assay can be used to screen individuals with nonsyndromic hearing loss for mutations in the Cx26 gene and developed and optimized allele‐specific PCR primers for each of the four mutations to rapidly determine carrier and noncarrier status within families.
Abstract: Mutations in the Cx26 gene have been shown to cause autosomal recessive nonsyndromic hearing loss (ARNSHL) at the DFNB1 locus on chromosome 13q12. Using direct sequencing, we screened the Cx26 coding region of affected and nonaffected members from seven ARNSHL families either linked to the DFNB1 locus or in which the ARNSHL phenotype cosegregated with markers from chromosome 13q12. Cx26 mutations were found in six of the seven families and included two previously described mutations (W24X and W77X) and two novel Cx26 mutations: a single base pair deletion of nucleotide 35 resulting in a frameshift and a C-to-T substitution at nucleotide 370 resulting in a premature stop codon (Q124X). We have developed and optimized allele-specific PCR primers for each of the four mutations to rapidly determine carrier and noncarrier status within families. We also have developed a single stranded conformational polymorphism (SSCP) assay which covers the entire Cx26 coding region. This assay can be used to screen individuals with nonsyndromic hearing loss for mutations in the CX26 gene.
TL;DR: Infants simultaneously receiving a tetravalent pneumococcal vaccine conjugated to TT (PncT) and a diphtheria-tetanus-pertussis–poliovirus–Haemophilus influenzae type b-Tetanus conjugate vaccine showed significantly lower anti-H.
Abstract: The plethora of newly discovered vaccines implies that, in the future, many vaccines will have to be administered simultaneously to infants. We examined the potential interference with the immune response of several coadministered vaccines containing the same protein component, namely, tetanus toxoid (TT). Infants simultaneously receiving a tetravalent pneumococcal vaccine conjugated to TT (PncT) and a diphtheria-tetanus-pertussis-poliovirus-Haemophilus influenzae type b-tetanus conjugate vaccine showed significantly lower anti-H. influenzae type b polysaccharide (polyribosylribitol phosphate [PRP]) antibody concentrations than those receiving either a tetravalent pneumococcal vaccine conjugated to diphtheria toxoid or placebo. A dose range study showed that anti-PRP antibody concentrations were inversely related to the TT content of the PncT vaccines administered in infancy. Postimmunization antitetanus antibody concentrations were also affected adversely as the TT content of the coadministered vaccines was increased. This phenomenon, which we believe derives from interference by a common protein carrier, should be taken into account when the introduction of an immunization program including multiple conjugate vaccines is considered.
TL;DR: The results suggest that the trafficking of fetal cells into the maternal periphery is disturbed in patients with preeclampsia, and may lead to interesting new concepts regarding the development of preeClampsia and possibly the associated syndrome of hemolysis, elevated liver enzymes, and low platelets.
TL;DR: In this paper, the in vivo emission spectra of chlorophyll (Chi) fluorescence of green leaves, taken at room temperature, show two maxima near 685 nm and 735 nm.
TL;DR: In this paper, the ripening behavior of preclimacteric plums was investigated using 1-methylcyclopropene (1-MCP) followed by continuous treatment with propylene.
TL;DR: A number of characteristics of these enzymes can now be better understood on the basis of such models: the nature of the herbicide binding site, the structural role of FAD and the binding of ThDP-Mg2+.
TL;DR: Radical grafting of two monomers, methacrylic acid and polyethylene glycolmethacrylate, onto commercial composite polyamide reverse osmosis membranes was performed and found that the membranes were surface modified without damage to their transport properties.
TL;DR: For each irradiance there is an optimal culture density, defined as the concentration that yields the highest output rate of cell mass under the prevailing conditions, which is the highest reported for a culture of photoautotrophic microorganisms exposed to direct beam radiation.
Abstract: The requirements for efficient utilization of high light fluxes in cultures of Spirulina platensis have previously been elucidated. The most important of these was a short light-path coupled with a highly turbulent flow, facilitating ultrahigh cell densities (i.e. above 100 mg chl l−1). The present study shows that for each irradiance there is an optimal culture density, defined as the concentration that yields the highest output rate of cell mass under the prevailing conditions. In ultrahigh cell density cultures, a linear relationship was observed between the output rate and the irradiance, up to a photon flux density (PFD) of 2500 μmol m−2 s−1. Using a total PFD of 8000 μmol m−2 s−1, a maximal output rate of 16.8 g dry weight m−2 h−1 was obtained, which is the highest reported for a culture of photoautotrophic microorganisms exposed to direct beam radiation. Testing the effect of reduction in light-path on productivity, output rate per unit volume increased 50-fold as the light-path was reduced 27-fold...
TL;DR: In this article, a new approach to the intergenerational transmission of Holocaust experiences, by focusing on attachment theory, is proposed, which is used as a framework for interpretation of the results of three studies on Holocaust survivors and their offspring, from different countries (The Netherlands, Canada, and Israel).
Abstract: In this paper, we advance a new approach to the intergenerational transmission of Holocaust experiences, by focusing on attachment theory The approach is used as a framework for interpretation of the results of three studies on Holocaust survivors and their offspring, from different countries (The Netherlands, Canada, and Israel), and based on different conceptual approaches and methods of data collection (quantitative as well as qualitative)
TL;DR: Standardized heart rate analysis carried out in 9 posttraumatic stress disorder patients at rest demonstrated clear-cut evidence of a baseline autonomic hyperarousal state, and the lack of response to the stress model applied in the study appears to imply that PTSD patients experience so great a degree of autonomichyperactivation at rest, that they are unable to marshal a further stressresponse to the recounting of the triggering trauma.
TL;DR: Despite the normal synthesis of NADPH oxidase subunits during differentiation of cPLA2-deficient PLB-985 cells, these cells fail to activate NAD PH oxidase in response to a variety of soluble and particulate stimuli, but the addition of exogenous AA fully restores oxidase activity.
TL;DR: A large, international study of infants and children with acute otitis media to identify pathogens and susceptibility patterns found S. pneumoniae, H. influenzae, and M. catarrhalis remain the most important bacterial pathogens in patients with acute Otitis media; however, their prevalence is variable and resistance patterns are changing.
Abstract: The management of acute otitis media is complicated by the emergence of resistance to β-lactam and other antibiotics among common pathogens. We conducted a large, international study of infants and children with acute otitis media to identify pathogens and susceptibility patterns. During the winter of 1994 to 1995, middle ear fluid samples were collected from 917 patients with acute otitis media in Bulgaria, the Czech Republic, Hungary, Romania, Slovakia, Israel, and the United States. A single reference laboratory performed in vitro susceptibility testing. Pathogens were isolated from 62% of the patients. For Streptococcus pneumoniae (30% of the patients), untypeable Haemophilus influenzae (17%), and Moraxella catarrhalis (4%), there was significant variation among geographic regions (P < 0.001). The composite susceptibilities of these three organisms to amoxicillin ranged from 62% in the United States to 89% in Eastern and Central Europe; the corresponding susceptibilities to amoxicillin-clavulanate ranged from 90% in Israel to 95% in Eastern and Central Europe. β-Lactamase was produced by 31 and 100% of the isolates of H. influenzae and M. catarrhalis, respectively. More isolates of S. pneumoniae were susceptible to amoxicillin (90%) or amoxicillin-clavulanate (90%) than to penicillin (70%; P = 0.002). The prevalence of resistant S. pneumoniae was highest in patients less than 12 months of age. S. pneumoniae, H. influenzae, and M. catarrhalis remain the most important bacterial pathogens in patients with acute otitis media; however, their prevalence is variable and resistance patterns are changing.
TL;DR: The therapeutic effect of transcranial magnetic stimulation in mania may show laterality opposite to its effect in depression.
Abstract: Objective:Left prefrontal transcranial magnetic stimulation has been reported to have ECT-like effects in depression; therefore, the authors planned a study of transcranial magnetic stimulation in mania.Method:Sixteen patients completed a 14-day double-blind, controlled trial of right versus left prefrontal transcranial magnetic stimulation at 20 Hz (2-second duration per train, 20 trains/day for 10 treatment days). Mania was evaluated with the Mania Scale, the Brief Psychiatric Rating Scale, and the Clinical Global Impression. Results:Significantly more improvement was observed in patients treated with right than with left prefrontal transcranial magnetic stimulation.Conclusions:The therapeutic effect of transcranial magnetic stimulation in mania may show laterality opposite to its effect in depression. Am J Psychiatry 1998; 155: 1608-1610
TL;DR: In this article, normal pubertal development and fertility depend on the intricate interplay of hypothalamic, pituitary, and gonadal factors, and normal secretory patterns of follicle-stimulating hormone and luteinizing hormone.
Abstract: Normal pubertal development and fertility depend on the intricate interplay of hypothalamic, pituitary, and gonadal factors. Crucial in this respect are normal secretory patterns of follicle-stimulating hormone and luteinizing hormone. These hormones stimulate the production of estrogen and ovulation in women and the production of testosterone and spermatogenesis in men. Secreted from common gonadotroph cells, the hormones are heterodimers composed of a common α-subunit and a specific β-subunit, each encoded by a separate gene. Specificity of action depends on the recognition of these hormones by specific receptors on the surface of gonadal cells. Various genetic defects of the hypothalamic–pituitary–gonadal axis . . .
TL;DR: Multivariate tests of significance showed a significant association of D4DR across four behavioral clusters pertinent to temperament including orientation, motor organization, range of state and regulation of state, and a significant multivariate interaction was also observed between D 4DR and STPR.
Abstract: Genetic effects on behavior were evaluated at a time in early development when we hypothesized that environmental influences are minimal and least likely to confound associations between temperament and genes. The behavioral effects of two common polymorphisms linked respectively in some, but not all, studies to novelty seeking (dopamine D4 receptor-D4DR) and neuroticism and harm avoidance (serotonin transporter promoter region-STPR) were examined in a group of 81 two-week-old neonates. Neonate temperament was evaluated using the Brazelton neonatal assessment scale (NBAS). Multivariate tests of significance showed a significant association of D4DR across four behavioral clusters pertinent to temperament including orientation, motor organization, range of state and regulation of state. A significant multivariate interaction was also observed between D4DR and STPR. The effect of the homozygous short STPR genotype (s/s) was to lower the orientation score for the group of neonates lacking the long form (L) of D4DR. When adult subjects were grouped by the STPR polymorphism there is no significant effect of L-D4DR in those subjects homozygous for the STPR short form (s/s) whereas in the group without the homozygous genotype the effect of L-D4DR is significant and accounts for 13% of the variance in novelty seeking scores between groups.
TL;DR: Continuous administration of triptorelin, a long-acting agonist analogue of gonadotropin-releasing hormone, together with supportive psychotherapy, may be an effective treatment for men with severe paraphilia.
Abstract: BACKGROUND Men with deviant sexual behavior, or paraphilia, are usually treated with psychotherapy, antidepressant drugs, progestins, and antiandrogens, but these treatments are often ineffective Selective inhibition of pituitary-gonadal function with a long-acting agonist analogue of gonadotropin-releasing hormone may abolish the deviant sexual behavior by reducing testosterone secretion METHODS In an uncontrolled observational study, we treated 30 men (mean age, 32 years) with severe long-standing paraphilia (25 with pedophilia and 5 with other types of abnormal behavior) with monthly injections of 375 mg of triptorelin and supportive psychotherapy for 8 to 42 months The efficacy of therapy was evaluated monthly by the Intensity of Sexual Desire and Symptoms Scale and yearly by the Three Main Complaints questionnaire RESULTS All the men had a decrease in the number of deviant sexual fantasies and desires, from a mean (+/-SD) of 48+/-10 per week before therapy to zero during therapy (P<0001), and a decrease in the number of incidents of abnormal sexual behavior (from 5+/-2 per month to zero, P<0001) while receiving triptorelin These effects were evident after 3 to 10 months of therapy (P<0001) and persisted in all 24 men who continued therapy for at least 1 year The men's mean serum testosterone concentration fell from 545+/-196 ng per deciliter (189+/-68 nmol per liter) before therapy to 23+/-14 ng per deciliter (08+/-05 nmol per liter, P<0001) after 42 months of triptorelin The main side effects were erectile failure, hot flashes, and decrease in bone mineral density in some men CONCLUSIONS Continuous administration of triptorelin, a long-acting agonist analogue of gonadotropin-releasing hormone, together with supportive psychotherapy, may be an effective treatment for men with severe paraphilia
TL;DR: Methodologic advances, the enlistment of new techniques and disciplines, and redirected research efforts may facilitate progress in the diagnosis and treatment of lower back pain.
Abstract: Study Design. Consensus process. Objectives. Reexamining and redirecting the research agenda for low back pain in primary care. of Background Data. Most research, publications, and funding have traditionally. Deen directed toward specially and biologically oriented investigations of spinal disorders from biomedical and biomechanical perspectives. Beginning in the mid-1980s, primary care researchers began to investigate this field in earnest, focusing on lower back pain as a pain syndrome within an individual, family, and community context. Unfortunately, more progress has been made on what should not be done in diagnosing and treating lower back pain than on what should be done. Methods. This was a modified group process designed to reach consensus among an international group of primary care lower back pain researchers. Results. Nearly all of the research priorities from the initial 1995 forum are still thought to be important, although only modest progress has been made on most of them. The priorities perceived to be the most feasible to investigate and the ones in which the greatest strides have been achieved are in methodologic rather than substantive areas. Identifying subgroups of people with lower back pain is still given top ranking in 1997, but the priorities nave changed dramatically. Greater emphasis is given to finding predictors and risk factors for lower back pain chronicity, improving self-care strategies, and stimulating self-reliance. New items now make up 50% of the top 10 priorities. In general, the additions reflect a greater emphasis on expanding methodologic avenues of inquiry. Conclusions. Methodologic advances, the enlistment of new techniques and disciplines, and redirected research efforts may tacilitate progress in the diagnosis and treatment of lower back pain.