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Sample records for providing symptom relief

  1. Laparoscopic cholecystectomy for biliary dyskinesia in children provides durable symptom relief.

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    Haricharan, Ramanath N; Proklova, Lyudmila V; Aprahamian, Charles J; Morgan, Traci L; Harmon, Carroll M; Barnhart, Douglas C; Saeed, Shehzad A

    2008-06-01

    The purpose of this study was to determine the effectiveness of laparoscopic cholecystectomy in children with biliary dyskinesia. Reports of children with an abnormal cholecystokinin (CCK)-stimulated HIDA scan between January 2001 and July 2006 who underwent laparoscopic cholecystectomy were reviewed. Postoperatively, a 23-item Likert scale, symptom questionnaire was administered to parents. Sixty-four children with chronic abdominal pain and no gallstones on ultrasound had an abnormal CCK-HIDA scan. Twenty-three children (median age, 14 years; 16 girls), with mean (SD) ejection fraction of 17% (8), underwent laparoscopic cholecystectomy and were further analyzed. Preoperatively, these children had right upper quadrant/epigastric pain (78%), nausea (52%), vomiting (43%), and generalized abdominal pain (22%) lasting for a median of 3 months (range, 1 month to 2.5 years). Median postoperative follow-up was 2.7 years. Sixteen (70%) parents completed the questionnaire. Of those who responded, 63% indicated that their children had no abdominal pain, 87% had no vomiting, and 69% had no nausea in the month preceding the questionnaire. Overall, 67% of parents indicated that their children's symptoms were completely relieved after cholecystectomy, whereas 7% indicated that the symptoms were not relieved. Laparoscopic cholecystectomy is effective in providing both short-term and long-term improvement of symptoms in children with biliary dyskinesia.

  2. A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial

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    Kuskowski Michael A

    2008-02-01

    Full Text Available Abstract Background This small, pilot study evaluated the impact of treatment with a natural multi-mineral supplement from seaweed (Aquamin on walking distance, pain and joint mobility in subjects with moderate to severe osteoarthritis of the knee. Methods Subjects (n = 70 with moderate to severe osteoarthritis of the knee were randomized to four double-blinded treatments for 12 weeks: (a Glucosamine sulfate (1500 mg/d; (b Aquamin (2400 mg/d; (c Combined treatment composed of Glucosamine sulfate (1500 mg/d plus Aquamin (2400 mg/d and (d Placebo. Primary outcome measures were WOMAC scores and 6 Minute Walking Distances (6 MWD. Laboratory based blood tests were used as safety measures. Results Fifty subjects completed the study and analysis of the data showed significant differences between the groups for changes in WOMAC pain scores over time (p = 0.009 ANCOVA; however, these data must be reviewed with caution since significant differences were found between the groups at baseline for WOMAC pain and stiffness scores (p = 0.0039 and p = 0.013, respectively, ANOVA. Only the Aquamin and Glucosamine groups demonstrated significant improvements in symptoms over the course of the study. The combination group (like the placebo group did not show any significant improvements in OA symptoms in this trial. Within group analysis demonstrated significant improvements over time on treatment for the WOMAC pain, activity, composite and stiffness (Aquamin only scores as well as the 6 minute walking distances for subjects in the Aquamin and Glucosamine treatment groups. The Aquamin and Glucosamine groups walked 101 feet (+7% and 56 feet (+3.5% extra respectively. All treatments were well tolerated and the adverse events profiles were not significantly different between the groups. Conclusion This small preliminary study suggested that a multi mineral supplement (Aquamin may reduce the pain and stiffness of osteoarthritis of the knee over 12 weeks of treatment and

  3. Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy

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    Michael C. Pitter

    2015-01-01

    Full Text Available Objective. To examine success of robot-assisted laparoscopic myomectomy (RALM measured by sustained symptom relief and fertility. Methods. This is a retrospective survey of 426 women who underwent RALM for fibroids, symptom relief, or infertility at three practice sites across the US. We examined rates of symptom recurrence and pregnancy and factors associated with these outcomes. Results. Overall, 70% of women reported being symptom-free, with 62.9% free of symptoms after three years. At >3 years, 66.7% of women who underwent surgery to treat infertility and 80% who were also symptom-free reported achieving pregnancy. Factors independently associated with symptom recurrence included greater time after surgery, preoperative dyspareunia, multiple fibroid surgeries, smoking after surgery, and preexisting diabetes. Factors positively correlated with achieving pregnancy included desiring pregnancy, prior pregnancy, greater time since surgery, and Caucasian race. Factors negatively correlated with pregnancy were advanced age and symptom recurrence. Conclusions. This paper, the first to examine symptom recurrence after RALM, demonstrates both short- and long-term effectiveness in providing symptom relief. Furthermore, RALM may have the potential to improve the chance of conception, even in a population at high risk of subfertility, with greater benefits among those who remain symptom-free. These findings require prospective validation.

  4. Laparoscopic Nissen fundoplication offers high patient satisfaction with relief of extraesophageal symptoms of gastroesophageal reflux disease.

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    Rakita, Steven; Villadolid, Desiree; Thomas, Ashley; Bloomston, Mark; Albrink, Michael; Goldin, Steven; Rosemurgy, Alexander

    2006-03-01

    Nissen fundoplication is applied for patients with gastroesophageal reflux disease (GERD), usually because of symptoms of esophageal injury. When presenting symptoms are extraesophageal, there is less enthusiasm for operative control of reflux because of concerns of etiology and efficacy. This study was undertaken to evaluate the efficacy of laparoscopic Nissen fundoplication in palliating extraesophageal symptoms of GERD. Patients were asked to score their symptoms before and after laparoscopic Nissen fundoplication on a Likert scale (0 = never/none to 5 = always/every time I eat). A total of 322 patients with extraesophageal symptoms (asthma, cough, gas/bloat, chest pain, and odynophagia) of 4 to 5 were identified and analyzed. After fundoplication, all extraesophageal symptom scores improved (P < 0.0001 for all, Wilcoxon matched-pairs test). Likewise, postoperative symptoms were noted to be greatly improved or resolved in 67 per cent to 82 per cent of patients for each symptom. Furthermore, after fundoplication, patients were less likely to modify their dietary (82% vs 49%) or sleeping habits (70% vs 28%) to avoid initiating/ exacerbating symptoms. Although extraesophageal symptoms are conventionally thought to be inadequately palliated by surgery, this study documents excellent relief of extraesophageal symptoms after laparoscopic Nissen fundoplication, denotes high patient satisfaction, and encourages application of laparoscopic Nissen fundoplication.

  5. 30 CFR 203.70 - What information must I provide after MMS approves relief?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What information must I provide after MMS... information must I provide after MMS approves relief? You must submit reports to us as indicated in the following table. Sections 203.81, 203.90, and 203.91 describe what these reports must include. The MMS...

  6. Symptom relief in patients with pneumonia and dementia: implementation of a practice guideline.

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    van der Maaden, Tessa; van der Steen, Jenny T; Koopmans, Raymond T C M; Doncker, Sarah M M M; Anema, Johannes R; Hertogh, Cees M P M; de Vet, Henrica C W

    2017-08-01

    This study aimed to assess the degree of implementation and barriers encountered in the use of a practice guideline for optimal symptom relief for patients with dementia and pneumonia in Dutch nursing homes. A process evaluation included assessment of reach, fidelity, and dose delivered using researcher's observations, and dose received was addressed in a question "use of the practice guideline," which the physicians completed for each patient included in the study. Perceived barriers were assessed with a structured questionnaire (response 69%) and semi-structured interviews (n = 14), which were subject to qualitative content analysis. Of the 55 physicians involved in the intervention phase, 87% attended an implementation meeting; 20 physicians joined the study later (reach). The intervention was implemented as planned, and all intervention components were delivered by the researchers (fidelity and dose delivered). Thirty-six physicians included 109 patients. For 81% of the patients, the treating physician stated to have used the guideline (dose received). The guideline was perceived as providing a good overview of current practice, but some physicians had expected a more directive protocol or algorithm. Further, recommended regular observations of symptoms were rarely performed. Physician's often felt that "this is not different from what we usually do," and with the acute illness, there was not always enough time to (re)familiarize with the contents. The physicians used the practice guideline frequently despite important barriers. Future implementation may involve strategies such as multiple interactive meetings. Further, the greatest potential to alter usual practice should be emphasized, such as using observational instruments. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Effects of nicotine versus placebo e-cigarette use on symptom relief during initial tobacco abstinence.

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    Perkins, Kenneth A; Karelitz, Joshua L; Michael, Valerie C

    2017-08-01

    Because electronic cigarettes (e-cigs) containing nicotine may relieve smoking abstinence symptoms similar to nicotine replacement therapy medication, we used within-subjects designs to test these effects with a first-generation e-cig in nonquitting and quitting smokers. In Study 1, 28 nontreatment-seeking smokers abstained overnight prior to each of 3 sessions. Minnesota Nicotine Withdrawal Scale (MNWS) withdrawal (and craving item) relief was assessed following 4 exposures (each 10 puffs) over 2 hr to e-cigs that either did (36 mg/ml) or did not (i.e., placebo, 0 mg/ml) contain nicotine or after no e-cig. Relief was greater after nicotine versus placebo e-cig (p < .05) but not after placebo versus no e-cig, showing relief was due to nicotine per se and not simple e-cig use behavior. Using a crossover design in Study 2, smokers preparing to quit soon engaged in 2 experimental 4-day quit periods on separate weeks. In weeks 1 and 3, all received a nicotine or placebo e-cig on Monday to use ad libitum while trying to abstain from smoking on Tuesday through Friday. (Week 2 involved resumption of ad libitum smoking.) MNWS and Questionnaire of Smoking Urges (QSU) craving were assessed at daily visits following 24-hr abstinence. Of 17 enrolled, 12 quit for ≥24 hr at least once, allowing test of relief because of e-cig use on quit days. Withdrawal and craving were reduced because of nicotine versus placebo e-cig use (both p < .05). In sum, compared with placebo e-cigs, nicotine e-cigs can relieve smoking abstinence symptoms, perhaps in a manner similar to Food and Drug Administration-approved nicotine replacement therapy products, although much more research with larger samples is needed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Reports of "satisfactory relief" by IBS patients receiving usual medical care are confounded by baseline symptom severity and do not accurately reflect symptom improvement.

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    Whitehead, William E; Palsson, Olafur S; Levy, Rona L; Feld, Andrew D; VonKorff, Michael; Turner, Marsha

    2006-05-01

    Treatment trials for irritable bowel syndrome (IBS) usually define a responder as a patient who reports satisfactory relief or adequate relief of symptoms at the end of the trial. However, these measures have not been adequately validated. (1) Compare a binary satisfactory relief measure to alternative ways of defining a treatment responder. (2) Determine whether baseline IBS symptom severity or psychological distress influence the sensitivity of these outcome measures. A total of 350 patients (81% females, average age 50 yr) who had a medical diagnosis of IBS and satisfied Rome II criteria, were recruited from Group Health Cooperative of Puget Sound. At baseline the Irritable Bowel Severity Scale (IBSS) was used to assess symptom severity and to classify patients as mild, moderate, or severe. Psychological distress and IBS-specific quality of life (IBS-QOL) were also assessed. After 6 months treatment with standard medical care, IBSS and IBS-QOL were reassessed, and patients were asked whether they had experienced satisfactory relief and whether they were somewhat or markedly better. Initial severity of IBS significantly affected the proportion who reported satisfactory relief (mild, 72%; moderate, 53%; severe, 44%) and the proportion who were somewhat or markedly better (mild, 62%; moderate, 44%; severe, 38%), but did not affect the proportion with a 50% reduction in symptoms (mild, 26%; moderate, 25%; severe, 23%). Although mild patients were the most likely to report satisfactory relief, they showed no average decrease in symptom severity or improvement in IBS-QOL. Conversely, severe patients, who were the least likely to report satisfactory relief, had the largest reductions in IBS symptom severity and the largest improvements in IBS-QOL. Psychological distress had no significant effect on the responder rate after adjusting for IBS symptom severity. These data from a descriptive study suggest that satisfactory relief is confounded with initial IBS symptom

  9. The efficacy of online communication platforms for plastic surgeons providing extended disaster relief.

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    Fan, Kenneth L; Avashia, Yash J; Dayicioglu, Deniz; DeGennaro, Vincent A; Thaller, Seth R

    2014-04-01

    Immediately after the January 2010 earthquake in Haiti, plastic surgeons provided disaster relief services through the University of Miami Miller School of Medicine for 5 months. To improve surgical care and promote awareness of plastic surgery's role in humanitarian assistance, an online communication platform (OCP) was initiated. An OCP is a Web-based application combining Web blogging, picture uploading, news posting, and private messaging systems into a single platform. The purpose of this study was to analyze the use of OCP during disaster relief. Surgeries performed during the period from January 13 to May 28, 2010, were documented. The OCP was established with 4 priorities: ease of use, multimedia integration, organization capabilities, and security. Web traffic was documented. A 17-question survey was administered to 18 plastic surgeons who used the OCP after 1 year to assess their attitudes and perceptions. From January 13 to May 28, 2010, 413 operations were performed at the field hospital. Of the overall number of procedures, 46.9% were performed by plastic surgery teams. In a year, beginning from January 12, 2011, the OCP had 1117 visits with 530 absolute unique visitors. Of 17 plastic surgeons, 71% responded that the OCP improved follow-up and continuity of care by debriefing rotating plastic surgery teams. One hundred percent claimed that the OCP conveyed the role of plastic surgeons with the public. Results demonstrate the necessity of OCP during disaster relief. Online communication platform permitted secure exchange of surgical management details, follow-up, photos, and miscellaneous necessary recommendations. Posted experiences and field hospital progress assisted in generating substantial awareness regarding the significant role and contribution played by plastic surgeons in disaster relief.

  10. Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria

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    Ogboli-Nwasor E

    2011-08-01

    Full Text Available E Ogboli-Nwasor1, SE Adaji2, SB Bature2, OS Shittu21Department of Anesthesia, 2Department of Obstetrics and Gynecology, Ahmadu Bello University Teaching Hospital, Zaria, NigeriaBackground: The purpose of this study was to assess the attitudes of maternal health care providers to pain relief during labor in Zaria, Nigeria.Methods: This was a multicenter, collaborative, cross-sectional pilot study of provider perspectives concerning pain relief during labor. A structured, self-administered, questionnaire was completed by 95 consenting maternal health care providers at three high-volume facilities in Zaria, an ancient northern Nigerian city. Descriptive statistics was performed on the data.Results: Most respondents (94.8% agreed that pain relief is needed during labor. Only 2.1% of respondents were undecided about the provision of pain relief during labor and 3.2% were of the opinion that pain relief was not necessary during labor. Most respondents (93.7% had attended a woman in labor in the 4 weeks preceding the survey. Of these, 56.8% had counseled a parturient in labor. Most of the counseling (42.1% took place during labor. Less than half of the respondents (48.4% had administered pain relief in labor in the preceding 4 weeks and systemic opioids was the most commonly form of pain relief. Among the respondents who did not offer pain relief agents in labor, the majority (54.5% had no reason for not offering it. Unavailability of methods, inability to afford the cost of pain relief, lack of knowledge and skills, as well as lack of essential equipment to provide the procedure were also given by respondents as reasons for not offering pain relief.Conclusion: Even though maternal health care providers in this environment have a positive attitude to pain relief in labor, most women go through labor without the benefit of analgesia. There exists a gap between provider attitudes to pain relief in labor and practice of the same, with many providers

  11. Massage with or without aromatherapy for symptom relief in people with cancer.

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    Shin, Ein-Soon; Seo, Kyung-Hwa; Lee, Sun-Hee; Jang, Ji-Eun; Jung, Yu-Min; Kim, Min-Ji; Yeon, Ji-Yun

    2016-06-03

    aromatherapy. Fourteen studies had a high risk of bias related to sample size and 15 studies had a low risk of bias for blinding the outcome assessment. We judged the studies to be at unclear risk of bias overall. Our primary outcomes were pain and psychological symptoms. Two studies reported physical distress, rash, and general malaise as adverse events. The remaining 17 studies did not report adverse events. We downgraded the GRADE quality of evidence for all outcomes to very low because of observed imprecision, indirectness, imbalance between groups in many studies, and limitations of study design. Massage versus no-massage groupsWe analysed results for pain and anxiety but the quality of evidence was very low as most studies were small and considered at an unclear or high risk of bias due to poor reporting. Short-term pain (Present Pain Intensity-Visual Analogue Scale) was greater for the massage group compared with the no-massage group (one RCT, n = 72, mean difference (MD) -1.60, 95% confidence interval (CI) -2.67 to -0.53). Data for anxiety (State-Trait Anxiety Inventory-state) relief showed no significant difference in anxiety between the groups (three RCTs, n = 98, combined MD -5.36, 95% CI -16.06 to 5.34). The subgroup analysis for anxiety revealed that the anxiety relief for children was greater for the massage group compared with the no-massage group (one RCT, n = 30, MD -14.70, 95% CI -19.33 to -10.07), but the size of this effect was considered not clinically significant. Furthermore, this review demonstrated no differences in effects of massage on depression, mood disturbance, psychological distress, nausea, fatigue, physical symptom distress, or quality of life when compared with no massage. Massage with aromatherapy versus no-massage groupsWe analysed results for pain, anxiety, symptoms relating to the breast, and quality of life but the quality of evidence was very low as studies were generally at a high risk of bias. There was some indication of benefit in

  12. Sympathetic Blocks Provided Sustained Pain Relief in a Patient with Refractory Painful Diabetic Neuropathy

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    Jianguo Cheng

    2012-01-01

    Full Text Available The sympathetic nervous system has been implicated in pain associated with painful diabetic neuropathy. However, therapeutic intervention targeted at the sympathetic nervous system has not been established. We thus tested the hypothesis that sympathetic nerve blocks significantly reduce pain in a patient with painful diabetic neuropathy who has failed multiple pharmacological treatments. The diagnosis of small fiber sensory neuropathy was based on clinical presentations and confirmed by skin biopsies. A series of 9 lumbar sympathetic blocks over a 26-month period provided sustained pain relief in his legs. Additional thoracic paravertebral blocks further provided control of the pain in the trunk which can occasionally be seen in severe diabetic neuropathy cases, consequent to extensive involvement of the intercostal nerves. These blocks provided sustained and significant pain relief and improvement of quality of life over a period of more than two years. We thus provided the first clinical evidence supporting the notion that sympathetic nervous system plays a critical role in painful diabetic neuropathy and sympathetic blocks can be an effective management modality of painful diabetic neuropathy. We concluded that the sympathetic nervous system is a valuable therapeutic target of pharmacological and interventional modalities of treatments in painful diabetic neuropathy patients.

  13. Disparity between General Symptom Relief and Remission Criteria in the Positive and Negative Syndrome Scale (PANSS): A Post-treatment Bifactor Item Response Theory Model.

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    Anderson, Ariana E; Reise, Steven P; Marder, Stephen R; Mansolf, Maxwell; Han, Carol; Bilder, Robert M

    2017-12-01

    Objective: Total scale scores derived by summing ratings from the 30-item PANSS are commonly used in clinical trial research to measure overall symptom severity, and percentage reductions in the total scores are sometimes used to document the efficacy of treatment. Acknowledging that some patients may have substantial changes in PANSS total scores but still be sufficiently symptomatic to warrant diagnosis, ratings on a subset of 8 items, referred to here as the "Remission set," are sometimes used to determine if patients' symptoms no longer satisfy diagnostic criteria. An unanswered question remains: is the goal of treatment better conceptualized as reduction in overall symptom severity, or reduction in symptoms below the threshold for diagnosis? We evaluated the psychometric properties of PANSS total scores, to assess whether having low symptom severity post-treatment is equivalent to attaining Remission. Design: We applied a bifactor item response theory (IRT) model to post-treatment PANSS ratings of 3,647 subjects diagnosed with schizophrenia assessed at the termination of 11 clinical trials. The bifactor model specified one general dimension to reflect overall symptom severity, and five domain-specific dimensions. We assessed how PANSS item discrimination and information parameters varied across the range of overall symptom severity (θ), with a special focus on low levels of symptoms (i.e., θexpected PANSS item score of 1.83, a rating between "Absent" and "Minimal" for a PANSS symptom. Results: The application of the bifactor IRT model revealed: (1) 88% of total score variation was attributable to variation in general symptom severity, and only 8% reflected secondary domain factors. This implies that a general factor may provide a good indicator of symptom severity, and that interpretation is not overly complicated by multidimensionality; (2) Post-treatment, 534 individuals (about 15% of the whole sample) scored in the "Relief" range of general symptom

  14. Food provision among food relief agencies in rural Australia, and perceived barriers and enablers to provide healthy food.

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    Bortolin, Natalia; Priestly, Jaqueline; Sangster, Janice

    2018-04-01

    Food insecurity affects 4-14% of Australians, and up to 82% of vulnerable groups. Food relief agencies commonly provide food parcels or food vouchers. Little research has been undertaken on food relief agencies within rural Australia. This study determined the type of food assistance provided by rural food relief agencies, and barriers and enablers to provide healthy food. Cross-sectional study, using telephone questionnaires with qualitative and quantitative aspects. Data were analysed using descriptive statistics and thematic analysis. Rural New South Wales, Australia. Representatives of 10 food relief agencies. Types of food assistance and food provided, and the barriers and enablers to provide healthy food to clients. Most agencies provided food hampers and perishable and non-perishable food. Rural food relief agencies had a greater capacity to provide non-perishable compared to perishable food. Grains, breads and cereals, and canned fruit and vegetables were most popular. Nine key themes emerged including 'Ability to purchase and provide healthy food', 'Ability to regulate food purchased or chosen by clients', 'Financial constraints of the agency' and 'Lack of storage'. There are many variables to consider in order to understand the capacity of rural food relief agencies to provide healthy food. There are also opportunities for food relief agencies to appraise current practices and make changes. Initiatives to improve storage facilities and food availability are key and include networking with local businesses, community organisations and government. Rural food relief agency clients could benefit from accessing food literacy and health programs like FoodREDi, OzHarvest NEST and SecondBite Fresh NED. © 2017 National Rural Health Alliance Inc.

  15. Spinal Cord Stimulation Provides Pain Relief with Improved Psychosocial Function: Results from EMP3OWER.

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    Rosenberg, Jason; Fabi, Alain; Candido, Kenneth; Knezevic, Nick; Creamer, Michael; Carayannopoulos, Alexios; Ghodsi, Abdi; Nelson, Christopher; Bennett, Matthew

    2016-12-01

    The EMP 3 OWER™ study evaluated spinal cord stimulation (SCS) safety and efficacy and the associated changes in psychosocial and functional outcomes. Upon informed consent and IRB approval, 620 eligible subjects were enrolled prior to SCS trial evaluation and were assessed at baseline, 3, 6 and 12 months post-implant. Patient-reported pain relief (PRP), numerical rating scale (NRS), satisfaction, quality of life (QOL), and pain disability index (PDI) were assessed at all follow-up visits while the pain catastrophizing scale (PCS), short form-36 (SF-36), short form-McGill pain questionnaire version 2 (SF-MPQ-2), and the state-trait anxiety inventory (STAI) were assessed at the 6- and 12-month follow-up visits. Device and/or procedure-related adverse events were also recorded and reported. Subjects reporting a PRP ≥ 50% were considered responders. Repeated measures analysis of variance (RMANOVA) examined the changes across time for all continuous measures. A total of 401 (71%) subjects received a permanent implant. Mean (±SD) patient-reported pain relief was 59.3% (±26.2), 59.2% (±28.9), and 58.2% (±32.0) at 3, 6, and 12 months, respectively. A majority of enrolled subjects were responders at 3 (75.5%), 6 (74.7%), and 12 months (69.7%). RMANOVA revealed a statistically significant change for NRS, PCS, PDI, SF-36, SF-MPQ-2, and STAI scores. At 3 months, the majority of subjects (85.7%) were either very satisfied or satisfied with their device, with similar results at 6 and 12 months. At 3 months, the majority of subjects (73.3%) reported greatly improved or improved QOL with similar results at 6 and 12 months. Spinal cord stimulation provided pain relief and significant improvement of patient psychological and functional outcome measures. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Efficacy of olanzapine in symptom relief and quality of life in gastric cancer patients receiving chemotherapy

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    Novin Nikbakhsh

    2016-01-01

    Full Text Available Background: Considering the incidence and prevalence rates of gastric cancer in Mazandaran Province of Iran, this research was performed to evaluate the efficacy and safety of olanzapine in symptom relief and quality of life (QOL improvement of gastric patients receiving chemotherapy. Materials and Methods: This clinical trial was conducted on thirty new cases of gastric cancer patients whose treatment protocol was planned on chemotherapy and were allocated into two groups by simple random sampling. Intervention group (15 patients received olanzapine tablets (2.5–10 mg/day a day before the beginning of chemotherapy; in the 1st day of chemotherapy to 8 weeks after chemotherapy, besides the routine treatment regimens. The control group received only the routine treatment regimens. The patients were followed for 8 weeks after intervention. All of the patients were assessed with Hospital Anxiety and Depression Scale (HADS and WHO-QOL-BREF questionnaires; further, Rhodes index was used to evaluate nausea and vomiting (N/V status. Results: All the recruited patients continued the allocated interventions (no lost to follow-up. N/V decreased in the case group, but the difference was not statistically significant (P = 0.438. The patients' appetite and body mass index increased (P = 0.006. Anxiety and depression subscales of HADS had significant differences between the two groups (P 0.05. No significant increase was observed in fasting and 2-h postprandial blood glucose and lipid profile (P > 0.05. Conclusion: Olanzapine can be considered as an effective drug to increase appetite and decrease anxiety and depression in patients with gastric cancer.

  17. Access to water provides economic relief through enhanced relationships in Kenya.

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    Zolnikov, Tara Rava; Blodgett-Salafia, Elizabeth

    2017-03-01

    Sub-Saharan Africa is comprised of low- and middle-income countries subject to the residual effects of chronic poverty. Poverty contributes to health disparities and social inequities. Public health strategies and solutions seek to remedy the effects of poverty. Providing access to quality water is one priority public health project that alleviates adverse health effects, but may have additional outcomes. Previous research has not thoroughly reviewed the economic relief and relationship changes from implemented water interventions. A qualitative phenomenological approach used 52 semi-structured interviews to understand relationship experiences among primary water gatherers and their families after implemented water interventions in a community. This study took place throughout the historically semi-arid eastern region in Kitui, Kenya, where community members have been beneficiaries of various water interventions. Prior to the water intervention, relationships were strained because of economic hardships. Households experienced economic difficulties in paying for children's school fees, buying bricks for housing structures, having water for house gardens, trees for shade in the compound, crops and providing water for their animals. After receiving access to water, relationships improved, because families were able to discuss and address economic challenges. Additional financial revenue was gained and used to pay for water to make bricks to sell or use on housing structures, expand on house gardens and agricultural crops, build new businesses, purchase water for animals, and construct local water spouts near the household. Access to water improved relationships, which encouraged economic growth. This information provides a critical component in understanding the interconnected nature between access to water, poverty and family relationships. Ultimately, this research suggests an increased need for access to quality water worldwide to improve both economic situations

  18. OnabotulinumtoxinA (Botox) nerve blocks provide durable pain relief for men with chronic scrotal pain: a pilot open-label trial.

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    Khambati, Aziz; Lau, Susan; Gordon, Allan; Jarvi, Keith A

    2014-12-01

    Chronic scrotal pain (CSP) is a common, often debilitating, condition affecting approximately 4.75% of men. While nerve blocks using local anesthetics usually provide temporary pain relief, there are no publications on the use of longer acting nerve blocks to provide more durable pain relief for men with CSP. The aim of this study was to determine if onabotulinumtoxinA (Botox) cord blocks provide durable pain relief for men with CSP. In this pilot open-label study, men with CSP who had failed medical management but experienced temporary pain relief from a standard cord block underwent a cord block with 100U Botox. The outcomes measured were changes 1, 3, and 6 months post-Botox injection in (i) a 10-point visual analog scale (VAS) pain score; (ii) scrotal tenderness on a three-point scale as rated by physical examination; and (iii) the Chronic Epididymitis Symptom Index (CESI) to measure the severity and impact of scrotal pain on men. Paired t-tests were used to compare groups. Eighteen patients with CSP seen between April and September 2013 had Botox injected as a cord block. At the 1-month follow-up, pain reduction was reported by 72% of patients (mean VAS score: 7.36 vs. 5.61, P pain reduction and reduced tenderness based on the VAS score (mean: 7.36 vs. 6.02, P pain and tenderness. Our pilot study found that Botox cord blocks provide pain reduction for 3 months or more for most men with CSP. © 2014 International Society for Sexual Medicine.

  19. The Relationship between Symptom Relief and Psychosocial Functional Improvement during Acute Electroconvulsive Therapy for Patients with Major Depressive Disorder.

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    Lin, Ching-Hua; Yang, Wei-Cheng

    2017-07-01

    We aimed to compare the degree of symptom relief to psychosocial functional (abbreviated as "functional") improvement and explore the relationships between symptom relief and functional improvement during acute electroconvulsive therapy for patients with major depressive disorder. Major depressive disorder inpatients (n=130) requiring electroconvulsive therapy were recruited. Electroconvulsive therapy was generally performed for a maximum of 12 treatments. Symptom severity, using the 17-item Hamilton Depression Rating Scale, and psychosocial functioning (abbreviated as "functioning"), using the Modified Work and Social Adjustment Scale, were assessed before electroconvulsive therapy, after every 3 electroconvulsive therapy treatments, and after the final electroconvulsive therapy. Both 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale scores were converted to T-score units to compare the degrees of changes between depressive symptoms and functioning after electroconvulsive therapy. Structural equation modeling was used to test the relationships between 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale during acute electroconvulsive therapy. One hundred sixteen patients who completed at least the first 3 electroconvulsive therapy treatments entered the analysis. Reduction of 17-item Hamilton Depression Rating Scale T-scores was significantly greater than that of Modified Work and Social Adjustment Scale T-scores at assessments 2, 3, 4, and 5. The model analyzed by structural equation modeling satisfied all indices of goodness-of-fit (chi-square = 32.882, P =.107, TLI = 0.92, CFI = 0.984, RMSEA = 0.057). The 17-item Hamilton Depression Rating Scale change did not predict subsequent Modified Work and Social Adjustment Scale change. Functioning improved less than depressive symptoms during acute electroconvulsive therapy. Symptom reduction did not predict subsequent functional improvement

  20. Ovarian surgery for symptom relief in women with polycystic ovary syndrome.

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    Lepine, Sam; Jo, Junyoung; Metwally, Mostafa; Cheong, Ying C

    2017-11-10

    Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo- or anovulation, clinical or biochemical hyperandrogenism or both, or polycystic ovaries.Women with PCOS can have a wide range of health problems, including infrequent and irregular periods, unwanted hair growth and acne, and subnormal fertility. Long-term health concerns include an increased risk of heart disease, diabetes and the development of precancerous disease of the womb. To assess the effectiveness and harms of ovarian surgery as a treatment for symptomatic relief of hirsutism, acne and menstrual irregularity in PCOS. We searched the Cochrane Gynaecology and Fertility Group specialized register, CENTRAL, MEDLINE, Embase and PsycINFO (from inception to 17 October 2016). We handsearched citation lists, registers of ongoing trials and conference proceedings. We included randomized controlled trials (RCTs) of women undergoing ovarian drilling in comparison to no treatment, medical treatment, or other forms of surgical treatment for the symptoms of PCOS. We used standard methodological procedures recommended by Cochrane. The primary outcome measures were improvement in menstrual regularity and androgenic symptoms of PCOS (hirsutism, acne); the secondary outcome measures included harms, change of body mass index (BMI), waist circumference, androgen levels, metabolic measures and quality of life. We assessed the quality of the evidence using GRADE methods. We included 22 RCTs (2278 women analyzed) of participants with PCOS and symptoms of acne, hirsutism or irregular menstrual cycles, all of which included laparoscopic ovarian drilling (LOD) as an intervention.Two studies reported their funding source (Farquhar 2002 - supported in part by the Auckland Medical Research Foundation; Sarouri 2015 - the authors thank the Vice Chancellor for Research of Guilan University of Medical Sciences for funding this project

  1. Controlled breathing with or without peppermint aromatherapy for postoperative nausea and/or vomiting symptom relief: a randomized controlled trial.

    Science.gov (United States)

    Sites, Debra S; Johnson, Nancy T; Miller, Jacqueline A; Torbush, Pauline H; Hardin, Janis S; Knowles, Susan S; Nance, Jennifer; Fox, Tara H; Tart, Rebecca Creech

    2014-02-01

    With little scientific evidence to support use of aromatherapy for postoperative nausea and/or vomiting (PONV) symptoms, this study evaluated controlled breathing with peppermint aromatherapy (AR) and controlled breathing alone (CB) for PONV relief. A single blind randomized control trial design was used. On initial PONV complaint, symptomatic subjects received either CB (n = 16) or AR (n = 26) intervention based on randomization at enrollment. A second treatment was repeated at 5 minutes if indicated. Final assessment occurred 10 minutes post initial treatment. Rescue medication was offered for persistent symptoms. Among eligible subjects, PONV incidence was 21.4% (42/196). Gender was the only risk factor contributing to PONV symptoms (P = .0024). Though not statistically significant, CB was more efficacious than AR, 62.5% versus 57.7%, respectively. CB can be initiated without delay as an alternative to prescribed antiemetics. Data also support use of peppermint AR in conjunction with CB for PONV relief. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  2. Immediate Symptom Relief After a First Session of Massage Therapy or Reiki in Hospitalized Patients: A 5-year Clinical Experience from a Rural Academic Medical Center.

    Science.gov (United States)

    Vergo, Maxwell T; Pinkson, Briane M; Broglio, Kathleen; Li, Zhongze; Tosteson, Tor D

    2018-04-05

    There is an increasing demand for and use of alternative and complementary therapies, such as reiki and massage therapy, in hospital-based settings. Most controlled studies and practice-based reports include oncology and surgical patient populations; thus the effect in a more heterogeneous hospitalized patient population is hard to estimate. We examined the immediate symptom relief from a single reiki or massage session in a hospitalized population at a rural academic medical center. Retrospective analysis of prospectively collected data on demographic, clinical, process, and quality of life for hospitalized patients receiving massage therapy or reiki. A 396-bed rural academic and tertiary medical center in the United States. Hospitalized patients requesting or referred to the healing arts team who received either a massage or reiki session and completed both a pre- and post-therapy symptom questionnaire. First session of routine reiki or massage therapy during a hospital stay. Differences between pre- and postsession patient-reported scores in pain, nausea, fatigue, anxiety, depression, and overall well-being using an 11-point Likert scale. Patients reported symptom relief with both reiki and massage therapy. Analysis of the reported data showed reiki improved fatigue (-2.06 vs. -1.55 p massage therapy and did not vary based on age, gender, length of session, and baseline symptoms. Reiki and massage clinically provide similar improvements in pain, nausea, fatigue, anxiety, depression, and overall well-being while reiki improved fatigue and anxiety more than massage therapy in a heterogeneous hospitalized patient population. Controlled trials should be considered to validate the data.

  3. From comic relief to real understanding; how intestinal gas causes symptoms.

    LENUS (Irish Health Repository)

    Quigley, E M M

    2012-02-03

    Gas content and transit appear to conspire with the motor and sensory responses of the gut to produce gas related symptoms, both in normal individuals and especially in patients with irritable bowel syndrome (IBS). In relation to gas in IBS, two questions need to be addressed: do IBS patients produce more gas and what are the relationships between intestinal gas and symptoms? The balance of evidence seems to indicate that distension is a real phenomenon in IBS and that such distension accurately reflects gas content. More problematic is extrapolation of the observations relating symptoms to gas transit and retention.

  4. Laparoscopic Heller myotomy provides durable relief from achalasia and salvages failures after botox or dilation.

    Science.gov (United States)

    Rosemurgy, Alexander; Villadolid, Desiree; Thometz, Donald; Kalipersad, Candice; Rakita, Steven; Albrink, Michael; Johnson, Milton; Boyce, Worth

    2005-05-01

    To report outcome after laparoscopic Heller myotomy in a large number of patients. Laparoscopic Heller myotomy has been undertaken for over a decade, but most studies involve small numbers of patients with limited follow-up. Since 1992, 262 patients have undergone laparoscopic Heller myotomy and been prospectively followed. Concomitant fundoplication was undertaken for a patulous hiatus or large hiatal hernia or to buttress the repair of an esophagotomy until recently when it became routinely applied. With mean follow-up at 32 months, symptoms were scored by patients on a Likert scale (frequency: 0 = Never to 10 = Every time I eat/always; severity: 0 = Not bothersome to 10 = Very bothersome). Before myotomy, 79% received Botox or bag dilation: 52% had Botox, 59% underwent dilation, and 36% had both. Inadvertent esophagotomy occurred in 5%. Concomitant diverticulectomy was undertaken in 4%, and fundoplication was undertaken in 30%. Complications were infrequent. Median length of stay was 1 day. After myotomy, the frequency and severity of symptoms of achalasia and reflux significantly decreased. Eighty-eight percent of patients felt their symptoms were greatly improved or resolved, and 90% felt their outcome was satisfying or better. Ninety-three percent felt they would undergo myotomy again, if necessary. Laparoscopic Heller myotomy can safely and durably relieve symptoms of dysphagia while also reducing symptoms of reflux. Length of stay is short and patient satisfaction is very high with extended follow-up. Laparoscopic Heller myotomy is strongly encouraged for patients with symptomatic achalasia and is efficacious even after failures of dilation and/or Botox therapy.

  5. Laparoscopic Heller Myotomy Provides Durable Relief From Achalasia and Salvages Failures After Botox or Dilation

    Science.gov (United States)

    Rosemurgy, Alexander; Villadolid, Desiree; Thometz, Donald; Kalipersad, Candice; Rakita, Steven; Albrink, Michael; Johnson, Milton; Boyce, Worth

    2005-01-01

    Objective: To report outcome after laparoscopic Heller myotomy in a large number of patients. Summary Background Data: Laparoscopic Heller myotomy has been undertaken for over a decade, but most studies involve small numbers of patients with limited follow-up. Methods: Since 1992, 262 patients have undergone laparoscopic Heller myotomy and been prospectively followed. Concomitant fundoplication was undertaken for a patulous hiatus or large hiatal hernia or to buttress the repair of an esophagotomy until recently when it became routinely applied. With mean follow-up at 32months, symptoms were scored by patients on a Likert scale (frequency: 0 = Never to 10 = Every time I eat/always; severity: 0 = Not bothersome to 10 = Very bothersome). Results: Before myotomy, 79% received Botox or bag dilation: 52% had Botox, 59% underwent dilation, and 36% had both. Inadvertent esophagotomy occurred in 5%. Concomitant diverticulectomy was undertaken in 4%, and fundoplication was undertaken in 30%. Complications were infrequent. Median length of stay was 1 day. After myotomy, the frequency and severity of symptoms of achalasia and reflux significantly decreased. Eighty-eight percent of patients felt their symptoms were greatly improved or resolved, and 90% felt their outcome was satisfying or better. Ninety-three percent felt they would undergo myotomy again, if necessary. Conclusions: Laparoscopic Heller myotomy can safely and durably relieve symptoms of dysphagia while also reducing symptoms of reflux. Length of stay is short and patient satisfaction is very high with extended follow-up. Laparoscopic Heller myotomy is strongly encouraged for patients with symptomatic achalasia and is efficacious even after failures of dilation and/or Botox therapy. PMID:15849508

  6. A Context-Aware Model to Provide Positioning in Disaster Relief Scenarios

    Directory of Open Access Journals (Sweden)

    Daniel Moreno

    2015-09-01

    Full Text Available The effectiveness of the work performed during disaster relief efforts is highly dependent on the coordination of activities conducted by the first responders deployed in the affected area. Such coordination, in turn, depends on an appropriate management of geo-referenced information. Therefore, enabling first responders to count on positioning capabilities during these activities is vital to increase the effectiveness of the response process. The positioning methods used in this scenario must assume a lack of infrastructure-based communication and electrical energy, which usually characterizes affected areas. Although positioning systems such as the Global Positioning System (GPS have been shown to be useful, we cannot assume that all devices deployed in the area (or most of them will have positioning capabilities by themselves. Typically, many first responders carry devices that are not capable of performing positioning on their own, but that require such a service. In order to help increase the positioning capability of first responders in disaster-affected areas, this paper presents a context-aware positioning model that allows mobile devices to estimate their position based on information gathered from their surroundings. The performance of the proposed model was evaluated using simulations, and the obtained results show that mobile devices without positioning capabilities were able to use the model to estimate their position. Moreover, the accuracy of the positioning model has been shown to be suitable for conducting most first response activities.

  7. Nasal budesonide offers superior symptom relief in perennial allergic rhinitis in comparison to nasal azelastine.

    Science.gov (United States)

    Stern, M A; Wade, A G; Ridout, S M; Cambell, L M

    1998-10-01

    Allergic rhinitis is usually treated with oral antihistamines or nasal steroids. Topically active nasal antihistamine is a new treatment modality for allergic rhinitis. The efficacy in comparison to well established topical treatment alternatives is not fully known. To compare the efficacy of intranasally administered azelastine to budesonide, at their respectively recommended dosage, on the symptoms of perennial rhinitis patients. A placebo-controlled, randomized, parallel group study was conducted to compare the efficacy and tolerability of intranasal budesonide aqueous suspension (256 microg once daily) with azelastine hydrochloride nasal spray (280 microg twice daily (560 microg/day)) and with placebo in the treatment of perennial allergic rhinitis. The 195 patients (with at least a 2-year history of perennial allergic rhinitis) recorded individual nasal symptom scores, the degree of symptom control achieved and any adverse events experienced over a 2-week baseline period and a 6-week treatment period. Following treatment, the reductions in mean combined and individual nasal symptom scores from baseline values were significantly greater in the budesonide group compared with the placebo group (P < .0001 for all variables except runny nose P = .01). In patients treated with budesonide, there were also significantly larger reductions from baseline values in combined nasal symptom scores (P < .01) and in scores for all individual nasal symptoms (P < or = .05) compared with those treated with azelastine. The reductions from baseline in both combined and individual nasal symptom scores did not differ between azelastine and placebo. The study medications were well tolerated, producing no unexpected or serious treatment-related adverse events. A once-daily dose of 256 microg of intranasal budesonide aqueous suspension is significantly more effective at relieving the symptoms of perennial allergic rhinitis compared with a twice daily dose of 280 microg of azelastine

  8. The relief of dry eye signs and symptoms using a combination of lubricants, lid hygiene and ocular nutraceuticals.

    Science.gov (United States)

    Ngo, William; Srinivasan, Sruthi; Houtman, Diane; Jones, Lyndon

    To determine the combined effect of TheraTears ® Lubricant Eye Drops, TheraTears ® SteriLid Eyelid Cleanser, and TheraTears ® Nutrition on dry eye signs and symptoms. This prospective study enrolled 28 dry eye participants. Participants were instructed to use the Lubricant Eye Drops at least 2-4× a day, SteriLid 1-2× a day, and Nutrition 3 gel caps once a day. Participants were followed up at baseline, 1 month and 3 months. Outcome variables were the Ocular Surface Disease Index (OSDI), Symptom Assessment iN Dry Eye (SANDE) questionnaire, non-invasive tear break-up time (NIBUT), osmolarity, number of meibomian glands blocked (#MG blocked), meibum quality, eyelid margin features, Schirmer's test, tear film lipid layer thickness (LLT), meniscus height, corneal and conjunctival staining. Twenty participants (mean age=43, from 23 to 66, 17F, 3M) completed the study. Participants reported having used, on average, the Lubricant Eye Drop 2.4×/day, the SteriLid 1.1×/day, and the Nutrition 3 gel caps 1×/day. There was a significant change over time (pEye Drop, SteriLid, and Nutrition, patients experience significant relief in both dry eye symptoms and signs. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  9. [Experience of Handicap International in providing humanitarian relief in region near Aceh, Indonesia from March 1 to 27, 2005].

    Science.gov (United States)

    Gillet, Y

    2005-01-01

    This report describes the experience of the author in March 2005 during the relief efforts deployed in the region near Aceh, Indonesia (North Sumatra) by Handicap International, one of the 400 NGO that provided humanitarian aid following the tsunami disaster that struck Southeast Asia on December 26, 2004. Working in Banda Aceh and Meulaboh, the author was confronted with the extent of the devastation both in terms of property damage and human suffering. Clinical cases were often severe and rarely encountered in industrialized countries. The tsunami worsened the already poor sanitary conditions: rundown care facilities, poorly trained health care personnel, tropical disease, poor hygiene, and AVP.

  10. Palliative Care: The Relief You Need When You're Experiencing Symptoms of Serious Illness

    Science.gov (United States)

    ... to you can bene fi t from this type of care. What is palliative care? Palliative care is ... that pain and other symptoms affect your quality of life and can leave you lacking the energy or motivation to pursue the things you enjoy. They also ...

  11. Microdose transdermal estrogen therapy for relief of vulvovaginal symptoms in postmenopausal women.

    Science.gov (United States)

    Bachmann, Gloria A; Schaefers, Matthias; Uddin, Alkaz; Utian, Wulf H

    2009-01-01

    The aim of this study was to investigate the effectiveness of microdose transdermal 17beta-estradiol (E2) therapy in postmenopausal women with moderate to severe vulvovaginal symptoms. This report is based on a subset of 121 women who reported most bothersome moderate or severe vulvovaginal symptoms at baseline, from a previous randomized, double-blind, placebo-controlled, multicenter study of 425 healthy, symptomatic, postmenopausal women. Recruits had experienced at least 7 moderate or severe hot flushes daily for at least 1 week or at least 50 moderate or severe hot flushes per week for at least 1 week. Effects on coprimary efficacy variables have been reported previously. Participants received low-dose transdermal E2 plus levonorgestrel (n = 43; nominal delivery 0.023 mg/d E2/0.0075 mg/d levonorgestrel), microdose E2 (n = 42; nominal delivery 0.014 mg/d), or placebo (n = 36) for 12 weeks. Secondary efficacy variables reported herein include mean change from baseline in vaginal pH and vaginal maturation index, the proportion of women with symptoms of vulvar and vaginal atrophy at baseline and week 12, and the proportion of women with moderate-to-severe symptoms of vulvar and vaginal atrophy. Microdose transdermal E2 treatment was associated with a consistent benefit versus placebo in women with vulvovaginal atrophy. There was a statistically significant difference between both E2 versus placebo for changes in vaginal pH and vaginal maturation index. Microdose transdermal E2 offers a useful addition to the therapeutic armamentarium for postmenopausal women in whom vulvovaginal symptoms are particularly troublesome.

  12. Prospectively surveying health-related quality of life and symptom relief in a lot-based sample of medical cannabis-using patients in urban Washington State reveals managed chronic illness and debility.

    Science.gov (United States)

    Aggarwal, S K; Carter, G T; Sullivan, M D; Zumbrunnen, C; Morrill, R; Mayer, J D

    2013-09-01

    To characterize health-related quality of life (HRQoL) in medical cannabis patients. Short Form 36 (SF-36) Physical Health Component Score and Mental Health Component Score (MCS) surveys as well has CDC (Centers for Disease Control) HRQoL-14 surveys were completed by 37 qualified patients. Mean SF-36 PCS and MCS, normalized at 50, were 37.4 and 44.2, respectively. Eighty percent of participants reported activity/functional limitations secondary to impairments or health problems. Patients reported using medical cannabis to treat a wide array of symptoms across multiple body systems with relief ratings consistently in the 7-10/10 range. The HRQoL results in this sample of medical cannabis-using patients are comparable with published norms in other chronically ill populations. Data presented provide insight into medical cannabis-using patients' self-rated health, HRQoL, disease incidences, and cannabis-related symptom relief.

  13. Effect of a local anesthetic lozenge in relief of symptoms in burning mouth syndrome.

    Science.gov (United States)

    Treldal, C; Jacobsen, C B; Mogensen, S; Rasmussen, M; Jacobsen, J; Petersen, J; Lynge Pedersen, A M; Andersen, O

    2016-03-01

    Patients with burning mouth syndrome (BMS) often represent a clinical challenge as available agents for symptomatic treatment are few and often ineffective. The aim was to evaluate the effect of a bupivacaine lozenge on oral mucosal pain, xerostomia, and taste alterations in patients with BMS. Eighteen patients (4 men and 14 women) aged 39-71 years with BMS were included in this randomized, double-blinded, placebo-controlled, crossover trial. Lozenges (containing bupivacaine or placebo) were administrated three times a day for 2 weeks for two separate treatment periods. Assessment of oral mucosal pain, xerostomia, and taste alterations was performed in a patient diary on a visual analog scale (ranging from 0 to 100 mm) before and after the lozenge was dissolved. The bupivacaine lozenge significantly reduced the burning oral pain (P < 0.001), increased the sense of taste disturbances (P < 0.001), and had no impact on xerostomia, when adjusted for the treatment period. Our results indicate that the bupivacaine lozenge offers a novel therapeutic modality to patients with BMS, although without alleviating effect on the associated symptoms, taste alterations, and xerostomia. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Clinical evaluation of tamsulosin in the relief of lower urinary tract symptoms in advanced prostate cancer patients.

    Science.gov (United States)

    Zhang, Tong; Wu, Haihu; Liu, Shuai; He, Wei; Ding, Kejia

    2017-07-01

    To assess the effectiveness and safety of tamsulosin combined with androgen deprivation therapy (ADT) for lower urinary tract symptoms (LUTS) in advanced prostate cancer (PC) patients. Ninety PC patients with moderate-to-severe LUTS randomized into two groups of 45 each. One group received ADT (group 1), and the other received ADT plus tamsulosin (group 2) for 24 weeks. The outcome measures were changes in the International Prostate Symptom Score (IPSS), IPSS obstructive and irritative subscores, quality of life (QoL), maximum urinary flow rate (Q max ), post-voiding residual (PVR) and prostate-specific antigen (PSA) from baseline. The treatment response was monitored at 8, 16 and 24 weeks. Both ADT monotherapy and ADT plus tamsulosin significantly improved IPSS,QoL score, Q max and PVR at the end of the treatment period. ADT plus tamsulosin had a greater impact on total IPSS, IPSS obstructive subscore, QoL and PVR at week 8 and week 16 than ADT monotherapy. Tamsulosin group showed greater improvement in Q max than ADT group. Significant improvements of IPSS, IPSS obstructive subscore and QoL were achieved at early treatment stage (week 8) in group 2, whereas similar improvements were achieved at week 16 in group 1. There were no significant differences in IPSS, IPSS subscores, QoL and PVR between the two groups at week 24. Additional administration of tamsulosin showed significantly greater and sooner relief in LUTS than ADT monotherapy, with good acceptability. It is feasible that ADT is used alone after 16-24 weeks of combination therapy.

  15. Budesonide/formoterol and formoterol provide similar rapid relief in patients with acute asthma showing refractoriness to salbutamol

    Directory of Open Access Journals (Sweden)

    Lombardi DM

    2006-01-01

    Full Text Available Abstract Background To compare the efficacy and safety of budesonide/formoterol (Symbicort® with formoterol (Oxis® in the treatment of patients with acute asthma who showed evidence of refractoriness to short-acting β2-agonist therapy. Methods In a 3 hour, randomized, double-blind study, a total of 115 patients with acute asthma (mean FEV1 40% of predicted normal and a refractory response to salbutamol (mean reversibility 2% of predicted normal after inhalation of 400 μg, were randomized to receive either budesonide/formoterol (320/9 μg, 2 inhalations at t = -5 minutes and 2 inhalations at 0 minutes [total dose 1280/36 μg] or formoterol (9 μg, 2 inhalations at t = -5 minutes and 2 inhalations at 0 minutes [total dose 36 μg]. The primary efficacy variable was the average FEV1 from the first intake of study medication to the measurement at 90 minutes. Secondary endpoints included changes in FEV1 at other timepoints and change in respiratory rate at 180 minutes. Treatment success, treatment failure and patient assessment of the effectiveness of the study medication were also measured. Results FEV1 increased after administration of the study medication in both treatment groups. No statistically significant difference between the treatment groups was apparent for the primary outcome variable, or for any of the other efficacy endpoints. There were no statistically significant between-group differences for treatment success, treatment failure or patient assessment of medication effectiveness. Both treatments were well tolerated. Conclusion Budesonide/formoterol and formoterol provided similarly rapid relief of acute bronchoconstriction in patients with asthma who showed evidence of refractoriness to a short-acting β2-agonist.

  16. Why are older peoples' health needs forgotten post-natural disaster relief in developing countries? A healthcare provider survey of 2005 Kashmir, Pakistan earthquake.

    Science.gov (United States)

    Chan, Emily Ying Yang

    2009-01-01

    Although older people may be recognized as a vulnerable group post-natural disasters, their particular needs are rarely met by the providers of emergency services. Studies about older people's health needs post disasters in the South East Asia Tsunami, Kashmir, Pakistan, China, and United States has revealed the lack of concern for older people's health needs. Recent study of older people's health needs post the Kashmir Pakistan earthquake (2005) found older peoples' health needs were masked within the general population. This survey study examines the providers' perceptions of older people's vulnerabilities post-2005 Pakistan earthquake. It aims to understand the awareness of geriatric issues and issues related to current service provision/planning for older people's health needs post disasters. Specifically, service delivery patterns will be compared among different relief agencies. Cross-sectional, structured stakeholder interviews were conducted within a 2 weeks period in February 2006, 4 months post-earthquake in Pakistan-administrated Kashmir. Health/medical relief agencies of three different types of organizational nature: international nongovernmental organization (INGO), national organization, and local/community group were solicited to participate in the study. Descriptive analysis was conducted. Important issues identified include the need to sensitize relief and health workers about older people's health needs post disaster the development of relevant clinical guidelines for chronic disease management postdisaster in developing countries and the advocacy of building in geriatric related components in natural disaster medical relief programs. To effectively address the vulnerability of older people, it is important for governments, relief agencies, and local partners to include and address these issues during their relief operations and policy planning.

  17. (Gynazole-1® Compared to Fluconazole 150 mg Tablets (Diflucan® in the Time to Relief of Symptoms in Patients With Vulvovaginal Candidiasis

    Directory of Open Access Journals (Sweden)

    Larry S. Seidman

    2005-01-01

    Full Text Available Background. It is estimated that as many as 13 million cases of vulvovaginal infection occur in the United States annually, the majority of which are the result of Candida albicans infection. The symptoms of vulvovaginal infections are often painful and distressing to the patient. The objective of this study was to compare the time to symptomatic relief of vulvovaginal candidiasis (VVC with butoconazole nitrate 2% Site Release® vaginal cream (Gynazole-1® and oral fluconazole 150 mg tablets (Diflucan®.

  18. Dextroamphetamine sulfate provided quick relief of severe post-partum depression that was recalcitrant to standard antidepressants and psychotherapy.

    Science.gov (United States)

    Check, J H; Jaffe, A

    2017-01-01

    To determine if dextroamphetamine sulfate could improve symptoms of post-partum depression. A woman with severe post-partum depression that was resistant to standard antidepressant therapy and psychotherapy was treated with dextroamphetamine sulfate extended release capsules 15 mg/day. A quick and complete abrogation of the depression ensued along with improvement of migraine headaches, insomnia, and chronic fatigue. Dextr6amphetamine sulfate should be considered as a treatment modality for post-partum depression.

  19. Higher dose rate Gamma Knife radiosurgery may provide earlier and longer-lasting pain relief for patients with trigeminal neuralgia.

    Science.gov (United States)

    Lee, John Y K; Sandhu, Sukhmeet; Miller, Denise; Solberg, Timothy; Dorsey, Jay F; Alonso-Basanta, Michelle

    2015-10-01

    Gamma Knife radiosurgery (GKRS) utilizes cobalt-60 as its radiation source, and thus dose rate varies as the fixed source decays over its half-life of approximately 5.26 years. This natural decay results in increasing treatment times when delivering the same cumulative dose. It is also possible, however, that the biological effective dose may change based on this dose rate even if the total dose is kept constant. Because patients are generally treated in a uniform manner, radiosurgery for trigeminal neuralgia (TN) represents a clinical model whereby biological efficacy can be tested. The authors hypothesized that higher dose rates would result in earlier and more complete pain relief but only if measured with a sensitive pain assessment tool. One hundred thirty-three patients were treated with the Gamma Knife Model 4C unit at a single center by a single neurosurgeon during a single cobalt life cycle from January 2006 to May 2012. All patients were treated with 80 Gy with a single 4-mm isocenter without blocking. Using an output factor of 0.87, dose rates ranged from 1.28 to 2.95 Gy/min. The Brief Pain Inventory (BPI)-Facial was administered before the procedure and at the first follow-up office visit 1 month from the procedure (mean 1.3 months). Phone calls were made to evaluate patients after their procedures as part of a retrospective study. Univariate and multivariate linear regression was performed on several independent variables, including sex, age in deciles, diagnosis, follow-up duration, prior surgery, and dose rate. In the short-term analysis (mean 1.3 months), patients' self-reported pain intensity at its worst was significantly correlated with dose rate on multivariate analysis (p = 0.028). Similarly, patients' self-reported interference with activities of daily living was closely correlated with dose rate on multivariate analysis (p = 0.067). A 1 Gy/min decrease in dose rate resulted in a 17% decrease in pain intensity at its worst and a 22% decrease

  20. Androgen deprivation therapy for volume reduction, lower urinary tract symptom relief and quality of life improvement in patients with prostate cancer

    DEFF Research Database (Denmark)

    Axcrona, Karol; Aaltomaa, Sirpa; da Silva, Carlos Martins

    2012-01-01

    Study Type--Therapy (RCT) Level of Evidence 1b. What's known on the subject? and What does the study add? Androgen deprivation therapy (ADT) is commonly used as a primary treatment for patients with prostate cancer (PCa) who are not eligible for radical treatment options. ADT is also used...... in patients with PCa as neo-adjuvant hormone therapy to reduce prostate volume and down-stage the disease before radiotherapy with curative intent. The present study showed that ADT with the gonadotropin hormone-releasing hormone (GhRH) antagonist degarelix is non-inferior to combined treatment with the LHRH...... agonist goserelin and bicalutamide in terms of reducing prostate volume during the treatment period of 3 months. Degarelix treatment evokes, however, significantly better relief of lower urinary tract symptoms in patients having moderate and severe voiding problems....

  1. Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.

    Science.gov (United States)

    Fiz, Jimena; Durán, Marta; Capellà, Dolors; Carbonell, Jordi; Farré, Magí

    2011-04-21

    The aim of this study was to describe the patterns of cannabis use and the associated benefits reported by patients with fibromyalgia (FM) who were consumers of this drug. In addition, the quality of life of FM patients who consumed cannabis was compared with FM subjects who were not cannabis users. Information on medicinal cannabis use was recorded on a specific questionnaire as well as perceived benefits of cannabis on a range of symptoms using standard 100-mm visual analogue scales (VAS). Cannabis users and non-users completed the Fibromyalgia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI) and the Short Form 36 Health Survey (SF-36). Twenty-eight FM patients who were cannabis users and 28 non-users were included in the study. Demographics and clinical variables were similar in both groups. Cannabis users referred different duration of drug consumption; the route of administration was smoking (54%), oral (46%) and combined (43%). The amount and frequency of cannabis use were also different among patients. After 2 hours of cannabis use, VAS scores showed a statistically significant (pcannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI. The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted.

  2. Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.

    Directory of Open Access Journals (Sweden)

    Jimena Fiz

    Full Text Available BACKGROUND: The aim of this study was to describe the patterns of cannabis use and the associated benefits reported by patients with fibromyalgia (FM who were consumers of this drug. In addition, the quality of life of FM patients who consumed cannabis was compared with FM subjects who were not cannabis users. METHODS: Information on medicinal cannabis use was recorded on a specific questionnaire as well as perceived benefits of cannabis on a range of symptoms using standard 100-mm visual analogue scales (VAS. Cannabis users and non-users completed the Fibromyalgia Impact Questionnaire (FIQ, the Pittsburgh Sleep Quality Index (PSQI and the Short Form 36 Health Survey (SF-36. RESULTS: Twenty-eight FM patients who were cannabis users and 28 non-users were included in the study. Demographics and clinical variables were similar in both groups. Cannabis users referred different duration of drug consumption; the route of administration was smoking (54%, oral (46% and combined (43%. The amount and frequency of cannabis use were also different among patients. After 2 hours of cannabis use, VAS scores showed a statistically significant (p<0.001 reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well being. The mental health component summary score of the SF-36 was significantly higher (p<0.05 in cannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI. CONCLUSIONS: The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted.

  3. Do cervical epidural injections provide long-term relief in neck and upper extremity pain? A systematic review.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Nampiaparampil, Devi E; Candido, Kenneth D; Bakshi, Sanjay; Grider, Jay S; Falco, Frank J E; Sehgal, Nalini; Hirsch, Joshua A

    2015-01-01

    The high prevalence of chronic persistent neck pain not only leads to disability but also has a significant economic, societal, and health impact. Among multiple modalities of treatments prescribed in the management of neck and upper extremity pain, surgical, interventional and conservative modalities have been described. Cervical epidural injections are also common modalities of treatments provided in managing neck and upper extremity pain. They are administered by either an interlaminar approach or transforaminal approach. To determine the long-term efficacy of cervical interlaminar and transforaminal epidural injections in the treatment of cervical disc herniation, spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. The literature search was performed from 1966 to October 2014 utilizing data from PubMed, Cochrane Library, US National Guideline Clearinghouse, previous systematic reviews, and cross-references. The evidence was assessed based on best evidence synthesis with Level I to Level V. There were 7 manuscripts meeting inclusion criteria. Of these, 4 assessed the role of interlaminar epidural injections for managing disc herniation or radiculitis, and 3 assessed these injections for managing central spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. There were 4 high quality manuscripts. A qualitative synthesis of evidence showed there is Level II evidence for each etiology category. The evidence is based on one relevant, high quality trial supporting the efficacy of cervical interlaminar epidural injections for each particular etiology. There were no randomized trials available assessing the efficacy of cervical transforaminal epidural injections. Paucity of available literature, specifically conditions other than disc herniation. This systematic review with qualitative best evidence synthesis shows Level II evidence for the efficacy of cervical interlaminar epidural injections with local

  4. The COMTval158met polymorphism is associated with symptom relief during exposure-based cognitive-behavioral treatment in panic disorder

    Directory of Open Access Journals (Sweden)

    Bergström Jan

    2010-11-01

    Full Text Available Abstract Background Cognitive behavioral therapy (CBT represents a learning process leading to symptom relief and resulting in long-term changes in behavior. CBT for panic disorder is based on exposure and exposure-based processes can be studied in the laboratory as extinction of experimentally acquired fear responses. We have recently demonstrated that the ability to extinguish learned fear responses is associated with a functional genetic polymorphism (COMTval158met in the COMT gene and this study was aimed at transferring the experimental results on the COMTval158met polymorphism on extinction into a clinical setting. Methods We tested a possible effect of the COMTval158met polymorphism on the efficacy of CBT, in particular exposure-based treatment modules, in a sample of 69 panic disorder patients. Results We present evidence that panic patients with the COMTval158met met/met genotype may profit less from (exposure-based CBT treatment methods as compared to patients carrying at least one val-allele. No association was found with the 5-HTTLPR/rs25531 genotypes which is presented as additional material. Conclusions We were thus able to transfer findings on the effect of the COMTval158met polymorphism from an experimental extinction study obtained using healthy subjects to a clinical setting. Furthermore patients carrying a COMT val-allele tend to report more anxiety and more depression symptoms as compared to those with the met/met genotype. Limitations of the study as well as possible clinical implications are discussed. Trial registration Clinical Trial Registry name: Internet-Versus Group-Administered Cognitive Behavior Therapy for Panic Disorder (IP2. Registration Identification number: NCT00845260, http://www.clinicaltrials.gov/ct2/show/NCT00845260

  5. National audit of the quality of pain relief provided in emergency departments in Aotearoa, New Zealand: The PRiZED 1 Study.

    Science.gov (United States)

    2017-04-01

    Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006-2012) from 26 New Zealand public hospital EDs. Of the 1685 charts randomly selected, 1547 (91%) were reviewed from 21 EDs. There were 866 ED presentations with painful conditions, of whom 132 (15%) did not have pain recorded, 205 (24%) did not receive pain relief and 19 (2%) did not have time of analgesia documented leaving 510 (59%) for the analysis of time to analgesia. Four hundred and fifty-seven (53%) did not have pain well documented sufficiently to assess adequacy, leaving 277 (32%) for the analysis of adequacy of analgesia. The median (interquartile range) time to analgesia was 62 (30-134) min and the provision of adequate analgesia was 141/277 (51%, 95% CI: 45-57%); however, there was some variation between hospitals for both outcomes. Although these outcomes are on a par with other countries, this baseline audit has shown both poor documentation and variation in the provision of timely and adequate pain relief in New Zealand EDs, with room for improvement with respect to this quality indicator. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  6. Inter-Rater Reliability of Provider Interpretations of Irritable Bowel Syndrome Food and Symptom Journals.

    Science.gov (United States)

    Zia, Jasmine; Chung, Chia-Fang; Xu, Kaiyuan; Dong, Yi; Schenk, Jeanette M; Cain, Kevin; Munson, Sean; Heitkemper, Margaret M

    2017-11-04

    There are currently no standardized methods for identifying trigger food(s) from irritable bowel syndrome (IBS) food and symptom journals. The primary aim of this study was to assess the inter-rater reliability of providers' interpretations of IBS journals. A second aim was to describe whether these interpretations varied for each patient. Eight providers reviewed 17 IBS journals and rated how likely key food groups (fermentable oligo-di-monosaccharides and polyols, high-calorie, gluten, caffeine, high-fiber) were to trigger IBS symptoms for each patient. Agreement of trigger food ratings was calculated using Krippendorff's α-reliability estimate. Providers were also asked to write down recommendations they would give to each patient. Estimates of agreement of trigger food likelihood ratings were poor (average α = 0.07). Most providers gave similar trigger food likelihood ratings for over half the food groups. Four providers gave the exact same written recommendation(s) (range 3-7) to over half the patients. Inter-rater reliability of provider interpretations of IBS food and symptom journals was poor. Providers favored certain trigger food likelihood ratings and written recommendations. This supports the need for a more standardized method for interpreting these journals and/or more rigorous techniques to accurately identify personalized IBS food triggers.

  7. Modeling relief.

    Science.gov (United States)

    Sumner, Walton; Xu, Jin Zhong; Roussel, Guy; Hagen, Michael D

    2007-10-11

    The American Board of Family Medicine deployed virtual patient simulations in 2004 to evaluate Diplomates' diagnostic and management skills. A previously reported dynamic process generates general symptom histories from time series data representing baseline values and reactions to medications. The simulator also must answer queries about details such as palliation and provocation. These responses often describe some recurring pattern, such as, "this medicine relieves my symptoms in a few minutes." The simulator can provide a detail stored as text, or it can evaluate a reference to a second query object. The second query object can generate details using a single Bayesian network to evaluate the effect of each drug in a virtual patient's medication list. A new medication option may not require redesign of the second query object if its implementation is consistent with related drugs. We expect this mechanism to maintain realistic responses to detail questions in complex simulations.

  8. Inter-Rater Reliability of Provider Interpretations of Irritable Bowel Syndrome Food and Symptom Journals

    Directory of Open Access Journals (Sweden)

    Jasmine Zia

    2017-11-01

    Full Text Available There are currently no standardized methods for identifying trigger food(s from irritable bowel syndrome (IBS food and symptom journals. The primary aim of this study was to assess the inter-rater reliability of providers’ interpretations of IBS journals. A second aim was to describe whether these interpretations varied for each patient. Eight providers reviewed 17 IBS journals and rated how likely key food groups (fermentable oligo-di-monosaccharides and polyols, high-calorie, gluten, caffeine, high-fiber were to trigger IBS symptoms for each patient. Agreement of trigger food ratings was calculated using Krippendorff’s α-reliability estimate. Providers were also asked to write down recommendations they would give to each patient. Estimates of agreement of trigger food likelihood ratings were poor (average α = 0.07. Most providers gave similar trigger food likelihood ratings for over half the food groups. Four providers gave the exact same written recommendation(s (range 3–7 to over half the patients. Inter-rater reliability of provider interpretations of IBS food and symptom journals was poor. Providers favored certain trigger food likelihood ratings and written recommendations. This supports the need for a more standardized method for interpreting these journals and/or more rigorous techniques to accurately identify personalized IBS food triggers.

  9. Effective Relief of Pain and Associated Symptoms With Closed-Loop Spinal Cord Stimulation System: Preliminary Results of the Avalon Study.

    Science.gov (United States)

    Russo, Marc; Cousins, Michael J; Brooker, Charles; Taylor, Nathan; Boesel, Tillman; Sullivan, Richard; Poree, Lawrence; Shariati, Nastaran Hesam; Hanson, Erin; Parker, John

    2018-01-01

    Conventional spinal cord stimulation (SCS) delivers a fixed-input of energy into the dorsal column. Physiologic effects such as heartbeat, respiration, spinal cord movement, and history of stimulation can cause both the perceived intensity and recruitment of stimulation to increase or decrease, with clinical consequences. A new SCS system controls stimulation dose by measuring the recruitment of fibers in the dorsal column and by using the amplitude of the evoked compound action potentials (ECAPs) to maintain stimulation within an individualized therapeutic range. Safety and efficacy of this closed-loop system was evaluated through six-month postimplantation. Chronic pain subjects with back and/or leg pain who were successfully trialed received a permanent system (Evoke; Saluda Medical, Sydney, Australia). Ratings of pain (100-mm visual analogue scale [VAS] and Brief Pain Instrument [BPI]), quality of life (EuroQol instrument [EQ-5D-5L]), function (Oswestry Disability Index [ODI]), and sleep (Pittsburgh Sleep Quality Index [PSQI]) were collected at baseline and repeated three and six months after implantation. Fifty-one subjects underwent a trial procedure; permanent implants were placed in 36 subjects. The proportion of subjects with ≥50% relief was 92.6% (back) and 91.3% (leg) at three months, and 85.7% (back) and 82.6% (leg) at six months. The proportion with ≥80% pain relief was 70.4% (back) and 56.5% (leg) at three months, and 64.3% (back) and 60.9% (leg) at six months. Statistically significant improvements in mean BPI, EQ-5D-5L, ODI, and PSQI were also observed at both time points. The majority of subjects experienced profound pain relief at three and six months, providing preliminary evidence for the effectiveness of the closed-loop SCS system. The exact mechanism of action for these outcomes is still being explored, although one likely hypothesis holds that ECAP feedback control may minimize recruitment of Aβ nociceptors and Aδ fibers during daily

  10. The livelihoods of Haitian health-care providers after the january 2010 earthquake: a pilot study of the economic and quality-of-life impact of emergency relief.

    Science.gov (United States)

    Haar, Rohini J; Naderi, Sassan; Acerra, John R; Mathias, Maxwell; Alagappan, Kumar

    2012-03-02

    An effective international response to a disaster requires cooperation and coordination with the existing infrastructure. In some cases, however, international relief efforts can compete with the local work force and affect the balance of health-care systems already in place. This study seeks to evaluate the impact of the international humanitarian response to the 12 January 2010 earthquake on Haitian health-care providers (HHP). Fifty-nine HHPs were surveyed in August of 2010 using a modified World Health Organization Quality of Life-Brief questionnaire (WHOQoL-B) that included questions on respondents' workload before the earthquake, immediately after, and presently. The study population consisted of physicians, nurses, and technicians at public hospitals, non-governmental organization (NGO) clinics, and private offices in Port-au-Prince, Haiti. Following the earthquake, public hospital and NGO providers reported a significant increase in their workload (15 of 17 and 22 of 26 respondents, respectively). Conversely, 12 of 16 private providers reported a significant decrease in workload (p working a similar number of hours prior to the earthquake (average 40 h/week), they reported working significantly different amounts following the earthquake. Public hospital and NGO providers averaged more than 50 h/week, and private providers averaged just over 33 h/week of employment (p working at public hospitals and NGOs, however, had significantly lower scores on the WHOQoL-B when answering questions about their environment (p work among HHPs. To create a robust health-care system in the long term while meeting short-term needs, humanitarian responses should seek to better integrate existing systems and involve local providers in the design and implementation of an emergency program.

  11. Fact Sheet on Sources and Uses of U.S. Funding Provided in Fiscal Year 2006 for Iraq Relief and Reconstruction

    National Research Council Canada - National Science Library

    2007-01-01

    ... about $5.4 billion, in additional non-IRRF funding made available in FY 2006, to four separate funds, for various relief and reconstruction projects in Iraq, including training of Iraqi security...

  12. Contemporary management of median arcuate ligament syndrome provides early symptom improvement

    Science.gov (United States)

    Columbo, Jesse A.; Trus, Thadeus; Nolan, Brian; Goodney, Philip; Rzucidlo, Eva; Powell, Richard; Walsh, Daniel; Stone, David

    2017-01-01

    Objective Optimal diagnosis and management of median arcuate ligament (MAL) syndrome (MALS) remains unclear in contemporary practice. The advent and evolution of laparoscopic and endovascular techniques has redirected management toward a less invasive therapeutic algorithm. This study examined our contemporary outcomes of patients treated for MALS. Methods All patients treated for MALS at Dartmouth-Hitchcock Medical Center from 2000 to 2013 were retrospectively reviewed. Demographics and comorbidities were recorded. Freedom from symptoms and freedom from reintervention were the primary end points. Return to work or school was assessed. Follow-up by clinic visits and telephone allowed quantitative comparisons among the patients. Results During the study interval, 21 patients (24% male), with a median age of 42 years, were treated for MALS. All patients complained of abdominal pain in the presence of a celiac stenosis, 16 (76%) also reported weight loss at the time of presentation, and 57% had a concomitant psychiatric history. Diagnostic imaging most commonly used included duplex ultrasound (81%), computed tomography angiography (66%), angiography (57%), and magnetic resonance angiography (5%). Fourteen patients (67%) underwent multiple diagnostic studies. All patients underwent initial laparoscopic MAL release. Seven patients (33%) underwent subsequent celiac stent placement in the setting of recurrent or unresolved symptoms with persistent celiac stenosis at a mean interval of 49 days. Two patients required surgical bypass after an endovascular intervention failed. The 6-month freedom from symptoms was 75% and freedom from reintervention was 64%. Eighteen patients (81%) reported early symptom improvement and weight gain, and 66% were able to return to work. Conclusions A multidisciplinary treatment approach using initial laparoscopic release and subsequent stent placement and bypass surgery provides symptom improvement in most patients treated for MALS. The

  13. Alternative medicine - pain relief

    Science.gov (United States)

    Acupuncture - pain relief; Hypnosis - pain relief; Guided imagery - pain relief ... neck, shoulder, knee, or elbow) Osteoarthritis Rheumatoid arthritis Hypnosis is a focused state of concentration. With self- ...

  14. Short-course diphenoxylate hydrochloride for treatment of methadone withdrawal symptoms.

    Science.gov (United States)

    Ives, T J; Stults, C C

    1983-11-01

    The authors conducted a preliminary trial of a 5-day course of diphenoxylate in the treatment of out-patients with methadone withdrawal symptoms. Diphenoxylate provided substantial relief from detoxification symptoms with no drug-associated adverse effects.

  15. Metabolomic Analysis Provides Insights on Paraquat-Induced Parkinson-Like Symptoms in Drosophila melanogaster.

    Science.gov (United States)

    Shukla, Arvind Kumar; Ratnasekhar, Ch; Pragya, Prakash; Chaouhan, Hitesh Singh; Patel, Devendra Kumar; Chowdhuri, Debapratim Kar; Mudiam, Mohana Krishna Reddy

    2016-01-01

    Paraquat (PQ) exposure causes degeneration of the dopaminergic neurons in an exposed organism while altered metabolism has a role in various neurodegenerative disorders. Therefore, the study presented here was conceived to depict the role of altered metabolism in PQ-induced Parkinson-like symptoms and to explore Drosophila as a potential model organism for such studies. Metabolic profile was generated in control and in flies that were fed PQ (5, 10, and 20 mM) in the diet for 12 and 24 h concurrent with assessment of indices of oxidative stress, dopaminergic neurodegeneration, and behavioral alteration. PQ was found to significantly alter 24 metabolites belonging to different biological pathways along with significant alterations in the above indices. In addition, PQ attenuated brain dopamine content in the exposed organism. The study demonstrates that PQ-induced alteration in the metabolites leads to oxidative stress and neurodegeneration in the exposed organism along with movement disorder, a phenotype typical of Parkinson-like symptoms. The study is relevant in the context of Drosophila and humans because similar alteration in the metabolic pathways has been observed in both PQ-exposed Drosophila and in postmortem samples of patients with Parkinsonism. Furthermore, this study provides advocacy towards the applicability of Drosophila as an alternate model organism for pre-screening of environmental chemicals for their neurodegenerative potential with altered metabolism.

  16. Extended-Release Guaifenesin/Pseudoephedrine Hydrochloride for Symptom Relief in Support of a Wait-and-See Approach for the Treatment of Acute Upper Respiratory Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Study.

    Science.gov (United States)

    Septimus, Edward J; Albrecht, Helmut H; Solomon, Gail; Shea, Tim; Guenin, Eric P

    2017-01-01

    -to-treat population (n = 1179). At Day 8, significantly fewer patients receiving guaifenesin/pseudoephedrine versus placebo desired antibiotics (4.2% vs 8.0%). No adverse effects were reported due to patients not taking antibiotics. Significant reductions in URTI symptoms were observed for extended-release guaifenesin/pseudoephedrine versus placebo, from Day 1 throughout the study; however, the proportion of patients experiencing overall relief at the Day 4 evening assessment (primary end point) did not reach statistical significance. Treatment-related adverse events were reported in 9.8% and 4.7% of patients receiving guaifenesin/pseudoephedrine and placebo, respectively. The study found that a wait and see approach was associated with decreased antibiotic use. In addition, the use of a guaifenesin pseudoephedrine combination product provided an effective symptom control compared to a placebo and a well-tolerated first-line strategy for the management of URTIs. This study was not designed to assess the effects of guaifenesin or pseudoephedrine individually. Other limitations include the need for better clinical methods to assess the effectiveness of treatments for acute symptoms of patients with URTIs. ClinicalTrials.gov identifier: NCT01202279.

  17. Challenges of correlating pH change with relief of clinical symptoms in gastro esophageal reflux disease: a phase III, randomized study of Zegerid versus Losec.

    Science.gov (United States)

    Walker, Dave; Ng Kwet Shing, Richard; Jones, Deborah; Gruss, Hans-Jurgen; Reguła, Jarosław

    2015-01-01

    Zegerid (on demand immediate-release omeprazole and sodium bicarbonate combination therapy) has demonstrated earlier absorption and more rapid pH change compared with Losec (standard enteric coated omeprazole), suggesting more rapid clinical relief of heartburn. This Phase III, multicenter, double-blind, double-dummy, randomized study assessed the clinical superiority of Zegerid versus Losec for rapid relief of heartburn associated with gastro-esophageal reflux disease (GERD). Patients with a history of frequent (2 3 days/week) uncomplicated GERD, were randomized to receive Zegerid (20 mg) or Losec (20 mg) with corresponding placebo. Study medication was self-administered on the first episode of heartburn, and could be taken for up to 3 days within a 14 day study period. Heartburn severity was self assessed up to 180 minutes post dose (9 point Likert scale). Primary endpoint was median time to sustained response (≥3 point reduction in heartburn severity for ≥45 minutes). Of patients randomized to Zegerid (N=122) or Losec (N=117), 228/239 had recorded ≥1 evaluable heartburn episodes and were included in the modified intent-to-treat population. No significant between-group differences were observed for median time to sustained response (60.0 vs. 52.2 minutes, Zegerid [N=117] and Losec [N=111], respectively), sustained partial response (both, 37.5 minutes) and sustained total relief (both, 105 minutes). Significantly more patients treated with Zegerid reached sustained total relief within 0-30 minutes post dose in all analysis sets (p<0.05). Both treatments were well tolerated and did not raise any safety concerns. Superiority of Zegerid over Losec for rapid heartburn relief was not demonstrated; both treatments were equally effective however the rapid onset of action of Losec was unexpected. Factors, including aspects of study design may have contributed to this. This study supports previously reported difficulty in correlating intra-gastric pH change with

  18. Challenges of correlating pH change with relief of clinical symptoms in gastro esophageal reflux disease: a phase III, randomized study of Zegerid versus Losec.

    Directory of Open Access Journals (Sweden)

    Dave Walker

    Full Text Available Zegerid (on demand immediate-release omeprazole and sodium bicarbonate combination therapy has demonstrated earlier absorption and more rapid pH change compared with Losec (standard enteric coated omeprazole, suggesting more rapid clinical relief of heartburn. This Phase III, multicenter, double-blind, double-dummy, randomized study assessed the clinical superiority of Zegerid versus Losec for rapid relief of heartburn associated with gastro-esophageal reflux disease (GERD.Patients with a history of frequent (2 3 days/week uncomplicated GERD, were randomized to receive Zegerid (20 mg or Losec (20 mg with corresponding placebo. Study medication was self-administered on the first episode of heartburn, and could be taken for up to 3 days within a 14 day study period. Heartburn severity was self assessed up to 180 minutes post dose (9 point Likert scale. Primary endpoint was median time to sustained response (≥3 point reduction in heartburn severity for ≥45 minutes.Of patients randomized to Zegerid (N=122 or Losec (N=117, 228/239 had recorded ≥1 evaluable heartburn episodes and were included in the modified intent-to-treat population. No significant between-group differences were observed for median time to sustained response (60.0 vs. 52.2 minutes, Zegerid [N=117] and Losec [N=111], respectively, sustained partial response (both, 37.5 minutes and sustained total relief (both, 105 minutes. Significantly more patients treated with Zegerid reached sustained total relief within 0-30 minutes post dose in all analysis sets (p<0.05. Both treatments were well tolerated and did not raise any safety concerns.Superiority of Zegerid over Losec for rapid heartburn relief was not demonstrated; both treatments were equally effective however the rapid onset of action of Losec was unexpected. Factors, including aspects of study design may have contributed to this. This study supports previously reported difficulty in correlating intra-gastric pH change with

  19. Efficacy of a novel food supplement in the relief of the signs and symptoms of seasonal allergic rhinitis and in the reduction of the consumption of anti-allergic drugs.

    Science.gov (United States)

    Ariano, Renato

    2015-04-27

    Seasonal Allergic rhinitis (SAR) is characterized by runny nose, congestion, sneezing and sinus pressure. A clinical study was performed to demonstrate the efficacy of Lertal®, an innovative food supplement containing Quercetin, Perilla frutescens and Vitamin D3 formu-lated in a double layer "fast-slow" release tablet form, in the relief of symptoms of seasonal allergic rhinitis and in the reduction of consumption of anti-allergic drugs. 23 subjects enrolled in the open clinical study had at least one year history of allergic rhinitis and positive skin prick test or RAST to Parietaria officinalis pollen. At baseline, the subjects had symptoms of nasal and/or ocular seasonal allergic rhinitis. The activity of the food supplement was evaluated using the Total Symptoms Score at first (baseline) and second (final) visit, after one month of supplementation. The consumption of anti-allergic drugs was also evaluated. All subjects enrolled completed the study. The comparison of the scores obtained in the two visits (baseline and final) showed a highly significant reduction of the overall symptoms: approximately 70% for symptom scores and 73% in use of anti-allergic drugs. Sneezing, rhinorrhea, nasal obstruction, ocular itching, lacrimation and congestion of the conjunctiva, all showed a highly significant reduction. No noteworthy side effect was recorded and all patients finished the study with good compliance. The results showed a clear efficacy of the food supplement Lertal® in reducing nasal and/or eye symptoms. This activity was objectively confirmed by the reduction in the consumption of anti-allergic drugs used to relieve symptoms. (www.actabiomedica.it).

  20. Can small island mountains provide relief from the Subtropical Precipitation Decline? Simulating future precipitation regimes for small island nations using high resolution Regional Climate Models.

    Science.gov (United States)

    Bowden, J.; Terando, A. J.; Misra, V.; Wootten, A.

    2017-12-01

    Small island nations are vulnerable to changes in the hydrologic cycle because of their limited water resources. This risk to water security is likely even higher in sub-tropical regions where anthropogenic forcing of the climate system is expected to lead to a drier future (the so-called `dry-get-drier' pattern). However, high-resolution numerical modeling experiments have also shown an enhancement of existing orographically-influenced precipitation patterns on islands with steep topography, potentially mitigating subtropical drying on windward mountain sides. Here we explore the robustness of the near-term (25-45 years) subtropical precipitation decline (SPD) across two island groupings in the Caribbean, Puerto Rico and the U.S. Virgin Islands. These islands, forming the boundary between the Greater and Lesser Antilles, significantly differ in size, topographic relief, and orientation to prevailing winds. Two 2-km horizontal resolution regional climate model simulations are used to downscale a total of three different GCMs under the RCP8.5 emissions scenario. Results indicate some possibility for modest increases in precipitation at the leading edge of the Luquillo Mountains in Puerto Rico, but consistent declines elsewhere. We conclude with a discussion of potential explanations for these patterns and the attendant risks to water security that subtropical small island nations could face as the climate warms.

  1. Patient-Provider Interactions Affect Symptoms in Gastroesophageal Reflux Disease: A Pilot Randomized, Double-Blind, Placebo-Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Michelle L Dossett

    Full Text Available It is unclear whether the benefits that some patients derive from complementary and integrative medicine (CIM are related to the therapies recommended or to the consultation process as some CIM provider visits are more involved than conventional medical visits. Many patients with gastrointestinal conditions seek out CIM therapies, and prior work has demonstrated that the quality of the patient-provider interaction can improve health outcomes in irritable bowel syndrome, however, the impact of this interaction on gastroesophageal reflux disease (GERD is unknown. We aimed to assess the safety and feasibility of conducting a 2 x 2 factorial design study preliminarily exploring the impact of the patient-provider interaction, and the effect of an over-the-counter homeopathic product, Acidil, on symptoms and health-related quality of life in subjects with GERD.24 subjects with GERD-related symptoms were randomized in a 2 x 2 factorial design to receive 1 either a standard visit based on an empathic conventional primary care evaluation or an expanded visit with questions modeled after a CIM consultation and 2 either Acidil or placebo for two weeks. Subjects completed a daily GERD symptom diary and additional measures of symptom severity and health-related quality of life.There was no significant difference in GERD symptom severity between the Acidil and placebo groups from baseline to follow-up (p = 0.41, however, subjects who received the expanded visit were significantly more likely to report a 50% or greater improvement in symptom severity compared to subjects who received the standard visit (p = 0.01. Total consultation length, perceived empathy, and baseline beliefs in CIM were not associated with treatment outcomes.An expanded patient-provider visit resulted in greater GERD symptom improvement than a standard empathic medical visit. CIM consultations may have enhanced placebo effects, and further studies to assess the active components of this

  2. How music and social engagement provides healthy aging and prevents behavioural and psychological symptoms of dementia

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2018-01-01

    engagement and learning, and further affects cognitive reserve and the way we age. Music and musical elements affect listeners differently but seem to regulate our body and brain at a much deeper level than we are aware of. When music touches and engages us, a release of the neurotransmitter Norepinephrine....... In addition, through musical interaction, meaningful expression of psychosocial needs may indirectly lead to a reduction of behavioural and psychological symptoms of dementia. For the person with severe dementia, with sensory and cognitive decline, this offers a healthy means of remaining active, autonomous...... follows. This process involves the brain stem (more precisely the locus coeruleus) and a compensatory effect is observed. By engaging in music from early childhood, preventive mechanisms add to healthy aging and may even slow down the development of dementia symptoms, although it cannot prevent dementia...

  3. A phase III, randomized, multi-center, double blind, placebo controlled study of safety and efficacy of lofexidine for relief of symptoms in individuals undergoing inpatient opioid withdrawal.

    Science.gov (United States)

    Gorodetzky, Charles W; Walsh, Sharon L; Martin, Peter R; Saxon, Andrew J; Gullo, Kristen L; Biswas, Kousick

    2017-07-01

    Lofexidine is an alpha-2-adrenergic receptor agonist approved in the United Kingdom (UK) for the treatment of opioid withdrawal symptoms. Lofexidine has demonstrated better efficacy than placebo for reducing opioid withdrawal symptoms in patients undergoing opioid withdrawal with less reported hypotension than clonidine. Designed as an FDA registration trial, this 8-day, randomized, double-blind, placebo-controlled, parallel-group study in 264 patients dependent on short-acting opioids evaluated the efficacy of lofexidine hydrochloride in reducing withdrawal symptoms in patients undergoing opioid withdrawal. The primary efficacy measures were SOWS-Gossop on Day 3 and time-to-dropout. Secondary endpoints included the proportion of participants who were completers; area under the 5-day SOWS-Gossop - time curve (i.e., AUC 1-5 ), and daily mean SOWS-Gossop, OOWS-Handelsman, MCGI (subject and rater), and VAS-E scores. Participants received lofexidine HCl 3.2mg daily in four divided doses or matching placebo on Days 1-5, followed by 2days of placebo. Lofexidine significantly decreased mean Day 3 SOWS scores compared to placebo, 6.32 versus 8.67, respectively, p=0.0212. Fewer lofexidine patients were early terminators compared to placebo (59 versus 80, respectively); and non-completers in the lofexidine group remained in the study longer than those assigned to placebo (p=0.0034). Secondary endpoints consistently favored lofexidine. Lofexidine was well tolerated in this trial. Lofexidine significantly decreased SOWS scores compared to placebo and demonstrated better retention rates in participants undergoing opioid withdrawal. Lofexidine potentially offers a useful non-opioid alternative to treat opioid withdrawal symptoms. Copyright © 2017. Published by Elsevier B.V.

  4. A randomized clinical evaluation of the safety of Systane® Lubricant Eye Drops for the relief of dry eye symptoms following LASIK refractive surgery

    Directory of Open Access Journals (Sweden)

    Daniel Durrie

    2008-12-01

    Full Text Available Daniel Durrie, Jason StahlDurrie Vision, Overland Park, Kansas, USAPurpose: To evaluate the safety of Systane® Lubricant Eye Drops in relieving the symptoms of dry eye following laser-assisted in situ keratomileusis (LASIK surgery.Methods: This was a randomized, double-masked, single-center, placebo-controlled, contralateral eye study of 30 patients undergoing LASIK surgery. The mean age of patients was 42.4 ± 10.7 years, and the mean spherical equivalent was −3.29 (range, +1.75 to −7.38. Patients’ right and left eyes were randomized to receive either Systane® or placebo – a preserved, thimerosal-free saline solution – beginning from the day of surgery and ending 30 days following surgery. Outcome measures included tear film break up time (TFBUT, visual acuity, degree of corneal and conjunctival staining, and treatment-related adverse events.Results: Preoperatively, placebo-treated eyes had statistically significantly higher sum corneal staining score than Systane®-treated eyes (p = 0.0464; however, the difference was clinically insignificant (p = 0.27. Two weeks post operatively, the average TFBUT in the Systane®-treated eyes was 1.23 seconds longer than that of the placebo-treated eyes (p = 0.028. All other evaluated variables were comparable between the two treatments. No adverse events were reported in the study.Conclusion: Systane® Lubricant Eye Drops are safe for use following LASIK surgery to relieve the discomfort symptoms of dry eye associated with the procedure.Keywords: Systane®, safety, dry eye, LASIK

  5. Effects of over-the-counter sales restriction of antibiotics on substitution with medicines for symptoms relief of cold in Mexico and Brazil : time series analysis

    NARCIS (Netherlands)

    Santa Ana Tellez, Y.; Teeuwisse, A.K.; Leufkens, H.G.M.; Wirtz, Veronika J

    2016-01-01

    We evaluated changes in the use of non-steroidal anti-inflammatory drugs (NSAIDs), non-opioid analgesics and cough and cold medicines and its relation with the use of antibiotics after the over-the-counter (OTC) antibiotic sales restrictions in Mexico and Brazil. IMS Health provided retail quarterly

  6. Effects of over-the-counter sales restriction of antibiotics on substitution with medicines for symptoms relief of cold in Mexico and Brazil: time series analysis.

    Science.gov (United States)

    Santa-Ana-Tellez, Yared; Mantel-Teeuwisse, Aukje K; Leufkens, Hubert G M; Wirtz, Veronika J

    2016-11-01

    We evaluated changes in the use of non-steroidal anti-inflammatory drugs (NSAIDs), non-opioid analgesics and cough and cold medicines and its relation with the use of antibiotics after the over-the-counter (OTC) antibiotic sales restrictions in Mexico and Brazil. IMS Health provided retail quarterly data from the private sectors in Mexico and Brazil from the first quarter of 2007 to the first quarter of 2013. Data of each active substance of antibiotics, easily accessible medicines perceived as antibiotics substitutes (cough and cold medicines, analgesics and NSAIDs-the latter two being combined in the analyses), and medicines to control for external factors that can affect the medicines usage trend (antihypertensives) were converted from kilograms to defined daily doses per 1000 inhabitants days (DDD/TID). Interrupted time series were used to estimate changes in level of medicines use at the intervention point and slope after the regulation. The Gregory-Hansen cointegration test was used to explore the relation between the use of antibiotics and perceived substitutes. After the regulation in Mexico NSAIDs-analgesics usage level increased by 1.1 DDD/TID with a slope increase of 0.2 DDD/TID per quarter and the cough and cold medicines usage level increased by 0.4 DDD/TID. In Brazil NSAIDs-analgesics usage level increased by 1.9 DDD/TID, and cough and cold medicines did not change. In the two countries, NSAIDs-analgesics usage changes were related with antibiotic usage changes; in Mexico cough and cold medicines usage changes had a relation with the antibiotics usage changes. These results showed a substitution effect on the use of other medicines, especially NSAIDs and analgesics, after reinforcement of OTC antibiotics sales restrictions. These regulations aimed to improve the antibiotics use and as a consequence reduce antimicrobial resistance; however, this type of policies should be comprehensive and take into account the potential substitution effects on the use

  7. Analysis of inservice inspection relief requests

    International Nuclear Information System (INIS)

    Aldrich, D.A.; Cook, J.F.

    1989-08-01

    Nuclear Regulatory Commission (NRC) regulations require inspection (ISI) of boiling or pressurized water-cooled nuclear power plants be performed in accordance with a referenced edition and addenda of Section XI, ''Rules for Inservice Inspection of Nuclear Power Plant components,'' of the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code. The regulations permit licensees to request relief from the NRC from specific ASME Code requirements that are determined to be impractical for the specific licensee. The NRC evaluates these requests and may grant such relief, but the NRC may also impose alternative or augmented inspections to assure structural reliability. The purpose,of this task was to evaluate the basis for ISI nondestructive examination (NDE) relief requests and to evaluate the effect of proposed ASME Code changes that would reduce the need for such requests or provide for more complete information in relief requests. This report contains the results of an analysis of an ISI relief request data base that has been expanded to include 1195 ISI relief requests versus the 296 relief requests covered in the first report in April 1987, EGG-SD-7430. Also relief requests were added to the data base which came from both first and second 10-year inspection intervals for several facilities. This provided the means to analyze the effect of recently approved ASME Code cases and updated Code requirements, some of which have been published as a result of earlier work on this task

  8. Extended-Release Guaifenesin/Pseudoephedrine Hydrochloride for Symptom Relief in Support of a Wait-and-See Approach for the Treatment of Acute Upper Respiratory Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Study

    Directory of Open Access Journals (Sweden)

    Edward J. Septimus, MD, FIDSA, FACP, FSHEA

    2017-01-01

    Conclusions: The study found that a wait and see approach was associated with decreased antibiotic use. In addition, the use of a guaifenesin pseudoephedrine combination product provided an effective symptom control compared to a placebo and a well-tolerated first-line strategy for the management of URTIs. This study was not designed to assess the effects of guaifenesin or pseudoephedrine individually. Other limitations include the need for better clinical methods to assess the effectiveness of treatments for acute symptoms of patients with URTIs. ClinicalTrials.gov identifier: NCT01202279.

  9. Crisis Communication Practices at an International Relief Agency

    Science.gov (United States)

    Genova, Gina L.

    2006-01-01

    When a disaster strikes, the affected population relies upon the swift response and aid rendered by relief organizations such as the California-based Direct Relief International. Since 1948, Direct Relief's mission has been to provide essential material resources to locally run health programs in areas affected by natural disasters, wars, and…

  10. U.S. Coastal Relief Model - Hawaii

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  11. U.S. Coastal Relief Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  12. Sustained relief of obstructive symptoms for the remaining life of patients following placement of an expandable metal stent for malignant colorectal obstruction Mejoría mantenida durante el resto de la vida de los síntomas obstructivos en pacientes con obstrucciones malignas colorrectales trás la colocación de prótesis metálicas expandibles

    Directory of Open Access Journals (Sweden)

    Jorge Manuel Canena

    2012-08-01

    Full Text Available Background: self-expanding metal stents are currently being used as a definitive palliative treatment for malignant colorectal obstruction in patients with incurable disease. Few studies have followed large numbers of patients from stent placement until death, and those few have reported conflicting results in the long-term clinical outcome data. Aims: this study evaluated the clinical effectiveness of stent placement for malignant colorectal obstruction throughout the patients' lives and related factors affecting stent patency, clinical success and complications. Methods: this was a multicentre, retrospective study of 89 consecutive patients who had undergone attempted expandable stent placement for symptomatic malignant colorectal obstruction during a 10-year period. Data were collected to analyse the sustained relief of obstructive symptoms throughout the patients' lives, as well as the technical success, immediate clinical success, stent patency, complications, reinterventions, survival, prognostic factors associated with stent patency and long-term clinical efficacy and risk factors for complications. Results: technical and immediate clinical success were achieved in 95.5% and 91.0% of patients, respectively. A total of 68 out of 89 patients (76.4% maintained relief of obstruction from stent implantation until death without reintervention. Twenty patients (22.5% had complications including perforation (n = 4; 4.5%, stent obstruction (n = 8; 9.0%, migration (n = 5; 5.6% and haemorrhage (n = 3; 3.4%. Stent-related mortality was seen in 1 patient (1.1%. The estimated median survival and estimated mean stent patency were 87.0 and 322.7 days, respectively. In total, 12 of the initial 89 patients (13.5% needed a colostomy for long-term relief of the obstructive symptoms. Univariate and multivariate analysis detected no significant prognostic factors associated with stent patency, long-term clinical efficacy and risk factors for complications

  13. Service Learning Through Disaster Relief

    Directory of Open Access Journals (Sweden)

    Donna J. Duerst

    2010-06-01

    Full Text Available The Rock County 4-H Disaster Relief Committee raised $1,550 to aid tsunami victims in Sri Lanka and then turned its attention to Hurricane Katrina relief efforts. Thirty-one 4-H youth participated in a service learning trip to the South with the objectives of helping hurricane victims, learning about new cultures and achieving personal growth during three days of service projects in Louisiana and Mississippi. Their written reflections and other evaluative measures revealed they learned about southern culture, gained a greater appreciation for their lives, gained self confidence and developed a desire to help others more often. The trip was a valuable developmental experience for the youth, and information from the trip could be utilized to create similar experiences based on service learning. This article provides an overview of the trip and describes the evaluation methods used to measure learning and assess personal growth.

  14. Higher Education: More Information Could Help Education Determine the Extent to Which Eligible Servicemembers Serving on Active Duty Benefited from Relief Provided by Lenders and Schools. Report to Congressional Requesters. GAO-07-11

    Science.gov (United States)

    Ashby, Cornelia M.

    2006-01-01

    Since September 11, 2001, over 1.3 million members of the armed forces have been deployed in service to the United States. Congress enacted the Higher Education Relief Opportunities for Students (HEROES) Act to recognize the needs of those servicemembers who are deployed in the midst of pursuing postsecondary education or repaying student loans.…

  15. Paper relief architecture

    NARCIS (Netherlands)

    Latka, J.F.

    2014-01-01

    The article presents two contemporary projects of paper structures relief architecture designed and built by Shigeru Ban Architects and Voluntary Architect Network. Author of the article took part in design and construction process of one of the projects. The project of Yaan Nursery School, which

  16. Relief valve testing study

    International Nuclear Information System (INIS)

    BROMM, R.D.

    2001-01-01

    Reclosing pressure-actuated valves, commonly called relief valves, are designed to relieve system pressure once it reaches the set point of the valve. They generally operate either proportional to the differential between their set pressure and the system pressure (gradual lift) or by rapidly opening fully when the set pressure is reached (pop action). A pop action valve allows the maximum fluid flow through the valve when the set pressure is reached. A gradual lift valve allows fluid flow in proportion to how much the system pressure has exceeded the set pressure of the valve (in the case of pressure relief) or has decreased below the set pressure (vacuum relief). These valves are used to protect systems from over and under pressurization. They are used on boilers, pressure vessels, piping systems and vacuum systems to prevent catastrophic failures of these systems, which can happen if they are under or over pressurized beyond the material tolerances. The construction of these valves ranges from extreme precision of less than a psi tolerance and a very short lifetime to extremely robust construction such as those used on historic railroad steam engines that are designed operate many times a day without changing their set pressure when the engines are operating. Relief valves can be designed to be immune to the effects of back pressure or to be vulnerable to it. Which type of valve to use depends upon the design requirements of the system

  17. Inheritance and molecular mapping of an allele providing resistance to Cowpea mild mottle virus-like symptoms in soybean

    Science.gov (United States)

    Damage to soybean [Glycine max (L.) Merr.] from Cowpea mild mottle virus-like (CPMMV-L) symptoms (family: Betaflexiviridae, genus: Carlavirus) has been of increasing concern in Argentina, Brazil, Mexico, and Puerto Rico. Soybean cultivars and lines differing in their reaction to the virus have been ...

  18. Internet-provided cognitive behaviour therapy of posttraumatic stress symptoms following childbirth-a randomized controlled trial.

    Science.gov (United States)

    Nieminen, Katri; Berg, Ida; Frankenstein, Katri; Viita, Lina; Larsson, Kamilla; Persson, Ulrika; Spånberger, Loviisa; Wretman, Anna; Silfvernagel, Kristin; Andersson, Gerhard; Wijma, Klaas

    2016-06-01

    The aim of this study was to analyse the effects of trauma-focused guided Internet-based cognitive behaviour therapy for relieving posttraumatic stress disorder (PTSD) symptoms following childbirth, a problem that about 3% women encounter postpartum. Following inclusion, 56 traumatized women were randomized to either treatment or to a waiting list control group. Primary outcome measures were the Traumatic Event Scale (TES) and Impact of Event Scale-Reversed (IES-R). Secondary measures were Beck depression inventory II, Patient Health Questionnaire (PHQ-9), Beck Anxiety Inventory, Quality Of Life Inventory and the EuroQol 5 Dimensions. The treatment was guided by a clinician and lasted eight weeks and comprised eight modules of written text. The between-group effect size (ES) was d = .82 (p post-treatment showed large within-group ESs for PTSD symptoms in the treatment group both on the TES (d = 1.42) and the IES-R (d = 1.30), but smaller ESs in the control group from inclusion to after deferred treatment (TES, d = .80; IES-R d = .45). In both groups, the treatment had positive effects on comorbid depression and anxiety, and in the treatment group also on quality of life. The results need to be verified in larger trials. Further studies are also needed to examine long-term effects.

  19. Identifying Motor, Emotional-Behavioral, and Cognitive Deficits that Comprise the Triad of HD Symptoms from Patient, Caregiver, and Provider Perspectives

    Directory of Open Access Journals (Sweden)

    David Victorson

    2014-04-01

    Full Text Available Background: The objective of this study was to identify important attributes associated with the triad of symptoms (cognition, emotional–behavioral, and motor of Huntington's disease (HD from patient, caregiver, and medical provider perspectives to facilitate development of a new disease‐specific, health‐related quality of life (HRQOL instrument. Methods: We conducted a targeted literature review of HD and HRQOL instruments, expert surveys, and patient and caregiver phone‐based interviews to extract information on the symptoms and issues most relevant to the HD symptom triad (HD triad. The data collected from these sources were used to generate themes and subdomains and to develop an integrated schema that highlights the key dimensions of the triad. Results: The search identified the following areas: emotional functioning/behavioral changes (e.g., positive emotions, sadness/depression; cognitive functioning (e.g., memory/learning, attention/comprehension; physical functioning (e.g., motor functioning, medication; social functioning (e.g., leisure, interpersonal relationships; end‐of‐life concerns/planning; and gene testing. Fifteen individuals diagnosed with HD and 16 HD caregivers, recruited from several Huntington's Disease Society of America support group networks, completed phone interviews. Nineteen US medical providers who specialize in HD completed the online survey. Twenty‐six subdomains of the HD symptom triad (seven cognition, 12 emotional–behavioral, and seven motor emerged relatively consistently across patient, caregiver, and provider samples. These included movements/chorea, memory impairment, depression, and anxiety. Discussion: Based on an integrated, mixed‐methods approach, important HD triad symptom were identified and organized into a guiding schema. These patient‐, caregiver‐, and provider‐triangulated data served as the basis for development of a HD‐specific HRQOL instrument, the HD‐PRO‐TRIAD™.

  20. Glovebox pressure relief and check valve

    International Nuclear Information System (INIS)

    Blaedel, K.L.

    1986-01-01

    This device is a combined pressure relief valve and check valve providing overpressure protection and preventing back flow into an inert atmosphere enclosure. The pressure relief is embodied by a submerged vent line in a mercury reservior, the releif pressure being a function of the submerged depth. The pressure relief can be vented into an exhaust system and the relieving pressure is only slightly influenced by the varying pressure in the exhaust system. The check valve is embodied by a ball which floats on the mercury column and contacts a seat whenever vacuum exists within the glovebox enclosure. Alternatively, the check valve is embodied by a vertical column of mercury, the maximum back pressure being a function of the height of the column of mercury

  1. Glovebox pressure relief and check valve

    Energy Technology Data Exchange (ETDEWEB)

    Blaedel, K.L.

    1986-03-17

    This device is a combined pressure relief valve and check valve providing overpressure protection and preventing back flow into an inert atmosphere enclosure. The pressure relief is embodied by a submerged vent line in a mercury reservior, the releif pressure being a function of the submerged depth. The pressure relief can be vented into an exhaust system and the relieving pressure is only slightly influenced by the varying pressure in the exhaust system. The check valve is embodied by a ball which floats on the mercury column and contacts a seat whenever vacuum exists within the glovebox enclosure. Alternatively, the check valve is embodied by a vertical column of mercury, the maximum back pressure being a function of the height of the column of mercury.

  2. Cost-effectiveness of providing patients with information on managing mild low-back symptoms in an occupational health setting

    Directory of Open Access Journals (Sweden)

    J. Rantonen

    2016-04-01

    Full Text Available Abstract Background Evidence shows that low back specific patient information is effective in sub-acute low back pain (LBP, but effectiveness and cost-effectiveness (CE of information in early phase symptoms is not clear. We assessed effectiveness and CE of patient information in mild LBP in the occupational health (OH setting in a quasi-experimental study. Methods A cohort of employees (N = 312, aged <57 with non-specific, mild LBP (Visual Analogue Scale between 10–34 mm was selected from the respondents of an employee survey (N = 2480; response rate 71 %. A random sample, representing the natural course of LBP (NC, N = 83; no intervention, was extracted as a control group. Remaining employees were invited (181 included, 47 declined, one excluded into a randomised controlled study with two 1:1 allocated parallel intervention arms (“Booklet”, N = 92; “Combined”, N = 89. All participants received the “Back Book” patient information booklet and the Combined also an individual verbal review of the booklet. Physical impairment (PHI, LBP, health care (HC utilisation, and all-cause sickness absence (SA were assessed at two years. CE of the interventions on SA days was analysed by using direct HC costs in one year, two years from baseline. Multiple imputation was used for missing values. Results Compared to NC, the Booklet reduced HC costs by 196€ and SA by 3.5 days per year. In 81 % of the bootstrapped cases the Booklet was both cost saving and effective on SA. Compared to NC, in the Combined arm, the figures were 107€, 0.4 days, and 54 %, respectively. PHI decreased in both interventions. Conclusions Booklet information alone was cost-effective in comparison to natural course of mild LBP. Combined information reduced HC costs. Both interventions reduced physical impairment. Mere booklet information is beneficial for employees who report mild LBP in the OH setting, and is also cost saving for the health care

  3. Doubling Your Payoff: Winning Pain Relief Engages Endogenous Pain Inhibition

    Science.gov (United States)

    Becker, Susanne; Gandhi, Wiebke; Kwan, Saskia; Ahmed, Alysha-Karima; Schweinhardt, Petra

    2015-01-01

    When in pain, pain relief is much sought after, particularly for individuals with chronic pain. In analogy to augmentation of the hedonic experience ("liking") of a reward by the motivation to obtain a reward ("wanting"), the seeking of pain relief in a motivated state might increase the experience of pain relief when obtained. We tested this hypothesis in a psychophysical experiment in healthy human subjects, by assessing potential pain-inhibitory effects of pain relief "won" in a wheel of fortune game compared with pain relief without winning, exploiting the fact that the mere chance of winning induces a motivated state. The results show pain-inhibitory effects of pain relief obtained by winning in behaviorally assessed pain perception and ratings of pain intensity. Further, the higher participants scored on the personality trait novelty seeking, the more pain inhibition was induced. These results provide evidence that pain relief, when obtained in a motivated state, engages endogenous pain-inhibitory systems beyond the pain reduction that underlies the relief in the first place. Consequently, such pain relief might be used to improve behavioral pain therapy, inducing a positive, perhaps self-amplifying feedback loop of reduced pain and improved functionality.

  4. Music for pain relief.

    Science.gov (United States)

    Cepeda, M S; Carr, D B; Lau, J; Alvarez, H

    2006-04-19

    The efficacy of music for the treatment of pain has not been established. To evaluate the effect of music on acute, chronic or cancer pain intensity, pain relief, and analgesic requirements. We searched The Cochrane Library, MEDLINE, EMBASE, PsycINFO, LILACS and the references in retrieved manuscripts. There was no language restriction. We included randomized controlled trials that evaluated the effect of music on any type of pain in children or adults. We excluded trials that reported results of concurrent non-pharmacological therapies. Data was extracted by two independent review authors. We calculated the mean difference in pain intensity levels, percentage of patients with at least 50% pain relief, and opioid requirements. We converted opioid consumption to morphine equivalents. To explore heterogeneity, studies that evaluated adults, children, acute, chronic, malignant, labor, procedural, or experimental pain were evaluated separately, as well as those studies in which patients chose the type of music. Fifty-one studies involving 1867 subjects exposed to music and 1796 controls met inclusion criteria. In the 31 studies evaluating mean pain intensity there was a considerable variation in the effect of music, indicating statistical heterogeneity ( I(2) = 85.3%). After grouping the studies according to the pain model, this heterogeneity remained, with the exception of the studies that evaluated acute postoperative pain. In this last group, patients exposed to music had pain intensity that was 0.5 units lower on a zero to ten scale than unexposed subjects (95% CI: -0.9 to -0.2). Studies that permitted patients to select the music did not reveal a benefit from music; the decline in pain intensity was 0.2 units, 95% CI (-0.7 to 0.2). Four studies reported the proportion of subjects with at least 50% pain relief; subjects exposed to music had a 70% higher likelihood of having pain relief than unexposed subjects (95% CI: 1.21 to 2.37). NNT = 5 (95% CI: 4 to 13). Three

  5. The search for pain relief in people with chronic fatigue syndrome: a descriptive study.

    Science.gov (United States)

    Marshall, Rebecca; Paul, Lorna; Wood, Les

    2011-07-01

    The purpose of this study was to investigate the use and perceived benefit of complimentary and alternative medicine (CAM) and physiotherapy treatments tried by people with chronic fatigue syndrome (CFS) to ease painful symptoms. This study used a descriptive, cross-sectional design. People with CFS who experienced pain were recruited to this study. Participants were asked during a semistructured interview about the treatments they had tried to relieve their pain. Each interview was conducted in the home of the participant. Fifty participants were recruited, of which, 10 participants were severely disabled by CFS. Eighteen participants were trying different forms of CAM treatment for pain relief at the time of assessment. Three participants were currently receiving physiotherapy. Throughout the duration of their illness 45 participants reported trying 19 different CAM treatments in the search for pain relief. Acupuncture was reported to provide the most pain relief (n=16). Twenty-seven participants reported a total of 16 different interventions prescribed by their physiotherapist. The results of this study suggest some physiotherapy and CAM treatments may help people manage painful CFS symptoms. Future research should be directed to evaluating the effectiveness of interventions such as acupuncture or gentle soft tissue therapies to reduce pain in people with CFS.

  6. Randomised clinical trial: relief of upper gastrointestinal symptoms by an acid pocket-targeting alginate-antacid (Gaviscon Double Action) - a double-blind, placebo-controlled, pilot study in gastro-oesophageal reflux disease.

    Science.gov (United States)

    Thomas, E; Wade, A; Crawford, G; Jenner, B; Levinson, N; Wilkinson, J

    2014-03-01

    The alginate-antacid, Gaviscon Double Action (Gaviscon DA; Reckitt Benckiser, Slough, UK) suppresses reflux after meals by creating a gel-like barrier that caps and displaces the acid pocket distal to the oesophago-gastric junction. The effect of Gaviscon DA on reflux and dyspepsia symptoms has not yet been demonstrated with a modern trial design. A pilot study to assess the efficacy and safety of Gaviscon DA compared with matched placebo for decreasing upper gastrointestinal symptoms in symptomatic gastro-oesophageal reflux disease (GERD) patients. A randomised, double-blind, parallel group study was performed in 110 patients with symptoms of GERD. Patients received Gaviscon DA or placebo tablets for 7 consecutive days. The primary endpoint compared the change in overall Reflux Disease Questionnaire (RDQ) symptom score (combined heartburn/regurgitation/dyspepsia). Secondary endpoints assessed individual dimensions, GERD dimension (heartburn and regurgitation) and overall treatment evaluation (OTE). There was a greater decrease in overall RDQ symptom score in the Gaviscon DA group compared with the placebo group (Least Squares Mean difference -0.55; P = 0.0033), and for each of the dimensions independently. Patients in the Gaviscon DA group evaluated their overall treatment response higher than patients in the placebo group [mean (standard deviation) OTE 4.1 (2.44) vs. 1.9 (3.34); P = 0.0005]. No differences in the incidence of adverse events were observed between treatment groups. Gaviscon DA decreases reflux and dyspeptic symptoms in GERD patients compared with matched placebo and has a favourable benefit-risk balance. Larger scale clinical investigations of medications targeting the acid pocket are warranted. (EudraCT, 2012-002188-84). © 2014 John Wiley & Sons Ltd.

  7. Multicenter, randomized, double-blind study comparing 20 and 40 mg of pantoprazole for symptom relief in adolescents (12 to 16 years of age) with gastroesophageal reflux disease (GERD)

    Science.gov (United States)

    An age-appropriate questionnaire (GASP-Q) was used to assess the frequency and severity of the gastroesophageal reflux disease (GERD) symptoms: abdominal/belly pain, chest pain/heartburn, pain after eating, nausea, burping/belching, vomiting/regurgitation, choking when eating, and difficulty swallow...

  8. Evaluation of a Web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial.

    Science.gov (United States)

    Yardley, Lucy; Joseph, Judith; Michie, Susan; Weal, Mark; Wills, Gary; Little, Paul

    2010-12-15

    There has been relatively little research on the role of web-based support for self-care in the management of minor, acute symptoms, in contrast to the wealth of recent research into Internet interventions to support self-management of long-term conditions. This study was designed as an evaluation of the usage and effects of the "Internet Doctor" website providing tailored advice on self-management of minor respiratory symptoms (eg, cough, sore throat, fever, runny nose), in preparation for a definitive trial of clinical effectiveness. The first aim was to evaluate the effects of using the Internet Doctor webpages on patient enablement and use of health services, to test whether the tailored, theory-based advice provided by the Internet Doctor was superior to providing a static webpage providing the best existing patient information (the control condition). The second aim was to gain an understanding of the processes that might mediate any change in intentions to consult the doctor, by comparing changes in relevant beliefs and illness perceptions in the intervention and control groups, and by analyzing usage of the Internet Doctor webpages and predictors of intention change. Participants (N = 714) completed baseline measures of beliefs about their symptoms and self-care online, and were then automatically randomized to the Internet Doctor or control group. These measures were completed again by 332 participants after 48 hours. Four weeks later, 214 participants completed measures of enablement and health service use. The Internet Doctor resulted in higher levels of satisfaction than the control information (mean 6.58 and 5.86, respectively; P = .002) and resulted in higher levels of enablement a month later (median 3 and 2, respectively; P = .03). Understanding of illness improved in the 48 hours following use of the Internet Doctor webpages, whereas it did not improve in the control group (mean change from baseline 0.21 and -0.06, respectively, P = .05). Decline

  9. Reward, motivation and emotion of pain and its relief

    Science.gov (United States)

    Porreca, Frank; Navratilova, Edita

    2016-01-01

    The experience of pain depends on interpretation of context and past experience that guide the choice of an immediate behavioral response and influence future decisions of actions to avoid harm. The aversive qualities of pain underlie its physiological role in learning and motivation. In this review, we highlight findings from human and animal investigations that suggest that both pain, and the relief of pain, are complex emotions that are comprised of feelings and their motivational consequences. Relief of aversive states, including pain, is rewarding. How relief of pain aversiveness occurs is not well understood. Termination of aversive states can directly provide relief as well as reinforce behaviors that result in avoidance of pain. Emerging preclinical data also suggests that relief may elicit a positive hedonic value that results from activation of neural cortical and mesolimbic brain circuits that may also motivate behavior. Brain circuits mediating the reward of pain relief, as well as relief-induced motivation are significantly impacted as pain becomes chronic. In chronic pain states, the negative motivational value of nociception may be increased while the value of the reward of pain relief may decrease. As a consequence, the impact of pain on these ancient, and conserved brain limbic circuits suggest a path forward for discovery of new pain therapies. PMID:28106670

  10. Temporary implantable nitinol device (TIND): a novel, minimally invasive treatment for relief of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH): feasibility, safety and functional results at 1 year of follow-up.

    Science.gov (United States)

    Porpiglia, Francesco; Fiori, Cristian; Bertolo, Riccardo; Garrou, Diletta; Cattaneo, Giovanni; Amparore, Daniele

    2015-08-01

    To report the first clinical experience with a temporary implantable nitinol device (TIND; Medi-Tate(®) ) for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). In all, 32 patients with LUTS were enrolled in this prospective study, which was approved by our Institutional Ethics Committee. Inclusion criteria were: age >50 years, International Prostate Symptom Score (IPSS) of ≥10, maximum urinary flow rate (Qmax ) of ≤12 mL/s, and prostate volume of BPH. TIND implantation is a feasible and safe minimally invasive option for the treatment of BPH-related LUTS. The functional results are encouraging and the treatment significantly improved patient QoL. Further studies are required to assess durability of TIND results and to optimise the indications of such a procedure. © 2014 The Authors BJU International © 2014 BJU International Published by John Wiley & Sons Ltd.

  11. Groundbreaking approach to disaster relief

    OpenAIRE

    2008-01-01

    The humanitarian response to Cyclone Nargis, which struck Myanmar on 2 and 3 May, heralds a fundamentally new approach to relief coordination. As a result, a unique survey showed what really happened to the survivors. Sarah Cumberland reports.

  12. Southern Alaska Coastal Relief Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA's National Geophysical Data Center (NGDC) is building coastal-relief models (CRM) for select U.S. coastal regions. Bathymetric, topographic, and shoreline data...

  13. Decongestants: OTC Relief for Congestion

    Science.gov (United States)

    ... CorrectlyPain Relievers: Understanding Your OTC OptionsAntacids and Acid Reducers: OTC Relief for Heartburn and Acid RefluxOTC Cough ... Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics ...

  14. Allergy Relief for Your Child

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates Allergy Relief for Your Child Share Tweet Linkedin Pin ... at the FDA. Avoid Pollen, Mold and Other Allergy Triggers If your child has seasonal allergies, pay ...

  15. U.S. Coastal Relief Model - Northwest Pacific

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  16. U.S. Coastal Relief Model - Western Gulf of Mexico

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  17. U.S. Coastal Relief Model - Southeast Atlantic

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  18. U.S. Coastal Relief Model - Central Gulf of Mexico

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  19. U.S. Coastal Relief Model - Central Pacific

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  20. U.S. Coastal Relief Model - Southern California

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  1. U.S. Coastal Relief Model - Northeast Atlantic

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  2. U.S. Coastal Relief Model - Puerto Rico

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  3. U.S. Coastal Relief Model - Southern California Version 2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides a comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a seamless...

  4. Engineering and Design. Design, Construction, and Maintenance of Relief Wells

    National Research Council Canada - National Science Library

    1992-01-01

    The objective of this manual is to provide guidance and information on the design, construction, and maintenance of pressure relief wells installed for the purpose of relieving subsurface hydrostatic...

  5. Associations Among Depressive Symptoms, Wellness, Patient Involvement, Provider Cultural Competency, and Treatment Nonadherence: A Pilot Study Among Community Patients Seen at a University Medical Center.

    Science.gov (United States)

    Hooper, Lisa M; Huffman, Lauren E; Higginbotham, John C; Mugoya, George C T; Smith, Annie K; Dumas, Tia N

    2018-02-01

    Treatment nonadherence is a pernicious problem associated with increasing rates of chronic diseases, escalating healthcare costs, and rising mortality in some patients. Although researchers have suggested numerous factors related to treatment nonadherence, several understudied aspects warrant attention, such as primary-care settings, provider cultural competence, and patient involvement. Adding to the research base, the present pilot study examined 88 primarily Black American and White American community patients from a large university medical center in the southern part of the United States. The study explored two research questions: (a) To what extent are there associations among depressive symptoms, wellness, patient involvement, cultural competency, and treatment nonadherence in a racially diverse community patient population? And (b) to what extent do the study exploratory variables and background characteristics predict treatment nonadherence, both separately and jointly? Depressive symptoms, the patient's perception of a provider's cultural competence, and marital/partnered status were found to be statistically significantly associated with treatment nonadherence, but not entirely in the directions expected.

  6. Using the symptom monitor in a randomized controlled trial: the effect on symptom prevalence and severity

    NARCIS (Netherlands)

    Hoekstra, Johanna; de Vos, Rien; van Duijn, Nico P.; Schadé, Egbert; Bindels, Patrick J. E.

    2006-01-01

    This randomized controlled trial investigated the effect of reporting physical symptoms by using a systematic symptom monitoring instrument, the Symptom Monitor, on symptom prevalence and severity among patients with cancer in the palliative phase. The overall objective was to achieve symptom relief

  7. Photobiomodulation: Implications for Anesthesia and Pain Relief.

    Science.gov (United States)

    Chow, Roberta T; Armati, Patricia J

    2016-12-01

    This review examines the evidence of neural inhibition as a mechanism underlying pain relief and anesthetic effect of photobiomodulation (PBM). PBM for pain relief has also been used for more than 30 years; however, the mechanism of its effectiveness has not been well understood. We review electrophysiological studies in humans and animal models and cell culture studies to examine neural responses to PBM. Evidence shows that PBM can inhibit nerve function in vivo, in situ, ex vivo, and in culture. Animal studies using noxious stimuli indicate nociceptor-specific inhibition with other studies providing direct evidence of local conduction block, leading to inhibited translation of pain centrally. Evidence of PBM-disrupted neuronal physiology affecting axonal flow, cytoskeleton organization, and decreased ATP is also presented. PBM changes are reversible with no side effects or nerve damage. This review provides strong evidence in neuroscience identifying inhibition of neural function as a mechanism for the clinical application of PBM in pain and anesthesia.

  8. The New COIN of the Domestic Realm: How the Military Services Can Combine Emerging Warfighting Doctrine with Innovative Methods of Interagency Coordination to Provide Improved Disaster Response and Relief

    National Research Council Canada - National Science Library

    Hildebrand, Steven J

    2007-01-01

    ... for the establishment of basic services that underpin the counterinsurgency warfighting model can be successfully transferred to the task of providing support to civil authorities during disaster response operations...

  9. Digital Shaded-Relief Image of Alaska

    Science.gov (United States)

    Riehle, J.R.; Fleming, Michael D.; Molnia, B.F.; Dover, J.H.; Kelley, J.S.; Miller, M.L.; Nokleberg, W.J.; Plafker, George; Till, A.B.

    1997-01-01

    of Alaska at 1:2,500,000 scale (Alaska Department of Natural Resources, 1994), using the 1,000-m digital elevation data set referred to below. An important difference between our image and these previous ones is the method of reproduction: like the Thelin and Pike (1991) image, our image is a composite of halftone images that yields sharp resolution and preserves contrast. Indeed, the first impression of many viewers is that the Alaskan image and the Thelin and Pike image are composites of satellite-generated photographs rather than an artificial rendering of a digital elevation model. A shaded-relief image represents landforms in a natural fashion; that is, a viewer perceives the image as a rendering of reality. Thus a shaded-relief image is intrinsically appealing, especially in areas of spectacular relief. In addition, even subtle physiographic features that reflect geologic structures or the type of bedrock are visible. To our knowledge, some of these Alaskan features have not been depicted before and so the image should provide earth scientists with a new 'look' at fundamental geologic features of Alaska.

  10. Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 1: state of the art.

    Science.gov (United States)

    Johansen, Monika Alise; Henriksen, Eva; Horsch, Alexander; Schuster, Tibor; Berntsen, Gro K Rosvold

    2012-10-03

    Over the last two decades, the number of studies on electronic symptom reporting has increased greatly. However, the field is very heterogeneous: the choices of patient groups, health service innovations, and research targets seem to involve a broad range of foci. To move the field forward, it is necessary to build on work that has been done and direct further research to the areas holding most promise. Therefore, we conducted a comprehensive review of randomized controlled trials (RCTs) focusing on electronic communication between patient and provider to improve health care service quality, presented in two parts. Part 2 investigates the methodological quality and effects of the RCTs, and demonstrates some promising benefits of electronic symptom reporting. To give a comprehensive overview of the most mature part of this emerging field regarding (1) patient groups, (2) health service innovations, and (3) research targets relevant to electronic symptom reporting. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles published from 1990 to November 2011. Inclusion criteria were RCTs of interventions where patients or parents reported health information electronically to the health care system for health care purposes and were given feedback. Of 642 records identified, we included 32 articles representing 29 studies. The included articles were published from 2002, with 24 published during the last 5 years. The following five patient groups were represented: respiratory and lung diseases (12 studies), cancer (6), psychiatry (6), cardiovascular (3), and diabetes (1). In addition to these, 1 study had a mix of three groups. All included studies, except 1, focused on long-term conditions. We identified four categories of health service innovations: consultation support (7 studies), monitoring with clinician support (12), self-management with clinician support (9

  11. Self-reported dietary adherence, disease-specific symptoms, and quality of life are associated with healthcare provider follow-up in celiac disease.

    Science.gov (United States)

    Hughey, Jacob J; Ray, Bonnie K; Lee, Anne R; Voorhees, Kristin N; Kelly, Ciaran P; Schuppan, Detlef

    2017-12-11

    The only treatment for celiac disease (CeD) is a lifelong gluten-free diet (GFD). The restrictive nature of the GFD makes adherence a challenge. As an integral part of CeD management, multiple professional organizations recommend regular follow-up with a healthcare provider (HCP). Many CeD patients also participate in patient advocacy groups (PAGs) for education and support. Previous work found that follow-up of CeD patients is highly variable. Here we investigated the self-reported factors associated with HCP follow-up among individuals diagnosed with CeD who participate in a PAG. We conducted a survey of members of Beyond Celiac (a PAG), collecting responses from 1832 U.S. adults ages 19-65 who reported having CeD. The survey queried HCP follow-up related to CeD and included validated instruments for dietary adherence (CDAT), disease-specific symptoms (CSI), and quality of life (CD-QOL). Overall, 27% of respondents diagnosed with CeD at least five years ago reported that they had not visited an HCP about CeD in the last five years. The most frequent reason for not visiting an HCP was "doing fine on my own" (47.6%). Using multiple logistic regression, we identified significant associations between whether a respondent reported visiting an HCP about CeD in the last five years and the scores for all three validated instruments. In particular, as disease-specific symptoms and quality of life worsened, the probability of having visited an HCP increased. Conversely, as dietary adherence worsened, the probability decreased. Our results suggest that many individuals with CeD manage their disease without ongoing support from an HCP. Our results thus emphasize the need for greater access to high quality CeD care, and highlight an opportunity for PAGs to bring together patients and HCPs to improve management of CeD.

  12. The three-item ALERT-B questionnaire provides a validated screening tool to detect chronic gastrointestinal symptoms after pelvic radiotherapy in cancer survivors

    OpenAIRE

    Taylor, Sophia; Byrne, Anthony; Adams, R.; Turner, J.; Hanna, L.; Staffurth, John Nicholas; Farnell, Damian; Sivell, Stephanie; Nelson, Annmarie; Green, J.

    2016-01-01

    Aims: Although pelvic radiotherapy is an effective treatment for various malignancies, around half of patients develop significant gastrointestinal problems. These symptoms often remain undetected, despite the existence of effective treatments. This study developed and refined a simple screening tool to detect common gastrointestinal symptoms in outpatient clinics. These symptoms have a significant effect on quality of life. This tool will increase detection rates and so enable access to spec...

  13. Application of biological effective dose (BED) to estimate the duration of symptomatic relief and repopulation dose equivalent in palliative radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Jones, Bleddyn; Cominos, Matilda; Dale, Roger G.

    2003-01-01

    Purpose: To investigate the potential for mathematic modeling in the assessment of symptom relief in palliative radiotherapy and cytotoxic chemotherapy. Methods: The linear quadratic model of radiation effect with the overall treatment time and the daily dose equivalent of repopulation is modified to include the regrowth time after completion of therapy. Results: The predicted times to restore the original tumor volumes after treatment are dependent on the biological effective dose (BED) delivered and the repopulation parameter (K); it is also possible to estimate K values from analysis of palliative treatment response durations. Hypofractionated radiotherapy given at a low total dose may produce long symptom relief in slow-growing tumors because of their low α/β ratios (which confer high fraction sensitivity) and their slow regrowth rates. Cancers that have high α/β ratios (which confer low fraction sensitivity), and that are expected to repopulate rapidly during therapy, are predicted to have short durations of symptom control. The BED concept can be used to estimate the equivalent dose of radiotherapy that will achieve the same duration of symptom relief as palliative chemotherapy. Conclusion: Relatively simple radiobiologic modeling can be used to guide decision-making regarding the choice of the most appropriate palliative schedules and has important implications in the design of radiotherapy or chemotherapy clinical trials. The methods described provide a rationalization for treatment selection in a wide variety of tumors

  14. Stress relief of transition zones

    International Nuclear Information System (INIS)

    Woodward, J.; van Rooyen, D.

    1984-01-01

    This paper considers the problem of intergranular stress corrosion cracking, initiated on the primary side, in the expansion transition region of roller expanded Alloy 600 tubing. In general it is believed that residual stresses, arising from the expansion process, are the cause of the problem. The work reported here concentrated on the identification of an optimal, in-situ stress relief treatment

  15. Petroleum industry assists hurricane relief

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper reports that the petroleum industry is aiding victims of last month's Hurricane Andrew with cash, clothing, food, water, and other supplies. Cash contributions announced as of last week totaled more than $2.7 million for distribution in South Florida and South Louisiana. Petroleum industry employees were collecting relief items such as bottled water and diapers for distribution in those areas

  16. Fraktalnist deformational relief polycrystalline aluminum

    Directory of Open Access Journals (Sweden)

    М.В. Карускевич

    2006-02-01

    Full Text Available  The possibility of the fractal geometry method application for the analisys of surface deformation structures under cyclic loading is presented.It is shown, that deformation relief of the alclad aluminium alloyes meets the criteria of the fractality. For the fractal demention estimation the method of  “box-counting”can be applied.

  17. Pictorial relief for equiluminant images

    NARCIS (Netherlands)

    Van Doorn, A.J.; De Ridder, H.; Koenderink, J.J.

    2005-01-01

    Pictorial relief depends strongly on “cues” in the image. For isoluminant renderings some cues are missing, namely all information that is related to luminance contrast (e.g., shading, atmospheric perspective). It has been suggested that spatial discrimination and especially pictorial space suffer

  18. Impact on perceived postnatal support, maternal anxiety and symptoms of depression in new mothers in Nepal when their husbands provide continuous support during labour.

    Science.gov (United States)

    Sapkota, Sabitri; Kobayashi, Toshio; Takase, Miyuki

    2013-11-01

    when a husband provides continuous support during his wife's labour, his presence is considered effective in reducing her dissatisfaction with the childbirth process. The impact of this on the postnatal well-being of a new mother, however, is not clear. to examine the impact on postnatal support, maternal anxiety and symptoms of depression experienced by new mothers in Nepal when their husband supported them continuously during labour. the study involved 231 Nepali women, of whom 77 were supported continuously by their husbands, 75 by female friends, and 79 were not supported by any companion during childbirth. They were contacted at six to eight weeks post partum, when postpartum support questionnaires, a state-trait anxiety inventory and the Edinburgh postnatal depression scale were administered. Structural equation modelling was conducted. observations showed that continuous support from a husband during his wife's labour was related to a greater degree of postnatal support than those who were not supported by their husband during labour (β=0.23, pdepression (β=0.43, pdepression in new mothers in Nepal. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Correct Diagnosis Provides Relief for Those with Dry Mouth

    Science.gov (United States)

    ... temporomandibular disorders (TMD). More What is Baby Bottle Tooth Decay? The History of Dental Advances When Should My Child First See a ... of baking soda and water." Applying sealants to teeth can help protect against cavities brought on by tooth decay. If the problem becomes serious, a dentist can ...

  20. [Providing regular relief; considerations for palliative care in the Netherlands

    NARCIS (Netherlands)

    Crul, B.J.P.; Weel, C. van

    2001-01-01

    Over the last few decades the attention devoted to the palliative aspects of medicine, particularly those in hospital care, has declined due to the emphasis on medical technology. In Anglo-Saxon countries a review of this development resulted in structured palliative care that benefited terminally

  1. [Providing regular relief; considerations for palliative care in the Netherlands].

    Science.gov (United States)

    Crul, B J; van Weel, C

    2001-10-20

    Over the last few decades the attention devoted to the palliative aspects of medicine, particularly those in hospital care, has declined due to the emphasis on medical technology. In Anglo-Saxon countries a review of this development resulted in structured palliative care that benefited terminally ill patients with a progressive fatal disease, especially cancer patients. Due to increasing national and international criticism of both the practice of euthanasia (assumed to be too liberal) and the lack of attention devoted to structured palliative care in the Netherlands, the Dutch government decided to improve the structure of palliative care. The government's viewpoint is based on the assumption that good palliative care that includes adequate pain control benefits patient care and might eventually lead to fewer requests for euthanasia. The improvements to palliative care should be realised by means of improvements in the structure, training and knowledge. Six academic medical clusters have been designated as Centres for the Development of Palliative Care (Dutch acronym: COPZ) for a 5-year period. Each COPZ must develop the various aspects needed to improve palliative care within the region it serves and ensure that its activities are carefully coordinated with those in the other centres. Research will focus on measuring the efficacy of palliative care as well as ethical and epidemiological aspects. A government committee will assess the appropriateness of the activities undertaken by each of the centres.

  2. Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 2: methodological quality and effects.

    Science.gov (United States)

    Johansen, Monika Alise; Berntsen, Gro K Rosvold; Schuster, Tibor; Henriksen, Eva; Horsch, Alexander

    2012-10-03

    We conducted in two parts a systematic review of randomized controlled trials (RCTs) on electronic symptom reporting between patients and providers to improve health care service quality. Part 1 reviewed the typology of patient groups, health service innovations, and research targets. Four innovation categories were identified: consultation support, monitoring with clinician support, self-management with clinician support, and therapy. To assess the methodological quality of the RCTs, and summarize effects and benefits from the methodologically best studies. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles between 1990 and November 2011. Risk of bias and feasibility were judged according to the Cochrane recommendation, and theoretical evidence and preclinical testing were evaluated according to the Framework for Design and Evaluation of Complex Interventions to Improve Health. Three authors assessed the risk of bias and two authors extracted the effect data independently. Disagreement regarding bias assessment, extraction, and interpretation of results were resolved by consensus discussions. Of 642 records identified, we included 32 articles representing 29 studies. No articles fulfilled all quality requirements. All interventions were feasible to implement in a real-life setting, and theoretical evidence was provided for almost all studies. However, preclinical testing was reported in only a third of the articles. We judged three-quarters of the articles to have low risk for random sequence allocation and approximately half of the articles to have low risk for the following biases: allocation concealment, incomplete outcome data, and selective reporting. Slightly more than one fifth of the articles were judged as low risk for blinding of outcome assessment. Only 1 article had low risk of bias for blinding of participants and personnel. We excluded 12

  3. 28 CFR 36.504 - Relief.

    Science.gov (United States)

    2010-07-01

    ... COMMERCIAL FACILITIES Enforcement § 36.504 Relief. (a) Authority of court. In a civil action under § 36.503, the court— (1) May grant any equitable relief that such court considers to be appropriate, including... disabilities; (2) May award other relief as the court considers to be appropriate, including monetary damages...

  4. Effectiveness of Property Tax Relief in Oregon.

    Science.gov (United States)

    Hartman, William T.; Hwang, C. S.

    This study examines the effects of the 1979 Oregon Property Tax Relief Plan on 1980-81 school district budget decisions by comparing the available tax relief, the school expenditures, and the tax levies in the state for the years 1975-81. The history of direct and indirect property tax relief in Oregon is sketched for the years prior to 1979; the…

  5. 76 FR 6819 - States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas...

    Science.gov (United States)

    2011-02-08

    ...' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas Marginal Properties... or not participate in accounting and auditing relief for Federal oil and gas marginal properties... September 13, 2004 (69 FR 55076), provide two types of accounting and auditing relief for Federal onshore or...

  6. 75 FR 1654 - States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas...

    Science.gov (United States)

    2010-01-12

    ...' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas Marginal Properties... participate in accounting and auditing relief for Federal oil and gas marginal properties located within the... the Code of Federal Regulations (CFR), to provide two types of accounting and auditing relief for...

  7. Increased joint loads during walking--a consequence of pain relief in knee osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Simonsen, Erik B; Alkjaer, T

    2006-01-01

    Joint pain is a primary symptom in knee osteoarthritis (OA), but the effect of pain and pain relief on the knee joint mechanics of walking is not clear. In this study, the effects of local knee joint analgesia on knee joint loads during walking were studied in a group of knee osteoarthritis....... Although the patients walked with less compressive knee joint forces compared to the reference group, the effects of pain relief may accelerate the degenerative changes....

  8. The Chicago Fire of 1871: A Bottom Up Approach to Disaster Relief

    OpenAIRE

    Skarbek, Emily C.

    2014-01-01

    Can bottom-up relief efforts lead to recovery after disasters? Conventional wisdom and contemporary public policy suggest that major crises require centralized authority to provide disaster relief goods. Using a novel set of comprehensive donation and expenditure data collected from archival records, this paper examines a bottom-up relief effort following one of the most devastating natural disasters of the nineteenth century: the Chicago Fire of 1871. Findings show that while there was no ce...

  9. Double Dividend Taxation Relief: A New View From The Corporate Income Tax Perspective

    OpenAIRE

    Sebastian Lazar

    2010-01-01

    Double taxation of dividends is a matter of great interest in the actual context of globalization and free movement of capital and persons. As the classical system is more and more abandoned, new solutions for the relief of double taxation are put into practice as a mean to reduce the fiscal burden on shareholders. With few exceptions, all these solutions are based on dividend tax relief. The paper aims at providing alternative solutions for double dividend taxation relief by taking some acti...

  10. The pre-positioning of warehouses at regional and local levels for a humanitarian relief organisation

    OpenAIRE

    Roh, Saeyeon; Pettit, Stephen John; Harris, Irina; Beresford, Anthony Kenneth Charles

    2015-01-01

    Using pre-positioned warehouses at strategic locations around the world is an approach commonly taken by some humanitarian relief organisations to improve their capacities to deliver sufficient relief aid within a relatively short time frame, and to provide shelter and assistance to disaster victims. Although research into the facility location problem is extensive in both theory and application, such approaches have received little attention from the humanitarian relief perspective. In this ...

  11. Feeling worse to feel better: pain-offset relief simultaneously stimulates positive affect and reduces negative affect.

    Science.gov (United States)

    Franklin, Joseph C; Lee, Kent M; Hanna, Eleanor K; Prinstein, Mitchell J

    2013-04-01

    Although pain itself induces negative affect, the removal (or offset) of pain induces a powerful state of relief. Despite being implicated in a wide range of psychological and behavioral phenomena, relief remains a poorly understood emotion. In particular, some theorists associate relief with increased positive affect, whereas others associate relief with diminished negative affect. In the present study, we examined the affective nature of relief in a pain-offset paradigm with psychophysiological measures that were specific to negative valence (startle eyeblink reactivity) and positive valence (startle postauricular reactivity). Results revealed that pain offset simultaneously stimulates positive affect and diminishes negative affect for at least several seconds. Results also indicated that pain intensity differentially affects the positive and negative valence aspects of relief. These findings clarify the affective nature of relief and provide insight into why people engage in both normal and abnormal behaviors associated with relief.

  12. Development and validation of an instrument for rapidly assessing symptoms: the general symptom distress scale.

    Science.gov (United States)

    Badger, Terry A; Segrin, Chris; Meek, Paula

    2011-03-01

    Symptom assessment has increasingly focused on the evaluation of total symptom distress or burden rather than assessing only individual symptoms. The challenge for clinicians and researchers alike is to assess symptoms, and to determine the symptom distress associated with the symptoms and the patient's ability for symptom management without a lengthy and burdensome assessment process. The objective of this article was to discuss the psychometric evaluation of a brief general symptom distress scale (GSDS) developed to assess specific symptoms and how they rank in relation to each other, the overall symptom distress associated with the symptom schema, and provide an assessment of how well or poorly that symptom schema is managed. Results from a pilot study about the initial development of the GSDS with 76 hospitalized patients are presented, followed by a more complete psychometric evaluation of the GSDS using three samples of cancer patients (n=190) and their social network members, called partners in these studies (n=94). Descriptive statistics were used to describe the GSDS symptoms, symptom distress, and symptom management. Point biserial correlations indexed the associations between dichotomous symptoms and continuous measures, and conditional probabilities were used to illustrate the substantial comorbidities of this sample. Internal consistency was examined using the KR-20 coefficient, and test-retest reliability was examined. Construct validity and predictive validity also were examined. The GSDS demonstrated satisfactory internal consistency and test-retest reliability, and good construct validity and predictive validity. The total score on the GSDS, symptom distress, and symptom management correlated significantly with related constructs of depression, positive and negative affect, and general health. The GSDS was able to demonstrate its ability to distinguish between those with or without chronic illness, and was able to significantly predict scores on

  13. Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis

    NARCIS (Netherlands)

    de Boer, Jacoba; Lok, Anja; van 't Verlaat, Ellen; Duivenvoorden, Hugo J.; Bakker, Arnold B.; Smit, Bert J.

    2011-01-01

    This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively

  14. Unmanned Aerial Vehicle Systems for Disaster Relief: Tornado Alley

    Science.gov (United States)

    DeBusk, Wesley M.

    2009-01-01

    Unmanned aerial vehicle systems are currently in limited use for public service missions worldwide. Development of civil unmanned technology in the United States currently lags behind military unmanned technology development in part because of unresolved regulatory and technological issues. Civil unmanned aerial vehicle systems have potential to augment disaster relief and emergency response efforts. Optimal design of aerial systems for such applications will lead to unmanned vehicles which provide maximum potentiality for relief and emergency response while accounting for public safety concerns and regulatory requirements. A case study is presented that demonstrates application of a civil unmanned system to a disaster relief mission with the intent on saving lives. The concept utilizes unmanned aircraft to obtain advanced warning and damage assessments for tornados and severe thunderstorms. Overview of a tornado watch mission architecture as well as commentary on risk, cost, need for, and design tradeoffs for unmanned aerial systems are provided.

  15. Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis.

    Science.gov (United States)

    de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J

    2011-07-01

    This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals

  16. Bridging the sanitation gap between disaster relief and development.

    Science.gov (United States)

    Lai, Ka-Man; Ramirez, Claudia; Liu, Weilong; Kirilova, Darina; Vick, David; Mari, Joe; Smith, Rachel; Lam, Ho-Yin; Ostovari, Afshin; Shibakawa, Akifumi; Liu, Yang; Samant, Sidharth; Osaro, Lucky

    2015-10-01

    By interpreting disasters as opportunities to initiate the fulfilment of development needs, realise the vulnerability of the affected community and environment, and extend the legacy of relief funds and effort, this paper builds upon the concept linking relief, rehabilitation and development (LRRD) in the sanitation sector. It aims to use a composite of case studies to devise a framework for a semi-hypothetical scenario to identify critical components and generic processes for a LRRD action plan. The scenario is based on a latrine wetland sanitation system in a Muslim community. Several sub-frameworks are developed: (i) latrine design; (ii) assessment of human waste treatment; (iii) connective sanitation promotion strategy; and (iv) ecological systems and environmental services for sanitation and development. This scenario illustrates the complex issues involved in LRRD in sanitation work and provides technical notes and references for a legacy plan for disaster relief and development. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

  17. Experiences from tsunami relief activity: implications for medical education.

    Science.gov (United States)

    Balasubramaniam, Sudharsanam Manni; Mohan, Yogesh; Roy, Gautam

    2012-01-01

    A tsunami struck the coast of Tamilnadu and Pondicherry on 26 December 2004. Jawaharlal Institute of Postgraduate Medical Education & Research, (JIPMER) in Pondicherry played a vital role in providing medical relief. The experiences from the relief activities revealed areas of deficiency in medical education in regards to disaster preparedness. A qualitative study using focus group discussion was employed to find the lacunae in skills in managing medical relief measures. Many skills were identified; the most important of which was addressing the psychological impact of the tsunami on the victims. Limited coordination and leadership skills were also identified. It is recommended that activity-based learning can be included in the curriculum to improve these skills.

  18. Complementary and alternative medicine used by persons with functional gastrointestinal disorders to alleviate symptom distress.

    Science.gov (United States)

    Stake-Nilsson, Kerstin; Hultcrantz, Rolf; Unge, Peter; Wengström, Yvonne

    2012-03-01

    The aim of this study was to describe the complementary and alternative medicine methods most commonly used to alleviate symptom distress in persons with functional gastrointestinal disorders. People with functional gastrointestinal disorders face many challenges in their everyday lives, and each individual has his/her own way of dealing with this illness. The experience of illness often leads persons with functional gastrointestinal disorders to complementary and alternative medicine as a viable healthcare choice. Quantitative and describing design. A study-specific complementary and alternative medicine questionnaire was used, including questions about complementary and alternative medicine methods used and the perceived effects of each method. Efficacy assessments for each method were preventive effect, partial symptom relief, total symptom relief or no effect. A total of 137 persons with functional gastrointestinal disorders answered the questionnaire, 62% (n = 85) women and 38% (n = 52) men. A total of 28 different complementary and alternative medicine methods were identified and grouped into four categories: nutritional, drug/biological, psychological activity and physical activity. All persons had tried at least one method, and most methods provided partial symptom relief. Persons with functional gastrointestinal disorders commonly use complementary and alternative medicine methods to alleviate symptoms. Nurses have a unique opportunity to expand their roles in this group of patients. Increased knowledge of complementary and alternative medicine practices would enable a more comprehensive patient assessment and a better plan for meaningful interventions that meet the needs of individual patients. © 2011 Blackwell Publishing Ltd.

  19. Pain Relief in Labor: A Randomized Controlled Trial Comparing ...

    African Journals Online (AJOL)

    Conclusions: This study showed that 600 mg intramuscular paracetamol provides similar and modest pain relief in labor when compared to 100 mg intramuscular tramadol. It also has fewer maternal adverse effects and favorable neonatal outcome such as tramadol. It is concluded that intramuscular paracetamol is simple, ...

  20. Paracetamol for pain relief after surgical removal of lower wisdom teeth

    NARCIS (Netherlands)

    Weil, K.; Hooper, L.; Afzal, Z.; Esposito, M.; Worthington, H.V.; van Wijk, A.J.; Coulthard, P.

    2008-01-01

    Background: Paracetamol has been commonly used for the relief of postoperative pain following oral surgery. In this review we investigated the optimal dose of paracetamol and the optimal time for drug administration to provide pain relief, taking into account the side effects of different doses of

  1. The Unintended Consequences of Property Tax Relief: New York's STAR Program

    Science.gov (United States)

    Eom, Tae Ho; Duncombe, William; Nguyen-Hoang, Phuong; Yinger, John

    2014-01-01

    New York's School Tax Relief Program, STAR, provides state-funded property tax relief for homeowners. Like a matching grant, STAR changes the price of education, thereby altering the incentives of voters and school officials and leading to unintended consequences. Using data for New York State school districts before and after STAR was…

  2. Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies.

    Science.gov (United States)

    Griffin, Sarah C; Curran, Sean; Chan, Annie W Y; Finn, Sacha B; Baker, Chris I; Pasquina, Paul F; Tsao, Jack W

    2017-04-01

    Research indicates that mirror therapy reduces phantom limb pain (PLP). Objectives were to determine when mirror therapy works in those who respond to treatment, the relevance of baseline PLP to when pain relief occurs, and what pain symptoms respond to mirror therapy. Data from two independent cohorts with unilateral lower limb amputation were analyzed for this study (n=33). Mirror therapy consisted of 15-min sessions in which amputees performed synchronous movements of the phantom and intact legs/feet. PLP was measured using a visual analogue scale and the Short-Form McGill Pain Questionnaire. The severity of PLP at the beginning of treatment predicted when pain relief occurred. Those with low baseline PLP experienced a reduction (ppain relief by session 14 of treatment, and those with high baseline PLP experienced pain relief by session 21 of treatment. Mirror therapy reduced throbbing, shooting, stabbing, sharp, cramping, aching, tender, splitting, tiring/exhausting, and punishing-cruel pain symptoms. The degree of PLP at baseline predicts when mirror therapy relieves pain. This article indicates that the degree of baseline PLP affects when mirror therapy relieves pain: relief occurs by session 7 in patients with low PLP but by session 21 in patients with high PLP. Clinicians should anticipate slower pain relief in patients who begin treatment with high levels of pain. ClinicalTrials.gov numbers:NCT00623818 and NCT00662415. Copyright © 2017 Scandinavian Association for the Study of Pain. All rights reserved.

  3. Doubling Your Payoff: Winning Pain Relief Engages Endogenous Pain Inhibition1,2,3

    Science.gov (United States)

    Kwan, Saskia; Schweinhardt, Petra

    2015-01-01

    Abstract When in pain, pain relief is much sought after, particularly for individuals with chronic pain. In analogy to augmentation of the hedonic experience (“liking”) of a reward by the motivation to obtain a reward (“wanting”), the seeking of pain relief in a motivated state might increase the experience of pain relief when obtained. We tested this hypothesis in a psychophysical experiment in healthy human subjects, by assessing potential pain-inhibitory effects of pain relief “won” in a wheel of fortune game compared with pain relief without winning, exploiting the fact that the mere chance of winning induces a motivated state. The results show pain-inhibitory effects of pain relief obtained by winning in behaviorally assessed pain perception and ratings of pain intensity. Further, the higher participants scored on the personality trait novelty seeking, the more pain inhibition was induced. These results provide evidence that pain relief, when obtained in a motivated state, engages endogenous pain-inhibitory systems beyond the pain reduction that underlies the relief in the first place. Consequently, such pain relief might be used to improve behavioral pain therapy, inducing a positive, perhaps self-amplifying feedback loop of reduced pain and improved functionality. PMID:26464995

  4. How absent negativity relates to affect and motivation: an integrative relief model.

    Science.gov (United States)

    Deutsch, Roland; Smith, Kevin J M; Kordts-Freudinger, Robert; Reichardt, Regina

    2015-01-01

    The present paper concerns the motivational underpinnings and behavioral correlates of the prevention or stopping of negative stimulation - a situation referred to as relief. Relief is of great theoretical and applied interest. Theoretically, it is tied to theories linking affect, emotion, and motivational systems. Importantly, these theories make different predictions regarding the association between relief and motivational systems. Moreover, relief is a prototypical antecedent of counterfactual emotions, which involve specific cognitive processes compared to factual or mere anticipatory emotions. Practically, relief may be an important motivator of addictive and phobic behaviors, self destructive behaviors, and social influence. In the present paper, we will first provide a review of conflicting conceptualizations of relief. We will then present an integrative relief model (IRMO) that aims at resolving existing theoretical conflicts. We then review evidence relevant to distinctive predictions regarding the moderating role of various procedural features of relief situations. We conclude that our integrated model results in a better understanding of existing evidence on the affective and motivational underpinnings of relief, but that further evidence is needed to come to a more comprehensive evaluation of the viability of IRMO.

  5. How Absent Negativity Relates to Affect and Motivation: An Integrative Relief Model

    Directory of Open Access Journals (Sweden)

    Roland eDeutsch

    2015-03-01

    Full Text Available The present paper concerns the motivational underpinnings and behavioral correlates of the prevention or stopping of negative stimulation – a situation referred to as relief. Relief is of great theoretical and applied interest. Theoretically, it is tied to theories linking affect, emotion and motivational systems (Carver & Scheier, 1990; Gray & McNaughton, 2000; Higgins, 1997; Lang, Bradley, & Cuthbert, 1990. Importantly, these theories make different predictions regarding the association between relief and motivational systems. Moreover, relief is a prototypical antecedent of counterfactual emotions, which involve specific cognitive processes compared to factual or mere anticipatory emotions. Practically, relief may be an important motivator of addictive and phobic behaviors (Mowrer, 1951; Ostafin & Brooks, 2011, self destructive behaviors (Favazza, 1998; Franklin, Lee, Hanna, & Prinstein, 2013, and social influence (Dolinski & Nawrat, 1998. In the present paper, we will first provide a review of conflicting conceptualizations of relief. We will then present an integrative relief model (IRMO that aims at resolving existing theoretical conflicts. We then review evidence relevant to distinctive predictions regarding the moderating role of various procedural features of relief situations. We conclude that our integrated model results in a better understanding of existing evidence on the affective and motivational underpinnings of relief, but that further evidence is needed to come to a more comprehensive evaluation of the viability of IRMO.

  6. How absent negativity relates to affect and motivation: an integrative relief model

    Science.gov (United States)

    Deutsch, Roland; Smith, Kevin J. M.; Kordts-Freudinger, Robert; Reichardt, Regina

    2015-01-01

    The present paper concerns the motivational underpinnings and behavioral correlates of the prevention or stopping of negative stimulation – a situation referred to as relief. Relief is of great theoretical and applied interest. Theoretically, it is tied to theories linking affect, emotion, and motivational systems. Importantly, these theories make different predictions regarding the association between relief and motivational systems. Moreover, relief is a prototypical antecedent of counterfactual emotions, which involve specific cognitive processes compared to factual or mere anticipatory emotions. Practically, relief may be an important motivator of addictive and phobic behaviors, self destructive behaviors, and social influence. In the present paper, we will first provide a review of conflicting conceptualizations of relief. We will then present an integrative relief model (IRMO) that aims at resolving existing theoretical conflicts. We then review evidence relevant to distinctive predictions regarding the moderating role of various procedural features of relief situations. We conclude that our integrated model results in a better understanding of existing evidence on the affective and motivational underpinnings of relief, but that further evidence is needed to come to a more comprehensive evaluation of the viability of IRMO. PMID:25806008

  7. Remembering reliefs that have disappeared

    International Nuclear Information System (INIS)

    Arnaud, N.

    1998-01-01

    Natural radioactivity can give information about age but also about thermal evolution of rocks. The accumulation of decay products in a material can be disturbed by temperature rising. Over a certain temperature called opening temperature the decay products are migrating due to atomic diffusion. The decay reactions used usually are K 40 /Ar 40 , Sm 143 /Nd 144 , C 14 /N 14 and the successive disintegrations of uranium leading to lead. A method known as thermo-chronology studies these isotopic ratios and links them to temperatures. The application of this method to the understanding of the tectonic slab collision between India and Asia is described and some conclusions about the relief are drawn. (A.C.)

  8. Exercise Based- Pain Relief Program

    DEFF Research Database (Denmark)

    Zadeh, Mahdi Hossein

    in the current study was to use exercise induced- muscle damage followed by ECC as an acute pain model and observe its effects on the sensitivity of the nociceptive system and blood supply in healthy subjects. Then, the effect of a repeated bout of the same exercise as a healthy pain relief strategy......Exercise-based pain management programs are suggested for relieving from musculoskeletal pain; however the pain experienced after unaccustomed, especially eccentric exercise (ECC) alters people´s ability to participate in therapeutic exercises. Subsequent muscle pain after ECC has been shown...... to cause localized pressure pain and hyperalgesia. A prior bout of ECC has been repeatedly reported to produce a protective adaptation known as repeated bout effect (RBE). One of the main scopes of the current project was to investigate the adaptations by which the RBE can be resulted from. The approach...

  9. Electric Stimulation for Pain Relief in Patients with Fibromyalgia: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Salazar, Ana Paula de Silva; Stein, Cinara; Marchese, Ritchele Redivo; Plentz, Rodrigo Della Mea; Pagnussat, Aline De Souza

    2017-02-01

    Fibromyalgia (FM) is a syndrome whose primary symptoms include chronic widespread muscle pain and fatigue. The treatment of patients with FM aims to provide symptomatic relief and improvement in physical capacities to perform daily tasks and quality of life. Invasive or non-invasive electric stimulation (ES) is used for pain relief in patients with FM. This systematic review aimed to assess the effects of treatment with ES, combined or not combined with other types of therapy, for pain relief in patients with FM. Systematic review and meta-analysis. Electronic search was conducted on databases (from the inception to April 2016): MEDLINE (accessed by PubMed), EMBASE, Cochrane Central Register of Controlled Trials (Cochrane CENTRAL), and Physiotherapy Evidence Database (PEDro). Two independent reviewers assessed the eligibility of studies based on the inclusion criteria: randomized controlled trials (RCTs) examining the effects of ES combined or not with other types of treatment for pain relief in patients with FM (according to the American College of Rheumatology), regardless of the ES dosages. The primary outcome was pain, assessed by the visual analogue scale (VAS). The secondary outcomes extracted were quality of life, assessed by short form-36 health survey (SF- 36), and fatigue, assessed by VAS. Nine studies were included, with 301 patients. The meta-analysis for pain showed positive effect of ES treatment versus control [-1.24 (95% CI: -2.39 to -0.08; I²: 87%, P = 0.04) n = 8 RCTs]. The sensitivity analysis for pain showed significant results for invasive ES, combined or not with other types of therapy [-0.94 (95% CI, -1.50 to -0.38; I² 0%, P = 0.001) n = 3 RCTs]. No significant improvement was found regarding quality of life [-3.48 (95% CI: -12.58 to 5.62; I²: 0%, P = 0.45), n = 2 RCTs] or fatigue [-0.57 (95% CI, -1.25 to 0.11; I² 34%, P = 0.100; n = 4 RCTs]. This systematic review included a small number of studies and reduced number of participants in

  10. Impact of Tax Relief on Public Finance

    Directory of Open Access Journals (Sweden)

    Bikas Egidijus

    2016-12-01

    Full Text Available Tax reliefs are optional, but a very important element of the taxation system. This element is used for different purposes by a country’s government institutions. Tax reliefs are a form of tax expenditure that helps to reduce budget revenues. Tax reliefs influence individual and corporate financial behaviour and can have positive or negative effects on the economic and social factors. In the last few years, expansion of tax relief has attracted worldwide attention because of the fact that, after the global financial crisis, many countries are still suffering from fiscal deficits, and expansion of tax relief has not contributed to solving this problem. Tax reliefs are presupposed to be a fiscal policy tool of significance in various subsystems of public finances. The main aim of this article is to examine the impact of personal income tax reliefs on Lithuanian public finances. To achieve this aim, statistical information was systemized; Monte Carlo method was used to group data by horizontal rows and logical links analysed, which helped to evaluate the influence of tax reliefs on public finances. In the simulations, the Monte Carlo method helped to simulate random samples, which were then examined by adapting the conclusions of the theory of probability and mathematical statistics methods.

  11. Oscillatory neural representations in the sensory thalamus predict neuropathic pain relief by deep brain stimulation.

    Science.gov (United States)

    Huang, Yongzhi; Green, Alexander L; Hyam, Jonathan; Fitzgerald, James; Aziz, Tipu Z; Wang, Shouyan

    2018-01-01

    Understanding the function of sensory thalamic neural activity is essential for developing and improving interventions for neuropathic pain. However, there is a lack of investigation of the relationship between sensory thalamic oscillations and pain relief in patients with neuropathic pain. This study aims to identify the oscillatory neural characteristics correlated with pain relief induced by deep brain stimulation (DBS), and develop a quantitative model to predict pain relief by integrating characteristic measures of the neural oscillations. Measures of sensory thalamic local field potentials (LFPs) in thirteen patients with neuropathic pain were screened in three dimensional feature space according to the rhythm, balancing, and coupling neural behaviours, and correlated with pain relief. An integrated approach based on principal component analysis (PCA) and multiple regression analysis is proposed to integrate the multiple measures and provide a predictive model. This study reveals distinct thalamic rhythms of theta, alpha, high beta and high gamma oscillations correlating with pain relief. The balancing and coupling measures between these neural oscillations were also significantly correlated with pain relief. The study enriches the series research on the function of thalamic neural oscillations in neuropathic pain and relief, and provides a quantitative approach for predicting pain relief by DBS using thalamic neural oscillations. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Exploring Heat Stress Relief Measures among the Australian Labour Force.

    Science.gov (United States)

    Zander, Kerstin K; Mathew, Supriya; Garnett, Stephen T

    2018-02-26

    Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor industries implement standards for heat stress management for their workforce. However, little is known about how people cope with heat at their workplaces apart from studies targeting some specific industries where labourers are exposed to extreme heat. Here, we analysed responses from 1719 people in the Australian labour force to self-reported heat stress and associated coping mechanisms. Three quarters of respondents experienced heat stress at their workplace with fatigue and headache being the two most frequently stated symptoms. Almost all of those who were affected by heat would hydrate (88%), 67% would cool, and 44% would rest as a strategy for coping with heat. About 10% intended to change their jobs because of heat stress in the workplace. We found differences in heat relief measures across gender, education, health, level of physical intensity of job, and time spent working outside. People working in jobs that were not very demanding physically were more likely to choose cooling down as a relief measure, while those in labour intensive jobs and jobs that required considerable time outside were more likely to rest. This has potential consequences for their productivity and work schedules. Heat affects work in Australia in many types of industry with impact dependent on workforce acclimatisation, yet public awareness and work relief plans are often limited to outdoor and labour intensive industries. Industries and various levels of government in all sectors need to implement standards for heat management specific to climate zones to help people cope better with high temperatures as well as plan strategies in anticipation of projected temperature

  13. Exploring Heat Stress Relief Measures among the Australian Labour Force

    Directory of Open Access Journals (Sweden)

    Kerstin K. Zander

    2018-02-01

    Full Text Available Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor industries implement standards for heat stress management for their workforce. However, little is known about how people cope with heat at their workplaces apart from studies targeting some specific industries where labourers are exposed to extreme heat. Here, we analysed responses from 1719 people in the Australian labour force to self-reported heat stress and associated coping mechanisms. Three quarters of respondents experienced heat stress at their workplace with fatigue and headache being the two most frequently stated symptoms. Almost all of those who were affected by heat would hydrate (88%, 67% would cool, and 44% would rest as a strategy for coping with heat. About 10% intended to change their jobs because of heat stress in the workplace. We found differences in heat relief measures across gender, education, health, level of physical intensity of job, and time spent working outside. People working in jobs that were not very demanding physically were more likely to choose cooling down as a relief measure, while those in labour intensive jobs and jobs that required considerable time outside were more likely to rest. This has potential consequences for their productivity and work schedules. Heat affects work in Australia in many types of industry with impact dependent on workforce acclimatisation, yet public awareness and work relief plans are often limited to outdoor and labour intensive industries. Industries and various levels of government in all sectors need to implement standards for heat management specific to climate zones to help people cope better with high temperatures as well as plan strategies in anticipation of projected

  14. Pictorial relief for equiluminant images

    Science.gov (United States)

    van Doorn, Andrea J.; de Ridder, Huib; Koenderink, Jan J.

    2005-03-01

    Pictorial relief depends strongly on "cues" in the image. For isoluminant renderings some cues are missing, namely all information that is related to luminance contrast (e.g., shading, atmospheric perspective). It has been suggested that spatial discrimination and especially pictorial space suffer badly in isoluminant conditions. We have investigated the issue through quantitative measurement of pictorial depth-structure under normal and isoluminant conditions. As stimuli we used monochrome halftone photographs, either as such, or "transposed" to Red/Green or Green/Red hue modulations. We used two distinct methods, one to probe pictorial pose (by way of correspondences settings between pictures of an object in different poses), the other to probe pictorial depth (by way of attitude settings of a gauge figure to a perceptual "fit"). In both experiments the depth reconstructions for Red/Green, Green/Red and monochrome conditions were very similar. Moreover, observers performed equally well in Red/Green, Green/Red and monochrome conditions. Thus, the general conclusion is that observers did not do markedly worse with the isoluminant Red/Green and Green/Red transposed images. Whereas the transposed images certainly looked weird, they were easily interpreted. Much of the structure of pictorial space was apparently preserved. Thus the notion that spatial representations are not sustained under isoluminant conditions should be applied with caution.

  15. Eksplorasi Pose dalam Pemotretan Model Melalui Kajian Visual Relief Karmawibhangga

    Directory of Open Access Journals (Sweden)

    Noor Latif CM

    2015-10-01

    Full Text Available Karmawibhangga Relief panel located at the foot of Borobudur is a relic of the visual artifacts that contains fragments of past life with a very high historical value. 160 Karmawibhangga panels tell the reality of people's lives at the time wrapped with a moral message plight. The relief provides a lot of visual references to be excavated and reconstructed again for the benefit of the creative industries today. This research digged one small part of the masterpieces of the past through photography. Understanding visual artists who create these reliefs will be beauty in the show gestures in building a very interesting story to be re-examined. Visual communication through gestures in relief Karmawibhangga enables new assumptions about body language dialect differences to current conditions. Through model genre photography, it is very useful in connection with the development of local nuanced scientific photography. Efforts to develop the traditions and culture through new media are expected to be creative commodity with a very strong product differentiation. 

  16. Japanese women's experiences of pharmacological pain relief in New Zealand.

    Science.gov (United States)

    Doering, Keiko; Patterson, Jean; Griffiths, Christine R

    2014-06-01

    In Japan, most women manage labour pain without pharmacological interventions. However, New Zealand statistics show a high percentage of epidural use amongst Asian women. Entonox (a gas mixture of nitrous oxide and oxygen) and pethidine are also available to women in New Zealand. This article investigates how Japanese women in New Zealand respond to the use of pharmacological pain relief in labour. The study was guided by two research questions: (1) How do Japanese women experience and manage labour pain in New Zealand? (2) How do they feel about the use of pharmacological pain relief? Thirteen Japanese women who had given birth in New Zealand were interviewed individually or in a focus group. The conversations were analysed using thematic analysis. Although in Japan very few women use pain relief, nine women received epidural and/or Entonox out of 11 women who experienced labour pain. The contrast between their Japanese cultural expectations and their birth experiences caused some of the women subsequent personal conflict. Japanese women's cultural perspectives and passive attitudes were demonstrated to influence the decision-making process concerning pain relief. It was concluded that understanding Japanese cultural worldviews and approaches to the role of pain in labour would help maternity providers in their provision of appropriate care for Japanese women. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  17. Performance of balanced bellows safety relief valves

    International Nuclear Information System (INIS)

    Lai, Y.S.

    1992-01-01

    By the nature of its design, the set point and lift of a conventional spring loaded safety relief valve are sensitive to back pressure. One way to reduce the adverse effects of the back pressure on the safety relief valve function is to install a balanced bellows in a safety relief valve. The metallic bellows has a rather wide range of manufacturing tolerance which makes the design of the bellows safety relief valve very complicated. The state-of-the-art balanced bellows safety relief valve can only substantially minimize, but cannot totally eliminate the back pressure effects on its set point and relieving capacity. Set point change is a linear function of the back pressure to the set pressure ratio. Depending on the valve design, the set point correction factor can be either greater or smaller than unity. There exists an allowable back pressure and critical back pressure for each safety relief valve. When total back pressure exceeds the R a , the relieving capacity will be reduced mainly resulting from the valve lift being reduced by the back pressure and the capacity reduction factor should be applied in valve sizing. Once the R c is exceeded, the safety relief valve becomes unstable and loses its over pressure protection capability. The capacity reduction factor is a function of system overpressure, but their relationship is non-linear in nature. (orig.)

  18. A neurogenetic dissociation between punishment-, reward- and relief-learning in Drosophila

    Directory of Open Access Journals (Sweden)

    ayse Yarali

    2010-12-01

    Full Text Available What is particularly worth remembering about a traumatic experience is what brought it about, and what made it cease. For example, fruit flies avoid an odour which during training had preceded electric shock punishment; on the other hand, if the odour had followed shock during training, it is later on approached as a signal for the relieving end of shock. We provide a neurogenetic analysis of such relief learning. Blocking, using UAS-shibirets1, the output from a particular set of dopaminergic neurons defined by the TH-Gal4 driver partially impaired punishment learning, but left relief learning intact. Thus, with respect to these particular neurons, relief learning differs from punishment learning. Targeting another set of dopaminergic/ serotonergic neurons defined by the DDC-Gal4 driver on the other hand affected neither punishment nor relief learning. As for the octopaminergic system, the tbhM18 mutation, compromising octopamine biosynthesis, partially impaired sugar-reward learning, but not relief learning. Thus, with respect to this particular mutation, relief learning and reward learning are dissociated. Finally, blocking output from the set of octopaminergic/ tyraminergic neurons defined by the TDC2-Gal4 driver affected neither reward, nor relief learning. We conclude that regarding the used genetic tools, relief learning is neurogenetically dissociated from both punishment and reward learning.

  19. Laparoscopic Adhesiolysis and Relief of Chronic Pelvic Pain

    OpenAIRE

    Nezhat, Farr R.; Crystal, Ruth Ann; Nezhat, Ceana H.; Nezhat, Camran R.

    2000-01-01

    Objective: To evaluate the short- and long-term results of laparoscopic enterolysis in patients with chronic pelvic pain following hysterectomy. Methods: Forty-eight patients were evaluated at time intervals from 2 weeks to 5 years after laparoscopic enterolysis. Patients were asked to rate postoperative relief of their pelvic pain as complete/near complete relief (80-100% pain relief), significant relief (50-80% pain relief), or less than 50% or no pain relief. Results: We found that after 2...

  20. Barriers to spousal contribution to childbirth pain relief in Nigeria.

    Science.gov (United States)

    Emelonye, A U; Pitkäaho, T; Aregbesola, A; Vehviläinen-Julkunen, K

    2017-12-01

    The aim of this study was to investigate the barriers inhibiting the use of spousal presence for childbirth pain relief in health facilities and recommendations from three perspectives: the midwife, the woman, and the spouse. Spousal presence is a non-invasive, participatory and inexpensive technique used in pain management during childbirth. Although it contributes to a large extent in relieving childbirth pain, it is underutilized in Nigerian hospitals. Overcoming the challenges impeding spousal presence and participation during childbirth will improve maternal outcome, satisfaction and midwifery care practices. A cross-sectional survey conducted in four hospitals in Nigeria involving midwives (n = 100), women (n = 142) and their spouses (n = 142) from June to December 2014 using pretested questionnaires. Five themes were identified: poor infrastructural facility, lack of adequate pain management policy, lack of midwife pain management practices, midwives' attitudes towards spousal presence during childbirth and feelings about spousal presence during childbirth pain relief. Infrastructural defects in the health facilities resulting in the lack of privacy in maternity units for both spouses and partners negatively influence the presence of a spouse during childbirth and pain relief. Adopting effective strategies such as good infrastructural facilities, staff training and spouse-friendly hospital policies will encourage spouses to fully participate in and contribute to childbirth pain relief. This study identified poor staff attitudes towards pain relief and spousal presence during childbirth as barriers. Providing adequate policies on pain management, continuous staff education and orientation on spousal relationship will improve active spousal participation and maternal satisfaction during childbirth. © 2016 International Council of Nurses.

  1. Shaded Relief of Minnesota Elevation - Color

    Data.gov (United States)

    Minnesota Department of Natural Resources — This file is a product of a shaded relief process on the 30 meter resolution Digital Elevation Model data (dem30im3). This image was created using a custom AML...

  2. Shaded Relief of Minnesota Elevation - Black & White

    Data.gov (United States)

    Minnesota Department of Natural Resources — This file is a product of a shaded relief process on the 30 meter resolution Digital Elevation Model data (dem30im3). This image was created using a custom AML...

  3. Brain Circuits Encoding Reward from Pain Relief.

    Science.gov (United States)

    Navratilova, Edita; Atcherley, Christopher W; Porreca, Frank

    2015-11-01

    Relief from pain in humans is rewarding and pleasurable. Primary rewards, or reward-predictive cues, are encoded in brain reward/motivational circuits. While considerable advances have been made in our understanding of reward circuits underlying positive reinforcement, less is known about the circuits underlying the hedonic and reinforcing actions of pain relief. We review findings from electrophysiological, neuroimaging, and behavioral studies supporting the concept that the rewarding effect of pain relief requires opioid signaling in the anterior cingulate cortex (ACC), activation of midbrain dopamine neurons, and the release of dopamine in the nucleus accumbens (NAc). Understanding of circuits that govern the reward of pain relief may allow the discovery of more effective and satisfying therapies for patients with acute or chronic pain.

  4. Non-Drug Pain Relief: Imagery

    Science.gov (United States)

    PATIENT EDUCATION patienteducation.osumc.edu Non-Drug Pain Relief: Imagery Relaxation helps lessen tension. One way to help decrease pain is to use imagery. Imagery is using your imagination to create a ...

  5. Supply Chain Management in Humanitarian Relief Logistics

    National Research Council Canada - National Science Library

    Rodman, William

    2004-01-01

    Hundreds of millions of people are affected by disasters each year. This thesis explores the use of supply chain management techniques to overcome the barriers encountered by logistics managers during humanitarian relief operations...

  6. Lake Bathymetric DEM Shaded Relief Image

    Data.gov (United States)

    Minnesota Department of Natural Resources — Geo-referenced, shaded relief image of lake bathymetry classified at 5-foot depth intervals. This dataset has a cell resolution of 5 meters (occasionally 10m) as...

  7. The Team Approach to Pain Relief

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues The Team Approach to Pain Relief Past Issues / Fall 2007 ... Roberts is seen here with some of the team members, (left to right) Dr. Berger, Jacques Bolle, ...

  8. 78 FR 32296 - Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy...

    Science.gov (United States)

    2013-05-29

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Second Allocation of Public... disaster that affects public transportation systems. The Disaster Relief Appropriations Act provides $10.9... projected total recovery costs for the four most severely affected public transportation systems, not...

  9. U.S. Coastal Relief Model - Florida and East Gulf of Mexico

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  10. FY2005 Supplemental Appropriations for Iraq and Afghanistan, Tsunami Relief, and Other Activities

    National Research Council Canada - National Science Library

    Belasco, Amy; Nowels, Larry

    2005-01-01

    ... (subsequently amended to total $82.04 billion) to provide funds for ongoing military operations in Iraq and Afghanistan, the global war on terror, reconstruction in Afghanistan, Tsunami relief and rehabilitation, and other activities...

  11. Administrative Relief for Grantees impacted by Hurricanes Harvey, Irma, and Maria

    Science.gov (United States)

    On October 26, 2017, the Office of Management and Budget issued the attached memorandum, Administrative Relief for Grantees impacted by Hurricanes, to provide Federal agencies with flexibility to assist their grant applicants and recipients.

  12. A Systematic Review and Meta-Analyses of Nonsucrose Sweet Solutions for Pain Relief in Neonates

    Directory of Open Access Journals (Sweden)

    Mariana Bueno

    2013-01-01

    Full Text Available BACKGROUND: Sucrose has been demonstrated to provide analgesia for minor painful procedures in infants. However, results of trials investigating other sweet solutions for neonatal pain relief have not yet been synthesized.

  13. Pain relief by touch: a quantitative approach.

    Science.gov (United States)

    Mancini, Flavia; Nash, Thomas; Iannetti, Gian Domenico; Haggard, Patrick

    2014-03-01

    Pain relief by touch has been studied for decades in pain neuroscience. Human perceptual studies revealed analgesic effects of segmental tactile stimulation, as compared to extrasegmental touch. However, the spatial organisation of touch-pain interactions within a single human dermatome has not been investigated yet. In 2 experiments we tested whether, how, and where within a dermatome touch modulates the perception of laser-evoked pain. We measured pain perception using intensity ratings, qualitative descriptors, and signal detection measures of sensitivity and response bias. Touch concurrent with laser pulses produced a significant analgesia, and reduced the sensitivity in detecting the energy of laser stimulation, implying a functional loss of information within the ascending Aδ pathway. Touch also produced a bias to judge laser stimuli as less painful. This bias decreased linearly when the distance between the laser and tactile stimuli increased. Thus, our study provides evidence for a spatial organisation of intrasegmental touch-pain interactions. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  14. Technology and Information Sharing in Disaster Relief.

    Science.gov (United States)

    Bjerge, Benedikte; Clark, Nathan; Fisker, Peter; Raju, Emmanuel

    2016-01-01

    This paper seeks to examine the extent to which technological advances can enhance inter-organizational information sharing in disaster relief. Our case is the Virtual OSOCC (On-Site Operations Coordination Centre) which is a part of the Global Disaster Alert and Coordination System (GDACS) under the United Nations Office for Coordination of Humanitarian Affairs (UN OCHA). The online platform, which has been developing for more than a decade, provides a unique insight into coordination behaviour among disaster management agencies and individual actors. We build our study on the analysis of a complete database of user interaction including more than 20,000 users and 11,000 comments spread across approximately 300 disaster events. Controlling for types and severities of the events, location-specific vulnerabilities, and the overall trends, we find that the introduction of new features have led to increases in user activity. We supplement the data-driven approach with evidence from semi-structured interviews with administrators and key users, as well as a survey among all users specifically designed to capture and assess the elements highlighted by both interviews and data analysis.

  15. Technology and Information Sharing in Disaster Relief.

    Directory of Open Access Journals (Sweden)

    Benedikte Bjerge

    Full Text Available This paper seeks to examine the extent to which technological advances can enhance inter-organizational information sharing in disaster relief. Our case is the Virtual OSOCC (On-Site Operations Coordination Centre which is a part of the Global Disaster Alert and Coordination System (GDACS under the United Nations Office for Coordination of Humanitarian Affairs (UN OCHA. The online platform, which has been developing for more than a decade, provides a unique insight into coordination behaviour among disaster management agencies and individual actors. We build our study on the analysis of a complete database of user interaction including more than 20,000 users and 11,000 comments spread across approximately 300 disaster events. Controlling for types and severities of the events, location-specific vulnerabilities, and the overall trends, we find that the introduction of new features have led to increases in user activity. We supplement the data-driven approach with evidence from semi-structured interviews with administrators and key users, as well as a survey among all users specifically designed to capture and assess the elements highlighted by both interviews and data analysis.

  16. Examples, clarifications, and guidance on preparing requests for relief from pump and valve inservice testing requirements

    International Nuclear Information System (INIS)

    Ransom, C.B.; Hartley, R.S.

    1996-02-01

    In this report, the Idaho National Engineering Laboratory reviewers discuss related to requests for relief from the American Society of Mechanical Engineers code requirements for inservice testing (IST) of safety-related pumps and valves at commercial nuclear power plants. This report compiles information and examples that may be useful to licensees in developing relief requests submitted to US Nuclear Regulatory Commission (NRC) for their consideration and provides insights and recommendations on related IST issues. The report also gives specific guidance on relief requests acceptable and not acceptable to the NRC and advises licensees in the use of this information for application at their facilities

  17. Ear Acupuncture versus  local anaestethic for pain relief during perineal repair - a randomised controlled trial

    DEFF Research Database (Denmark)

    Kindberg, Sara

    2007-01-01

    ACUPUNCTURE OR LOCAL ANAESTETICS FOR PAIN RELIEF DURING PERINEAL REPAIR AFTER VAGINAL DELIVERY: A RANDOMISED CONTROLLED TRIAL.   By:  Sara Kindberg. Midwife and PhD student, Sønderborg Hospital, Denmark. Objective: To evaluate acupuncture as a new method of pain relief for postpartum perineal...... as photos of the acupuncture points. Perspectives:  Basic midwifery services such as providing sufficient pain relief during perineal repair still need improvement. Clinical practice should be improved continuously and thus produce reliable evidence on different pain relief methods. Website:        http...

  18. Reward and motivation in pain and pain relief

    Science.gov (United States)

    Navratilova, Edita; Porreca, Frank

    2015-01-01

    Pain is fundamentally unpleasant, a feature that protects the organism by promoting motivation and learning. Relief of aversive states, including pain, is rewarding. The aversiveness of pain, as well as the reward from relief of pain, is encoded by brain reward/motivational mesocorticolimbic circuitry. In this Review, we describe current knowledge of the impact of acute and chronic pain on reward/motivation circuits gained from preclinical models and from human neuroimaging. We highlight emerging clinical evidence suggesting that anatomical and functional changes in these circuits contribute to the transition from acute to chronic pain. We propose that assessing activity in these conserved circuits can offer new outcome measures for preclinical evaluation of analgesic efficacy to improve translation and speed drug discovery. We further suggest that targeting reward/motivation circuits may provide a path for normalizing the consequences of chronic pain to the brain, surpassing symptomatic management to promote recovery from chronic pain. PMID:25254980

  19. Safety and relief valves in light water reactors

    International Nuclear Information System (INIS)

    Singh, A.

    1985-12-01

    Information is presented to: provide an introduction to and descriptions of various types of safety and relief valves in both PWR and BWR plants; describe anticipated operating conditions for these valves; describe the test facilities, procedures, and major results for both types of valves; present an extensive discussion of modeling and analysis of safety and relief valve performance, including the prediction of flow capacity and stability during operation; deal with the analyses related to the prediction of thermal-hydraulic loads on discharge piping and comparison against test data; discuss results of small-scale valve tests and flow visualization studies through transparent valve models; and describe an EPRI study for optimizing a typical PWR over-pressure protection system to enhance the availability and reliability of plant operation and thus reduce operation costs

  20. Neural mechanisms underlying the induction and relief of perceptual curiosity

    Directory of Open Access Journals (Sweden)

    Marieke eJepma

    2012-02-01

    Full Text Available Curiosity is one of the most basic biological drives in both animals and humans, and has been identified as a key motive for learning and discovery. Despite the importance of curiosity and related behaviors, the topic has been largely neglected in human neuroscience; hence little is known about the neurobiological mechanisms underlying curiosity. We used functional magnetic resonance imaging (fMRI to investigate what happens in our brain during the induction and subsequent relief of perceptual curiosity. Our core findings were that (i the induction of perceptual curiosity, through the presentation of ambiguous visual input, activated the anterior insula and anterior cingulate cortex, brain regions sensitive to conflict and arousal; (ii the relief of perceptual curiosity, through visual disambiguation, activated regions of the striatum that have been related to reward processing; and (iii the relief of perceptual curiosity was associated with hippocampal activation and enhanced incidental memory. These findings provide the first demonstration of the neural basis of human perceptual curiosity. Our results provide neurobiological support for a classic psychological theory of curiosity, which holds that curiosity is an aversive condition of increased arousal whose termination is rewarding and facilitates memory.

  1. Immediate pain relief by microvascular decompression for idiopathic trigeminal neuralagia

    International Nuclear Information System (INIS)

    Haq, N.U.; Ali, M.; Khan, H.M.; Ishaq, M.; Khattak, M.I.

    2016-01-01

    Background: Trigeminal neuralgia is a common entity which is managed by neurosurgeons in day to day practice. Up-till now many treatment options have been adopted for it but micro-vascular decompression is much impressive in terms of pain control and recurrence rate in all of them. The objective of study was known the efficacy of micro vascular decompression for idiopathic trigeminal neuralgia by using muscle patch in terms of immediate pain relief. Methods: This descriptive study was carried out in Neurosurgery Department lady reading hospital, Peshawar from January 2010 to December 2012. All patients who underwent micro vascular decompression for idiopathic trigeminal neuralgia were included in the study. Patients were assessed 72 hours after the surgery by borrow neurological institute pain scale (BNIP scale) for pain relief and findings were documented on predesigned proforma. Data was analysed by SPSS-17. Results: Total 52 patients were included in this study. Among these 32 (61.53 percentage) were female and 20 (38.46 percentage) were males having age from 22-76 years (mean 49 years). Right side was involved in 36 (69.23 percentage) and left side in 16 (30.76 percentage) patients. Duration of symptoms ranged from 6 months to 16 years (mean 8 years). History of dental extraction and peripheral neurectomy was present in 20 (38 percentage) and 3(5.76 percentage) patients while V3 was most commonly involved branch with 28(57.69 percentage) frequency and combined V2,V3 involvement was 1 (11.53 percentage). Superior cerebellar artery was most common offending vessel in 46(88.46 percentage) while arachnoid adhesions were in 2(3.84 percentage) patients. We assessed patient immediate postoperatively using BNIP pain scale. Conclusion: Micro-vascular decompression is most effective mode of treatment for trigeminal neuralgia in terms of immediate pain relief. (author)

  2. Management of somatic symptoms

    DEFF Research Database (Denmark)

    Schröder, Andreas; Dimsdale, Joel

    2014-01-01

    on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides...

  3. Glaucoma Symptoms

    Science.gov (United States)

    ... up You can help find a cure for glaucoma Give now Signs & Symptoms The most common types ... have completely different symptoms. Symptoms of Open-Angle Glaucoma Most people who develop open-angle glaucoma don’ ...

  4. Relief-oriented use of marijuana by teens

    Directory of Open Access Journals (Sweden)

    Johnson Joy L

    2009-04-01

    Full Text Available Abstract Background There are indications that marijuana is increasingly used to alleviate symptoms and for the treatment of a variety of medical conditions both physical and psychological. The purpose of this study was to describe the health concerns and problems that prompt some adolescents to use marijuana for therapeutic reasons, and their beliefs about the risks and benefits of the therapeutic use of marijuana. Methods As part of a larger ethnographic study of 63 adolescents who were regular marijuana users, we analyzed interviews conducted with 20 youth who self-identified as using marijuana to relieve or manage health problems. Results Thematic analysis revealed that these teens differentiated themselves from recreational users and positioned their use of marijuana for relief by emphasizing their inability to find other ways to deal with their health problems, the sophisticated ways in which they titrated their intake, and the benefits that they experienced. These teens used marijuana to gain relief from difficult feelings (including depression, anxiety and stress, sleep difficulties, problems with concentration and physical pain. Most were not overly concerned about the risks associated with using marijuana, maintaining that their use of marijuana was not 'in excess' and that their use fit into the realm of 'normal.' Conclusion Marijuana is perceived by some teens to be the only available alternative for teens experiencing difficult health problems when medical treatments have failed or when they lack access to appropriate health care.

  5. Optimal Laser Phototherapy Parameters for Pain Relief.

    Science.gov (United States)

    Kate, Rohit J; Rubatt, Sarah; Enwemeka, Chukuka S; Huddleston, Wendy E

    2018-03-27

    Studies on laser phototherapy for pain relief have used parameters that vary widely and have reported varying outcomes. The purpose of this study was to determine the optimal parameter ranges of laser phototherapy for pain relief by analyzing data aggregated from existing primary literature. Original studies were gathered from available sources and were screened to meet the pre-established inclusion criteria. The included articles were then subjected to meta-analysis using Cohen's d statistic for determining treatment effect size. From these studies, ranges of the reported parameters that always resulted into large effect sizes were determined. These optimal ranges were evaluated for their accuracy using leave-one-article-out cross-validation procedure. A total of 96 articles met the inclusion criteria for meta-analysis and yielded 232 effect sizes. The average effect size was highly significant: d = +1.36 (confidence interval [95% CI] = 1.04-1.68). Among all the parameters, total energy was found to have the greatest effect on pain relief and had the most prominent optimal ranges of 120-162 and 15.36-20.16 J, which always resulted in large effect sizes. The cross-validation accuracy of the optimal ranges for total energy was 68.57% (95% CI = 53.19-83.97). Fewer and less-prominent optimal ranges were obtained for the energy density and duration parameters. None of the remaining parameters was found to be independently related to pain relief outcomes. The findings of meta-analysis indicate that laser phototherapy is highly effective for pain relief. Based on the analysis of parameters, total energy can be optimized to yield the largest effect on pain relief.

  6. 76 FR 76757 - States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas...

    Science.gov (United States)

    2011-12-08

    ... DEPARTMENT OF THE INTERIOR Office of Natural Resources Revenue [Docket No. ONRR-2011-0002] States' Decisions on Participating in Accounting and Auditing Relief for Federal Oil and Gas Marginal Properties... published September 13, 2004 (69 FR 55076), provide two types of accounting and auditing relief for Federal...

  7. Nonprescription medications for respiratory symptoms: Facts and marketing fictions.

    Science.gov (United States)

    Weinberger, Miles; Hendeles, Leslie

    2018-05-01

    There are many nonprescription (over-the-counter [OTC]) medications available on pharmacy shelves marketed for relief of respiratory symptoms. The number of such medications has been increasing. This review provides an evidence-based examination of OTC products used for respiratory symptoms. Antihistamines, decongestants, mucolytics, antitussives, and intranasal steroids were selected as the most common OTC medications taken by adults and children for various respiratory symptoms. Controlled clinical trials of efficacy were identified by searching a medical literature data base. Those trials and key publications related to the pharmacokinetics and pharmacodynamics of the products were reviewed. Comparisons of the various OTC antihistamines' ability to suppress the effects of histamine were related to their clinical benefit. Intranasal corticosteroids are the preferred agents for maintenance therapy of persistent nasal congestion and are highly effective for symptoms of inhalant allergy other than allergic conjunctivitis. The disconnect between marketing claims and evidence was demonstrated for antihistamines and oral alpha-1 adrenergic agonist decongestants. Data for OTC mucolytics and antitussives were insufficient to justify their use based on the evidence. There was little relationship between marketing claims and evidence regarding OTC medications used for respiratory symptoms. Analysis of data supported cetirizine, levocetirizine, and fexofenadine as the most effective of the OTC antihistamines. There were no data that supported the use of oral phenylephrine as a decongestant. Neither OTC mucolytics or antitussives provided sufficient evidence to justify their use.

  8. [Safety and efficacy of ketamine for pain relief].

    Science.gov (United States)

    Niesters, Marieke; Dahan, Albert; van Kleef, Maarten

    2016-01-01

    Intravenous ketamine treatment is frequently used for the management of chronic pain, especially in those patients who do not benefit from other therapies. In this commentary we discuss the efficacy of ketamine for relief of chronic pain and ketamine's safety profile. A review of the literature indicates that only a few studies show that intravenous ketamine has analgesic effects that persist beyond the infusion period, an effect that occurs in about two-thirds of patients. Ketamine has multiple safety issues, ranging from psychotomimetic and schizotypal symptoms, sympathetic stimulation, tachycardia and hypertension, and damage to the liver and the urogenital tract. Damage to the urogenital tract seems to be restricted to individuals who chronically abuse ketamine. We indicate the need for large randomized trials in which ketamine is compared with an 'active' placebo.

  9. Nasal Filters For Relief From Atopic Dermatitis Caused by Inhalants

    Directory of Open Access Journals (Sweden)

    J S Pasricha

    1989-01-01

    Full Text Available Nasal filter is a simple device consisting of a net mounted in a frame made to fit inside the nostrils. These filters thus are not visible from outside. If a person uses the nasal filters the .u particulate material from the air that the person breathes gets removed and in case the person is allergic to an inhalant antigen, he stops having the allergic symptoms. We tried nasal filters on two females patients aged 32 and 7 years respectively, having topics dermatitis the age of I year, caused by an inhalant (indicated by seasonal aggravations, and spontaneous recovery during brief visits to other towns. Unrig a follow-up of 2 1/2 and 2 years respectively, both the patients experienced almost 80-90% relief from the dermatitis and required only animal treatment.

  10. Flurbiprofen 8.75 mg lozenges for treating sore throat symptoms: a randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    Schachtel, Bernard P; Shephard, Adrian; Shea, Timothy; Sanner, Kathleen; Savino, Laurie; Rezuke, Jeanne; Schachtel, Emily; Aspley, Sue

    2016-11-01

    This study assessed multiple doses of flurbiprofen 8.75 mg lozenges for the relief of three prominent symptoms of acute pharyngitis: pain intensity (primary end point), difficulty swallowing and swollen throat. A total of 204 patients (102 in each group) with confirmed pharyngitis (onset ≤4 days) were randomly assigned to take up to five flurbiprofen or placebo lozenges every 3-6 h, for 7 days. Using validated rating scales (sore throat pain intensity, difficulty swallowing and swollen throat) patients rated their symptoms for the duration of the study. Over the first 24 h, patients treated with flurbiprofen lozenges reported significantly greater reductions in sore throat pain (47%) as well as difficulty swallowing (66%) and swollen throat (40%) compared with placebo (all p flurbiprofen lozenges provide effective relief of sore throat pain intensity as well as difficulty swallowing and swollen throat.

  11. Proceedings: The Appendix 'K' relief workshop

    International Nuclear Information System (INIS)

    1989-11-01

    The licensing and operation of commercial LWRs were impacted significantly when Appendix 'K' requirements for loss-of-coolant accident (LOCA) and emergency core cooling systems (ECCS) analyses were implemented in 1974. The Appendix K requirements included both criteria and mandatory assumptions for LOCA analysis. Plants must meet these criteria, using analysis methods that have included very conservative assumptions, such as estimating decay heat energy as 20% greater than the 1971 American Nuclear Society standard. Additional constraints were placed on the application of specific models and correlations. The Appendix K requirements had a significant impact on licensing, analysis, fuel design, reload management, plant operation, and some supporting equipment. The overall impact of Appendix K could be translated into increased costs of millions of dollars per year to utilities. The Appendix 'K' Relief Workshop provided an improved understanding of the trade-offs -- both benefits and efforts required -- inherent in continuing to use existing analysis methods or adopting BE analysis under revised NRC rule. A range of options is available to each utility. The workshop explored options and benefits to the utility industry from LOCA/ECCS rule change. A forum for complete and open discussion of the issues germaine to the question of BE methodology versus existing methodology in view of LOCA/ECCS rule changes was incorporated. Both regulatory and utility perspectives on the implementation of proposed changes were discussed. Existing and planned efforts in developing and implementing BE uncertainty methodologies for plant-licensing application have been included. The individual papers have been cataloged separately

  12. Topical Drugs for Pain Relief

    Directory of Open Access Journals (Sweden)

    Anjali Srinivasan

    2015-03-01

    Full Text Available Topical therapy helps patients with oral and perioral pain problems such as ulcers, burning mouth syndrome, temporomandibular disorders, neuromas, neuropathies and neuralgias. Topical drugs used in the field of dentistry are topical anaesthetics, topical analgesics, topical antibiotics and topical corticosteroids. It provides symptomatic/curative effect. Topical drugs are easy to apply, avoids hepatic first pass metabolism and more sites specific. But it can only be used for medications that require low plasma concentrations to achieve a therapeutic effect.

  13. 24 CFR 965.508 - Individual relief.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Individual relief. 965.508 Section 965.508 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... PHA-OWNED OR LEASED PROJECTS-GENERAL PROVISIONS Resident Allowances for Utilities § 965.508 Individual...

  14. Emergency networking: famine relief in ant colonies

    NARCIS (Netherlands)

    Sendova-Franks, A.B.; Hayward, R.; Wulf, B.; Klimek, T.; James, R.; Planque, R.; Britton, N.F.; Franks, N.R.

    2009-01-01

    Resource distribution is fundamental to social organization, but it poses a dilemma. How to facilitate the spread of useful resources but restrict harmful substances? This dilemma reaches a zenith in famine relief. Survival depends on distributing food fast but that could increase vulnerability to

  15. 32 CFR 516.19 - Injunctive relief.

    Science.gov (United States)

    2010-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Reporting Legal Proceedings to HQDA § 516.19 Injunctive relief. (a) General. Plaintiffs...). Because these actions can quickly impede military functions, immediate and decisive action must be taken...

  16. 78 FR 19136 - Emergency Relief Program

    Science.gov (United States)

    2013-03-29

    ... issuing this interim final rule in order to comply with the Disaster Relief Appropriations Act of 2013... FTA-2013-0004. All electronic submissions must be made to the U.S. Government electronic site at http... operating costs in the event of a catastrophic event, such as a natural disaster, that affects a wide area...

  17. Humanitarian power : Canadian electrical techies help hurricane relief in Honduras

    International Nuclear Information System (INIS)

    Mallett, N.

    1999-01-01

    A review of the emergency assistance provided to Honduras by Canada following Hurricane Mitch that struck the country with a ferocity not seen in 200 years, was described. Thousands of Hondurans were killed and three million were left homeless as vast regions of the country were literally washed away. The secondary effects of the storm - famine and disease - set in to claim even more lives. The Canadian Forces' Disaster Response Team (DART) was dispatched to conduct emergency relief operations for up to 40 days in order to bridge the gap until members of the international community arrive to provide long-term help. DART focused on providing medical care, clean drinking water, an engineering capability, and reliable communications. The medical team consisting of a small field hospital with a staff of 45 provided care for up to 500 outpatients and 30 inpatients daily, depending on the severity of injuries. The engineering team of about 40 provided a wide range of services, such as water purification, using a reverse osmosis water purification unit, fresh water distribution and power generation. The communications unit provided contact with headquarters in Honduras, and communicated with bases back in Canada. The operation was a great success, and well received by the Honduran people. This was the first deployment of DART, a team initially conceived after the Canadian Forces participated in relief efforts in Rwanda in 1994 and 1995

  18. Understanding medical symptoms

    DEFF Research Database (Denmark)

    Malterud, Kirsti; Guassora, Ann Dorrit Kristiane; Graungaard, Anette Hauskov

    2015-01-01

    is a social and relational phenomenon of containment, and regulating the situation where the symptoms originate implies adjusting containment. Discourse analysis, as presented by Jonathan Potter and Margaret Wetherell, provides a tool to notice the subtle ways in which language orders perceptions and how...... to the bodily messages. Symptom management is then determined by the meaning of a symptom. Dorte E. Gannik’s concept “situational disease” explains how situations can be reviewed not just in terms of their potential to produce signs or symptoms, but also in terms of their capacity to contain symptoms. Disease...

  19. Prolonged knee pain relief by saphenous block (new technique

    Directory of Open Access Journals (Sweden)

    Rajeev Harshe

    2013-01-01

    Full Text Available Pain in the knee joint can be from a variety of reasons. It can be either from the joint itself, it can be myofascial or it can be neuropathy, radicular pain. The myofascial component can be in different forms, namely, collateral ligament pain, bursitis, tendinitis, and so on. This responds well to local injections of steroids. Pain from the joint can be because of osteoarthritis (OA, rheumatoid arthritis or any other variety of arthritis. Among these osteoarthritis is the most common and naturally occurring pain. There are several modalities used for managing pain in the knee joint. They include medicines and physiotherapy, intra-articular steroid injection, intra-articular Hyalgan, Synvisc injection, prolotherapy, genicular nerve block, ablation, intra-articular pulsed radio frequency (PRF ablation, acupuncture, injection of platelet-rich plasma in the joint, total knee replacement, high tibial osteotomy, arthroscopy and lavage, and so on. All these modalities have their pros and cons. Literature and experience state that the pain relief provided may last for a few months with these modalities except in surgical interventions in advanced OA. The saphenous nerve is termination of femoral nerve and it is essentially sensory nerve. It supplies the medial compartment and some part of the anterior compartment of the knee joint. This nerve has been blocked near the knee joint by way of infiltration by surgeons and anesthetists, for relief of pain after knee surgery, with varying pain relief of postoperative pain. When we block the saphenous in the mid thigh in the sartorial canal, the fluid tends to block the medial branch of the anterior femoral cutaneous nerve also. It is hypothesized that this may give complete medial and anterior knee pain relief and as most of the knee OA patients have medial and anterior knee pain, this may prove useful. Use of ultrasonography helps to locate the nerve better, ensuring perfection. An effort has been made to

  20. Prescription opioid use among addictions treatment patients: nonmedical use for pain relief vs. other forms of nonmedical use.

    Science.gov (United States)

    Bohnert, Amy S B; Eisenberg, Anna; Whiteside, Lauren; Price, Amanda; McCabe, Sean Esteban; Ilgen, Mark A

    2013-03-01

    Differences between those who engage in nonmedical prescription opioid use for reasons other than pain relief and those who engage in nonmedical use for reasons related to pain only are not well understood. Adults in a residential treatment program participated in a cross-sectional self-report survey. Participants reported whether they used opioids for reasons other than pain relief (e.g., help sleep, improve mood, or relieve stress). Within those with past-month nonmedical opioid use (n=238), logistic regression tested differences between those who reported use for reasons other than pain relief and those who did not. Nonmedical use of opioids for reasons other than pain relief was more common (66%) than nonmedical use for pain relief only (34%), and those who used for reasons other than pain relief were more likely to report heavy use (43% vs. 11%). Nonmedical use for reasons other than pain relief was associated with having a prior overdose (odds ratio [OR]=2.54, 95% CI: 1.36-4.74) and use of heroin (OR=4.08, 95% CI: 1.89-8.79), barbiturates (OR=6.44, 95% CI: 1.47, 28.11), and other sedatives (OR=5.80, 95% CI: 2.61, 12.87). Individuals who reported nonmedical use for reasons other than pain relief had greater depressive symptoms (13.1 vs. 10.5) and greater pain medication expectancies across all three domains (pleasure/social enhancement, pain reduction, negative experience reduction). Among patients in addictions treatment, individuals who report nonmedical use of prescription opioids for reasons other than pain relief represent an important clinical sub-group with greater substance use severity and poorer mental health functioning. Published by Elsevier Ltd.

  1. Patient Preference Before and After Arthroscopic Rotator Cuff Repair: Which Is More Important, Pain Relief or Strength Return?

    Science.gov (United States)

    Virk, Mandeep S; Levy, David M; Kuhns, Benjamin D; Krecher, James S; Parsley, Billy K; Burkhart, Stephen S; Romeo, Anthony A; Verma, Nikhil N; Cole, Brian J

    Our understanding of patients' desired outcomes and expectations of arthroscopic rotator cuff repair (ARCR) is limited, particularly regarding the importance of pain relief and strength return relative to each other. We conducted a study of patient's ratings of the importance of pain relief and strength return after ARCR. Before undergoing surgery, 60 patients completed a shoulder questionnaire on which they assessed severity of symptoms and rated, on a 10-point scale, the importance of postoperative improvements in pain relief and strength return. After surgery, they completed the same questionnaire, again rating the importance of pain relief and strength return. About 50% of the patients valued pain relief and strength return equally before and after ARCR. However, overall patient ratings were higher for strength return over pain relief, both before surgery, mean (SD), 9.2 (2.1) vs 8.6 (2.3) (P = .02), and afterward, at a follow-up of 5.2 (0.2) years, 8.9 (1.9) vs 8.2 (3.1) (P = .03). This significant preference for strength return held irrespective of sex, age, active sports involvement, preoperative self-assessed pain score, and subjective shoulder weakness. Before surgery, increasing age was associated with a stronger preference for pain relief (r = 0.33, P = .01), and retirees preferred pain relief over strength return. These results show the patterns of patient preference for pain relief and strength return after ARCR. Improved understanding of these patients' expectations will allow meaningful changes in patient satisfaction.

  2. The Effectiveness of Aromatherapy for Depressive Symptoms: A Systematic Review

    Science.gov (United States)

    Ngai, Shirley Pui-Ching; He, Wanjia; Chow, Jason Ka-Wing; Tsang, Hector Wing-Hong

    2017-01-01

    Background. Depression is one of the greatest health concerns affecting 350 million people globally. Aromatherapy is a popular CAM intervention chosen by people with depression. Due to the growing popularity of aromatherapy for alleviating depressive symptoms, in-depth evaluation of the evidence-based clinical efficacy of aromatherapy is urgently needed. Purpose. This systematic review aims to provide an analysis of the clinical evidence on the efficacy of aromatherapy for depressive symptoms on any type of patients. Methods. A systematic database search was carried out using predefined search terms in 5 databases: AMED, CINHAL, CCRCT, MEDLINE, and PsycINFO. Outcome measures included scales measuring depressive symptoms levels. Results. Twelve randomized controlled trials were included and two administration methods for the aromatherapy intervention including inhaled aromatherapy (5 studies) and massage aromatherapy (7 studies) were identified. Seven studies showed improvement in depressive symptoms. Limitations. The quality of half of the studies included is low, and the administration protocols among the studies varied considerably. Different assessment tools were also employed among the studies. Conclusions. Aromatherapy showed potential to be used as an effective therapeutic option for the relief of depressive symptoms in a wide variety of subjects. Particularly, aromatherapy massage showed to have more beneficial effects than inhalation aromatherapy. PMID:28133489

  3. [Disaster relief through inter-professional collaboration --from the standpoint of a dietitian].

    Science.gov (United States)

    Inamura, Yukiko

    2013-01-01

    The present study examined disaster relief efforts by registered and other dietitians following the Great East Japan Earthquake to identify related problems. Based on this, the study discussed what is required to develop a "disaster relief system through inter-professional collaboration" to cope with unanticipated disasters. On March 15, 2011, the Japan Dietetic Association (JDA) independently established the "Great East Japan Earthquake relief emergency headquarters". The association along with these volunteers was committed to the establishment of a system for disaster relief activities with the support of Iwate, Miyagi, and Fukushima Prefectures: the number of registered volunteers was 978; a total of 1,588 dietitians were dispatched; and 602 became involved in relief work in the disaster-stricken areas. Registered and other dietitians dispatched for disaster relief provided support and home care for evacuation centers, elderly facilities, and temporary housing, including dietary and nutrition advice and consultation, in cooperation and collaboration with administrative dietitians in disaster areas, registered and other dietitians of disaster headquarters in disaster-stricken prefectures, the Primary Care for All Teams (PCAT) of the Japan Primary Care Association, disaster medical assistance teams (DMATs), and volunteer groups. Through the course of the relief activities, the following problems were identified: difficulties in responding to varying needs in different phases, nutritional measures (population-based and high-risk approaches), nutritional disparities among evacuation centers, necessity of a section to collect ever-changing information on disaster areas in a comprehensive manner, importance of working cooperatively to establish a support system, and differences in volunteers' support skills. To facilitate disaster relief through inter-professional collaboration, it is necessary for many different organizations to understand each other's capabilities

  4. Measuring Paleolandscape Relief in Alluvial River Systems from the Stratigraphic Record

    Science.gov (United States)

    Hajek, E. A.; Trampush, S. M.; Chamberlin, E.; Greenberg, E.

    2017-12-01

    Aggradational alluvial river systems sometimes generate relief in the vicinity of their channel belts (i.e. alluvial ridges) and it has been proposed that this process may define important thresholds in river avulsion. The compensation scale can be used to estimate the maximum relief across a landscape and can be connected to the maximum scale of autogenic organization in experimental and numerical systems. Here we use the compensation scale - measured from outcrops of Upper Cretaceous and Paleogene fluvial deposits - to estimate the maximum relief that characterized ancient fluvial landscapes. In some cases, the compensation scale significantly exceeds the maximum channel depth observed in a deposit, suggesting that aggradational alluvial systems organize to sustain more relief than might be expected by looking only in the immediate vicinity of the active channel belt. Instead, these results indicate that in some systems, positive topographic relief generated by multiple alluvial ridge complexes and/or large-scale fan features may be associated with landscape-scale autogenic organization of channel networks that spans multiple cycles of channel avulsion. We compare channel and floodplain sedimentation patterns among the studied ancient fluvial systems in an effort to determine whether avulsion style, channel migration, or floodplain conditions influenced the maximum autogenic relief of ancient landscapes. Our results emphasize that alluvial channel networks may be organized at much larger spatial and temporal scales than previously realized and provide an avenue for understanding which types of river systems are likely to exhibit the largest range of autogenic dynamics.

  5. Medications for Pain Relief during Labor and Delivery

    Science.gov (United States)

    ... FAQ086 LABOR, DELIVERY, AND POSTPARTUM CARE Medications for Pain Relief During Labor and Delivery • What types of medications for pain relief are used during labor and delivery? • What are ...

  6. Mechanical Designs for Relief Valves for Cryogenic Apparatuses and Installations

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    There are also pressure relief valves with warm seat available on which the set pressure is based on an adjustment of forces by permanent magnets. Pressure vessel rules allows also the choice for an active triggered pressure relief valve (Cont...

  7. Late-Cenozoic relief evolution under evolving climate: A review

    OpenAIRE

    Champagnac Jean Daniel; Valla Pierre G.; Herman Frédéric

    2014-01-01

    The present review paper is an attempt to summarize quantitative evidence of Late Cenozoic changes in topographic relief. Different meanings of the word "relief" as it is commonly used and detail the metrics used to quantify it. We then specify methodological tools used to quantify relief change (primarily low temperature thermochronometry and terrestrial cosmogenic nuclides) and analyze published evidence for different regions.Our review first shows that relief changes and rates of changes a...

  8. Use, perceived effectiveness, and gender differences of pain relief strategies among the community-dwelling elderly in Taiwan.

    Science.gov (United States)

    Yu, Hsing-Yi; Tang, Fu-In; Yeh, Ming-Chen; Kuo, Benjamin Ing-Tiau; Yu, Shu

    2011-03-01

    Pain is a common problem among the elderly. The entire scope of chronic pain relief strategies used by community elderly is still unclear. A limited number of studies have investigated this issue from diverse culture perspectives. In the present study, we investigated the use and perceived effectiveness of pain relief strategies adopted by the elderly; gender differences between frequently used relief strategies were also explored. Two hundred nineteen participants living in Taiwan City, Taiwan, were recruited by a random sampling method and interviewed face to face. The prevalence of chronic pain among the elderly was 42.0% (n = 92). The elderly tended to adopt multiple strategies (mean ± SD = 9.08 ± 3.56; range = 2-18) to relieve their chronic pain. In three domains of pain relief strategies, conventional medicine was used more frequently than complementary and alternative medicine and psychologic approaches. Most pain relief strategies were ineffective. Among the 22 strategies used, no strategy was reported as "much improved" by a majority of users. The top five pain relief strategies used by men and women were the same. Elderly women tended to adopt more psychologic approaches, such as acceptance and ignoring to relieve pain, than men. The findings suggest that nurses should pay more attention to the issue of chronic pain relief and provide the elderly with more effective pain relief strategies. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  9. 48 CFR 252.229-7001 - Tax relief.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Tax relief. 252.229-7001... Clauses 252.229-7001 Tax relief. As prescribed in 229.402-70(a), use the following clause: Tax Relief (JUN 1997) (a) Prices set forth in this contract are exclusive of all taxes and duties from which the United...

  10. 19 CFR 210.52 - Motions for temporary relief.

    Science.gov (United States)

    2010-04-01

    ....52 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.52 Motions for temporary relief... issuance of temporary relief, the Commission will be guided by practice under Rule 65 of the Federal Rules...

  11. Coordinating Robot Teams for Disaster Relief

    Science.gov (United States)

    2015-05-01

    eventually guide vehicles in cooperation with its Operator(s), but in this paper we assume static mission goals, a fixed number of vehicles, and a...is tedious and error prone. Kress-Gazit et al. (2009) instead synthesize an FSA from an LTL specification using a game theory approach (Bloem et al...helping an Operator coordinate a team of vehicles in Disaster Relief. Acknowledgements Thanks to OSD ASD (R&E) for sponsoring this research. The

  12. Relief Evolution in Tectonically Active Mountain Ranges

    Science.gov (United States)

    Whipple, Kelin X.

    2004-01-01

    The overall aims of this 3-yr project, as originally proposed were to: (1) investigate quantitatively the roles of fluvial and glacial erosion in the evolution of relief in mountainous regions, and (2) test rigorously the quality and accuracy of SRTM topographic data in areas of rugged relief - both the most challenging and of greatest interest to geomorphic, neotectonic, and hazards applications. Natural laboratories in both the western US and the Southern Alps of New Zealand were identified as most promising. The project has been both successful and productive, despite the fact that no SRTM data for our primary field sites in New Zealand were released on the time frame of the work effort. Given the delayed release of SRTM data, we pursued the scientific questions of the roles of fluvial and, especially, glacial erosion in the evolution of relief in mountainous regions using available digital elevation models (DEMs) for the Southern Alps of New Zealand (available at both 25m and 50m pixel sizes), and USGS 10m and 30m DEMs within the Western US. As emphasized in the original proposal, we chose the emphasis on the role of glacial modification of topographic relief because there has been little quantitative investigation of glacial erosion processes at landscape scale. This is particularly surprising considering the dramatic sculpting of most mid- and high-latitude mountain ranges, the prodigious quantities of glacially-derived sediment in terrestrial and marine basins, and the current cross-disciplinary interest in the role of denudational processes in orogenesis and the evolution of topography in general. Moreover, the evolution of glaciated landscapes is not only a fundamental problem in geomorphology in its own right, but also is at the heart of the debate over Late Cenozoic linkages between climate and tectonics.

  13. Venting of gas deflagrations through relief pipes

    OpenAIRE

    Ferrara, Gabriele

    2006-01-01

    Vent devices for gas and dust explosions are often ducted to safety locations by means of relief pipes for the discharge of hot combustion products or blast waves (NFPA 68, 2002). The presence of the duct is likely to increase the severity of the explosion with respect to simply vented vessels posing a problem for the proper design of this venting configuration. The phenomenology of the vented explosion is complicated as the interaction of combustion in the duct with primary combustion in...

  14. OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder.

    Science.gov (United States)

    Sievert, K-D; Chapple, C; Herschorn, S; Joshi, M; Zhou, J; Nardo, C; Nitti, V W

    2014-10-01

    A prespecified pooled analysis of two placebo-controlled, phase 3 trials evaluated whether the number of prior anticholinergics used or reason for their discontinuation affected the treatment response to onabotulinumtoxinA 100U in overactive bladder (OAB) patients with urinary incontinence (UI). Patients with symptoms of OAB received intradetrusor injections of onabotulinumtoxinA 100U or placebo, sparing the trigone. Change from baseline at week 12 in UI episodes/day, proportion of patients reporting a positive response ('greatly improved' or 'improved') on the treatment benefit scale (TBS), micturition and urgency were evaluated by number of prior anticholinergics (1, 2 or ≥ 3) and reason for their discontinuation (insufficient efficacy or side effects). Adverse events (AE) were assessed. Patients had taken an average of 2.4 anticholinergics before study enrolment. OnabotulinumtoxinA reduced UI episodes/day from baseline vs. placebo, regardless of the number of prior anticholinergics (-2.82 vs. -1.52 for one prior anticholinergic; -2.58 vs. -0.58 for two prior anticholinergics; and -2.92 vs. -0.73 for three or more prior anticholinergics; all p reason for discontinuation. OnabotulinumtoxinA reduced the episodes of urgency and frequency of micturition vs. placebo in all groups. AEs were well tolerated, with a comparable incidence in all groups. In patients with symptoms of OAB who were inadequately managed by one or more anticholinergics, onabotulinumtoxinA 100U provided significant and similar treatment benefit and safety profile regardless of the number of prior anticholinergics used or reason for inadequate management of OAB. ClinicalTrials.gov: NCT00910845, NCT00910520. © 2014 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd.

  15. Treating the root cause: acupuncture for the treatment of migraine, menopausal vasomotor symptoms, and chronic insomnia.

    Science.gov (United States)

    Hammes, Amber E; Wahner-Roedler, Dietlind L; Bauer, Brent A

    2014-01-01

    This case report describes the effectiveness of a single intervention, acupuncture, for relieving or abolishing severe migraines, menopausal vasomotor symptoms, and chronic insomnia and, thus, markedly improving quality of life. A 49-year-old woman was referred for acupuncture treatment of her daily migraines, menopausal vasomotor symptoms, and chronic insomnia. The patient had received polypharmacy treatment for these conditions for several years but had rather limited relief of her symptoms. The patient received 10 weekly or biweekly acupuncture treatments over three months. Her migraines reduced in frequency and intensity after her first acupuncture treatment, and she was able to discontinue use of her migraine medications after her eighth treatment. Subsequently, her menopausal vasomotor symptoms and chronic insomnia resolved. This case illustrates successful treatment of the symptoms of three medical conditions with a single complementary, alternative, and integrative medicine procedure, namely, acupuncture, one of the key elements of traditional Chinese medicine. The patient's medical problems had been treated for years with a multitude of medications, which led to adverse effects and little symptomatic improvement. Providers of complementary, alternative, and integrative medicine and providers practicing allopathic medicine should seek treatment options for their patients that promise to be helpful for various symptoms or diseases, that is, treating the root cause rather than using polypharmacy for various symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. 75 FR 66702 - Western Electric Coordinating Council; Qualified Transfer Path Unscheduled Flow Relief Regional...

    Science.gov (United States)

    2010-10-29

    ..., stating that ``IRO-006-WECC-1 provides entities with the necessary motivation to curtail off-path... notification of Unscheduled Flow Events, calculate and display required relief, and provide a rapid method of... of Management and Budget (OMB) regulations require approval of certain information collection...

  17. Relief of depression and pain improves daily functioning and quality of life in patients with major depressive disorder.

    Science.gov (United States)

    Lin, Ching-Hua; Yen, Yung-Chieh; Chen, Ming-Chao; Chen, Cheng-Chung

    2013-12-02

    The objective of this study was to investigate the effects of depression relief and pain relief on the improvement in daily functioning and quality of life (QOL) for depressed patients receiving a 6-week treatment of fluoxetine. A total of 131 acutely ill inpatients with major depressive disorder (MDD) were enrolled to receive 20mg of fluoxetine daily for 6 weeks. Depression severity, pain severity, daily functioning, and health-related QOL were assessed at baseline and again at week 6. Depression severity, pain severity, and daily functioning were assessed using the 17-item Hamilton Depression Rating Scale, the Short-Form 36 (SF-36) Body Pain Index, and the Work and Social Adjustment Scale. Health-related QOL was assessed by three primary domains of the SF-36, including social functioning, vitality, and general health perceptions. Pearson's correlation and structural equation modeling were used to examine relationships among the study variables. Five models were proposed. In model 1, depression relief alone improved daily functioning and QOL. In model 2, pain relief alone improved daily functioning and QOL. In model 3, depression relief, mediated by pain relief, improved daily functioning and QOL. In model 4, pain relief, mediated by depression relief, improved daily functioning and QOL. In model 5, both depression relief and pain relief improved daily functioning and QOL. One hundred and six patients completed all the measures at baseline and at week 6. Model 5 was the most fitted structural equation model (χ(2) = 8.62, df = 8, p = 0.376, GFI = 0.975, AGFI = 0.935, TLI = 0.992, CFI = 0.996, RMSEA = 0.027). Interventions which relieve depression and pain improve daily functioning and QOL among patients with MDD. The proposed model can provide quantitative estimates of improvement in treating patients with MDD. © 2013 Elsevier Inc. All rights reserved.

  18. South America, Shaded Relief and Colored Height

    Science.gov (United States)

    2003-01-01

    This image of South America was generated with data from the Shuttle Radar Topography Mission (SRTM). For this broad view the resolution of the data was first reduced to 30 arcseconds (about 928 meters north-south but variable east-west), matching the best previously existing global digital topographic data set called GTOPO30. The data were then resampled to a Mercator projection with approximately square pixels (about one kilometer, or 0.6 miles, on each side). Even at this decreased resolution the variety of landforms comprising the South American continent is readily apparent.Topographic relief in South America is dominated by the Andes Mountains, which extend all along the Pacific Coast. These mountains are created primarily by the convergence of the Nazca and South American tectonic plates. The Nazca Plate, which underlies the eastern Pacific Ocean, slides under western South America resulting in crustal thickening, uplift, and volcanism. Another zone of plate convergence occurs along the northwestern coast of South America where the Caribbean Plate also slides under the South American Plate and forms the northeastern extension of the Andes Mountains.East of the Andes, much of northern South America drains into the Amazon River, the world's largest river in terms of both watershed area and flow volume. Topographic relief is very low in much of the Amazon Basin but SRTM data provide an excellent detailed look at the basin's three-dimensional drainage pattern, including the geologic structural trough (syncline) that hosts the eastern river channel.North of the Amazon, the Guiana Highlands commonly stand in sharp contrast to the surrounding lowlands, indeed hosting the world's tallest waterfall, Angel Falls (979 meters or 3212 feet). Folded and fractured bedrock structures are distinctive in the topographic pattern.South of the Amazon, the Brazilian Highlands show a mix of landforms, including some broad areas of consistent topographic patterns that indicate the

  19. Bas-relief map using texture analysis with application to live enhancement of ultrasound images.

    Science.gov (United States)

    Du, Huarui; Ma, Rui; Wang, Xiaoying; Zhang, Jue; Fang, Jing

    2015-05-01

    For ultrasound imaging, speckle is one of the most important factors in the degradation of contrast resolution because it masks meaningful texture and has the potential to interfere with diagnosis. It is expected that researchers would explore appropriate ways to reduce the speckle noise, to find the edges of structures and enhance weak borders between different organs in ultrasound imaging. Inspired by the principle of differential interference contrast microscopy, a "bas-relief map" is proposed that depicts the texture structure of ultrasound images. Based on a bas-relief map, an adaptive bas-relief filter was developed for ultrafast despeckling. Subsequently, an edge map was introduced to enhance the edges of images in real time. The holistic bas-relief map approach has been used experimentally with synthetic phantoms and digital ultrasound B-scan images of liver, kidney and gallbladder. Based on the visual inspection and the performance metrics of the despeckled images, it was found that the bas-relief map approach is capable of effectively reducing the speckle while significantly enhancing contrast and tissue boundaries for ultrasonic images, and its speckle reduction ability is comparable to that of Kuan, Lee and Frost filters. Meanwhile, the proposed technique could preserve more intra-region details compared with the popular speckle reducing anisotropic diffusion technique and more effectively enhance edges. In addition, the adaptive bas-relief filter was much less time consuming than the Kuan, Lee and Frost filter and speckle reducing anisotropic diffusion techniques. The bas-relief map strategy is effective for speckle reduction and live enhancement of ultrasound images, and can provide a valuable tool for clinical diagnosis. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  20. [The Red Cross System for War Relief during the Second World War and Actual Conditions of Its Efforts in Burma].

    Science.gov (United States)

    Kawahara, Yukari

    2015-12-01

    This paper aims to show the system for relief provided by the Japanese Red Cross relief units during the Second World War, as well as the actual activities of sixteen of its relief units dispatched to Burma. The Red Cross wartime relief efforts involved using personnel and funding prepared beforehand to provide aid to those injured in war, regardless of their status as ally or enemy. Thus they were able to receive support from the army in order to ensure safety and provide supplies. Nurses dispatched to Burma took care of many patients who suffered from malnutrition and physical injuries amidst the outbreak of infectious diseases typical of tropical areas, without sufficient replacement members. Base hospitals not meant for the front lines also came under attack, and the nurses' lives were thus in mortal danger. Of the 374 original members, 29 died or went missing in action.

  1. LOFT pressurizer safety: relief valve reliability

    International Nuclear Information System (INIS)

    Brown, E.S.

    1978-01-01

    The LOFT pressurizer self-actuating safety-relief valves are constructed to the present state-of-the-art and should have reliability equivalent to the valves in use on PWR plants in the U.S. There have been no NRC incident reports on valve failures to lift that would challenge the Technical Specification Safety Limit. Fourteen valves have been reported as lifting a few percentage points outside the +-1% Tech. Spec. surveillance tolerance (9 valves tested over and 5 valves tested under specification). There have been no incident reports on failures to reseat. The LOFT surveillance program for assuring reliability is equivalent to nuclear industry practice

  2. LOFT pressurizer safety: relief valve reliability

    Energy Technology Data Exchange (ETDEWEB)

    Brown, E.S.

    1978-01-18

    The LOFT pressurizer self-actuating safety-relief valves are constructed to the present state-of-the-art and should have reliability equivalent to the valves in use on PWR plants in the U.S. There have been no NRC incident reports on valve failures to lift that would challenge the Technical Specification Safety Limit. Fourteen valves have been reported as lifting a few percentage points outside the +-1% Tech. Spec. surveillance tolerance (9 valves tested over and 5 valves tested under specification). There have been no incident reports on failures to reseat. The LOFT surveillance program for assuring reliability is equivalent to nuclear industry practice.

  3. Shaded Relief of Rio Sao Francisco, Brazil

    Science.gov (United States)

    2000-01-01

    This topographic image acquired by SRTM shows an area south of the Sao Francisco River in Brazil. The scrub forest terrain shows relief of about 400 meters (1300 feet). Areas such as these are difficult to map by traditional methods because of frequent cloud cover and local inaccessibility. This region has little topographic relief, but even subtle changes in topography have far-reaching effects on regional ecosystems. The image covers an area of 57 km x 79 km and represents one quarter of the 225 km SRTM swath. Colors range from dark blue at water level to white and brown at hill tops. The terrain features that are clearly visible in this image include tributaries of the Sao Francisco, the dark-blue branch-like features visible from top right to bottom left, and on the left edge of the image, and hills rising up from the valley floor. The San Francisco River is a major source of water for irrigation and hydroelectric power. Mapping such regions will allow scientists to better understand the relationships between flooding cycles, forestation and human influences on ecosystems.This shaded relief image was generated using topographic data from the Shuttle Radar Topography Mission. A computer-generated artificial light source illuminates the elevation data to produce a pattern of light and shadows. Slopes facing the light appear bright, while those facing away are shaded. On flatter surfaces, the pattern of light and shadows can reveal subtle features in the terrain. Shaded relief maps are commonly used in applications such as geologic mapping and land use planning.The Shuttle Radar Topography Mission (SRTM), launched on February 11, 2000, uses the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. The mission is designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200

  4. Pain relief in labour: tramadol versus pentazocine

    OpenAIRE

    Kavita Chandnani; H. B. Sainee

    2013-01-01

    Background: The present study was undertaken to compare the effect of 100 mg intramuscular tramadol to 30 mg intramuscular Pentazocine for labour analgesia. Methods: A total of 60 cases with 37-40 weeks pregnancy in labour, without any foetal or maternal complications were selected. Out of them Inj. Tramadol was given to 30 cases while rest of the 30 patients received injection Pentazocine. Results: In Tramadol group pain relief was observed in 80% cases, effect started as early as 7-8 min an...

  5. Targinact--opioid pain relief without constipation?

    Science.gov (United States)

    2010-12-01

    Targinact (Napp Pharmaceuticals Ltd) is a modified-release combination product containing the strong opioid oxycodone plus the opioid antagonist naloxone. It is licensed for "severe pain, which can be adequately managed only with opioid analgesics".1 The summary of product characteristics (SPC) states that "naloxone is added to counteract opioid-induced constipation by blocking the action of oxycodone at opioid receptors locally in the gut". Advertising for the product claims "better pain relief", "superior GI [gastrointestinal] tolerability" and "improved quality of life" "compared to previous treatment in a clinical practice study (n=7836)". Here we consider whether Targinact offers advantages over using strong opioids plus laxatives where required.

  6. [Body integrity identity disorder, relief after amputation].

    Science.gov (United States)

    Blom, R M; Braam, A W; de Boer-Kreeft, N; Sonnen, M P A M

    2014-01-01

    Body integrity identity disorder (BIID) is a rare condition in which a person, for no apparent physical reason, is tormented by the experience that a body-part, such as a limb, does not really belong to the body. Patients experience an intense desire for the limb to be amputated (a 'desire' formerly referred to as 'apotemnophilia'). We report on a 58-year-old male patient with BIID who froze one of his legs so that he could amputate it himself. A surgeon ultimately intervened and amputated the leg professionally. The patient was extremely relieved and was still experiencing relief at a follow-up three years later.

  7. GIS plays key role in NYC Rescue and Relief Operation

    Science.gov (United States)

    Showstack, Randy

    New York City, Sept. 17—The posters of missing loved ones are pasted onto New York City walls and street signs six days after 2 hijacked commercial airlines destroyed the World Trade Center in lower Manhattan on September 11. Several miles uptown from “ground zero,” heightened security hovers around the city's Office of Emergency Management rescue and relief command center, an around-the-clock operation. Police, firefighters, military, officials with the Federal Emergency Management Agency, communications technicians, and a beehive of others work in controlled chaos in this cavernous, convention center-sized hall, lined with computers and adorned with several American flags.After the original command center at 7 World Trade Center collapsed to rubble as an after-effect of the plane strikes, city officials scrambled to recreate it. Alan Leidner, director of New York's citywide geographic information systems (GIS), and who is with the Department of Information Technology and Telecommunications, knew that maps would be an integral component of the rescue and relief efforts. Maps provide emergency workers and others with accurate and detailed scientific data in the form of visual aids upon which they can make informed decisions.

  8. Humanitarian assistance and disaster relief: changing the face of defense.

    Science.gov (United States)

    Laraby, Patrick R; Bourdeaux, Margaret; Casscells, S Ward; Smith, David J; Lawry, Lynn

    2009-01-01

    The US Department of Defense (DOD) is evolving to meet new security challenges in the twenty-first century. Today's challenges result from growing political, environmental, and economic instability in important areas of the globe that threaten national and global security. Immediate outreach to foreign nations in times of violent instability or natural disaster fosters security and stability both for the affected country and for the United States. Foreign humanitarian assistance (FHA) is a rapidly evolving military mission that addresses conflict prevention, conflict, postconflict, and natural disasters. With DOD's extensive global medical resources, it is often uniquely qualified to execute a critical role in relief and/or public health efforts. When and how the American military will act in FHA and disaster relief is a still evolving doctrine with three issues deserving particular attention: aligning operations with host government leadership, preserving humanitarian space, and tailoring the US military's unique resources to the specific political and medical situation at hand. The DOD's response to a large-scale earthquake in Peru suggests useful approaches to these three issues, provides a template for future FHA mission, and points to strategic decisions and operational capabilities that need further development to establish the FHA mission firmly within DOD's repertoire of security engagement activities.

  9. Pain relief by Cyberknife radiosurgery for spinal metastasis.

    Science.gov (United States)

    Lee, Sunyoung; Chun, Mison

    2012-01-01

    To report pain relief effect in patients with spinal metastases treated with Cyberknife® and to analyze the factors associated with pain relapse after initial pain relief. We retrospectively analyzed patients with spinal metastasis treated with stereotactic body radiosurgery between April 2007 and June 2009. A total of 57 patients with 73 lesions were available for analysis with a median follow-up of 6.8 months (range, 1-30). Pain was assessed by a verbal/visual analogue scale at each visit: from 0 to 10. Pain relief was defined as a decrease of at least three levels of the pain score without an increase in analgesic use. Complete relief was defined as no analgesics or a score 0 or 1. Pain relief was achieved in 88% of the lesions, with complete relief in 51% within 7 days from the start of radiosurgery. The median duration of pain relief was 3.2 months (range, 1-30). Pain reappeared in 16 patients (27%). Spinal cord compression (P = 0.001) and performance status (P = 0.01) were predictive of pain relapse by multivariate Cox analysis. All 6 patients treated with solitary spinal metastasis experienced pain relief; 5 of them were alive without evidence of disease at a median of 16 months (range, 7-30). As previous studies have shown, our study confirms that pain relief with spinal radiosurgery is around 90%. In particular, long-term pain relief and disease control was observed in patients with solitary spinal metastasis.

  10. Relief memory consolidation requires protein synthesis within the nucleus accumbens.

    Science.gov (United States)

    Bruning, Johann E A; Breitfeld, Tino; Kahl, Evelyn; Bergado-Acosta, Jorge R; Fendt, Markus

    2016-06-01

    Relief learning refers to the association of a stimulus with the relief from an aversive event. The thus-learned relief stimulus then can induce, e.g., an attenuation of the startle response or approach behavior, indicating positive valence. Previous studies revealed that the nucleus accumbens is essential for the acquisition and retrieval of relief memory. Here, we ask whether the nucleus accumbens is also the brain site for consolidation of relief memory into a long-term form. In rats, we blocked local protein synthesis within the nucleus accumbens by local infusions of anisomycin at different time points during a relief conditioning experiment. Accumbal anisomycin injections immediately after the relief conditioning session, but not 4 h later, prevented the consolidation into long-term relief memory. The retention of already consolidated relief memory was not affected by anisomycin injections. This identifies a time window and site for relief memory consolidation. These findings should complement our understanding of the full range of effects of adverse experiences, including cases of their distortion in humans such as post-traumatic stress disorder and/or phobias. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Seeking Allergy Relief: When Breathing Becomes Bothersome

    Science.gov (United States)

    ... symptoms. But triggers aren’t always easy to identify. Notice when and where your symptoms occur. This can help you figure out the cause. “Most people with allergies are sensitive to more than one allergen,” Salo explains. “Grass, weed, and tree pollens are the most common causes of outdoor ...

  12. Relationship between onset of pain relief and patient satisfaction with fentanyl pectin nasal spray for breakthrough pain in cancer.

    Science.gov (United States)

    Torres, Luis M; Revnic, Julia; Knight, Alastair D; Perelman, Michael

    2014-10-01

    Satisfaction with pain relief in patients with breakthrough pain in cancer (BTPc) has typically been assessed by overall efficacy without consideration of the rapidity of that response. To determine the relationship between speed of onset of pain relief and patient satisfaction for treated BTPc episodes overall and for individual treatments. Pooled data from two randomized, double-blinded crossover studies. Patients having 1-4 BTPc episodes per day on ≥60 mg/day oral morphine or equivalent. Episodes treated with fentanyl pectin nasal spray (FPNS; 100-800 μg), immediate-release morphine sulfate (IRMS), or placebo. Pain intensity was measured on an 11-point scale (5-60 minutes posttreatment); satisfaction was measured on a 4-point scale (30 and 60 minutes). The primary analysis assessed the overall relationship of time to onset of pain relief (pain intensity difference [PID]≥1) or time to clinically meaningfully reduction in pain (PID≥2) versus patient satisfaction and overall pain intensity (summed pain intensity difference at 30 [SPID30] and 60 minutes [SPID60]) assessed by analysis of variance (ANOVA). A secondary analysis assessed whether satisfaction was different between treatments using a within-patient comparison. Eight hundred thirty-one FPNS-treated, 368 IRMS-treated, and 200 placebo-treated episodes were analyzed. Overall, within the pool there was a statistically significant relationship between time to onset of pain relief (PID≥1 and PID≥2) and patient satisfaction (both speed of relief and overall) at 30 and 60 minutes (ppain intensity reduction. When treatment groups were compared using within-patient data, FPNS provided earlier onset of pain relief than IRMS or placebo (ppain relief resulted in greater patient satisfaction and overall relief of pain; between-treatment comparisons showed that FPNS provided earlier pain relief and greater satisfaction than IRMS or placebo.

  13. Partial symptom-response to proton pump inhibitors in patients with non-erosive reflux disease or reflux oesophagitis - a post hoc analysis of 5796 patients

    DEFF Research Database (Denmark)

    Bytzer, P; van Zanten, S Veldhuyzen; Mattsson, H

    2012-01-01

    Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief.......Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief....

  14. Adequacy of Flood Relief Shelters: A Case Study in Perak, Malaysia

    Science.gov (United States)

    Zawani Zahari, Nur; Mustafa Hashim, Ahmad

    2018-03-01

    The recent flood event occurred in 2014 had caused disastrous effects in Peninsular Malaysia in states of Kelantan, Pahang, Terengganu, Perak, Johor and Perlis. Perak state was reported with 12,115 victims from 2,896 families registered at 77 relief shelters. There are several issues encountered by the victims and related agencies which caused inconveniences and interruptions during the flooding period. Besides, the usage of public buildings as relief shelters contributes to deterioration of the infrastructures whereby their suitability, convenient, capacity and safety might not be optimum for longer period of time. This paper focuses on the assessment of relief shelters established in Perak Tengah district, Perak. Standards and guidelines for relief shelters were reviewed according to the most relevant agreed principles for humanitarian response. Data and information in this study were obtained from survey activities, interview sessions and observations. In Perak Tengah, more than 50% of the previous relief shelters were public buildings with low capacity areas. Strategic location of shelters with proper design standards should be established to ensure safe and healthy environment for the victims. Findings from this paper provide important outcomes to serve as better preparation in handling future disaster.

  15. Experiences and unmet needs of women with physical disabilities for pain relief during labor and delivery.

    Science.gov (United States)

    Long-Bellil, Linda; Mitra, Monika; Iezzoni, Lisa I; Smeltzer, Suzanne C; Smith, Lauren D

    2017-07-01

    Childbirth is widely acknowledged as one of the most painful experiences most women will undergo in their lifetimes. Alleviating labor and delivery pain for women with physical disabilities can involve an additional level of complexity beyond that experienced by most women, but little research has explored their experiences. The purpose of this study was to explore the experiences of women with physical disabilities with respect to pain relief during labor and delivery with the goal of informing their care. Data were collected using semi-structured interviews with twenty-five women with physical disabilities from across the United States. Women expressed specific preferences for the method of pain relief. Some confronted systemic barriers in exploring their options for pain relief, while others were given a choice. At times, anesthesiologists lacked knowledge and experience in caring for women with disabilities. Conversely, some women described how the administration of anesthesia was meticulously planned and attributed their positive labor and delivery experiences to this careful planning. Advanced, individualized planning and evaluation of their options for pain relief was most satisfying to women and enabled them to make an informed choice. This approach is consistent with the recommendations of clinicians who have successfully provided pain relief during labor to women with complex physical disabilities. Clinicians who have successfully delivered babies of women with these and similar disabilities emphasize the importance of a team approach where the anesthesiologist and other specialists are involved early on in a woman's care. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Fluid-structure interaction dynamic simulation of spring-loaded pressure relief valves under seismic wave

    Science.gov (United States)

    Lv, Dongwei; Zhang, Jian; Yu, Xinhai

    2018-05-01

    In this paper, a fluid-structure interaction dynamic simulation method of spring-loaded pressure relief valve was established. The dynamic performances of the fluid regions and the stress and strain of the structure regions were calculated at the same time by accurately setting up the contact pairs between the solid parts and the coupling surfaces between the fluid regions and the structure regions. A two way fluid-structure interaction dynamic simulation of a simplified pressure relief valve model was carried out. The influence of vertical sinusoidal seismic waves on the performance of the pressure relief valve was preliminarily investigated by loading sine waves. Under vertical seismic waves, the pressure relief valve will flutter, and the reseating pressure was affected by the amplitude and frequency of the seismic waves. This simulation method of the pressure relief valve under vertical seismic waves can provide effective means for investigating the seismic performances of the valves, and make up for the shortcomings of the experiment.

  17. The dynamic implications of debt relief for low-income countries

    Directory of Open Access Journals (Sweden)

    Alma Lucía Romero-Barrutieta

    2015-06-01

    Full Text Available Debt relief provides low-income countries with an incentive to accumulate debt, boost consumption, and reduce investment over time. We quantify this incentive effect employing a dynamic stochastic general equilibrium model, calibrated to 1982–2006 Ugandan data, and find that long-run debt and consumption-to-GDP ratios are about twice as high with debt relief than without it, while the investment-to-GDP ratio is sixty percent lower. Our simulations show that debt-relief episodes are likely to have only a temporary impact on debt levels but may have a lasting effect over the size of the economy, lowering GDP growth up to twenty percent over time. These results fill a gap in the debt relief literature since, to the best of our knowledge, the quantification of incentive effects is rather scarce. The paper further contributes to the literature by constructing a tractable structural model that is able to replicate the data well and captures key features of low-income countries facing the possibility of debt relief.

  18. Iraq's Debt Relief: Procedure and Potential Implications for International Debt Relief

    National Research Council Canada - National Science Library

    Weiss, Martin A

    2009-01-01

    .... Reducing this debt to a sustainable level has been a priority of the U.S. government. Since 2003, debt relief negotiations have taken place in a variety of fora and led to the cancellation of a significant amount of Iraq's external debt...

  19. Immediate pain relief effect of low level laser therapy for sports injuries: Randomized, double-blind placebo clinical trial.

    Science.gov (United States)

    Takenori, A; Ikuhiro, M; Shogo, U; Hiroe, K; Junji, S; Yasutaka, T; Hiroya, K; Miki, N

    2016-12-01

    To determine the immediate pain relief effect of low-level laser therapy on sports injuries in athletes and degree of pain relief by the therapy. Double-blind, randomized, comparative clinical study. Participants were 32 college athletes with motion pain at a defined site. Participants were randomized into two groups in which the tested or placebo laser therapy was administered to determine pain intensity from painful action before and after laser irradiation, using the Modified Numerical Rating Scale. The post-therapeutic Modified Numerical Rating Scale score was subtracted from the pre-therapeutic Modified Numerical Rating Scale score to determine pain intensity difference, and the rate of pain intensity difference to pre-therapeutic Modified Numerical Rating Scale was calculated as pain relief rate. Low-level laser therapy was effective in 75% of the laser group, whereas it was not effective in the placebo group, indicating a significant difference in favor of the laser group (p<0.001). Pain relief rate was significantly higher in the laser group than in the placebo group (36.94% vs. 8.20%, respectively, p<0.001), with the difference in pain relief rate being 28.74%. Low-level laser therapy provided an immediate pain relief effect, reducing pain by 28.74%. It was effective for pain relief in 75% of participants. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Increasing the Useful Life of Quench Reliefs with Inconel Bellows

    Energy Technology Data Exchange (ETDEWEB)

    Soyars, W. M. [Fermilab

    1999-01-01

    Reliable quench relief valves are an important part of superconducting magnet systems. Fermilab developed bellows-actuated cryogenic quench reliefs which have been in use since the early l 980's. The original design uses a stainless steel bellows. A high frequency, low amplitude vibration during relieving events has resulted in fatigue failures in the original design. To take advantage of the improved resistance to fatigue of Inconel, a nickel-chromium alloy, reliefs using Inconel 625 bellows were made. Design, development, and testing of the new version reliefs will be discussed. Tests show that relief valve lifetimes using Inconel bellows are more than five times greater than when using the original stainless steel bellows. Inconel bellows show great promise in increasing the lifetime of quench relief valves, and thus the reliability of accelerator cryogenic systems.

  1. Complementary therapies for symptom management in cancer patients

    Directory of Open Access Journals (Sweden)

    Aanchal Satija

    2017-01-01

    Full Text Available Cancer patients are often poly-symptomatic which distressingly affects their quality of lives (QOLs. Alhough, conventional management provides adequate symptom control, yet is coupled with some limitations. Complementary therapies (CTs have shown beneficial effects in cancer patients for symptomatic relief. The aim of this article is to provide evidence-based review of commonly used CTs for symptom management in cancer care. Hypnosis has promising evidence to be used for managing symptoms such as pain, chemotherapy-induced nausea/vomiting, distress, fatigue, and hot flashes. Guided imagery increases comfort and can be used as a psycho-supportive therapy. Meditation substantially improves psychological function, mental health, and QOL. Cognitive behavioral therapies effectively reduce pain, distress, fatigue, anxiety, and depression; and improve subjective sleep outcomes along with mood and QOL. Yoga has short term beneficial effects for anxiety, depression, fatigue, perceived stress, QOL, and well-being. T'ai Chi and qigong are beneficial adjunctive therapies for supportive cancer care, but their role in reducing cancer pain is not well proven. Acupuncture is effective for reducing treatment related side-effects, pain and fatigue. Other therapies such as massage techniques, energy therapies, and spiritual interventions have also demonstrated positive role in managing cancer-related symptoms and improve overall well-being. However, the clinical effectiveness of these therapies for symptom management in cancer patients cannot be concluded due to poor strength of evidence. Nonetheless, these are relatively free from risks and hence can be given along with conventional treatments. Only by tailoring these therapies as per patient's beliefs and preferences, optimal patient-centered holistic care can be provided.

  2. Exploring the Association of Deliberate Self-Harm With Emotional Relief Using a Novel Implicit Association Test

    Science.gov (United States)

    Gratz, Kim L.; Chapman, Alexander L.; Dixon-Gordon, Katherine L.; Tull, Matthew T.

    2017-01-01

    Despite the growing consensus that negative reinforcement in the form of emotional relief plays a key role in the maintenance of deliberate self-harm (DSH), most of the research in this area has relied exclusively on self-report measures of the perceived motives for and emotional consequences of DSH. Thus, the primary aim of this study was to extend extant research on the role of emotional relief in DSH by examining the strength of the association of DSH with emotional relief using a novel version of the Implicit Association Test (IAT). The strength of the DSH-relief association among both participants with (vs. without) DSH and self-harming participants with (vs. without) BPD, as well as its associations with relevant clinical constructs (including DSH characteristics, self-reported motives for DSH, BPD pathology, and emotion dysregulation and avoidance) were examined in a community sample of young adults (113 with recent recurrent DSH; 135 without DSH). As hypothesized, results revealed stronger associations between DSH and relief among participants with versus without DSH, as well as among DSH participants with versus without BPD. Moreover, the strength of the DSH-relief association was positively associated with DSH frequency and versatility (both lifetime and at 6-month follow-up), BPD pathology, emotion dysregulation, experiential avoidance, and self-reported emotion relief motives for DSH. Findings provide support for theories emphasizing the role of emotional relief in DSH (particularly among individuals with BPD), as well as the construct validity, predictive utility, and incremental validity (relative to self-reported emotion relief motives) of this IAT. PMID:26147069

  3. 75 FR 54794 - Commodity Pool Operators: Relief From Compliance With Certain Disclosure, Reporting and...

    Science.gov (United States)

    2010-09-09

    ... Proposal is intended to respond to financial market developments by providing relief to operators of... concern: Protection of market participants and the public; efficiency, competitiveness, and financial... Considerations The Proposal will also take into account new product developments in the financial services...

  4. 30 CFR 204.203 - What is the other relief option?

    Science.gov (United States)

    2010-07-01

    ... MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.203 What is the other... that is appropriate for production from your marginal property, provided it is not prohibited under... are: (1) To report and pay royalties using a valuation method other than that required under 30 CFR...

  5. Legal Guidance on When Schools Can Remove Students for Exhibiting Dangerous Behaviors through Injunctive Relief

    Science.gov (United States)

    Counts, Jennifer; Katsiyannis, Antonis; Beard, Jenna

    2018-01-01

    Violence in schools remains a complex and challenging issue. In this article, we examine schools' responsibilities in placement and the provision of services for students who have chronically exhibited dangerous behaviors. Multiple court cases have provided schools guidance in evaluating when student removal through injunctive relief for dangerous…

  6. Sharing Information among Various Organizations in Relief Efforts

    National Research Council Canada - National Science Library

    Costur, Gurkan

    2005-01-01

    .... An analysis is presented of the December 2004 Indian Ocean tsunami relief effort; specifically, how different organizations such as the military, United Nations, and non-governmental organizations...

  7. Sandy PMO Disaster Relief Appropriations Act of 2013 Financial Data

    Data.gov (United States)

    Department of Homeland Security — Sandy PMO: Disaster Relief Appropriations Act of 2013 (Sandy Supplemental Bill) Financial Data. This is the Sandy Supplemental Quarterly Financial Datasets that are...

  8. Shaded relief of Bahia State, Brazil

    Science.gov (United States)

    2000-01-01

    This topographic image is the first to show the full 240-kilometer-wide (150 mile)swath collected by the Shuttle Radar Topography Mission (SRTM). The area shown is in the state of Bahia in Brazil. The semi-circular mountains along the left side of the image are the Serra Da Jacobin, which rise to 1100 meters (3600 feet) above sea level. The total relief shown is approximately 800 meters (2600 feet). The top part of the image is the Sertao, a semi-arid region, that is subject to severe droughts during El Nino events. A small portion of the San Francisco River, the longest river (1609 kilometers or 1000 miles) entirely within Brazil, cuts across the upper right corner of the image. This river is a major source of water for irrigation and hydroelectric power. Mapping such regions will allow scientists to better understand the relationships between flooding cycles, drought and human influences on ecosystems.This shaded relief image was generated using topographic data from the Shuttle Radar Topography Mission. A computer-generated artificial light source illuminates the elevation data to produce a pattern of light and shadows. Slopes facing the light appear bright, while those facing away are shaded. On flatter surfaces, the pattern of light and shadows can reveal subtle features in the terrain. Colors show the elevation as measured by SRTM. Colors range from green at the lowest elevations to reddish at the highest elevations. Shaded relief maps are commonly used in applications such as geologic mapping and land use planning.The Shuttle Radar Topography Mission (SRTM), launched on February 11, 2000, uses the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. The mission is designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200-foot) mast, an additional C-band imaging

  9. Plague Symptoms

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search the CDC Plague Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Plague Home Ecology & Transmission Symptoms Diagnosis & Treatment Maps & Statistics ...

  10. Recognizing Symptoms

    Science.gov (United States)

    ... helpful, please consider supporting IFFGD with a small tax- deductible donation. Make Donation Signs and Symptoms Overview ... arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). All ...

  11. Rotavirus Symptoms

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search The CDC Rotavirus Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Rotavirus Home About Rotavirus Symptoms Transmission Treatment Photos Vaccination ...

  12. Pain Relief in Nonhuman Primate Models of Arthritis.

    Science.gov (United States)

    Vierboom, Michel P M; Breedveld, Elia; Keehnen, Merei; Klomp, Rianne; Bakker, Jaco

    2017-01-01

    Animal models of rheumatoid arthritis are important in the elucidation of etiopathogenic mechanisms of the disease and for the development of promising new therapies. Species specificity of new biological compounds and their mode of action preclude safety and efficacy testing in rodent models of disease. Nonhuman primates (NHP) can fill this niche and provide the only relevant model. Over the last two decades models of collagen-induced arthritis (CIA) were developed in the rhesus monkey and the common marmoset. However, NHP are higher-order animals and complex sentient beings. So especially in models where pain is an intricate part of the disease, analgesia needs to be addressed because of ethical considerations. In our model, a morphine-based pain relief was used that does not interfere with the normal development of disease allowing us to evaluate important mechanistic aspects of the arthritis.

  13. Gain-Based Relief for Invasion of Privacy

    Directory of Open Access Journals (Sweden)

    Sirko Harder

    2013-11-01

    Full Text Available In many common law jurisdictions, some or all instances of invasion of privacy constitute a privacy-specific wrong either at common law (including equity or under statute. A remedy invariably available for such a wrong is compensation for loss. However, the plaintiff may instead seek to claim the profit the defendant has made from the invasion. This article examines when a plaintiff is, and should be, entitled to claim that profit, provided that invasion of privacy is actionable as such. After a brief overview of the relevant law in major common law jurisdictions, the article investigates how invasion of privacy fits into a general concept of what is called ‘restitution for wrongs’. It will be argued that the right to privacy is a right against the whole world and as such forms a proper basis of awarding gain-based relief for the unauthorised use of that right.

  14. Pain and symptom control. Patient rights and physician responsibilities.

    Science.gov (United States)

    Emanuel, E J

    1996-02-01

    In considering the care of patients with incurable and terminal diseases, there are three types of interventions: (1) palliative care and symptom management; (2) experimental therapies; and (3) active life-ending interventions. Relief of pain, other symptoms, and suffering should be the basic and standard treatment; the other interventions are meant to supplement, not replace, this intervention. This means the physician's primary obligation is to inform patients about the options for palliative care and to provide quality palliative care. Thus, physicians who care for terminally ill patients have an obligation to keep their knowledge base and skills in palliative care current. In those circumstances in which a patient's needs exceeds the physician's knowledge and skills, physicians have a responsibility to refer the patient to a palliative care specialist. With regard to experimental therapies, physicians must obtain full informed consent, provide especially accurate data on the risks and benefits of experimental therapies, and ensure that the patient understands the aims of the proposed therapy. Regarding active life-ending therapies, physicians have the obligation to withhold or withdraw life-sustaining treatment if the patient so desires and to provide adequate pain medication even if this hastens death. Even if euthanasia or physician-assisted suicide are legalized, there is unlikely to be an obligation to provide this intervention.

  15. 30 CFR 203.53 - What relief will MMS grant?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What relief will MMS grant? 203.53 Section 203.53 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE...-Life Leases § 203.53 What relief will MMS grant? (a) If we approve your application and you meet...

  16. Bas-Relief Modeling from Normal Images with Intuitive Styles.

    Science.gov (United States)

    Ji, Zhongping; Ma, Weiyin; Sun, Xianfang

    2014-05-01

    Traditional 3D model-based bas-relief modeling methods are often limited to model-dependent and monotonic relief styles. This paper presents a novel method for digital bas-relief modeling with intuitive style control. Given a composite normal image, the problem discussed in this paper involves generating a discontinuity-free depth field with high compression of depth data while preserving or even enhancing fine details. In our framework, several layers of normal images are composed into a single normal image. The original normal image on each layer is usually generated from 3D models or through other techniques as described in this paper. The bas-relief style is controlled by choosing a parameter and setting a targeted height for them. Bas-relief modeling and stylization are achieved simultaneously by solving a sparse linear system. Different from previous work, our method can be used to freely design bas-reliefs in normal image space instead of in object space, which makes it possible to use any popular image editing tools for bas-relief modeling. Experiments with a wide range of 3D models and scenes show that our method can effectively generate digital bas-reliefs.

  17. Donation to disaster relief campaigns: underlying social cognitive factors exposed

    NARCIS (Netherlands)

    Oosterhof, Liesbeth; Heuvelman, A.; Peters, O.

    2009-01-01

    number of very serious natural disasters have put an enormous pressure on relief organizations in the last few years. The present study exposes underlying social cognitive factors for donation to relief campaigns. A causal model was constructed, based on social cognitive theory, research on

  18. 46 CFR 154.801 - Pressure relief systems.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Pressure relief systems. 154.801 Section 154.801 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... Vent Systems § 154.801 Pressure relief systems. (a) Each cargo tank that has a volume of 20m3 (706 ft.3...

  19. 47 CFR 52.19 - Area code relief.

    Science.gov (United States)

    2010-10-01

    ... meetings to which the telecommunications industry and the public are invited on area code relief for a... 47 Telecommunication 3 2010-10-01 2010-10-01 false Area code relief. 52.19 Section 52.19 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) NUMBERING...

  20. The control of tonic pain by active relief learning.

    Science.gov (United States)

    Zhang, Suyi; Mano, Hiroaki; Lee, Michael; Yoshida, Wako; Kawato, Mitsuo; Robbins, Trevor W; Seymour, Ben

    2018-02-27

    Tonic pain after injury characterises a behavioural state that prioritises recovery. Although generally suppressing cognition and attention, tonic pain needs to allow effective relief learning to reduce the cause of the pain. Here, we describe a central learning circuit that supports learning of relief and concurrently suppresses the level of ongoing pain. We used computational modelling of behavioural, physiological and neuroimaging data in two experiments in which subjects learned to terminate tonic pain in static and dynamic escape-learning paradigms. In both studies, we show that active relief-seeking involves a reinforcement learning process manifest by error signals observed in the dorsal putamen. Critically, this system uses an uncertainty ('associability') signal detected in pregenual anterior cingulate cortex that both controls the relief learning rate, and endogenously and parametrically modulates the level of tonic pain. The results define a self-organising learning circuit that reduces ongoing pain when learning about potential relief. © 2018, Zhang et al.

  1. The control of tonic pain by active relief learning

    Science.gov (United States)

    Mano, Hiroaki; Lee, Michael; Yoshida, Wako; Kawato, Mitsuo; Robbins, Trevor W

    2018-01-01

    Tonic pain after injury characterises a behavioural state that prioritises recovery. Although generally suppressing cognition and attention, tonic pain needs to allow effective relief learning to reduce the cause of the pain. Here, we describe a central learning circuit that supports learning of relief and concurrently suppresses the level of ongoing pain. We used computational modelling of behavioural, physiological and neuroimaging data in two experiments in which subjects learned to terminate tonic pain in static and dynamic escape-learning paradigms. In both studies, we show that active relief-seeking involves a reinforcement learning process manifest by error signals observed in the dorsal putamen. Critically, this system uses an uncertainty (‘associability’) signal detected in pregenual anterior cingulate cortex that both controls the relief learning rate, and endogenously and parametrically modulates the level of tonic pain. The results define a self-organising learning circuit that reduces ongoing pain when learning about potential relief. PMID:29482716

  2. Shaded relief, color as height, Fiji

    Science.gov (United States)

    2000-01-01

    The Sovereign Democratic Republic of the Fiji Islands, commonly known as Fiji, is an independent nation consisting of some 332 islands surrounding the Koro Sea in the South Pacific Ocean. This topographic image shows Viti Levu, the largest island in the group. With an area of 10,429 square kilometers (about 4000 square miles), it comprises more than half the area of the Fiji Islands. Suva, the capital city, lies on the southeast shore. The Nakauvadra, the rugged mountain range running from north to south, has several peaks rising above 900 meters (about 3000 feet). Mount Tomanivi, in the upper center, is the highest peak at 1324 meters (4341 feet). The distinct circular feature on the north shore is the Tavua Caldera, the remnant of a large shield volcano that was active about 4 million years ago. Gold has been mined on the margin of the caldera since the 1930's. The Nadrau plateau is the low relief highland in the center of the mountain range. The coastal plains in the west, northwest and southeast account for only 15 percent of Viti Levu's area but are the main centers of agriculture and settlement.This shaded relief image was generated using topographic data from the Shuttle Radar Topography Mission. A computer-generated artificial light source illuminates the elevation data to produce a pattern of light and shadows. Slopes facing the light appear bright, while those facing away are shaded. On flatter surfaces, the pattern of light and shadows can reveal subtle features in the terrain. Colors show the elevation as measured by SRTM. Colors range from green at the lowest elevations top ink at the highest elevations. This image contains about 1300 meters(4300 feet) of total relief.The Shuttle Radar Topography Mission (SRTM), launched on February 11,2000, uses the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. The mission is designed to collect

  3. Bazedoxifene/conjugated estrogens for managing the burden of estrogen deficiency symptoms.

    Science.gov (United States)

    Mirkin, Sebastian; Ryan, Kelly A; Chandran, Arthi B; Komm, Barry S

    2014-01-01

    The bothersome vasomotor and vaginal symptoms and bone loss that accompany the menopausal transition are associated with significant direct costs due to physician visits and medication, as well as indirect costs from reduced health-related quality of life (HRQoL) and work productivity. With life expectancies increasing, the number of postmenopausal women is also increasing, and more women are remaining in the workforce. These factors have led to an increased burden of menopausal symptoms on healthcare systems. Hormone therapy (HT) has been shown to effectively reduce menopausal symptoms and significantly increase quality-adjusted life years in postmenopausal women, particularly in women experiencing severe symptoms. However, many women discontinue use of HT before their symptoms have dissipated due to safety and tolerability concerns. The tissue selective estrogen complex (TSEC) that pairs bazedoxifene (BZA) with conjugated estrogens (CE) has been developed to provide relief of menopausal symptoms and prevent bone loss without stimulating the breast or endometrium, and to have improved tolerability compared with HT. In this context, BZA 20mg/CE 0.45 and 0.625 mg were shown to prevent bone loss and effectively treat menopausal symptoms in postmenopausal women with an intact uterus, while also demonstrating a favorable safety/tolerability profile. BZA 20mg/CE 0.45 and 0.625 mg were further associated with clinically significant improvements in HRQoL, sleep, and treatment satisfaction. Taken together, the reduction in menopausal symptoms, improvement in HRQoL, and favorable safety/tolerability profile associated with BZA/CE suggest that it is a cost-effective alternative to HT for managing the burden of menopausal symptoms. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review.

    Science.gov (United States)

    Suter, Valerie G A; Sjölund, Sophia; Bornstein, Michael M

    2017-05-01

    The aim of this systematic review was to assess a potential benefit of laser use in the treatment of recurrent aphthous stomatitis (RAS). The primary outcome variables were pain relief, duration of wound healing and reduction in episode frequency. A PICO approach was used as a search strategy in Medline, Embase and Cochrane databases. After scanning and excluding titles, abstracts and full texts, 11 studies (ten RCTs and one non-randomised controlled trial) were included. Study selection and data extraction was done by two observers. Study participants varied between 7-90 for the laser and 5-90 for the control groups. Laser treatment included Nd:YAG laser ablation, CO 2 laser applied through a transparent gel (non-ablative) and diode laser in a low-level laser treatment (LLLT) mode. Control groups had placebo, no therapy or topical corticosteroid treatment. Significant pain relief immediately after treatment was found in five out of six studies. Pain relief in the days following treatment was recorded in seven studies. The duration of RAS wound healing was also reduced in five studies. However, criteria of evaluation differed between the studies. The episode frequency was not evaluated as only one study addressed this outcome parameter, but did not discriminate between the study (LLLT) and control (corticosteroid) groups. Jadad scores (ranging from 0 to 5) for quality assessment of the included studies range between 0 and 2 (mean = 1.0) for studies analysing pain relief and between 0 and 3 (mean = 1.1) for studies evaluating wound healing. The use of lasers (CO 2 laser, Nd:YAG laser and diode laser) to relieve symptoms and promote healing of RAS is a therapeutic option. More studies for laser applications are necessary to demonstrate superiority over topical pharmaceutical treatment and to recommend a specific laser type, wavelength, power output and applied energy (ablative versus photobiomodulation).

  5. Norovirus Symptoms

    Science.gov (United States)

    ... many times a day. This can lead to dehydration, especially in young children, older adults, and people with other illnesses. Symptoms of dehydration— decrease in urination dry mouth and throat feeling dizzy when standing up Children who are dehydrated may cry with few or ...

  6. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  7. Evaluation of reward from pain relief

    Science.gov (United States)

    Navratilova, Edita; Xie, Jennifer Yanhua; King, Tamara; Porreca, Frank

    2014-01-01

    The human experience of pain is multidimensional and comprises sensory, affective, and cognitive dimensions. Preclinical assessment of pain has been largely focused on the sensory features that contribute to nociception. The affective (aversive) qualities of pain are clinically significant but have received relatively less mechanistic investigation in preclinical models. Recently, operant behaviors such as conditioned place preference, avoidance, escape from noxious stimulus, and analgesic drug self-administration have been used in rodents to evaluate affective aspects of pain. An important advance of such operant behaviors is that these approaches may allow the detection and mechanistic investigation of spontaneous neuropathic or ongoing inflammatory/nociceptive (i.e., nonevoked) pain that is otherwise difficult to assess in nonverbal animals. Operant measures may allow the identification of mechanisms that contribute differentially to reflexive hypersensitivity or to pain affect and may inform the decision to progress novel mechanisms to clinical trials for pain therapy. Additionally, operant behaviors may allow investigation of the poorly understood mechanisms and neural circuits underlying motivational aspects of pain and the reward of pain relief. PMID:23496247

  8. Influence of relief on permanent preservation areas.

    Science.gov (United States)

    Dos Santos, Alexandre Rosa; Chimalli, Tessa; Peluzio, João Batista Esteves; da Silva, Aderbal Gomes; Dos Santos, Gleissy Mary Amaral Dino Alves; Lorenzon, Alexandre Simões; Teixeira, Thaisa Ribeiro; de Castro, Nero Lemos Martins; Soares Ribeiro, Carlos Antonio Alvares

    2016-01-15

    Many countries have environmental legislation to protecting natural resources on private property. In Brazil, the Brazilian Forestry Code determines specific areas to maintain with natural vegetation cover, known as areas of permanent preservation (APP). Currently, there are few studies that relate topographic variables on APP. In this context, we sought to evaluate the influence of relief on the conservation of areas of permanent preservation (APP) in the areas surrounding Caparaó National Park, Brazil. By using the chi-squared statistical test, we verified that the presence of forest cover is closely associated with altitude. The classes of APP in better conservation status are slopes in addition to hilltops and mountains, whereas APP streams and springs are among the areas most affected by human activities. The most deforested areas are located at altitudes below 1100.00 m and on slopes less than 45°. All orientations of the sides were significant for APP conservation status, with the southern, southeastern, and southwestern sides showing the lower degrees of impact. The methodology can be adjusted to environmental legislation to other countries.

  9. Analysis of United States Marine Corps Operations in Support of Humanitarian Assistance and Disaster Relief

    Science.gov (United States)

    2013-12-01

    water and waste resulting from the storm surge (GoB, 2008). The MEU was criticized for a lack of organic relief supplies, and appropriately...equipping personnel with waste bags and sanitation equipment prior to debarkation from the ships (CO, SCMAGTF, APS-10, 2010). 39 As a result of...clearance are always greatly demanded during the emergency response (Carafano, 2011). Rice and bread was provided for victims to provide basic

  10. A clinical trial comparing Lanconone® with ibuprofen for rapid relief in acute joint pain.

    Science.gov (United States)

    Girandola, Robert N; Srivastava, Shalini; Loullis, Costas C

    2016-04-06

    To study the effect of Lanconone® (1000 mg) on acute pain on exertion as compared to the standard of care, Ibuprofen (400 mg). The study recruited 72 subjects diagnosed with mild to moderate knee joint pain on exertion. Subjects with Pain Visual Analogue Scale of more than 40 mm were included. Uphill walking was provided as the stressor using Naughton's protocol on a treadmill. The subjects walked for 10 minutes continuously followed by a rest period and baseline pain score for index knee joint was recorded. Subjects were administered a single dose of Lanconone® (1000 mg)/Ibuprofen (400 mg). Thereafter the same stressor was provided at 0.5, 1, 2, 3, 4, and 6 hours, subsequently, pain scores were recorded on a visual analogue scale. Double stopwatch method was used to evaluate the onset of pain relief and time taken to meaningful pain relief. Both Lanconone® and Ibuprofen showed the first perceived pain relief at 65.31 ± 35.57 mins as compared to 60.82 ± 32.56 mins respectively. The mean time taken to experience meaningful pain relief in Lanconone® group was 196.59 ± 70.85 mins compared to 167.13 ± 71.41 mins amongst Ibuprofen group. The meaningful pain relief continued for 6 hours. The current study successfully demonstrated rapid pain-relieving potential of Lanconone® which was comparable to Ibuprofen. No adverse event related to the interventions was reported in the study. Clinical trials.gov NCT02417506 . 21 January 2015.

  11. Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review

    Science.gov (United States)

    Carlson, Cathy L

    2016-01-01

    Inadequate cancer pain relief has been documented extensively across historical records. In response, in 1986, the World Health Organization (WHO) developed guidelines for cancer pain treatment. The purpose of this paper is to disseminate the results of a comprehensive, integrative review of studies that evaluate the effectiveness of the WHO guidelines. Studies were included if they: 1) identified patients treated with the guidelines, 2) evaluated self-reported pain, 3) identified instruments used, 4) provided data documenting pain relief, and 5) were written in English. Studies were coded for duration of treatment, definition of pain relief, instruments used, findings related to pain intensity or relief, and whether measures were used other than the WHO analgesic ladder. Twenty-five studies published since 1987 met the inclusion criteria. Evidence indicates 20%–100% of patients with cancer pain can be provided pain relief with the use of the WHO guidelines – while considering their status of treatment or end-of-life care. Due to multiple limitations in included studies, analysis was limited to descriptions. Future research to examine the effectiveness of the WHO guidelines needs to consider recommendations to facilitate study comparisons by standardizing outcome measures. Recent studies have reported that patients with cancer experience pain at moderate or greater levels. The WHO guidelines reflect the knowledge and effectual methods to relieve most cancer pain, but the guidelines are not being adequately employed. Part of the explanation for the lack of adoption of the WHO guidelines is that they may be considered outdated by many because they are not specific to the pharmacological and interventional options used in contemporary pain management practices. The conundrum of updating the WHO guidelines is to encompass the latest pharmacological and interventional innovations while maintaining its original simplicity. PMID:27524918

  12. Flood, disaster, and turmoil: social issues in cleft and craniofacial care and crisis relief.

    Science.gov (United States)

    Strauss, Ronald P; van Aalst, John A; Fox, Lynn; Stein, Margot; Moses, Michael; Cassell, Cynthia H

    2011-11-01

    To examine social issues in the conduct of cleft and craniofacial care through relief programs in disrupted crisis contexts. Social, health policy, and ethical analyses. At best, craniofacial team care is multidisciplinary, coordinated, and sustained, requiring a long-term relationship between team members, patients, and families. Disasters and societal turmoil interrupt such relationships, causing craniofacial care to become a secondary concern. Providing craniofacial team care in a crisis setting requires rebuilding disrupted coordination and communication. Crisis relief care involves a complex set of expectations and responsibilities and raises issues such as (1) quality assurance, infection control, appropriate standards of care, and follow-up care/continuity; (2) equity of access to services and clinical ethics in the context of war and/or deprivation; (3) training of visitors in the local nation or site; (4) disciplinary composition of teams, interprofessional communication/rivalry, and credentials of clinicians; (5) ownership of the site and local visitor relations; (6) fundraising and marketing strategies; and (7) ethical issues in the doctor-patient relationship. Specific ethical standards for international cleft and craniofacial care delivery also apply to domestic and global crisis relief contexts. Guidance on issues related to professional experience, informed consent, and continuity of care will help care providers address social and ethical issues raised in crisis relief programs. This paper proposes that the Position Paper of the American Cleft Palate-Craniofacial Association (ACPA) on International Treatment Programs should be used as a template to develop and disseminate a set of standards that apply to crisis relief.

  13. Surveys right after the atomic bombing and a relief squad

    Energy Technology Data Exchange (ETDEWEB)

    Mine, Mariko [Nagasaki Univ. (Japan). School of Medicine

    1998-12-01

    An outline of four survey reports right after the atomic bombing in Nagasaki and Hiroshima is introduced. The report of Manhattan District Atomic Bomb Investigating Groups: The subjects of this survey were 900 inpatients in Nagasaki (for 16 days from September 20) and Hiroshima (for 5 days from October 3). Two hundreds and forty-nine patients (16%) died. In cases died without injury, the severe symptoms were alopecia, purpura, hemorrhage, oral cavity and pharynx lesion, vomiting, diarrhea and fever. The residual radioactivity measured at six weeks later was 6-25 roentgen in Hiroshima and 30-110 roentgen in Nagasaki (Nishiyama riverhead area). These values were lower than the predicted value from the clinical consequence. The report of Joint Commission for the Investigation of the Atomic Bomb: Following the above survey, about 6500 subjects were investigated both in Nagasaki and Hiroshima. Incidence of alopecia was investigated by shielded situation at a spot of 2.1 to 2.5 km from a blast center. It was 7.2% of outdoors (shielded: 7.3%, non-shielded: 17.4%) and 2.9% of indoors. The report of the Special Committee for Atomic Bomb Casualty Investigation and Research of the Scientific Research Council of Japan: General part of the report consists of medical part and physical part, and reports from each university were classified and listed in the supplement. Survey of Nagasaki Medical College (not in public): About 8000 subjects were investigated from October to December. Data were gathered up about lethality, time of death, injury and radiation sickness, etc. There was also autograph of a relief squad of the Nagasaki Medical College. (K.H.)

  14. Ultrasonic evaluation of heat treatment for stress relief in steel

    International Nuclear Information System (INIS)

    Bittencourt, Marcelo de S.Q.; Lamy, Carlos A.; Goncalves Filho, Orlando J.A.; Payao Filho, Joao da C.

    2000-01-01

    Residual stresses in materials arise due to the manufacturing processes. As a consequence, in the nuclear area some components must suffer a stress relief treatment according to strict criteria. Although these treatments are carefully carried on, concern with nuclear safety is constantly growing. This work proposes a nondestructive ultrasonic method to guarantee the efficiency of the heat treatment. It was used a short peened steel plate with tensile and compressive stresses which was submitted to a stress relief treatment. The results show that the proposed ultrasonic method could be used to confirm the efficiency of the stress relief heat treatment. (author)

  15. Safety relief valve alternate analysis method

    International Nuclear Information System (INIS)

    Adams, R.H.; Javid, A.; Khatua, T.P.

    1981-01-01

    An experimental test program was started in the United States in 1976 to define and quantify Safety Relief Valve (SRV) phenomena in General Electric Mark I Suppression Chambers. The testing considered several discharged devices and was used to correlate SRV load prediction models. The program was funded by utilities with Mark I containments and has resulted in a detailed SRV load definition as a portion of the Mark I containment program Load Definition Report (LDR). The (USNRC) has reviewed and approved the LDR SRV load definition. In addition, the USNRC has permitted calibration of structural models used for predicting torus response to SRV loads. Model calibration is subject to confirmatory in-plant testing. The SRV methodology given in the LDR requires that transient dynamic pressures be applied to a torus structural model that includes a fluid added mass matrix. Preliminary evaluations of torus response have indicated order of magnitude conservatisms, with respect to test results, which could result in unrealistic containment modifications. In addition, structural response trends observed in full-scale tests between cold pipe, first valve actuation and hot pipe, subsequent valve actuation conditions have not been duplicated using current analysis methods. It was suggested by others that an energy approach using current fluid models be utilized to define loads. An alternate SRV analysis method is defined to correct suppression chamber structural response to a level that permits economical but conservative design. Simple analogs are developed for the purpose of correcting the analytical response obtained from LDR analysis methods. Analogs evaluated considered forced vibration and free vibration structural response. The corrected response correlated well with in-plant test response. The correlation of the analytical model at test conditions permits application of the alternate analysis method at design conditions. (orig./HP)

  16. Dimethyl sulfoxide-sodium bicarbonate infusion for palliative care and pain relief in patients with metastatic prostate cancer.

    Science.gov (United States)

    Hoang, Ba X; Le, Bao T; Tran, Hau D; Hoang, Cuong; Tran, Hung Q; Tran, Dao M; Pham, Cu Q; Pham, Tuan D; Ha, Trung V; Bui, Nga T; Shaw, D Graeme

    2011-01-01

    Prostate cancer (adenocarcinoma of the prostate) is the most widespread cancer in men. It causes significant suffering and mortality due to metastatic disease. The main therapy for metastatic prostate cancer (MPC) includes androgen manipulation, chemotherapy, and radiotherapy and/or radioisotopes. However, these therapeutic approaches are considered palliative at this stage, and their significant side effects can cause further decline in patients' quality of life and increase non-cancer-related morbidity/mortality. In this study, the authors have used the infusion of dimethyl sulfoxide-sodium bicarbonate (DMSO-SB) to treat 18 patients with MPC. The 90-day follow-up of the patients having undergone the proposed therapeutic regimen showed significant improvement in clinical symptoms, blood and biochemistry tests, and quality of life. There were no major side effects from the treatment. In searching for new and better methods for palliative treatment and pain relief, this study strongly suggested therapy with DMSO-SB infusions could provide a rational alternative to conventional treatment for patients with MPC.

  17. Location Optimization of Mobile Cold-Formed Steel Systems to Provide Humanitarian Relief After Natural Disasters

    Science.gov (United States)

    2015-12-01

    has its beginnings traced back to the California gold rush when Peter Naylor advertised “portable iron houses for California” (History, n.d...extreme winter conditions (snow pressure, icing, freezing rain , avalanche). Wildfire is forest fires and land fires (grass, scrub, bush, etc

  18. Implementation of a portable electronic system for providing pain relief to patellofemoral pain syndrome patients

    Science.gov (United States)

    Chang Chien, Jia-Ren; Lin, Guo-Hong; Hsu, Ar-Tyan

    2011-10-01

    In this study, a portable electromyogram (EMG) system and a stimulator are developed for patellofemoral pain syndrome patients, with the objective of reducing the pain experienced by these patients; the patellar pain is caused by an imbalance between the vastus medialis obliquus (VMO) and the vastus lateralis (VL). The EMG measurement circuit and the electrical stimulation device proposed in this study are specifically designed for the VMO and the VL; they are capable of real-time waveform recording, possess analyzing functions, and can upload their measurement data to a computer for storage and analysis. The system can calculate and record the time difference between the EMGs of the VMO and the VL, as well as the signal strengths of both the EMGs. As soon as the system detects the generation of the EMG of the VL, it quickly calculates and processes the event and stimulates the VMO as feedback through electrical stimulation units, in order to induce its contraction. The system can adjust the signal strength, time length, and the sequence of the electrical stimulation, both manually and automatically. The output waveform of the electrical stimulation circuit is a dual-phase asymmetrical pulse waveform. The primary function of the electrical simulation circuit is to ensure that the muscles contract effectively. The performance of the device can be seen that the width of each pulse is 20-1000 μs, the frequency of each pulse is 10-100 Hz, and current strength is 10-60 mA.

  19. Knowledge of and attitude towards pain relief during labour of ...

    African Journals Online (AJOL)

    This study determined women's knowledge of and attitudes to pain relief during labour. Methods ... Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa .... Breathing exercises. 25.

  20. Antiemetic Medicines: OTC Relief for Nausea and Vomiting

    Science.gov (United States)

    ... CorrectlyPain Relievers: Understanding Your OTC OptionsAntacids and Acid Reducers: OTC Relief for Heartburn and Acid RefluxOTC Cough ... Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics ...

  1. Anti-Seizure Medications: Relief from Nerve Pain

    Science.gov (United States)

    Anti-seizure medications: Relief from nerve pain Anti-seizure drugs often are used to help control the type of ... by damaged nerves. By Mayo Clinic Staff Anti-seizure medications were originally designed to treat people with ...

  2. 29 CFR 1601.23 - Preliminary or temporary relief.

    Science.gov (United States)

    2010-07-01

    ..., or political subdivision. (b) In a case involving a government, governmental agency, or political... private individuals from exercising their rights to seek temporary or preliminary relief on their own...

  3. Leakage characterization of a piloted power operated relief valve

    International Nuclear Information System (INIS)

    Ezekoye, L.I.; Hess, M.D.

    1995-01-01

    In Westinghouse Pressurized Water Reactors (PWRs), power operated relief valves (PORVs) are used to provide overpressure protection of the Pressurizer. The valves are fail closed globe valves which means that power is required to open the valves and, on loss of power, the valves close. There are two ways to operate the PORVs. The more common way is to directly couple the disc to an actuator via a disc-stem assembly. The type of design is not the object of this paper. The other and less common way of operating a PORV is by piloting the main valve such that the opening or closing of a pilot valve opens and closes the main valve. This is the design of interest. In most plants, the PORVs are installed with a water loop seal while in some plants no water loop seals are used. It is generally accepted that loop seal installation minimizes valve seat leakage. In non-loop seal installation, the valve seat is exposed to steam which increases the potential for seat leakage. This paper describes the results of some tests performed with nitrogen and steam to characterize the leakage potential of a pilot operated PORV. The test results were compared with seat leakage tests of check valves to provide insight on the leakage testing of pilot operated valves and check valves. The paper also compares the test data with leakage estimates using the ASME/ANSI OM Code guidance on valve leakage

  4. Will a Twenty-First Century Logistics Management System Improve Federal Emergency Management Agency's Capability to Deliver Supplies to Critical Areas, during Future Catastrophic Disaster Relief Operations

    National Research Council Canada - National Science Library

    Gill, Glenda A

    2007-01-01

    The United States Homeland Security's Federal Emergency Management Agency (FEMA) must be prepared at all times to supplement state and local emergency personnel, or to provide logistics support during disaster relief operations...

  5. Spontaneous formation of optically induced surface relief gratings

    International Nuclear Information System (INIS)

    Leblond, H; Barille, R; Ahmadi-Kandjani, S; Nunzi, J-M; Ortyl, E; Kucharski, S

    2009-01-01

    We develop a model based on Fick's law of diffusion as a phenomenological description of the molecular motion, and on the coupled mode theory, to describe single-beam surface relief grating formation in azopolymer thin films. The model allows us to explain the mechanism of spontaneous patterning, and self-organization. It allows us to compute the surface relief profile and its evolution, with good agreement with experiments.

  6. Spontaneous formation of optically induced surface relief gratings

    Energy Technology Data Exchange (ETDEWEB)

    Leblond, H; Barille, R; Ahmadi-Kandjani, S; Nunzi, J-M [Laboratoire POMA, Universite d' Angers, CNRS FRE 2988, 2, Bd Lavoisier, 49045 Angers (France); Ortyl, E; Kucharski, S, E-mail: herve.leblond@univ-angers.f [Wroclaw University of Technology, Faculty of Chemistry, Department of Polymer Engineering and Technology, 50-370 Wroclaw (Poland)

    2009-10-28

    We develop a model based on Fick's law of diffusion as a phenomenological description of the molecular motion, and on the coupled mode theory, to describe single-beam surface relief grating formation in azopolymer thin films. The model allows us to explain the mechanism of spontaneous patterning, and self-organization. It allows us to compute the surface relief profile and its evolution, with good agreement with experiments.

  7. Quadratus lumborum block for post-operative pain relief in patient with Prune belly syndrome.

    Science.gov (United States)

    Garg, Chitra; Khanna, Sangeeta; Mehta, Yatin

    2017-10-01

    Abdominal field blocks are commonly used as part of multimodal analgesia for post-operative pain relief in patients undergoing abdominal surgery. Conventionally, transversus abdominis plane block is used, but has the disadvantage of limited spread only to T10-T12 segments, providing only partial pain relief. The new quadratus lumborum (QL) block has the advantage of providing wider sensory block from T6 to L1 and thus has an evolving role in opioid-free anaesthesia. Opioid-induced cough depression, urinary retention, and drowsiness can be problematic in patients with Prune belly syndrome, who have deficient abdominal muscles and myriad of genitourinary problems. We report a case of a young male with Prune belly syndrome, who had a pain-free post-operative period after high inguinal orchidectomy with unilateral QL block.

  8. Quadratus lumborum block for post-operative pain relief in patient with Prune belly syndrome

    Directory of Open Access Journals (Sweden)

    Chitra Garg

    2017-01-01

    Full Text Available Abdominal field blocks are commonly used as part of multimodal analgesia for post-operative pain relief in patients undergoing abdominal surgery. Conventionally, transversus abdominis plane block is used, but has the disadvantage of limited spread only to T10–T12 segments, providing only partial pain relief. The new quadratus lumborum (QL block has the advantage of providing wider sensory block from T6 to L1 and thus has an evolving role in opioid-free anaesthesia. Opioid-induced cough depression, urinary retention, and drowsiness can be problematic in patients with Prune belly syndrome, who have deficient abdominal muscles and myriad of genitourinary problems. We report a case of a young male with Prune belly syndrome, who had a pain-free post-operative period after high inguinal orchidectomy with unilateral QL block.

  9. Bali, Shaded Relief and Colored Height

    Science.gov (United States)

    2004-01-01

    The volcanic nature of the island of Bali is evident in this shaded relief image generated with data from the Shuttle Radar Topography Mission (SRTM).Bali, along with several smaller islands, make up one of the 27 Provinces of Indonesia. It lies over a major subduction zone where the Indo-Australian tectonic plate collides with the Sunda plate, creating one of the most volcanically active regions on the planet.The most significant feature on Bali is Gunung Agung, the symmetric, conical mountain at the right-center of the image. This 'stratovolcano,' 3,148 meters (10,308 feet) high, is held sacred in Balinese culture, and last erupted in 1963 after being dormant and thought inactive for 120 years. This violent event resulted in over 1,000 deaths, and coincided with a purification ceremony called Eka Dasa Rudra, meant to restore the balance between nature and man. This most important Balinese rite is held only once per century, and the almost exact correspondence between the beginning of the ceremony and the eruption is though to have great religious significance.Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations.Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot

  10. Colored Height and Shaded Relief, Kamchatka Peninsula

    Science.gov (United States)

    2002-01-01

    Russia's Kamchatka Peninsula, lying between the Sea of Okhotsk to the west and the Bering Sea and Pacific Ocean to the east, is one of the most active volcanic regions along the Pacific Ring of Fire. It covers an area about the size of Colorado but contains more than 100 volcanoes stretching across the 1000-kilometer-long (620-mile-long) land mass. A dozen or more of these have active vents, with the youngest located along the eastern half of the peninsula. This color-coded shaded relief image, generated with data from the Shuttle Radar Topography Mission (SRTM), shows Kamchatka's volcanic nature to dramatic effect.Kliuchevskoi, one of the most active and renowned volcanoes in the world, dominates the main cluster of volcanoes called the Kliuchi group, visible as a circular feature in the center-right of the image. The two other main volcanic ranges lie along northeast-southwest lines, with the older, less active range occupying the center and western half of Kamchatka. The younger, more active belt begins at the southernmost point of the peninsula and continues upward along the Pacific coastline.Two visualization methods were combined to produce this image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the north-south direction, so northern slopes appear bright and southern slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and brown to white at the highest elevations.The Shuttle Radar Topography Mission flew aboard the Space Shuttle Endeavour, launched on February 11, 2000. The mission used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar that flew twice on the Space Shuttle Endeavour in 1994. The Shuttle Radar Topography Mission was designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (200

  11. Sinai Peninsula, Shaded Relief and Colored Height

    Science.gov (United States)

    2004-01-01

    The Sinai Peninsula, located between Africa and Asia, is a result of those two continents pulling apart from each other. Earth's crust is cracking, stretching, and lowering along the two northern branches of the Red Sea, namely the Gulf of Suez, seen here on the west (left), and the Gulf of Aqaba, seen to the east (right). This color-coded shaded relief image shows the triangular nature of the peninsula, with the coast of the Mediterranean Sea forming the northern side of the triangle. The Suez Canal can be seen as the narrow vertical blue line in the upper left connecting the Red Sea to the Mediterranean. The peninsula is divided into three distinct parts; the northern region consisting chiefly of sandstone, plains and hills, the central area dominated by the Tih Plateau, and the mountainous southern region where towering peaks abound. Much of the Sinai is deeply dissected by river valleys, or wadis, that eroded during an earlier geologic period and break the surface of the plateau into a series of detached massifs with a few scattered oases. Two visualization methods were combined to produce the image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations. Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed

  12. Ireland, Shaded Relief and Colored Height

    Science.gov (United States)

    2005-01-01

    The island of Ireland comprises a large central lowland of limestone with a relief of hills surrounded by a discontinuous border of coastal mountains which vary greatly in geological structure. The mountain ridges of the south are composed of old red sandstone separated by limestone river valleys. Granite predominates in the mountains of Galway, Mayo and Donegal in the west and north-west and in Counties Down and Wicklow on the east coast, while a basalt plateau covers much of the north-east of the country. The central plain, which is broken in places by low hills, is extensively covered with glacial deposits of clay and sand. It has considerable areas of bog and numerous lakes. The island has seen at least two general glaciations and everywhere ice-smoothed rock, mountain lakes, glacial valleys and deposits of glacial sand, gravel and clay mark the passage of the ice. Two visualization methods were combined to produce this image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction, so that northwest slopes appear bright and southeast slopes appear dark. Color coding is directly related to topographic height, with green at the lower elevations, rising through yellow and tan, to white at the highest elevations. Elevation data used in this image were acquired by the Shuttle Radar Topography Mission aboard the Space Shuttle Endeavour, launched on Feb. 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect 3-D measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter (approximately 200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between NASA, the National Geospatial-Intelligence Agency

  13. San Gabriel Mountains, California, Shaded relief, color as height

    Science.gov (United States)

    2000-01-01

    This topographic image shows the relationship of the urban area of Pasadena, California to the natural contours of the land. The image includes the alluvial plain on which Pasadena and the Jet Propulsion Laboratory sit, and the steep range of the San Gabriel Mountains. The mountain front and the arcuate valley running from upper left to the lower right are active fault zones, along which the mountains are rising. The chaparral-covered slopes above Pasadena are also a prime area for wildfires and mudslides. Hazards from earthquakes, floods and fires are intimately related to the topography in this area. Topographic data and other remote sensing images provide valuable information for assessing and mitigating the natural hazards for cities along the front of active mountain ranges.This shaded relief image was generated using topographic data from the Shuttle Radar Topography Mission. A computer-generated artificial light source illuminates the elevation data to produce a pattern of light and shadows. Slopes facing the light appear bright, while those facing away are shaded. On flatter surfaces, the pattern of light and shadows can reveal subtle features in the terrain. Colors show the elevation as measured by SRTM. Colors range from blue at the lowest elevations to white at the highest elevations. This image contains about 2300 meters (7500 feet) of total relief. White speckles on the face of some of the mountains are holes in the data caused by steep terrain. These will be filled using coverage from an intersecting pass.The Shuttle Radar Topography Mission (SRTM), launched on February 11,2000, uses the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. The mission is designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200-foot) mast, an additional C-band imaging antenna

  14. Effect of a local anesthetic lozenge in relief of symptoms in burning mouth syndrome

    DEFF Research Database (Denmark)

    Treldal, Charlotte; Jacobsen, C B; Mogensen, Stine

    2016-01-01

    with BMS. METHODS: Eighteen patients (4 men and 14 women) aged 39-71 years with BMS were included in this randomized, double-blinded, placebo-controlled, crossover trial. Lozenges (containing bupivacaine or placebo) were administrated three times a day for 2 weeks for two separate treatment periods...

  15. Is reflexology as effective as aromatherapy massage for symptom relief in an adult outpatient oncology population?

    Science.gov (United States)

    Dyer, Jeannie; Thomas, Karen; Sandsund, Cathy; Shaw, Clare

    2013-08-01

    To test whether reflexology was inferior to aromatherapy massage for ameliorating self-selected problems or concerns. Non-blinded, randomised study with a 1:1 allocation. Adult outpatients recruited from a UK cancer centre, randomised by the minimisation method to either four aromatherapy massage or four reflexology sessions. MYCaW scores at baseline and completion; VAS (relaxation) pre and post-sessions. Unpaired t-test for the primary outcome; analysis of variance tests for repeated measures for VAS (relaxation); descriptive statistics (means and 95% confidence intervals) and content analysis for patient comments. 115 subjects (58 aromatherapy massage, 57 reflexology) recruited. Reflexology was found to be no less effective than aromatherapy massage for MYCaW first concerns (p = 0.046). There was no statistical difference between groups for MYCaW second concerns or overall well-being scores, proportions of patients gaining clinical benefit, VAS scores over time (p = 0.489) or between groups (p = 0.408) or in the written responses. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Pain Relief in Depressive Disorders: A Meta-Analysis of the Effects of Antidepressants.

    Science.gov (United States)

    Gebhardt, Stefan; Heinzel-Gutenbrunner, Monika; König, Udo

    2016-12-01

    Pain is a common symptom in patients with depressive disorders, which, if present, worsens the prognosis. However, there is little empirical knowledge of the therapeutic effects of antidepressants on painful physical symptoms of patients with depressive disorders. Furthermore, tricyclic/tetracyclic antidepressants (TCAs) have not yet been included in existing meta-analyses. A broad, systematic search of PubMed literature on antidepressant drug treatment of patients with depressive disorders with comorbid pain symptoms was carried out. A random-effects meta-analysis has been performed among 3 different groups of drugs for the 2 end points: pain and depression. Fourteen placebo-controlled studies with selective serotonin-noradrenaline reuptake inhibitors (SSNRIs) could be included, with 3 of them also investigating selective serotonin reuptake inhibitors (SSRIs). Three further placebo-controlled SSRI studies were identified, but only 2 placebo-controlled TCA studies.Both SSNRIs and SSRIs, but not TCAs, were significantly superior to placebo as regards their analgesic effects. However, all effects were small. For SSNRIs, there was a strong positive correlation between their effectiveness for pain relief and their positive effect on the mood of the patients. The analgesic effects of SSNRIs and SSRIs in patients with primary depressive disorders can be interpreted as largely equivalent. Because of a lack of placebo-controlled TCA studies, the results for TCAs would be comparable only to those of SSRIs and SSNRIs, if non-placebo-controlled TCA studies were included. The positive correlation found indicates a close relationship of pain relief and antidepressant treatment effects. These results refer merely to patients with primary depressive disorders, not to patients with primary pain disorders. Further studies comparing the effects of different types of antidepressant drugs on pain in depressive patients are warranted.

  17. Olduvai Gorge, Shaded Relief and Colored Height

    Science.gov (United States)

    2004-01-01

    Three striking and important areas of Tanzania in eastern Africa are shown in this color-coded shaded relief image from the Shuttle Radar Topography Mission. The largest circular feature in the center right is the caldera, or central crater, of the extinct volcano Ngorongoro. It is surrounded by a number of smaller volcanoes, all associated with the Great Rift Valley, a geologic fault system that extends for about 4,830 kilometers (2,995 miles) from Syria to central Mozambique. Ngorongoro's caldera is 22.5 kilometers (14 miles) across at its widest point and is 610 meters (2,000 feet) deep. Its floor is very level, holding a lake fed by streams running down the caldera wall. It is part of the Ngorongoro Conservation Area and is home to over 75,000 animals. The lakes south of the crater are Lake Eyasi and Lake Manyara, also part of the conservation area. The relatively smooth region in the upper left of the image is the Serengeti National Park, the largest in Tanzania. The park encompasses the main part of the Serengeti ecosystem, supporting the greatest remaining concentration of plains game in Africa including more than 3,000,000 large mammals. The animals roam the park freely and in the spectacular migrations, huge herds of wild animals move to other areas of the park in search of greener grazing grounds (requiring over 4,000 tons of grass each day) and water. The faint, nearly horizontal line near the center of the image is Olduvai Gorge, made famous by the discovery of remains of the earliest humans to exist. Between 1.9 and 1.2 million years ago a salt lake occupied this area, followed by the appearance of fresh water streams and small ponds. Exposed deposits show rich fossil fauna, many hominid remains and items belonging to one of the oldest stone tool technologies, called Olduwan. The time span of the objects recovered dates from 2,100,000 to 15,000 years ago. Two visualization methods were combined to produce the image: shading and color coding of

  18. 30 CFR 204.205 - How do I obtain accounting and auditing relief?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How do I obtain accounting and auditing relief... MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.205 How do I obtain accounting and auditing relief? (a) To take cumulative reports and payments relief...

  19. 30 CFR 204.201 - Who may obtain accounting and auditing relief?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Who may obtain accounting and auditing relief... MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.201 Who may obtain accounting and auditing relief? (a) You may obtain accounting and auditing relief under...

  20. 30 CFR 204.211 - When may MMS rescind relief for a property?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When may MMS rescind relief for a property? 204... MMS rescind relief for a property? (a) MMS may retroactively rescind the relief for your property if MMS determines that your property was not eligible for the relief obtained under this subpart because...

  1. A novel and effective acupuncture modality as a complementary therapy to acute pain relief in inpatients with rib fractures.

    Science.gov (United States)

    Ho, Hsin-Yi; Chen, Chao-Wei; Li, Ming-Chieh; Hsu, Yu-Pao; Kang, Shih-Ching; Liu, Erh-Hao; Lee, Ko-Hung

    2014-01-01

    Pain control has been emphasized as a priority for both practitioners and inpatients with rib fractures, since analgesia could only offer limited relief from severe pain. A prospective and randomized controlled trial was conducted to analyze the efficacy and efficiency of acupuncture in acute pain relief for inpatients with rib fractures. A total of 58 inpatients were recruited and allocated to two groups, receiving identical doses of conventional oral analgesics as well as filiform needles as treatment and thumbtack intradermal (TI) needles placed upon the skin surface as a control, respectively, via novel acupuncture modality once daily for three consecutive days. The effect of pain relief was evaluated during activities that induce pain, and sustained maximal inspiration (SMI) lung volumes and sleep quality were assessed. The patients treated with filiform needles had more effective pain relief than those in the TI needle group during deep breathing, coughing, and turning over the body (p pain relief via acupuncture. The active evaluation could provide a more adaptive model for assessing pain intensity due to rib fractures. This novel acupuncture modality in which the needle insertion sites are corresponding to the pain spots can be a safe and viable therapy for relieving pain in inpatients with rib fractures.

  2. A novel and effective acupuncture modality as a complementary therapy to acute pain relief in inpatients with rib fractures

    Directory of Open Access Journals (Sweden)

    Hsin-Yi Ho

    2014-06-01

    Full Text Available Background: Pain control has been emphasized as a priority for both practitioners and inpatients with rib fractures, since analgesia could only offer limited relief from severe pain. A prospective and randomized controlled trial was conducted to analyze the efficacy and efficiency of acupuncture in acute pain relief for inpatients with rib fractures. Methods: A total of 58 inpatients were recruited and allocated to two groups, receiving identical doses of conventional oral analgesics as well as filiform needles as treatment and thumbtack intradermal (TI needles placed upon the skin surface as a control, respectively, via novel acupuncture modality once daily for three consecutive days. The effect of pain relief was evaluated during activities that induce pain, and sustained maximal inspiration (SMI lung volumes and sleep quality were assessed. Results: The patients treated with filiform needles had more effective pain relief than those in the TI needle group during deep breathing, coughing, and turning over the body (p < 0.05, and the effect persisted for at least 6 h in most patients. Sustained maximal inspiration lung volumes and sleep quality did not show improvement through every acupuncture intervention, and they could not respond accurately to pain relief via acupuncture. Conclusion: The active evaluation could provide a more adaptive model for assessing pain intensity due to rib fractures. This novel acupuncture modality in which the needle insertion sites are corresponding to the pain spots can be a safe and viable therapy for relieving pain in inpatients with rib fractures.

  3. Periarticular infiltration for pain relief after total hip arthroplasty: a comparison with epidural and PCA analgesia.

    Science.gov (United States)

    Pandazi, Ageliki; Kanellopoulos, Ilias; Kalimeris, Konstantinos; Batistaki, Chrysanthi; Nikolakopoulos, Nikolaos; Matsota, Paraskevi; Babis, George C; Kostopanagiotou, Georgia

    2013-11-01

    Epidural and intravenous patient-controlled analgesia (PCA) are established methods for pain relief after total hip arthroplasty (THA). Periarticular infiltration is an alternative method that is gaining ground due to its simplicity and safety. Our study aims to assess the efficacy of periarticular infiltration in pain relief after THA. Sixty-three patients undergoing THA under spinal anaesthesia were randomly assigned to receive postoperative analgesia with continuous epidural infusion with ropivacaine (epidural group), intraoperative periarticular infiltration with ropivacaine, clonidine, morphine, epinephrine and corticosteroids (infiltration group) or PCA with morphine (PCA group). PCA morphine provided rescue analgesia in all groups. We recorded morphine consumption, visual analog scale (VAS) scores at rest and movement, blood loss from wound drainage, mean arterial pressure (MAP) and adverse effects at 1, 6, 12, 24 h postoperatively. Morphine consumption at all time points, VAS scores at rest, 6, 12 and 24 h and at movement, 6 and 12 h postoperatively were lower in infiltration group compared to PCA group (p PCA group (p PCA with morphine after THA, providing better pain relief and lower opioid consumption postoperatively. Infiltration seems to be equally effective to epidural analgesia without having the potential side effects of the latter.

  4. Non-invasive nursing technologies for pain relief during childbirth--the Brazilian nurse midwives' view.

    Science.gov (United States)

    Vargens, Octavio M C; Silva, Alexandra C V; Progianti, Jane M

    2013-11-01

    to describe the non-invasive care technologies most frequently used by nurse midwives to relieve childbirth pain, and provide a synthesis of studies published by Brazilian nurse midwives on the use of such technologies. a systematic literature review focusing on the non-invasive pain relief strategies used by nurse midwives in Brazil. Surveys of three databases (BDENF, CINAHL and MEDLINE) were conducted between 2002 and 2012. The inclusion criteria were: (1) full-text article available; (2) published between 2002 and 2012; (3) written by Brazilian nurse midwives, and (4) fitting the descriptors: childbirth pain; non-invasive technologies; labour; and pain relief. For purposes of analysis, the technologies mentioned were classified into four main categories of support as they relate to environment, position, tactile stimulation, and energy level. we located 21 scientific articles that met the inclusion criteria and addressed the non-invasive technologies that nurse midwives use to provide pain relief during labour. The technologies most used was: stimulation of breathing and relaxation; use of massage with essential oils; encouraging freedom to move, to walk and the free choice for vertical positioning; use of showers and baths; use of birth ball. Brazilian nurse midwives have made efforts to focus care during delivery on the parturient. By studying and publishing about the non-invasive care technologies they have strengthened de-medicalised knowledge, based on scientific evidence and good outcomes in pain relief during labour. the study presented ideas towards improved theoretical foundations and strategies for establishing practice consonant with humanised care. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Inventory slack routing application in emergency logistics and relief distributions.

    Science.gov (United States)

    Yang, Xianfeng; Hao, Wei; Lu, Yang

    2018-01-01

    Various natural and manmade disasters during last decades have highlighted the need of further improving on governmental preparedness to emergency events, and a relief supplies distribution problem named Inventory Slack Routing Problem (ISRP) has received increasing attentions. In an ISRP, inventory slack is defined as the duration between reliefs arriving time and estimated inventory stock-out time. Hence, a larger inventory slack could grant more responsive time in facing of various factors (e.g., traffic congestion) that may lead to delivery lateness. In this study, the relief distribution problem is formulated as an optimization model that maximize the minimum slack among all dispensing sites. To efficiently solve this problem, we propose a two-stage approach to tackle the vehicle routing and relief allocation sub-problems. By analyzing the inter-relations between these two sub-problems, a new objective function considering both delivery durations and dispensing rates of demand sites is applied in the first stage to design the vehicle routes. A hierarchical routing approach and a sweep approach are also proposed in this stage. Given the vehicle routing plan, the relief allocation could be easily solved in the second stage. Numerical experiment with a comparison of multi-vehicle Traveling Salesman Problem (TSP) has demonstrated the need of ISRP and the capability of the proposed solution approaches.

  6. New and Emerging Technologies in Treatment of Lower Urinary Tract Symptoms From Benign Prostatic Hyperplasia.

    Science.gov (United States)

    Gupta, Nikhil K; Gange, Steven N; McVary, Kevin T

    2018-03-29

    Lower urinary tract symptoms (LUTS) from bladder outlet obstruction from benign prostatic hyperplasia (BPH) occur in a large percentage of urologic patients. Treatment of this condition with medical and surgical therapy provides symptom relief but has serious adverse effects and causes sexual dysfunction. New technologies to treat BPH-associated LUTS aim to effectively treat urinary symptoms and minimize side effects and sexual dysfunction. To review the efficacy of new and emerging therapies for treatment of LUTS from BPH. A literature search was performed to identify therapies for LUTS from BPH with early outcomes data within the past 5 years. Improvement in International Prostate Symptom Score (IPSS) and effect on sexual functions such as erectile and ejaculatory functions as measured on the International Index of Erectile Function and the Male Sexual Health Questionnaire. Technologies introduced within the past 5 years include techniques using intraprostatic injectables, mechanical devices, and prostatic tissue ablation. Most technologies remain in the development phase and have only phase I and II studies available that show promising alleviation of urinary symptoms. Injectables have not typically surpassed placebo or sham effects, although special cohorts could be exceptions. Thus far, convective water vapor ablation therapy and prostatic urethral lift have shown the most promise, with short- and medium-term data available on phase III studies demonstrating significant improvement in IPSS with minimal impact on sexual function. Many of these technologies are limited in their potential treatment population by prostate size and conformation, whereas other therapies might be more generalizable. Many new technologies aim to treat LUTS from BPH and minimize sexual side effects. Most therapies remain experimental, although prostatic urethral lift and water vapor ablation therapy have been brought to market and show promise. Long-term durability of symptom relief

  7. Negative reinforcement eating expectancies, emotion dysregulation, and symptoms of bulimia nervosa.

    Science.gov (United States)

    Hayaki, Jumi

    2009-09-01

    Research suggests that emotion dysregulation or difficulties in the modulation of emotional experience constitute risk for eating disorders. Recent work has also highlighted the role of certain eating-related cognitions, specifically expectations of negative emotional reinforcement from eating, in the development of disturbed eating patterns. However, it is unclear whether these expectancies are merely a dimension of a general inability to regulate emotions effectively or rather a unique cognitive-affective risk factor for the development of an eating disorder. This study examines the unique contribution of eating expectancies to symptoms of bulimia nervosa (BN) after controlling for two dimensions of emotion dysregulation (alexithymia and experiential avoidance) previously implicated in the phenomenology of eating disorders. Participants were 115 undergraduate women who self-reported demographics, alexithymia, experiential avoidance, eating expectancies, and symptoms of BN. Eating expectancies uniquely contributed 12.4% of the variance in symptoms of BN, F(2, 108) = 11.74, p symptoms of BN. These results suggest that individuals who expect eating to provide emotional relief may be especially susceptible to disordered eating. Findings are discussed in terms of emotional risk models and clinical interventions for BN.

  8. Retrospection-Simulation-Revision: Approach to the Analysis of the Composition and Characteristics of Medical Waste at a Disaster Relief Site.

    Science.gov (United States)

    Zhang, Li; Wu, Lihua; Tian, Feng; Wang, Zheng

    2016-01-01

    A large amount of medical waste is produced during disaster relief, posing a potential hazard to the habitat and the environment. A comprehensive understanding of the composition and characteristics of medical waste that requires management is one of the most basic steps in the development of a plan for medical waste management. Unfortunately, limited reliable information is available in the open literature on the characteristics of the medical waste that is generated at disaster relief sites. This paper discusses the analysis of the composition and characteristics of medical waste at a disaster relief site using the retrospection-simulation-revision method. For this study, we obtained 35 medical relief records of the Wenchuan Earthquake, Sichuan, May 2008 from a field cabin hospital. We first present a retrospective analysis of the relief medical records, and then, we simulate the medical waste generated in the affected areas. We ultimately determine the composition and characteristics of medical waste in the affected areas using untreated medical waste to revise the composition of the simulated medical waste. The results from 35 cases showed that the medical waste generated from disaster relief consists of the following: plastic (43.2%), biomass (26.3%), synthetic fiber (15.3%), rubber (6.6%), liquid (6.6%), inorganic salts (0.3%) and metals (1.7%). The bulk density of medical relief waste is 249 kg/m3, and the moisture content is 44.75%. The data should be provided to assist the collection, segregation, storage, transportation, disposal and contamination control of medical waste in affected areas. In this paper, we wish to introduce this research method of restoring the medical waste generated in disaster relief to readers and researchers. In addition, we hope more disaster relief agencies will become aware of the significance of medical case recording and storing. This may be very important for the environmental evaluation of medical waste in disaster areas, as

  9. Epidural morphine for postoperative pain relief in children

    DEFF Research Database (Denmark)

    Henneberg, S W; Hole, P; Haas, Inge Madsen De

    1993-01-01

    Epidural morphine for postoperative pain relief is in general use, and has proved to be very efficient in adults. The epidural technique and the use of epidural morphine are much less frequent in children. For 2 years we have prospectively followed 76 children who had epidural morphine...... for postoperative pain relief after major abdominal surgery. The age distribution was from newborn to 13 years, with a median age of 12 months. It was estimated that 94% of the patients had good analgesia for the first 24 postoperative hours and no other opioids were given. The side effects were few, but one case...... the investigation. We observed a change in the sleeping pattern with an increased number of sleep-induced myoclonia during the administration of epidural morphine. In conclusion, the use of epidural morphine in children for postoperative pain relief is very efficient. The minimal effective dose has not been...

  10. Patient expectations predict greater pain relief with joint arthroplasty.

    Science.gov (United States)

    Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

    2009-08-01

    We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.

  11. rTMS Induced Tinnitus Relief Is Related to an Increase in Auditory Cortical Alpha Activity

    Science.gov (United States)

    Müller, Nadia; Lorenz, Isabel; Langguth, Berthold; Weisz, Nathan

    2013-01-01

    Chronic tinnitus, the continuous perception of a phantom sound, is a highly prevalent audiological symptom. A promising approach for the treatment of tinnitus is repetitive transcranial magnetic stimulation (rTMS) as this directly affects tinnitus-related brain activity. Several studies indeed show tinnitus relief after rTMS, however effects are moderate and vary strongly across patients. This may be due to a lack of knowledge regarding how rTMS affects oscillatory activity in tinnitus sufferers and which modulations are associated with tinnitus relief. In the present study we examined the effects of five different stimulation protocols (including sham) by measuring tinnitus loudness and tinnitus-related brain activity with Magnetoencephalography before and after rTMS. Changes in oscillatory activity were analysed for the stimulated auditory cortex as well as for the entire brain regarding certain frequency bands of interest (delta, theta, alpha, gamma). In line with the literature the effects of rTMS on tinnitus loudness varied strongly across patients. This variability was also reflected in the rTMS effects on oscillatory activity. Importantly, strong reductions in tinnitus loudness were associated with increases in alpha power in the stimulated auditory cortex, while an unspecific decrease in gamma and alpha power, particularly in left frontal regions, was linked to an increase in tinnitus loudness. The identification of alpha power increase as main correlate for tinnitus reduction sheds further light on the pathophysiology of tinnitus. This will hopefully stimulate the development of more effective therapy approaches. PMID:23390539

  12. ''Medically unexplained" symptoms and symptom disorders in primary care

    DEFF Research Database (Denmark)

    Rosendal, Marianne; Hartman, Tim C. Olde; Aamland, Aase

    2017-01-01

    that better supports clinical decision-making, creates clearer communication and provides scientific underpinning of research to ensure effective interventions. Discussion: We propose a classification of symptoms that places greater emphasis on prognostic factors. Prognosis-based classification aims...

  13. Synapsin determines memory strength after punishment- and relief-learning.

    Science.gov (United States)

    Niewalda, Thomas; Michels, Birgit; Jungnickel, Roswitha; Diegelmann, Sören; Kleber, Jörg; Kähne, Thilo; Gerber, Bertram

    2015-05-13

    Adverse life events can induce two kinds of memory with opposite valence, dependent on timing: "negative" memories for stimuli preceding them and "positive" memories for stimuli experienced at the moment of "relief." Such punishment memory and relief memory are found in insects, rats, and man. For example, fruit flies (Drosophila melanogaster) avoid an odor after odor-shock training ("forward conditioning" of the odor), whereas after shock-odor training ("backward conditioning" of the odor) they approach it. Do these timing-dependent associative processes share molecular determinants? We focus on the role of Synapsin, a conserved presynaptic phosphoprotein regulating the balance between the reserve pool and the readily releasable pool of synaptic vesicles. We find that a lack of Synapsin leaves task-relevant sensory and motor faculties unaffected. In contrast, both punishment memory and relief memory scores are reduced. These defects reflect a true lessening of associative memory strength, as distortions in nonassociative processing (e.g., susceptibility to handling, adaptation, habituation, sensitization), discrimination ability, and changes in the time course of coincidence detection can be ruled out as alternative explanations. Reductions in punishment- and relief-memory strength are also observed upon an RNAi-mediated knock-down of Synapsin, and are rescued both by acutely restoring Synapsin and by locally restoring it in the mushroom bodies of mutant flies. Thus, both punishment memory and relief memory require the Synapsin protein and in this sense share genetic and molecular determinants. We note that corresponding molecular commonalities between punishment memory and relief memory in humans would constrain pharmacological attempts to selectively interfere with excessive associative punishment memories, e.g., after traumatic experiences. Copyright © 2015 Niewalda et al.

  14. Synapsin Determines Memory Strength after Punishment- and Relief-Learning

    Science.gov (United States)

    Niewalda, Thomas; Michels, Birgit; Jungnickel, Roswitha; Diegelmann, Sören; Kleber, Jörg; Kähne, Thilo

    2015-01-01

    Adverse life events can induce two kinds of memory with opposite valence, dependent on timing: “negative” memories for stimuli preceding them and “positive” memories for stimuli experienced at the moment of “relief.” Such punishment memory and relief memory are found in insects, rats, and man. For example, fruit flies (Drosophila melanogaster) avoid an odor after odor-shock training (“forward conditioning” of the odor), whereas after shock-odor training (“backward conditioning” of the odor) they approach it. Do these timing-dependent associative processes share molecular determinants? We focus on the role of Synapsin, a conserved presynaptic phosphoprotein regulating the balance between the reserve pool and the readily releasable pool of synaptic vesicles. We find that a lack of Synapsin leaves task-relevant sensory and motor faculties unaffected. In contrast, both punishment memory and relief memory scores are reduced. These defects reflect a true lessening of associative memory strength, as distortions in nonassociative processing (e.g., susceptibility to handling, adaptation, habituation, sensitization), discrimination ability, and changes in the time course of coincidence detection can be ruled out as alternative explanations. Reductions in punishment- and relief-memory strength are also observed upon an RNAi-mediated knock-down of Synapsin, and are rescued both by acutely restoring Synapsin and by locally restoring it in the mushroom bodies of mutant flies. Thus, both punishment memory and relief memory require the Synapsin protein and in this sense share genetic and molecular determinants. We note that corresponding molecular commonalities between punishment memory and relief memory in humans would constrain pharmacological attempts to selectively interfere with excessive associative punishment memories, e.g., after traumatic experiences. PMID:25972175

  15. Pain relief and clinical outcome: from opioids to balanced analgesia

    DEFF Research Database (Denmark)

    Kehlet, H

    1996-01-01

    If it is generally accepted that adequate postoperative pain relief will improve outcome from surgery, several controlled trials demonstrated this only for lower body surgical procedures with epidural and spinal anesthetics. Important effects on outcome were not shown when postoperative opioids...... were administered with patient controlled (PCA) or epidural techniques. However, the most optimal pain relief seems to be best achieved with balanced analgesia techniques using combinations of epidural opioids and local anesthetics and systemic non-steroidal antiinflammatory drugs. Future efforts...... should aim at including physical rehabilitation programs in the pain treatment regimen....

  16. Acupucture as pain relief during delivery - a randomized controlled trial

    DEFF Research Database (Denmark)

    Borup, Lissa; Wurlitzer, Winnie; Hedegaard, Morten

    2009-01-01

    Background: Many women need some kind of analgesic treatment to relieve pain during childbirth. The objective of our study was to compare the effect of acupuncture with transcutaneous electric nerve stimulation (TENS) and traditional analgesics for pain relief and relaxation during delivery...... with respect to pain intensity, birth experience, and obstetric outcome. Methods: A randomized controlled trial was conducted with 607 healthy women in labor at term who received acupuncture, TENS, or traditional analgesics. Primary outcomes were the need for pharmacological and invasive methods, level of pain...... to existing pain relief methods. (BIRTH 36:1 March 2009)...

  17. Experimental investigation of processes in primary circuit relief system

    International Nuclear Information System (INIS)

    Tomas, Z.; Simo, T.; Konecny, A.

    1989-01-01

    The protective condenser (direct contact condenser) is one of the basic components of the primary circuit relief system of WWER power plants. The steam flowing from the surge tank through relief valves into the subcooled water condensates in the protective condenser vessel. Two simple physical models were designed and constructed for investigation of bubbling through (contact condensation). An experimental program was performed with the aim of determining the distribution of temperatures in the axis of the steam jet and its vicinity, determining the velocity field of water into vicinity of steam jets, observing the geometrical shape of jets and their interaction and determining important values for mathematical model. (orig.)

  18. Structural analysis strategies of the pressurized relief and safety valves discharge piping of NPP Angra 1

    International Nuclear Information System (INIS)

    Lima, Maria Ines Prates de; Kuramoto, Edson; Suanno, Rodolfo

    2002-01-01

    The pressurizer relief and safety valve system provides the reactor coolant system overpressure protection and, therefore, it is fundamental for the security of a nuclear plant. This paper discusses the safety valve loop seal strategies adopted by others nuclear power plants over the world in order to attend the recommendations of NUREG-0578 (TMI-2 Lessons Learned Task Force Status Report and Short Term Recommendations). The technical option adopted for Angra 1 consists in making specific modifications on the original piping and support configuration of the pressurizer relief and safety valve system. These modifications were proposed in order to reduce the high stress levels induced by the thermal-hydrodynamic loads caused by the discharge of the sub-cooled water during the opening of the relief or the safety valves. Several thermal-hydraulic models were tested to assess the influence of the seal water heating and the simultaneous opening of the valves in order to minimize the thermal hydrodynamic loads effects. The piping structural analysis was performed, using the computer program system KWUROHR, to satisfy the requirements of the appropriate equations of the code ASME Section III, Subsections NB3650 and NC3650. (author)

  19. Occlusal relief changes with molar wear in Pan troglodytes troglodytes and Gorilla gorilla gorilla.

    Science.gov (United States)

    M'kirera, Francis; Ungar, Peter S

    2003-06-01

    Most research on primate tooth form-function relationships has focused on unworn teeth. This study presents a morphological comparison of variably worn lower second molars (M(2)s) of lowland gorillas (Gorilla gorilla gorilla; n=47) and common chimpanzees (Pan troglodytes troglodytes; n=54) using dental topographic analysis. High-resolution replicas of occlusal surfaces were prepared and scanned in 3D by laser scanning. The resulting elevation data were used to create a geographic information system (GIS) for each tooth. Occlusal relief, defined as the ratio of 3D surface area to 2D planometric area of the occlusal table, was calculated and compared between wear stages, taxa, and sexes. The results failed to show a difference in occlusal relief between males and females of a given taxon, but did evince differences between wear stages and between taxa. A lack of significant interaction between wear stage and taxon factors suggests that differences in occlusal relief between chimpanzees and gorillas are maintained throughout the wear sequence. These results add to a growing body of information on how molar teeth change with wear, and how differences between primate species are maintained at comparable points throughout the wear sequence. Such studies provide new insights into form-function relationships, which will allow us to infer certain aspects of diet in fossils with worn teeth.

  20. Requests for cesarean deliveries: The politics of labor pain and pain relief in Shanghai, China.

    Science.gov (United States)

    Wang, Eileen

    2017-01-01

    Cesarean section rates have risen dramatically in China within the past 25 years, particularly driven by non-medical factors and maternal requests. One major reason women request cesareans is the fear of labor pain, in a country where a minority of women are given any form of pain relief during labor. Drawing upon ethnographic fieldwork and in-depth interviews with 26 postpartum women and 8 providers at a Shanghai district hospital in June and July of 2015, this article elucidates how perceptions of labor pain and the environment of pain relief constructs the cesarean on maternal request. In particular, many women feared labor pain and, in a context without effective pharmacological pain relief or social support during labor, they came to view cesarean sections as a way to negotiate their labor pain. In some cases, women would request cesarean sections during labor as an expression of their pain and a call for a response to their suffering. However, physicians, under recent state policy, deny such requests, particularly as they do not view pain as a reasonable indication for a cesarean birth. This disconnect leads to a mismatch in goals for the experience of birth. To reduce unnecessary C-sections, policy makers should instead address the lack of pain relief during childbirth and develop other means of improving the childbirth experience that may relieve maternal anxiety, such as allowing family members to support the laboring woman and integrating a midwifery model for low-risk births within China's maternal-services system. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Flurbiprofen microgranules for relief of sore throat: a randomised, double-blind trial

    Science.gov (United States)

    Russo, Marc; Bloch, Mark; de Looze, Fred; Morris, Christopher; Shephard, Adrian

    2013-01-01

    Background Many people with sore throat seek, and are often inappropriately prescribed, antibiotics. Aim The objective of this study was to determine the analgesic efficacy of flurbiprofen 8.75 mg microgranules versus placebo. These microgranules are a possible alternative treatment for patients with sore throat due to upper respiratory tract infection (URTI). Design and setting Randomised, double-blind, placebo-controlled, multiple-dose study conducted at eight primary care sites in Australia. Method Participants with sore throat of onset within the past 4 days received either flurbiprofen 8.75 mg microgranules or non-medicated placebo microgranules. Throat soreness, difficulty in swallowing, sore throat pain intensity, sore throat relief, oral temperature, and treatment benefits were all assessed at regular intervals. Result Of 373 patients from eight centres, 186 received flurbiprofen 8.75 mg microgranules and 187 received placebo microgranules (intent-to-treat population). Throat soreness was significantly reduced over the first 2 hours after the first dose. Reductions in difficulty in swallowing were observed at all time points from 5 to 360 minutes after the first dose, after taking flurbiprofen microgranules versus placebo. Sore throat relief was also evident at 1 minute and lasted for at least 6 hours. The multiple-dose efficacy results showed reduction of difficulty in swallowing at the end of days 1–3 and sore throat relief at the end of day 1. Conclusion Microgranules containing flurbiprofen 8.75 mg provided fast and effective relief from sore throat due to URTI and represent an alternative treatment option to antibiotic therapy. PMID:23561694

  2. Treatment Outcome of Diode Laser for Symptomatic Relief in Oral Sub Mucous Fibrosis: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Jithender Mudigonda

    2016-01-01

    Full Text Available Aim : Oral submucous fibrosis (OSMF is a progressive premalignant condition largely occurring in Indian subcontinent due to habitual chewing of betel nut. Major symptoms of the condition include burning sensation to spicy food and progressive trismus. Since aetiology and pathogenesis of this condition is not fully understood; the management of patient focuses on symptomatic relief of trismus and burning sensation. Materials and Method : This was a pilot study to compare the outcome of diode laser (category A to steroid and hyaluronidase injections (category B in early stage of OSMF. Results : By the end of six months, patients in either of the categories showed significant improvement in reduction of symptoms, however; patients in category A showed greater significance in mouth opening ( p=0.002 vs. p=0.011 and reduction in burning sensation (p=0.002 vs. p=0.004. Conclusion: Although laser excision is not an answer for OSMF, it is a simple surgical procedure with effective results in the management of symptoms of OSMF. Improved mouth opening further facilitates periodic inspection of mucosa for initial signs of malignant transformation.

  3. The role of hydromorphone and OPRM1 in postoperative pain relief with hydrocodone.

    Science.gov (United States)

    Boswell, Mark V; Stauble, M Elaine; Loyd, Gary E; Langman, Loralie; Ramey-Hartung, Bronwyn; Baumgartner, Richard N; Tucker, William W; Jortani, Saeed A

    2013-01-01

    Postoperative pain management remains a challenge for clinicians due to unpredictable patient responses to opioid therapy. Some of this variability may result from single nucleotide polymorphisms (SNPs) of the human opioid mu-1 receptor (OPRM1) that modify receptor binding or signal transduction. The OPRM1 variant with the highest frequency is the A118G SNP. However, previous studies have produced inconsistent results regarding the clinical effects of A118G on opioid response. We hypothesized that measurement of serum opioid concentrations, in addition to determining total opioid consumption, may provide a more precise method of assessing the effects of A118G on analgesic response. The current study evaluated the relationship of analgesia, side effects, total hydrocodone consumption, quantitative serum hydrocodone and hydromorphone concentrations, and A118G SNP in postoperative patients following Cesarean section. 158 women scheduled for Cesarean section were enrolled prospectively in the study. The patients had bupivacaine spinal anesthesia for surgery and received intrathcal morphine with the spinal anesthetic or parenteral morphine for the first 24 hours after surgery. Thereafter, patients received hydrocodone/acetaminophen for postoperative pain control. On postoperative day 3, venous blood samples were obtained for OPRM1 A118G genotyping and serum opioid concentrations. 131 (82.9%) of the subjects were homozygous for the 118A allele of OPRM1 (AA) and 27 (17.1%) carried the G allele (AG/GG). By regression analysis, pain relief was significantly associated with total hydrocodone dose in the AA group (P = 0.01), but not in the AG/GG group (P = 0.554). In contrast, there was no association between pain relief and serum hydrocodone concentration in either group. However, pain relief was significantly associated with serum hydromorphone concentration (a metabolite of hydrocodone) in the AA group (P = 0.004), but not in the AG/GG group (P = 0.724). Conversely, side

  4. Stress relief treatment of Alloy 600 steam generator tubing

    International Nuclear Information System (INIS)

    Rooyen, D. van; Cragnolino, C.

    1994-01-01

    The intergranular stress corrosion cracking (IGSCC) of Alloy 600 tubing in the primary side of operating steam generators is the subject of this investigation. The objective of the program was to examine the feasibility of heat treatment to alleviate the IGSCC problem. In addition to this, tests were also performed to examine the IGSCC susceptibility of nuclear grade Alloy 600 tubing obtained from various sources. Examination of temperature-time combinations that may hold potential for improved IGSCC resistance of the transition regions of tubes expanded into tube sheet holes was done. The combinations fall in two categories. One is of short duration and relatively high temperature, where induction is the best method of heating because the treatment only lasts from some tens of seconds to a few minutes. The other is carried out in a lower temperature range and lasts for several hours. This latter combination of temperatures and times is considered for the so-called global heat treatment of entire tube sheet. To assess the effect of these treatments, reverse U-bend testing in high purity deaerated water containing an overpressure of hydrogen was employed and several heats of Alloy 600 were compared in tests at 365 degrees C, which is well above actual operating temperatures of steam generators, but provides an accelerated test procedure. Results of furnace heating in the range of 550-610 degrees C indicated improvement in IGSCC resistance, with best performance after a heat treatment at 610 degrees C for nine hours. In addition to stress relief, carbide precipitation can also occur, and their relative contributions to the improvement is discussed

  5. Pain relief at the end of life: nurses' experiences regarding end-of-life pain relief in patients with dementia.

    Science.gov (United States)

    Brorson, Hanna; Plymoth, Henrietta; Örmon, Karin; Bolmsjö, Ingrid

    2014-03-01

    Patients with dementia receive suboptimal palliative care, and this patient group is at risk to have pain at the end of life. Because communicative impairments are common in this patient group, nurses play an important caregiver role in identifying, assessing, and relieving patients' pain. This study aimed to describe nurses' experiences regarding end-of-life pain relief in patients with dementia. This descriptive exploratory qualitative study was based on seven semistructured interviews. Burnard's content analysis inspired the data analysis. Two main categories were identified: (1) nurses' experience of difficulties concerning pain relief and (2) nurses' experience of resources concerning pain relief. Nurses experienced difficulties, such as feeling of powerlessness because of difficulties in obtaining adequate prescriptions for analgesics, ethical dilemmas, feeling of inadequacy because analgesia did not have the desired effect, and a feeling of not being able to connect with the patient. Factors, including knowledge about the patient, professional experience, utilization of pain assessment tools, interpersonal relationships, and interprofessional cooperation, served as resources and enabled end-of-life pain relief. The results of this study highlight the complexity of pain relief in patients with dementia at the end of life from a nursing perspective. The inability of patients with dementia to verbally communicate their pain makes them a vulnerable patient group, dependent on their caregivers. Knowing the life story of the patient, professional experience, teamwork based on good communication, and use of a pain assessment tool were reported by the nurses to improve pain relief at the end of life for patients with dementia. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  6. A sigh of relief or a sigh to relieve: The psychological and physiological relief effect of deep breaths.

    Science.gov (United States)

    Vlemincx, Elke; Van Diest, Ilse; Van den Bergh, Omer

    2016-10-15

    Both animal and human research have revealed important associations between sighs and relief. Previously we argued to conceive of sighs as resetters which temporarily induce relief. The present study aimed to investigate the psychological and physiological relief effect of sighs by instructed deep breaths and spontaneous sighs compared to a control breathing maneuver. Participants completed three blocks of 40 trials during which uncertainty cues were followed by either safety cues followed by a positive picture, or danger cues followed by a negative picture. One block was presented without breathing instructions, two subsequent blocks with breathing instructions. During the presentation of the safety and danger cues, an instruction was given to either 'take a deep breath' or 'postpone the next inhalation for 2 s (breath hold). Continuously, participants rated relief and Frontalis electromyography was recorded. Trait anxiety sensitivity was assessed by the Anxiety Sensitivity Index. Self-reported relief and physiological tension were compared 5s before and after instructed deep breaths and breath holds, and before and after spontaneous deep breaths and breath holds in the respective blocks. Results show that self-reported relief following an instructed deep breath was higher than before. Physiological tension decreased following a spontaneous sigh in high anxiety sensitive persons and following a spontaneous breath hold in low anxiety sensitive persons. These results are the first to show that a deep breath relieves and, in anxiety sensitive persons, reduces physiological tension. These findings support the hypothesis that sighs are psychological and physiological resetters. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. A comparison of polyethylene glycol laxative and placebo for relief of constipation from constipating medications.

    Science.gov (United States)

    DiPalma, Jack A; Cleveland, Mark B; McGowan, John; Herrera, Jorge L

    2007-11-01

    Medications often cause constipation and little data are available concerning treatment interventions. This study was designed to evaluate the safety and efficacy of polyethylene glycol (PEG) 3350 laxative (MiraLax) for relief of constipation from medicines associated with symptoms of constipation. Study subjects were enrolled who met defined criteria for chronic constipation and were also taking medications that were associated with a reported side effect incidence of more than 3% constipation. Subjects were randomized into a double-blind, parallel, multicenter study where they received 17 g per day of PEG laxative or placebo for 28 days. The primary efficacy variable, "Treatment Success," was defined as relief of ROME II criteria for constipation over the last 7 days of the treatment period. Various secondary measures were also assessed. Daily bowel movement experience, patient perception of efficacy, and safety information were recorded in a diary. Laboratory testing was performed at baseline and at end of study for hematology and blood chemistry, including BUN, calcium, electrolytes, and TSH. One hundred patients were enrolled at 4 study centers. Successful treatment according to the primary efficacy variable was seen in 78.3% of PEG and 39.1% of placebo subjects (P PEG compared with placebo (P PEG and placebo. No significant differences in laboratory findings or adverse events, including the gastrointestinal category, were observed. Diarrhea and flatulence occurred more frequently with PEG treatment, although they were not individually statistically different from placebo. Similar results were observed when these symptoms were analyzed for differences due to gender, race, or age. PEG laxative is safe and effective for use in treating constipation in patients taking constipating medications.

  8. Does Immediate Pain Relief After an Injection into the Sacroiliac Joint with Anesthetic and Corticosteroid Predict Subsequent Pain Relief?

    Science.gov (United States)

    Schneider, Byron J; Huynh, Lisa; Levin, Josh; Rinkaekan, Pranathip; Kordi, Ramin; Kennedy, David J

    2018-02-01

    To determine if immediate pain response following an injection with local anesthetic and corticosteroid predicts subsequent relief. Prospective observational cohort. An institutional review board-approved prospective study from a single academic medical center. Patients with clinical diagnosis of sacroiliac (SIJ) pain and referred for SIJ injection were enrolled; 1 cc of 2% lidocaine and 1 cc of triamcinolone 40 mg/mL were injected into the SIJ. Pain score on 0-10 numeric rating scale (NRS) during provocation maneuvers was recorded immediately before injection, immediately after injection, and at two and four weeks of follow-up. Oswestry Disability Index (ODI) was also recorded. Various cutoffs were identified to establish positive anesthetic response and successful outcomes at follow-up. These were used to calculated likelihood ratios. Of those with 100% anesthetic response, six of 11 (54.5%, 95% confidence interval [CI]+/-29.4%, +LR 2.6, 95% CI = 1.1-5.9) demonstrated 50% or greater pain relief at follow-up, and four of 11 (36.5%, 95% CI+/-28.4%, +LR 3.00, 95% CI = 1.4-5.1) had 100% relief at two to four weeks. Fourteen of 14 (100%, 95% CI+/-21.5%, -LR 0.0, 95% CI = 0.0-2.1) with an initial negative block failed to achieve 100% relief at follow-up. Patients who fail to achieve initial relief after SIJ injection with anesthetic and steroid are very unlikely to achieve significant pain relief at follow-up; negative likelihood ratios (LR) in this study, based on how success is defined, range between 0 and 0.9. Clinically significant positive likelihood ratios of anesthetic response to SIJ injection are more limited and less robust, but are valuable in predicting 50% relief or 100% relief at two to four weeks. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. Symptoms and Symptom Clusters Identified by Adolescents and Young Adults With Cancer Using a Symptom Heuristics App.

    Science.gov (United States)

    Ameringer, Suzanne; Erickson, Jeanne M; Macpherson, Catherine Fiona; Stegenga, Kristin; Linder, Lauri A

    2015-12-01

    Adolescents and young adults (AYAs) with cancer experience multiple distressing symptoms during treatment. Because the typical approach to symptom assessment does not easily reflect the symptom experience of individuals, alternative approaches to enhancing communication between the patient and provider are needed. We developed an iPad-based application that uses a heuristic approach to explore AYAs' cancer symptom experiences. In this mixed-methods descriptive study, 72 AYAs (13-29 years old) with cancer receiving myelosuppressive chemotherapy used the Computerized Symptom Capture Tool (C-SCAT) to create images of the symptoms and symptom clusters they experienced from a list of 30 symptoms. They answered open-ended questions within the C-SCAT about the causes of their symptoms and symptom clusters. The images generated through the C-SCAT and accompanying free-text data were analyzed using descriptive, content, and visual analyses. Most participants (n = 70) reported multiple symptoms (M = 8.14). The most frequently reported symptoms were nausea (65.3%), feeling drowsy (55.6%), lack of appetite (55.6%), and lack of energy (55.6%). Forty-six grouped their symptoms into one or more clusters. The most common symptom cluster was nausea/eating problems/appetite problems. Nausea was most frequently named as the priority symptom in a cluster and as a cause of other symptoms. Although common threads were present in the symptoms experienced by AYAs, the graphic images revealed unique perspectives and a range of complexity of symptom relationships, clusters, and causes. Results highlight the need for a tailored approach to symptom management based on how the AYA with cancer perceives his or her symptom experience. © 2015 Wiley Periodicals, Inc.

  10. Extending our knowledge of fermentable, short-chain carbohydrates for managing gastrointestinal symptoms.

    Science.gov (United States)

    Barrett, Jacqueline S

    2013-06-01

    The Monash University low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet is now accepted as an effective strategy for managing symptoms of irritable bowel syndrome (IBS) in Australia, with interest expanding across the world. These poorly absorbed, short-chain carbohydrates have been shown to induce IBS symptoms of diarrhea, bloating, abdominal pain, and flatus due to their poor absorption, osmotic activity, and rapid fermentation. Four clinical trials have been published to date, all with significant symptomatic response to the low FODMAP diet. Up to 86% of patients with IBS have achieved relief of overall gastrointestinal symptoms and, more specifically, bloating, flatus, abdominal pain, and altered bowel habit from the approach. This review provides an overview of the low FODMAP diet and summarizes the research to date, emerging concepts, and limitations. FODMAPs are known to be beneficial to bowel health; the importance of this and how this should be considered in the clinical management of IBS is also discussed. A clinical management flowchart is provided to assist nutrition professionals in the use of this approach.

  11. Epidural morphine for postoperative pain relief in children

    DEFF Research Database (Denmark)

    Henneberg, S W; Hole, P; Haas, Inge Madsen De

    1993-01-01

    the investigation. We observed a change in the sleeping pattern with an increased number of sleep-induced myoclonia during the administration of epidural morphine. In conclusion, the use of epidural morphine in children for postoperative pain relief is very efficient. The minimal effective dose has not been...

  12. Careful: Acetaminophen in Pain Relief Medicines Can Cause Liver Damage

    Science.gov (United States)

    ... Pain Relievers and Fever Reducers Careful: Acetaminophen in pain relief medicines can cause liver damage Share Tweet Linkedin Pin it More sharing options Linkedin Pin ... ingredient in many over-the-counter and prescription medicines that help relieve pain and reduce fever. More than 600 over-the- ...

  13. Building relations with women's organisations in relief work.

    Science.gov (United States)

    Gell, F

    1997-02-01

    An Oxfam Emergency Team arrived in Ingushetia in the Northern Caucasus region of the former Soviet Union in August 1996 to set up a program of shelter, rehabilitation, and relief in response to the large influx of people displaced by conflicts in the neighboring republics of Chechnya and North Ossetia. The team was also tasked with contacting community organizations such as women's groups and developing a relationship with them through joint relief work. The Chechen population was comprised of mainly women, children, and the elderly. The internally displaced population of 100,000 people is now scattered throughout the republic in collective centers and host families. Small committees of women were formed to help identify the most vulnerable residents and to distribute winter clothing. It was found during the relief work that fledgling women's groups are establishing themselves as vehicles for change, increasingly open to work with and learn from international organizations such as Oxfam. The Chechen branch of the Union of North Caucasian Women and the Ingushetian ALMOS played leading roles in peacemaking, human rights observance, and humanitarian relief.

  14. Topology-optimized broadband surface relief transmission grating

    DEFF Research Database (Denmark)

    Andkjær, Jacob; Ryder, Christian P.; Nielsen, Peter C.

    2014-01-01

    We propose a design methodology for systematic design of surface relief transmission gratings with optimized diffraction efficiency. The methodology is based on a gradient-based topology optimization formulation along with 2D frequency domain finite element simulations for TE and TM polarized plane...

  15. 19 CFR 210.68 - Complainant's temporary relief bond.

    Science.gov (United States)

    2010-04-01

    ... Section 210.68 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.68 Complainant's temporary... by Individual Surety United States International Trade Commission Affidavit by Individual Surety 19...

  16. Effective International Medical Disaster Relief: A Qualitative Descriptive Study.

    Science.gov (United States)

    Broby, Nicolette; Lassetter, Jane H; Williams, Mary; Winters, Blaine A

    2018-04-01

    Purpose The aim of this study was to assist organizations seeking to develop or improve their medical disaster relief effort by identifying fundamental elements and processes that permeate high-quality, international, medical disaster relief organizations and the teams they deploy. A qualitative descriptive design was used. Data were gathered from interviews with key personnel at five international medical response organizations, as well as during field observations conducted at multiple sites in Jordan and Greece, including three refugee camps. Data were then reviewed by the research team and coded to identify patterns, categories, and themes. The results from this qualitative, descriptive design identified three themes which were key characteristics of success found in effective, well-established, international medical disaster relief organizations. These characteristics were first, ensuring an official invitation had been extended and the need for assistance had been identified. Second, the response to that need was done in an effective and sustainable manner. Third, effective organizations strived to obtain high-quality volunteers. By following the three key characteristics outlined in this research, organizations are more likely to improve the efficiency and quality of their work. In addition, they will be less likely to impede the overall recovery process. Broby N , Lassetter JH , Williams M , Winters BA . Effective international medical disaster relief: a qualitative descriptive study. Prehosp Disaster Med. 2018;33(2):119-126.

  17. Pentazocine Pain Relief in Adult Patients With Acute Abdominal ...

    African Journals Online (AJOL)

    jen

    on pain relief, diagnostic accuracy and treatment decisions in patients with acute ... With level of power at 80% and a 5% significance level, a ... 72 hours` duration and were judged by the attending physician to require surgical consultation. .... Clinically Important Differences Between Pre Injection, Post Injection and Final ...

  18. Corruption in cyclone preparedness and relief efforts in coastal Bangladesh

    DEFF Research Database (Denmark)

    Mahmud, Tanvir; Prowse, Martin

    2012-01-01

    This article seeks to draw possible lessons for adaptation programmes in Bangladesh by examining whether cyclone preparedness and relief interventions are subject to corrupt practices. Based on a random sample survey of 278 households, three focus-group discussions and seven key-informant...

  19. Measured Maritime Responses to Disaster Relief Scenarios in the Pacific

    Science.gov (United States)

    2012-12-01

    command center. USS TORTUGA assisted the Japanese Ground Self Defense Force (JGSDF) by moving nearly 100 vehicles and 300 SDF personnel from Hokkaido to...northern Honshu and thus facilitated faster relief. Subsequently, TORTUGA became the flagship for Task Group 776.36, a port clearance group that

  20. A Closer Look: The American Taxpayer Relief Act of 2012

    Science.gov (United States)

    Balmer, Mary

    2013-01-01

    School districts may be affected by the American Taxpayer Relief Act of 2012 with regard to fixed assets management and education entities. The act avoids the scheduled increases to individual income tax rates for most Americans and extends a host of expired and expiring tax provisions for both individuals and businesses. The provisions described…

  1. 78 FR 49242 - Relief From Joint and Several Liability

    Science.gov (United States)

    2013-08-13

    ... 66(c) allows the requesting spouse to avoid liability for tax on community income of which the... is added to Sec. 1.66-4(j)(2)(ii) for claims for equitable relief from the Federal income tax... amended as follows: PART 1--INCOME TAXES 0 Paragraph 1. The authority citation for part 1 continues to...

  2. Poverty Relief or Poverty Eradication? | Kritzinger | Acta Theologica

    African Journals Online (AJOL)

    The author challenges the reader to make two mindshifts: from a focus on poverty relief to an emphasis on poverty eradication; and from viewing the poor as the objects of poverty alleviation to accepting them as the subjects of poverty eradication. The case is argued and a practical approach towards poverty eradication is ...

  3. 108 AN ASSESSMENT OF TAX RELIEFS AND ECONOMIC ...

    African Journals Online (AJOL)

    As advantageous as the payment of taxes to the government is, as a result of its ... Therefore, this study seeks to examine the nature of tax reliefs available to tax ... in the level of economic activity or tax payer's behaviour, then the tax policy ... The implication of this is that any tax payer that receives earned income shall be.

  4. Seismic assessment of the Pickering pressure relief duct

    International Nuclear Information System (INIS)

    Ghobarah, A.

    1995-05-01

    The objectives of the study are to examine the structural response of the Pickering pressure relief duct when subjected to earthquake ground motion and to estimate the seismic withstand capacity of various components of the structural system on the basis of performance criteria consistent with the safety function of the duct. (author). 24 refs., 16 tabs., 31 figs

  5. Diffraction from relief gratings on a biomimetic elastomer cast

    International Nuclear Information System (INIS)

    Guerrero, Raphael A.; Aranas, Erika B.

    2010-01-01

    Biomimetic optical elements combine the optimized designs of nature with the versatility of materials engineering. We employ a beetle carapace as the template for fabricating relief gratings on an elastomer substrate. Biological surface features are successfully replicated by a direct casting procedure. Far-field diffraction effects are discussed in terms of the Fraunhofer approximation in Fourier space.

  6. A Surface Relief Meter Based on Trinocular Vision

    NARCIS (Netherlands)

    Ernst, V.G.S.; Sablik, P.W.; Balendonck, J.; Houkes, Z.; Regtien, Paulus P.L.

    1995-01-01

    The concept for the relief meter being developed, appears to function well, when used with the artificial images. The described matching criterion leads to high matching percentages, and accurate results. The percentage of mismatches is reduced to practically zero for the tested scenes. Future work

  7. 2-minute Gridded Global Relief Data (ETOPO2) v2

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Two-minute gridded global relief for both ocean and land areas are available in the ETOPO2v2 (2006) database. ETOPO2v2 replaced ETOPO2 (2001). The historic 2-minute...

  8. 27 CFR 24.158 - Extent of relief.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Extent of relief. 24.158 Section 24.158 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT..., until all tax is fully paid. (d) Wine vinegar plant bond. The surety will be relieved of liability for...

  9. Shaded Relief with Height as Color, Iturralde Structure, Bolivia

    Science.gov (United States)

    2002-01-01

    An 8-kilometer (5-mile) wide crater of possible impact origin is shown in this view of an isolated part of the Bolivian Amazon from the Shuttle Radar Topography Mission. The circular feature at the center-left of the image, known as the Iturralde Structure, is possibly the Earth's most recent 'big' impact event recording collision with a meteor or comet that might have occurred between 11,000 and 30,000 years ago.Although the structure was identified on satellite photographs in the mid-1980s, its location is so remote that it has only been visited by scientific investigators twice, most recently by a team from NASA's Goddard Space Flight Center in September 2002. Lying in an area of very low relief, the landform is a quasi-circular closed depression only about 20 meters (66 feet) in depth, with sharply defined sub-angular 'rim' materials. It resembles a 'cookie cutter' in that its appearance 'cuts' the heavily vegetated soft-sediments and pampas of this part of Bolivia. The SRTM data have provided investigators with the first topographic map of the site and will allow studies of its three-dimensional structure crucial to determining whether it actually is of impact origin.Two visualization methods were combined to produce this image: shading and color coding of topographic height. The shade image was derived by computing topographic slope in the northwest-southeast direction. North-facing slopes appear bright and south-facing slopes appear dark. Color coding is directly related to topographic height, with brown and green at the lower elevations, rising through yellow and brown to white at the highest elevations.Elevation data used in this image was acquired by the Shuttle Radar Topography Mission aboard Space Shuttle Endeavour, launched on Feb. 11, 2000. The mission used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on Endeavour in 1994. The Shuttle Radar Topography Mission was

  10. Pharmacological interventions for pain relief during orthodontic treatment.

    Science.gov (United States)

    Monk, Aoife B; Harrison, Jayne E; Worthington, Helen V; Teague, Annabel

    2017-11-28

    Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial. We conducted this Cochrane Review to assess and summarize the international evidence relating to the effectiveness of analgesics for preventing this unwanted side effect associated with orthodontic treatment. The objectives of this review are to determine:- the effectiveness of drug interventions for pain relief during orthodontic treatment; and- whether there is a difference in the analgesic effect provided by different types, forms and doses of analgesia taken during orthodontic treatment. Cochrane Oral Health's Information Specialist searched the following databases: the Cochrane Oral Health Trials Register (to 19 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL;the Cochrane Library 2016, Issue 7), MEDLINE Ovid (1946 to 19 June 2017), Embase Ovid (1980 to 19 June 2017) and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 19 June 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched on the 19 June 2017 for ongoing studies. We placed no restrictions on language or date of publication when searching the electronic databases. We included randomized controlled trials (RCTs) relating to pain control during orthodontic treatment. Pain could be measured on a visual analogue scale (VAS), numerical

  11. Relief for maritime medical emergencies through telematics.

    Science.gov (United States)

    Anogianakis, G; Maglavera, S; Pomportsis, A

    1998-12-01

    MERMAID is a European Union (EU)-financed maritime telemedicine project with global reach and 24-h multilingual capability, so as to serve multinational crews working in the isolation of the world's oceans. It provides a model for the provision of healthcare services based on the electronic transmission of medical information via ISDN-based video conferencing. This model is not limited to medical diagnostics, but it encompasses all cases in which the actual delivery of healthcare services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an extensive telecommunications infrastructure that includes both satellite transmission for ship to shore communication and an extensive ground-based network for summoning expert medical help from around the world so as to meet the project's multilinguality requirements and, therefore, the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low-, medium-, and high-bandwidth data requirements) are considered, while the full range of network choices (digital land lines, cellular/wireless, satellite, and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their lifecycle. Finally, out of that, MERMAID utilizes advanced land-based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  12. Comparison of epidural butorphanol versus epidural morphine in postoperative pain relief.

    Science.gov (United States)

    Parikh, Geeta P; Veena, Shah R; Vora, Kalpana; Parikh, Beena; Joshi, Anish

    2014-02-01

    Epidural route is preferable for postoperative pain relief in thoraco-abdominal and lower limb surgeries. We aimed to compare epidural butorphanol versus morphine for postoperative analgesia up to 24 hours in open nephrectomy surgery. 80 ASA physical status I and II adult patients were selected for this randomized double blind prospective study. A standard balanced general anesthesia technique was applied for all patients. Epidural catheter was placed in lower thoracic inter-vertebral space before the start of surgery. Injection butorphanol 0.04 mg/kg in group B (n = 40) or morphine 0.06 mg/kg in group M (n = 40) was given in a double blind manner after completion of surgery and before extubation through the epidural catheter. Patients were observed for pain relief by Visual Analogue Scale (VAS) for the next 24 hours. Dose was repeated when VAS was > 4. The onset and peak effect of pain relief, duration of analgesia of 1st dose, frequency of drug administration and side effects if any were observed. The average onset of analgesia was 26.5 +/- 7.61 minutes with butorphanol and 62.5 +/- 13.4 minutes with morphine group which was statistically significant (p < 0.05). The mean peak effect of pain relief following 1st dose was 173 +/- 51.25 minutes with butorphanol and 251 +/- 52.32 minutes with morphine group. The duration of pain relief after 1st dose was statistically significant and was 339.13 +/- 79.57 minutes in group B and 709.75 +/- 72.12 minutes in group M which was gradually increased on repeated dosing in group B while it was almost same in Group M. Number of doses required in 24 hours was significantly higher (p < 0.05) in butorphanol group than morphine group. Somnolence was the main side effect in group B while pruritus was the main side effect with group M. Epidural butorphanol appears to provide safer and faster postoperative analgesia without much untoward effects but its analgesic action is short so more repeated doses are required than morphine via

  13. Should intranasal corticosteroids be used for the treatment of ocular symptoms of allergic rhinoconjunctivitis? A review of their efficacy and safety profile.

    Science.gov (United States)

    Lightman, Sue; Scadding, Glenis K

    2012-01-01

    Allergic rhinoconjunctivitis (ARC) presents as nasal symptoms, eye watering and additional signs of ocular allergy (e.g. itchy/burning eyes). Intranasal corticosteroids (INSs) are the most effective treatment for the nasal symptoms of seasonal allergic rhinitis (SAR; based on 4 meta-analyses) and are considered first-line therapy when nasal congestion forms a substantial component of the patient's rhinitis symptoms. Clinical trial evidence shows that INSs also provide some relief from ocular symptoms of SAR and seasonal ARC in adults. INSs probably alleviate eye watering, the main ocular symptom of SAR, by relieving nasal congestion. Other ocular symptoms also improve with INSs. The mechanism for this effect is unknown, but might relate to naso-ocular reflex reduction. There are limited data on ocular safety with INSs. However, the literature supports the use of INSs over several months as there appears to be no considerable increase in the risk of ocular hypertension or glaucoma. Copyright © 2012 S. Karger AG, Basel.

  14. Multinarasi Relief Yeh Pulu Basis Penciptaan Seni Lukis Kontemporer

    Directory of Open Access Journals (Sweden)

    I Wayan Adnyana

    2018-05-01

    Full Text Available Kajian ini merupakan skema penelitian terapan, yang bertujuan untuk mengungkap konsep multinarasi relief Yeh Pulu, Bedulu, Gianyar, Bali, sebagai basis penciptaan seni lukis kontemporer. Secara metodologis penelitian ini dilakukan dalam dua tahapan: penelitian lapangan (kajian atas narasi relief berdasar perspektif ikonologi Panofsky (1971, dan berikutnya penelitian eksperimen terkait penciptaan seni lukis kontemporer berdasar perspektif ‘art practice as a research’ (Sullivan, 2005 yang menunjuk pada tiga tahapan: eksperimen medium, bahasa visual, dan penyusunan konteks yang relevan. Berdasar kajian ikonologi, terutama tahap analisis ikonografi, ditemukan bahwa narasi relief Yeh Pulu bersifat multinarasi, yakni pahatan relief yang memiliki beragam jenis tema cerita, seperti praktik pertanian, berburu, meditasi, pesta, asmara, dan lain-lain. Kemudian konsep multinarasi dalam penciptaan seni lukis kontemporer, menjadi: (a secara medium menggunakan multiteknik dan medium; (b bahasa visual, menghadirkan berbagai adegan secara berulang, terpadu dan bahkan terkesan saling berlawanan; (c konteks yang relevan, dengan memasukan ikon tokok-toko pahlawan dunia pop, seperti superman, superwomen, dan lain-lain. Secara ikonologis, bangunan visual yang mempertemukan adegan multinarasi relief Yeh Pulu dengan narasi kepahlawanan dunia pop, menjadi semakin menguatkan konsep multinarasi dalam membangun pesan kepahlawanan dunia sehari-hari dalam karya seni lukis kontemporer semakin berhasil. Penelitian ini melibatkan: Anak Agung Rai Remawa (pengumpul data, dan  Ni Luh Desi In Diana Sari (fotografi dan layout. This paper serves as an applied research scheme which aims to reveal the concept of multiple narratives of Yeh Pulu Relief, located in Bedulu, Bali, as the basis for the creation of contemporary painting. Methodologically speaking, this study was conducted in two stages: a field research (a field study on the relief narratives based on Panofsky

  15. 78 FR 33467 - Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy...

    Science.gov (United States)

    2013-06-04

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Second Allocation of Public Transportation Emergency Relief Funds in Response to Hurricane Sandy: Response, Recovery & Resiliency; Correction... allocation of $3.7 billion under the Public Transportation Emergency Relief Program to the four FTA...

  16. 48 CFR 252.229-7010 - Relief from customs duty on fuel (United Kingdom).

    Science.gov (United States)

    2010-10-01

    ..., February 1973, entitled “Relief from Customs Duty and/or Value Added Tax on United States Government... Office. (b) Specific information should be included in the request for tax relief, such as the number of...

  17. Asthma Patients in US Overuse Quick-Relief Inhalers, Underuse Control Medications

    Science.gov (United States)

    ... quick-relief inhalers, underuse control medications Share | Asthma patients in US overuse quick-relief inhalers, underuse control ... and uncontrolled asthma result in poor health outcomes. Patients with well-controlled asthma are at lower risk ...

  18. Integration of real-time mapping technology in disaster relief distribution.

    Science.gov (United States)

    2013-02-01

    Vehicle routing for disaster relief distribution involves many challenges that distinguish this problem from those in commercial settings, given the time sensitive and resource constrained nature of relief activities. While operations research approa...

  19. A computational method to predict fluid-structure interaction of pressure relief valves

    Energy Technology Data Exchange (ETDEWEB)

    Kang, S. K.; Lee, D. H.; Park, S. K.; Hong, S. R. [Korea Electric Power Research Institute, Taejon (Korea, Republic of)

    2004-07-01

    An effective CFD (Computational fluid dynamics) method to predict important performance parameters, such as blowdown and chattering, for pressure relief valves in NPPs is provided in the present study. To calculate the valve motion, 6DOF (six degree of freedom) model is used. A chimera overset grid method is utilized to this study for the elimination of grid remeshing problem, when the disk moves. Further, CFD-Fastran which is developed by CFD-RC for compressible flow analysis is applied to an 1' safety valve. The prediction results ensure the applicability of the presented method in this study.

  20. Guidelines for confirmatory inplant tests of safety-relief valve discharges for BWR plants

    International Nuclear Information System (INIS)

    Su, T.M.

    1981-05-01

    Inplant tests of safety/relief valve (SRV) discharges may be required to confirm generically established specifications for SRV loads and the maximum suppression pool temperature, and to evaluate possible effects of plant-unique parameters. These tests are required in those plants which have features that differ substantially from those previously tested. Guidelines for formulating appropriate test matrices, establishing test procedures, selecting necessary instrumentation, and reporting the test results are provided in this report. Guidelines to determine if inplant tests are required on the basis of the plant unique parameters are also included in the report

  1. The addition of tramadol as a second opioid may improve pain relief in severe osteoarthritis: a prospective study.

    Science.gov (United States)

    Di Lorenzo, Luigi; Foti, Calogero; Forte, Alfonso Maria; Palmieri, Enzo; Formisano, Rita; Vatakencherry, Abraham; Pappagallo, Marco

    2010-01-01

    Opioid combination has been shown to reduce the need for escalating doses for the treatment of cancer pain. A prospective study was planned to evaluate the addition of tramadol to a stronger opioid for the treatment of severe pain as a result of osteoarthritis, previously uncontrolled by non-opioid analgesics or weak opioids. All subjects received tramadol 200 mg and tizanidine 2 mg. At 2 weeks, tramadol was discontinued for patients still reporting poor pain relief (effectiveness ≤50%), and a stronger opioid was titrated to a morphine equivalent amount (MEA) of 40-60 mg orally. After two additional weeks, patients were then divided into two groups: the Strong Opioid Group (SO) and the Tramadol plus the Strong Opioid Group (TSO). The SO group was allowed to escalate opioid dose for lack of effectiveness; the TSO group received tramadol 150 mg daily, thereafter additional strong opioid titration was allowed. A total of 74 patients were studied: SO (n = 40) and TSOG (n = 34). All patients eventually achieved pain relief quality, with both groups reporting similar Karnofsky Performance Scale effectiveness. The SO group achieved satisfactory pain relief (>50%) at an average daily oral MEA of 120 mg. TSO subjects achieved satisfactory pain relief (>50%) at an average daily oral MEA of 95 mg. The addition of tramadol provided a synergistic effect resulting in a 30-mg decrease in necessary morphine equivalents with fewer opioid-related adverse effects. © 2010 The Authors. Pain Practice © 2010 World Institute of Pain.

  2. Selecting boundary conditions in physiological strain analysis of the femur: Balanced loads, inertia relief method and follower load.

    Science.gov (United States)

    Heyland, Mark; Trepczynski, Adam; Duda, Georg N; Zehn, Manfred; Schaser, Klaus-Dieter; Märdian, Sven

    2015-12-01

    Selection of boundary constraints may influence amount and distribution of loads. The purpose of this study is to analyze the potential of inertia relief and follower load to maintain the effects of musculoskeletal loads even under large deflections in patient specific finite element models of intact or fractured bone compared to empiric boundary constraints which have been shown to lead to physiological displacements and surface strains. The goal is to elucidate the use of boundary conditions in strain analyses of bones. Finite element models of the intact femur and a model of clinically relevant fracture stabilization by locking plate fixation were analyzed with normal walking loading conditions for different boundary conditions, specifically re-balanced loading, inertia relief and follower load. Peak principal cortex surface strains for different boundary conditions are consistent (maximum deviation 13.7%) except for inertia relief without force balancing (maximum deviation 108.4%). Influence of follower load on displacements increases with higher deflection in fracture model (from 3% to 7% for force balanced model). For load balanced models, follower load had only minor influence, though the effect increases strongly with higher deflection. Conventional constraints of fixed nodes in space should be carefully reconsidered because their type and position are challenging to justify and for their potential to introduce relevant non-physiological reaction forces. Inertia relief provides an alternative method which yields physiological strain results. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  3. Stress relief to prevent stress corrosion in the transition region of expanded Alloy 600 steam-generator tubing. Final report

    International Nuclear Information System (INIS)

    Woodward, J.; van Rooyen, D.

    1983-05-01

    The feasibility of preventing primary side roll transition cracking has been investigated, using induction heating to attain stress relief of expanded Ni-Cr-Fe Alloy 600 steam generator tubing. Work on rolled tubing and U-bends has shown that temperatures with which stress relief can be obtained range from 700 to 850 0 C, with lower temperatures in this range requiring longer times at temperature to provide the requisite reduction in residual stresses. No work has yet been done outside this range. Preliminary tests, using induction heating, have been carried out on a mock tube sheet assembly, designed to the dimensions of a typical steam generator, and have identified the type of heating/cooling cycle that would occur in the tube sheet during a stress relief operation. Preliminary results show that the times to reach the higher temperatures in the range observed to give stress relief, of the order of 850 0 C, can be as short as 8 seconds, and less with optimum coil design and power control

  4. Guiana Highlands, Shaded Relief and Colored Height

    Science.gov (United States)

    2003-01-01

    [figure removed for brevity, see original site] These two images show exactly the same area in South America, the Guiana Highlands straddling the borders of Venezuela, Guyana and Brazil. The image on the left was created using the best global topographic data set previously available, the U.S. Geological Survey's GTOPO30. In contrast, the image on the right was generated with a new data set recently released by the Shuttle Radar Topography Mission (SRTM) called SRTM30, which represents a significant improvement in our knowledge of the topography of much of the world.GTOPO30, with a resolution of about 928 meters (1496 feet), was developed over a three-year period and published in 1996, and since then has been the primary source of digital elevation data for scientists and analysts involved in global studies. However, since it was compiled from a number of different map sources with varying attributes, the data for some parts of the globe were inconsistent or of low quality.The SRTM data, on the other hand, were collected within a ten-day period using the same instrument in a uniform fashion, and were processed into elevation data using consistent processing techniques. Thus SRTM30 provides a new resource of uniform quality for all parts of the Earth, and since the data, which have an intrinsic resolution of about 30 meters, were averaged and resampled to match the GTOPO30 sample spacing and format, and can be used by the same computer software without modification.The Guiana Highlands are part of the Guyana Shield, which lies in northeast South America and represent one of the oldest land surfaces in the world. Chemical weathering over many millions of years has created a landscape of flat-topped table mountains with dramatic, steep cliffs with a large number of spectacular waterfalls. For example Angel Falls, at 979 meters the highest waterfall in the world, plunges from Auyan Tebuy, part of a mesa of the type that may have been the inspiration for Arthur Conan

  5. Estimation of Erosion Dissection of North-Eastern Caucasus Relief for Recreational Land Use

    Directory of Open Access Journals (Sweden)

    Zagir V. Ataev

    2012-02-01

    Full Text Available The digital model of the relief (DMR of North-East Caucasus relief was used for an estimation of an erosive partition of territory. The card of usages of erosive forms and density of an erosive partition of a relief was made on basis of GIS-technology. The analysis of these parameters has allowed to estimate the potential of a relief of studied territory for such kinds of touristic and recreational activity, as foot and a cycle tourism

  6. Drug treatment of lower urinary tract symptoms in males. Role uroselectivity in the choice of drug

    Directory of Open Access Journals (Sweden)

    Yu. G. Alyaev

    2014-12-01

    Full Text Available Most patients lower urinary tract symptoms (LUTS caused both mechanical and functional factors. Timely identification of the nature of urodynamics, primarily of bladder outlet obstruction and detrusor overactivity, in patients with benign prostatic hyperplasia is of practical importance, since without this factor significantly worse functional outcome of surgical treatment. α1-adrenoblockers are the first line therapy for men with bothersome LUTS. They should be offered to patients with moderate to severe LUTS. Choosing α1-adrenoblocker should lean toward more selective class representatives. Selectivity α1-adrenoblocker provides high efficiency along with a low percentage of adverse effects, especially for cardiovascular system.As well as α-adrenoblockers, M-cholinobloсkers varying degrees of selectivity of the impact is on the bladder. Solifenacin is more selective for the bladder than tolterodine and oxybutynin. The selectivity of the drug with respect to the bladder is reflected in the relatively low frequency of adverse effects, especially occurrence of dry mouth in its application, as well as the possibility of long term therapy. Combined treatment with α1-adrenoreceptor antagonist with M-cholinergic antagonists may be considered in patients with moderate to severe LUTS with a predominance of filling symptoms, especially if monotherapy led to relief of symptoms.

  7. Actometry in measuring the symptom severity of restless legs syndrome.

    Science.gov (United States)

    Tuisku, K; Holi, M M; Wahlbeck, K; Ahlgren, A J; Lauerma, H

    2005-05-01

    In a previous, controlled study we demonstrated that the general lower limb activity measured by three-channel actometry is a promising objective measure of restless legs syndrome (RLS) severity. In the present study we have further evaluated the method in measuring RLS symptom severity in an open, single-day pramipexole intervention with 15 RLS patients. Both our standardized actometric parameters (nocturnal lower limb activity and controlled rest activity) decreased significantly during the intervention in parallel with the subjectively reported relief of RLS symptoms.

  8. Preliminary development of an advanced modular pressure relief cushion: Testing and user evaluation.

    Science.gov (United States)

    Freeto, Tyler; Mitchell, Steven J; Bogie, Kath M

    2018-02-01

    Effective pressure relief cushions are identified as a core assistive technology need by the World Health Organization Global Cooperation on Assistive Technology. High quality affordable wheelchair cushions could provide effective pressure relief for many individuals with limited access to advanced assistive technology. Value driven engineering (VdE) principles were employed to develop a prototype modular cushion. Low cost dynamically responsive gel balls were arranged in a close packed array and seated in bilayer foam for containment and support. Two modular cushions, one with high compliance balls and one with moderate compliance balls were compared with High Profile and Low Profile Roho ® and Jay ® Medical 2 cushions. ISO 16480-2 biomechanical standardized tests were applied to assess cushion performance. A preliminary materials cost analysis was carried out. A prototype modular cushion was evaluated by 12 participants who reported satisfaction using a questionnaire based on the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) instrument. Overall the modular cushions performed better than, or on par with, the most widely prescribed commercially available cushions under ISO 16480-2 testing. Users rated the modular cushion highly for overall appearance, size and dimensions, comfort, safety, stability, ease of adjustment and general ease of use. Cost-analysis indicated that every modular cushion component a could be replaced several times and still maintain cost-efficacy over the complete cushion lifecycle. A VdE modular cushion has the potential provide effective pressure relief for many users at a low lifetime cost. Copyright © 2017. Published by Elsevier Ltd.

  9. 30 CFR 204.204 - What accounting and auditing relief will MMS not allow?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What accounting and auditing relief will MMS... INTERIOR MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.204 What accounting and auditing relief will MMS not allow? MMS will not approve your request for...

  10. 21 CFR 882.5880 - Implanted spinal cord stimulator for pain relief.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted spinal cord stimulator for pain relief... Implanted spinal cord stimulator for pain relief. (a) Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to relieve...

  11. 21 CFR 882.5890 - Transcutaneous electrical nerve stimulator for pain relief.

    Science.gov (United States)

    2010-04-01

    ... pain relief. 882.5890 Section 882.5890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 882.5890 Transcutaneous electrical nerve stimulator for pain relief. (a) Identification. A transcutaneous electrical nerve stimulator for pain relief is a device used to apply an electrical current to...

  12. 21 CFR 882.5840 - Implanted intracerebral/subcortical stimulator for pain relief.

    Science.gov (United States)

    2010-04-01

    ... pain relief. 882.5840 Section 882.5840 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 882.5840 Implanted intracerebral/subcortical stimulator for pain relief. (a) Identification. An implanted intracerebral/subcortical stimulator for pain relief is a device that applies electrical current...

  13. 31 CFR 309.12 - Relief on account of loss, theft or destruction, etc.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Relief on account of loss, theft or... BILLS § 309.12 Relief on account of loss, theft or destruction, etc. (a) Relief on account of the loss, theft, destruction, mutilation or defacement of Treasury bills may be given only under the authority of...

  14. 30 CFR 204.202 - What is the cumulative royalty reports and payments relief option?

    Science.gov (United States)

    2010-07-01

    ... Auditing Relief § 204.202 What is the cumulative royalty reports and payments relief option? (a) The... information on Form MMS-2014 for the calendar year, the same as if it were a monthly report; and (5) Report... section until the date MMS receives it. (d) If you take relief you are not qualified for, you may be...

  15. ASSESSMENT OF SURFACE QUALITY FOR CHOSEN MILLING STRATEGIES WHEN PRODUCING RELIEF SURFACES

    OpenAIRE

    Jan Varga; Jozef Stahovec; Jozef Beno; Marek Vrabeľ

    2014-01-01

    The paper deals with design and modeling of the relief surfaces that are produced in milling. Modeled and real surface quality is presented for the chosen fragments of the relief surfaces. Fragmentation of the relief surfaces has been made by the surface sampling. Milling strategies are compared with regard to surface formation. Surface quality was checked with regard to applied cutting conditions.

  16. Pressure relief experiments on a cyclindrical carbon brick tube

    International Nuclear Information System (INIS)

    Lang, H.; Weise, H.J.; Ennen, P.

    1978-08-01

    Pressure relief experiments have been carried out on a carbon brick tube. The outer diameter of the specimen was 580 mm, the inner diameter 280 mm, the length 800 mm. The experiments were made with helium at the temperature of the environment. The measurements were carried out in the pressure range from 15 upto 39 bar. The pressure loss was measured dependent on the initial pressure and on time at 5 positions uniformly distributed over the thickness of the tube wall and in the pressure vessel. The maximum pressure transients occurred amounted to approximately 60 bar/second. The maximum overpressure with respect to the environment which occurred in the carbon brick during the relief experiments was about 3.3 bar. The measurements distinctly showed the presence and the effects of inhomogeneities in the sample material. No damages or changes in the carbon brick, which could be regarded as a consequence of the experiments, were found. (orig./GSC) [de

  17. Diffraction efficiency calculations of polarization diffraction gratings with surface relief

    Science.gov (United States)

    Nazarova, D.; Sharlandjiev, P.; Berberova, N.; Blagoeva, B.; Stoykova, E.; Nedelchev, L.

    2018-03-01

    In this paper, we evaluate the optical response of a stack of two diffraction gratings of equal one-dimensional periodicity. The first one is a surface-relief grating structure; the second, a volume polarization grating. This model is based on our experimental results from polarization holographic recordings in azopolymer films. We used films of commercially available azopolymer (poly[1-[4-(3-carboxy-4-hydroxyphenylazo) benzenesulfonamido]-1,2-ethanediyl, sodium salt]), shortly denoted as PAZO. During the recording process, a polarization grating in the volume of the material and a relief grating on the film surface are formed simultaneously. In order to evaluate numerically the optical response of this “hybrid” diffraction structure, we used the rigorous coupled-wave approach (RCWA). It yields stable numerical solutions of Maxwell’s vector equations using the algebraic eigenvalue method.

  18. Symptomatic relief precedes improvement of myocardial blood flow in patients under spinal cord stimulation

    Directory of Open Access Journals (Sweden)

    Koulousakis Athanassios

    2005-05-01

    Full Text Available Abstract Background Spinal cord electrical stimulation (SCS has shown to be a treatment option for patients suffering from angina pectoris CCS III-IV although being on optimal medication and not suitable for conventional treatment strategies, e.g. CABG or PTCA. Although many studies demonstrated a clear symptomatic relief under SCS therapy, there are only a few short-term studies that investigated alterations in cardiac ischemia. Therefore doubts remain whether SCS has a direct effect on myocardial perfusion. Methods A prospective study to investigate the short- and long-term effect of spinal cord stimulation (SCS on myocardial ischemia in patients with refractory angina pectoris and coronary multivessel disease was designed. Myocardial ischemia was measured by MIBI-SPECT scintigraphy 3 months and 12 months after the beginning of neurostimulation. To further examine the relation between cardiac perfusion and functional status of the patients we measured exercise capacity (bicycle ergometry and 6-minute walk test, symptoms and quality of life (Seattle Angina Questionnaire [SAQ], as well. Results 31 patients (65 ± 11 SEM years; 25 male, 6 female were included into the study. The average consumption of short acting nitrates (SAN decreased rapidly from 12 ± 1.6 times to 3 ± 1 times per week. The walking distance and the maximum workload increased from 143 ± 22 to 225 ± 24 meters and 68 ± 7 to 96 ± 12 watt after 3 months. Quality of life increased (SAQ significantly after 3 month compared to baseline, as well. No further improvement was observed after one year of treament. Despite the symptomatic relief and the improvement in maximal workload computer based analysis (Emory Cardiac Toolbox of the MIBI-SPECT studies after 3 months of treatment did not show significant alterations of myocardial ischemia compared to baseline (16 patients idem, 7 with increase and 6 with decrease of ischemia, 2 patients dropped out during initial test phase

  19. Mechanical behavior of multipass welded joint during stress relief annealing

    International Nuclear Information System (INIS)

    Ueda, Yukio; Fukuda, Keiji; Nakacho, Keiji; Takahashi, Eiji; Sakamoto, Koichi.

    1978-01-01

    An investigation into mechanical behavior of a multipass welded joint of a pressure vessel during stress relief annealing was conducted. The study was performed theoretically and experimentally on idealized research models. In the theoretical analysis, the thermal elastic-plastic creep theory developed by the authors was applied. The behavior of multipass welded joints during the entire thermal cycle, from welding to stress relief annealing, was consistently analyzed by this theory. The results of the analysis show a good, fundamentally coincidence with the experimental findings. The outline of the results and conclusions is as follows. (1) In the case of the material (2 1/4Cr-1Mo steel) furnished in this study, the creep strain rate during stress relief annealing below 575 0 C obeys the strain-hardening creep law using the transient creep and the one above 575 0 C obeys the power creep law using the stational creep. (2) In the transverse residual stress (σsub(x)) distribution after annealing, the location of the largest tensile stress on the top surface is about 15 mm away from the toe of weld, and the largest at the cross section is just below the finishing bead. These features are similar to those of welding residual stresses. But the stress distribution after annealing is smoother than one from welding. (3) The effectiveness of stress relief annealing depends greatly on the annealing temperature. For example, most of residual stresses are relieved at the heating stage with a heating rate of 30 0 C/hr. to 100 0 C/hr. if the annealing temperature is 650 0 C, but if the annealing temperature is 550 0 C, the annealing is not effective even with a longer holding time. (4) In the case of multipass welding residual stresses studied in this paper, the behaviors of high stresses during annealing are approximated by ones during anisothermal relaxation. (auth.)

  20. Tax reliefs in legal entities' capital gains tax

    OpenAIRE

    Dimitrijević, Marko

    2013-01-01

    Reducing a national corporate tax rate and introducing numerous/ ample tax reliefs may have adverse effects on a country's reputation as it is perceived as being susceptible to unfair tax competition practices and prone to allowing the subsidiaries of foreign companies to enter the national market at any cost (even at the expense of preserving its natural assets). For this reason, it is essential to find the right balance between the need to attract foreign capital (on the one hand) and the p...

  1. Multiple cutaneous leiomyomas: Pain relief with pulsed hysocine butyl bromide

    Directory of Open Access Journals (Sweden)

    Kaliyadan Feroze

    2009-01-01

    Full Text Available A 35-year-old male patient presented to our outpatient department, complaining of multiple, raised skin lesions on the forehead and back, associated with intermittent pain, especially on exposure to cold. A diagnosis of cutaneous leiomyoma (type 2 segmental was made, which was confirmed by skin biopsy. The patient was started on a trial of pulsed Hyoscine Butyl bromide tablets, following which the patient had significant relief from pain associated with the lesions.

  2. Simultaneous Provision of Flexible Ramping Product and Demand Relief by Interruptible Loads Considering Economic Incentives

    Directory of Open Access Journals (Sweden)

    Jiahua Hu

    2017-12-01

    Full Text Available To cope with the net load variability in real time, sufficient ramp capability from controllable resources is required. To address the issue of insufficient ramp capacity in real time operations, flexible ramping products (FRPs have been adopted by some Independent System Operators (ISOs in the USA as a new market design. The inherent variability and uncertainty caused by renewable energy sources (RESs call for new FRP providers apart from conventional generating units. The so-called interruptible load (IL has proved to be useful in maintaining the supply-demand balance by providing demand relief and can be a viable FRP provider in practice. Given this background, this work presents a stochastic real-time unit commitment model considering ramp requirement and simultaneous provision of IL for FRP and demand relief. Load serving entities (LSEs are included in the proposed model and act as mediators between the ISO and multiple ILs. In particular, incentive compatible contracts are designed to encourage customers to reveal their true outage costs. Case studies indicate both the system and LSEs can benefit by employing the proposed method and ILs can gain the highest profits by signing up a favorable contract.

  3. Flying Real-Time Network to Coordinate Disaster Relief Activities in Urban Areas

    Directory of Open Access Journals (Sweden)

    Matias Micheletto

    2018-05-01

    Full Text Available While there have been important advances within wireless communication technology, the provision of communication support during disaster relief activities remains an open issue. The literature in disaster research reports several major restrictions to conducting first response activities in urban areas, given the limitations of telephone networks and radio systems to provide digital communication in the field. In search-and-rescue operations, the communication requirements are increased, since the first responders need to rely on real-time and reliable communication to perform their activities and coordinate their efforts with other teams. Therefore, these limitations open the door to improvisation during disaster relief efforts. In this paper, we argue that flying ad-hoc networks can provide the communication support needed in these scenarios, and propose a new solution towards that goal. The proposal involves the use of flying witness units, implemented using drones, that act as communication gateways between first responders working at different locations of the affected area. The proposal is named the Flying Real-Time Network, and its feasibility to provide communication in a disaster scenario is shown by presenting both a real-time schedulability analysis of message delivery, as well as simulations of the communication support in a physical scenario inspired by a real incident. The obtained results were highly positive and consistent, therefore this proposal represents a step forward towards the solution of this open issue.

  4. Flying Real-Time Network to Coordinate Disaster Relief Activities in Urban Areas †

    Science.gov (United States)

    Micheletto, Matias; Orozco, Javier; Mosse, Daniel

    2018-01-01

    While there have been important advances within wireless communication technology, the provision of communication support during disaster relief activities remains an open issue. The literature in disaster research reports several major restrictions to conducting first response activities in urban areas, given the limitations of telephone networks and radio systems to provide digital communication in the field. In search-and-rescue operations, the communication requirements are increased, since the first responders need to rely on real-time and reliable communication to perform their activities and coordinate their efforts with other teams. Therefore, these limitations open the door to improvisation during disaster relief efforts. In this paper, we argue that flying ad-hoc networks can provide the communication support needed in these scenarios, and propose a new solution towards that goal. The proposal involves the use of flying witness units, implemented using drones, that act as communication gateways between first responders working at different locations of the affected area. The proposal is named the Flying Real-Time Network, and its feasibility to provide communication in a disaster scenario is shown by presenting both a real-time schedulability analysis of message delivery, as well as simulations of the communication support in a physical scenario inspired by a real incident. The obtained results were highly positive and consistent, therefore this proposal represents a step forward towards the solution of this open issue. PMID:29789458

  5. Hypnosis to alleviate the symptoms of ciguatera toxicity: a case study.

    Science.gov (United States)

    Laser, Eleanor D; Shenefelt, Philip D

    2012-01-01

    Ciguatera toxicity is a poisoning from consuming reef fish that had fed on dinoflagellates such as Gambierdiscus toxicus found along coral reefs. The toxin is oil soluble, odorless, colorless, tasteless, heat stable, and is concentrated in larger carnivorous fish such as amberjack, barracuda, eel, grouper, red snapper, sea bass, and Spanish mackerel. Onset of symptoms is usually within 6-12 hours after ingestion. Gastrointestinal symptoms lasting 1-2 days include abdominal pain, nausea, vomiting, and diarrhea. Neurological symptoms may persist for weeks or several months or--rarely--years and include circumoral and extremity paresthesias, temperature sensation reversal, itching, weakness, ataxia, and others. A patient with burning hands and feet who had not found relief using other methods had diagnosis of ciguatera toxicity assisted by hypnotically refreshed memory followed by rapid relief with hypnotic suggestions in 1 session and remained free of symptoms.

  6. Parents' knowledge, attitudes, use of pain relief methods and satisfaction related to their children's postoperative pain management: a descriptive correlational study.

    Science.gov (United States)

    Chng, Hui Yi; He, Hong-Gu; Chan, Sally Wai-Chi; Liam, Joanne Li Wee; Zhu, Lixia; Cheng, Karis Kin Fong

    2015-06-01

    To examine parents' knowledge about and attitudes towards pain management, use of pain relief strategies and satisfaction with their children's postoperative pain management, as well as the relationships among these variables. Children's postoperative pain is inadequately managed worldwide. Despite increasing emphasis on parental involvement in children's postoperative pain management, few studies have examined parents' management of their child's postoperative pain in Singapore. A descriptive correlational study. A convenience sample of 60 parents having 6- to 14-year-old children undergoing inpatient elective surgery in a public hospital in Singapore was recruited. Data were collected one day after each child's surgery using the Pain Management Knowledge and Attitudes questionnaire and the Parents' Use of Pain Relief Strategies questionnaire. Descriptive statistics, Mann-Whitney U tests, Kruskal-Wallis tests and Spearman's rank correlation coefficient were used for data analyses. Parents displayed moderate levels of knowledge, attitudes and use of pain relief methods in relation to their children's postoperative pain and pain management. They were generally satisfied with the management of their child's postoperative pain. There was significant difference in Parents' Use of Pain Relief Strategies scores between parents with and without previous experience of caring for their hospitalised child. Statistically significant positive correlations were found between parents' knowledge and attitude, knowledge and satisfaction, attitude and satisfaction, knowledge and pain relief strategies, as well as attitude and pain relief strategies. This study indicates the need to provide parents with more information regarding their children's postoperative pain management. Future studies are needed to develop educational interventions for parents to improve their knowledge and attitudes, which will eventually improve their use of pain relief strategies for their children. Health

  7. Direct Magnetic Relief Recording Using As40S60: Mn-Se Nanocomposite Multilayer Structures.

    Science.gov (United States)

    Stronski, A; Achimova, E; Paiuk, O; Meshalkin, A; Prisacar, A; Triduh, G; Oleksenko, P; Lytvyn, P

    2017-12-01

    Processes of holographic recording of surface relief structures using As 2 S 3 :Mn-Se multilayer nanostructures as registering media were studied in this paper. Optical properties of As 2 S 3 :Mn, Se layers, and As 2 S 3 :Mn-Se multilayer nanostructures were investigated. Values of optical bandgaps were obtained from Tauc dependencies. Surface relief diffraction gratings were recorded. Direct one-stage formation of surface relief using multilayer nanostructures is considered. For the first time, possibility of direct formation of magnetic relief simultaneous with surface relief formation under optical recording using As 2 S 3 :Mn-Se multilayer nanostructures is shown.

  8. Evaluation of an International Disaster Relief Team After Participation in an ASEAN Regional Forum Disaster Relief Exercise.

    Science.gov (United States)

    Lee, Jeong Il; Lee, Kang Hyun; Kim, Oh Hyun; Cha, Yong Sung; Hwang, Sung Oh; Kim, Hyun; Cha, Kyung Chul

    2016-10-01

    Devastating disasters around the world directly contribute to significant increases in human mortality and economic costs. The objective of this study was to examine the current state of the Korea Disaster Relief Team that participated in an international training module. The whole training period was videotaped in order to observe and evaluate the respondents. The survey was carried out after completion of the 3-day training, and the scores were reported by use of a 5-point Likert scale. A total of 43 respondents were interviewed for the survey, and the results showed that the overall preparedness score for international disasters was 3.4±1.6 (mean±SD). The awareness of the Incident Command System for international disasters was shown to be low (3.5±1.1). Higher scores were given to personnel who took on leadership roles in the team and who answered "I knew my duty" (4.4±0.6) in the survey, as well as to the training participants who answered "I clearly knew my duty" (4.5±0.5). The preparedness level of the Korea Disaster Relief Team was shown to be insufficient, whereas understanding of the roles of leaders and training participants in the rescue team was found to be high. It is assumed that the preparedness level for disaster relief must be improved through continued training. (Disaster Med Public Health Preparedness. 2016;1-5).

  9. Endogenous opioid activity in the anterior cingulate cortex is required for relief of pain.

    Science.gov (United States)

    Navratilova, Edita; Xie, Jennifer Yanhua; Meske, Diana; Qu, Chaoling; Morimura, Kozo; Okun, Alec; Arakawa, Naohisa; Ossipov, Michael; Fields, Howard L; Porreca, Frank

    2015-05-06

    Pain is aversive, and its relief elicits reward mediated by dopaminergic signaling in the nucleus accumbens (NAc), a part of the mesolimbic reward motivation pathway. How the reward pathway is engaged by pain-relieving treatments is not known. Endogenous opioid signaling in the anterior cingulate cortex (ACC), an area encoding pain aversiveness, contributes to pain modulation. We examined whether endogenous ACC opioid neurotransmission is required for relief of pain and subsequent downstream activation of NAc dopamine signaling. Conditioned place preference (CPP) and in vivo microdialysis were used to assess negative reinforcement and NAc dopaminergic transmission. In rats with postsurgical or neuropathic pain, blockade of opioid signaling in the rostral ACC (rACC) inhibited CPP and NAc dopamine release resulting from non-opioid pain-relieving treatments, including peripheral nerve block or spinal clonidine, an α2-adrenergic agonist. Conversely, pharmacological activation of rACC opioid receptors of injured, but not pain-free, animals was sufficient to stimulate dopamine release in the NAc and produce CPP. In neuropathic, but not sham-operated, rats, systemic doses of morphine that did not affect withdrawal thresholds elicited CPP and NAc dopamine release, effects that were prevented by blockade of ACC opioid receptors. The data provide a neural explanation for the preferential effects of opioids on pain affect and demonstrate that engagement of NAc dopaminergic transmission by non-opioid pain-relieving treatments depends on upstream ACC opioid circuits. Endogenous opioid signaling in the ACC appears to be both necessary and sufficient for relief of pain aversiveness. Copyright © 2015 the authors 0270-6474/15/357264-08$15.00/0.

  10. Effect of birth ball on labor pain relief: A systematic review and meta-analysis.

    Science.gov (United States)

    Makvandi, Somayeh; Latifnejad Roudsari, Robab; Sadeghi, Ramin; Karimi, Leila

    2015-11-01

    To critically evaluate the available evidence related to the impact of using a birth ball on labor pain relief. The Cochrane library, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE/PubMed and Scopus were searched from their inception to January 2015 using keywords: (Birth* OR Swiss OR Swedish OR balance OR fitness OR gym* OR Pezzi OR sport* OR stability) AND (ball*) AND (labor OR labour OR Obstetric). All available randomized controlled trials involving women using a birth ball for pain relief during labor were considered. The search resulted in 341 titles and abstracts, which were narrowed down to eight potentially relevant articles. Of these, four studies met the inclusion criteria. Pain intensity on a 10 cm visual analogue scale was used as the main outcome measure. Risk of bias was assessed using the Cochrane Risk of Bias tool. Comprehensive Meta-Analysis Version 2 was used for statistical analysis. Four RCTs involving 220 women were included in the systematic review. One study was excluded from the meta-analysis because of heterogeneous interventions and a lack of mean and standard deviation results of labor pain score. The meta-analysis showed that birth ball exercises provided statistically significant improvements to labor pain (pooled mean difference -0.921; 95% confidence interval -1.28, -0.56; P = 0.0000005; I(2)  = 33.7%). The clinical implementation of a birth ball exercise could be an effective tool for parturient women to reduce labor pain. However, rigorous RCTs are needed to evaluate the effect of the birth ball on labor pain relief. © 2015 Japan Society of Obstetrics and Gynecology.

  11. A Credibility-Based Chance-Constrained Transfer Point Location Model for the Relief Logistics Design (Case Study: Earthquake Disaster on Region 1 of Tehran City

    Directory of Open Access Journals (Sweden)

    Ahmad Mohamadi

    2015-02-01

    Full Text Available Occurrence of natural disaster inflicts irreparable injuries and symptoms on humans. In such conditions, affected people are waiting for medical services and relief commodities. Thus, quick reaction of medical services and relief commodities supply play important roles in improving natural disaster management. In this paper, a multi-objective non-linear credibility-based fuzzy mathematical programming model under uncertainty conditions is presented, which considers two vital needs in disaster time including medical services and relief commodities through location of hospitals, transfer points, and location routing of relief depots. The proposed model approaches reality by considering time, cost, failures probability in routes, and parameters uncertainty. The problem is first linearized and then global criterion method is applied for solving the multi objective model. Moreover, to illustrate model efficiency, a case study is performed on region 1 of Tehran city for earthquake disaster. Results demonstrate that if Decision-makers want to meet uncertainty with lowered risk, they have to choose a high minimum constraint feasibility degree even though the objective function will be worse.

  12. Analysis of preservice inspection relief requests and recommendations for ASME code changes

    International Nuclear Information System (INIS)

    Cook, J.F.

    1985-05-01

    NRC regulations require that preservice inspection (PSI) of nuclear plants be performed in accordance with referenced editions and addenda of Division 1 rules of Section XI, ''Rules for Inservice Inspection of Nuclear Power Plant Components'', of the ASME Boiler and Pressure Vessel Code (ASME Code). The regulations permit applicants to request and obtain relief from the NRC from specific ASME Code requirements that are determined to be impractical. Applicant requests for relief from preservice inspection (PSI) requirements were compiled and analyzed. From this data, covering a total of 178 relief requests, common problems with examination requirements were identified. Changes to examination requirements to solve selected problems are proposed. By following later ASME Code requirements, 46 out of the 178 relief requests can be eliminated. Implementing proposed Code changes would eliminate another 25 relief requests, leaving 107 relief requests out of the original 178 relief requests covered by this survey

  13. Non destructive neutron diffraction measurements of cavities, inhomogeneities, and residual strain in bronzes of Ghiberti's relief from the Gates of Paradise

    Science.gov (United States)

    Festa, G.; Senesi, R.; Alessandroni, M.; Andreani, C.; Vitali, G.; Porcinai, S.; Giusti, A. M.; Materna, T.; Paradowska, A. M.

    2011-03-01

    Quantitative neutron studies of cultural heritage objects provide access to microscopic, mesoscopic, and macroscopic structures in a nondestructive manner. In this paper we present a neutron diffraction investigation of a Ghiberti Renaissance gilded bronze relief devoted to the measurement of cavities and inhomogeneities in the bulk of the sample, along with the bulk phase composition and residual strain distribution. The quantitative measurements allowed the determination of the re-melting parts extension, as well as improving current knowledge about the manufacturing process. The study provides significant and unique information to conservators and restorators about the history of the relief.

  14. Non destructive neutron diffraction measurements of cavities, inhomogeneities, and residual strain in bronzes of Ghiberti's relief from the Gates of Paradise

    International Nuclear Information System (INIS)

    Festa, G.; Senesi, R.; Alessandroni, M.; Andreani, C.; Vitali, G.; Porcinai, S.; Giusti, A. M.; Materna, T.; Paradowska, A. M.

    2011-01-01

    Quantitative neutron studies of cultural heritage objects provide access to microscopic, mesoscopic, and macroscopic structures in a nondestructive manner. In this paper we present a neutron diffraction investigation of a Ghiberti Renaissance gilded bronze relief devoted to the measurement of cavities and inhomogeneities in the bulk of the sample, along with the bulk phase composition and residual strain distribution. The quantitative measurements allowed the determination of the re-melting parts extension, as well as improving current knowledge about the manufacturing process. The study provides significant and unique information to conservators and restorators about the history of the relief.

  15. Steroids for symptom control in infectious mononucleosis.

    Science.gov (United States)

    Rezk, Emtithal; Nofal, Yazan H; Hamzeh, Ammar; Aboujaib, Muhammed F; AlKheder, Mohammad A; Al Hammad, Muhammad F

    2015-11-08

    Infectious mononucleosis, also known as glandular fever or the kissing disease, is a benign lymphoproliferative disorder. It is a viral infection caused by the Epstein-Barr virus (EBV), a ubiquitous herpes virus that is found in all human societies and cultures. Epidemiological studies show that over 95% of adults worldwide have been infected with EBV. Most cases of symptomatic infectious mononucleosis occur between the ages of 15 and 24 years. It is transmitted through close contact with an EBV shedder, contact with infected saliva or, less commonly, through sexual contact, blood transfusions or by sharing utensils; however, transmission actually occurs less than 10% of the time. Precautions are not needed to prevent transmission because of the high percentage of seropositivity for EBV. Infectious mononucleosis is self-limiting and typically lasts for two to three weeks. Nevertheless, symptoms can last for weeks and occasionally months.Symptoms include fever, lymphadenopathy, pharyngitis, hepatosplenomegaly and fatigue. Symptom relief and rest are commonly recommended treatments. Steroids have been used for their anti-inflammatory effects, but there are no universal criteria for their use. The objectives of the review were to determine the efficacy and safety of steroid therapy versus placebo, usual care or different drug therapies for symptom control in infectious mononucleosis. For this 2015 update we searched the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), which includes the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (January 1966 to August 2015) and EMBASE (January 1974 to August 2015). We also searched trials registries, however we did not identify any new relevant completed or ongoing trials for inclusion. We combined the MEDLINE search with the Cochrane search strategy for identifying randomised controlled trials (RCTs). We adapted the search terms when searching EMBASE. RCTs comparing the

  16. Efficacy of transverse tripolar spinal cord stimulator for the relief of chronic low back pain from failed back surgery.

    Science.gov (United States)

    Buvanendran, Asokumar; Lubenow, Timothy J

    2008-01-01

    Failed back surgery syndrome is a common clinical entity for which spinal cord stimulation has been found to be an effective mode of analgesia, but with variable success rates. To determine if focal stimulation of the dorsal columns with a transverse tripolar lead might achieve deeper penetration of the electrical stimulus into the spinal cord and therefore provide greater analgesia to the back. Case report. We describe a 42-year-old female with failed back surgery syndrome that had greater back pain than leg pain. The tripolar lead configuration was achieved by placing percutaneously an octapolar lead in the spinal midline followed by 2 adjacent quadripolar leads, advanced to the T7-T10 vertebral bodies. Tripolar stimulation pattern resulted in more than 70% pain relief in this patient during the screening trial, while stimulation of one or 2 electrodes only provided 20% pain relief. After implantation of a permanent tripolar electrode system with a single rechargeable battery, the pain relief was maintained for one year. This is case report describing a case of a patient with chronic low back pain with a diagnosis of failed back surgery syndrome in which transverse tripolar stimulation using an octapolar and 2 quadripolar leads appeared to be beneficial. The transverse tripolar system consists of a central cathode surrounded by anodes, using 3 leads. This arrangement may contribute to maximum dorsal column stimulation with minimal dorsal root stimulation and provide analgesia to the lower back.

  17. Nonmotor symptoms in genetic Parkinson disease

    DEFF Research Database (Denmark)

    Kasten, Meike; Kertelge, Lena; Brüggemann, Norbert

    2010-01-01

    To review current knowledge on nonmotor symptoms (NMS), particularly psychiatric features, in genetic Parkinson disease (PD) and to provide original data for genetic and idiopathic PD.......To review current knowledge on nonmotor symptoms (NMS), particularly psychiatric features, in genetic Parkinson disease (PD) and to provide original data for genetic and idiopathic PD....

  18. Vibration stress relief of DH 36 rectangle welded plates

    Science.gov (United States)

    Li, Shuqi; Fang, Hongyuan

    2018-03-01

    Vibration stress relief (VSR) is widely used in reducing residual stress in welded structures. However, the effectiveness of this method is still instable in some circumstance. In this study, a covert negative treatment phenomenon was investigated, i.e. natural frequency of welded structures decreased after VSR but residual stress in one direction increased. When the alteration of natural frequency after VSR is significant, the residual stresses in both the longitudinal and transversal directions shall decrease. Otherwise, residual stresses may increase on one direction. Thus, sufficient power shall be applied to the welded structures to avoid negative results.

  19. Root cause evaluation of pressurizer relief valve leakage

    International Nuclear Information System (INIS)

    Olson, D.E.; Voll, B.J.

    1996-01-01

    Pressurizer relief valves at two pressurized water reactor units experienced unacceptable leakage during plant heatup. The leakage was suspected to be caused by excessive pipe loads on the valves. This paper describes how monitoring via hard-wired transducers and a digital data acquisition system was used to quantify the pipe loads on the valves, and assist in determining the root cause of the pipe loads and appropriate corrective actions. The selection of the parameters monitored, how the monitoring was accomplished and interpretation of the results is discussed. The corrective actions implemented based on the monitoring results are also discussed

  20. Optically induced surface relief phenomena in azobenzene polymers

    DEFF Research Database (Denmark)

    Holme, NCR; Nikolova, Ludmila; Hvilsted, Søren

    1999-01-01

    Azobenzene polymers and oligomers show intriguing surface relief features when irradiated with polarized laser light. We show through atomic force microscopic investigation of side-chain azobenzene polymers after irradiation through an amplitude mask that large peaks or trenches result depending...... on the architecture of the polymer. Extensive mass transport over long distances has been observed, paving the way for easy replication of nanostructures. We also show that it is possible to store microscopic images as topographic features in the polymers just through polarized light irradiation. (C) 1999 American...... Institute of Physics....

  1. Tethered Balloon Technology in Design Solutions for Rescue and Relief Team Emergency Communication Services.

    Science.gov (United States)

    Alsamhi, Saeed Hamood; Ansari, Mohd Samar; Ma, Ou; Almalki, Faris; Gupta, Sachin Kumar

    2018-05-23

    The actions taken at the initial times of a disaster are critical. Catastrophe occurs because of terrorist acts or natural hazards which have the potential to disrupt the infrastructure of wireless communication networks. Therefore, essential emergency functions such as search, rescue, and recovery operations during a catastrophic event will be disabled. We propose tethered balloon technology to provide efficient emergency communication services and reduce casualty mortality and morbidity for disaster recovery. The tethered balloon is an actively developed research area and a simple solution to support the performance, facilities, and services of emergency medical communication. The most critical requirement for rescue and relief teams is having a higher quality of communication services which enables them to save people's lives. Using our proposed technology, it has been reported that the performance of rescue and relief teams significantly improved. OPNET Modeler 14.5 is used for a network simulated with the help of ad hoc tools (Disaster Med Public Health Preparedness. 2018;page 1 of 8).

  2. Glaucoma: Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Glaucoma Symptoms, Treatment and Research Past Issues / Spring 2015 ... vision, without any pain. Photo courtesy of NEI Glaucoma Symptoms At first, open-angle glaucoma has no ...

  3. Chronic Pain: Symptoms, Diagnosis, & Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... chronic pain. These methods can be powerful and effective in some people. When it comes to chronic pain treatment, many people find adding complementary or alternative medicine (CAM) approaches can provide additional relief. These may ...

  4. Symptom structure of PTSD following breast cancer.

    Science.gov (United States)

    Cordova, M J; Studts, J L; Hann, D M; Jacobsen, P B; Andrykowski, M A

    2000-04-01

    Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the re-experiencing, avoidance/numbing, and arousal symptom clusters specified in DSM-IV. The present study employed confirmatory factor analysis to evaluate the extent to which the implied second-order factor structure of PTSD was replicated in a sample of 142 breast cancer survivors. PTSD symptoms were measured using the PTSD Checklist--Civilian Version (PCL-C). Fit indices reflected a moderate fit of the symptom structure implied by the DSM-IV. These findings provide some tentative support for the DSM-IV clustering of PTSD symptoms and for the validity of cancer-related PTSD.

  5. Measuring bothersome menopausal symptoms

    DEFF Research Database (Denmark)

    Lund, Kamma Sundgaard; Siersma, Volkert Dirk; Christensen, Karl Bang

    2018-01-01

    BACKGROUND: The experience of menopausal symptoms is common and an adequate patient-reported outcome measure is crucial in studies where women are treated for these symptoms. The aims of this study were to identify a patient-reported outcome measure for bothersome menopausal symptoms and, in the ...

  6. Does pain relief by CT-guided indirect cervical nerve root injection with local anesthetics and steroids predict pain relief after decompression surgery for cervical nerve root compression?

    Science.gov (United States)

    Antoniadis, Alexander; Dietrich, Tobias J; Farshad, Mazda

    2016-10-01

    The relationship of pain relief from a recently presented CT-guided indirect cervical nerve root injection with local anesthetics and steroids to surgical decompression as a treatment for single-level cervical radiculopathy is not clear. This retrospective study aimed to compare the immediate and 6-week post-injection effects to the short- and long-term outcomes after surgical decompression, specifically in regard to pain relief. Patients (n = 39, age 47 ± 10 years) who had undergone CT-guided indirect injection with local anesthetics and steroids as an initial treatment for single cervical nerve root radiculopathy and who subsequently needed surgical decompression were included retrospectively. Pain levels (VAS scores) were monitored before, immediately after, and 6 weeks after injection (n = 34), as well as 6 weeks (n = 38) and a mean of 25 months (SD ± 12) after surgical decompression (n = 36). Correlation analysis was performed to find potential associations of pain relief after injection and after surgery to investigate the predictive value of post-injection pain relief. There was no correlation between immediate pain relief after injection (-32 ± 27 %) and 6 weeks later (-7 ± 19 %), (r = -0.023, p = 0.900). There was an association by tendency between immediate pain relief after injection and post-surgical pain relief at 6 weeks (-82 ± 27 %), (r = 0.28, p = 0.08). Pain relief at follow-up remained high at -70 ± 21 % and was correlated with the immediate pain amelioration effect of the injection (r = 0.37, p = 0.032). Five out of seven patients who reported no pain relief from injection had a pain relief from surgery in excess of 50 %. The amount of immediate radiculopathic pain relief after indirect cervical nerve root injection is associated with the amount of pain relief achieved at long-term follow-up after surgical decompression of single-level cervical radiculopathy

  7. Putting Qumran, Jesus and his movement into relief

    Directory of Open Access Journals (Sweden)

    Eben Scheffler

    2016-11-01

    Full Text Available After referring briefly to the fantasies regarding the origins of Christianity as elicited by the discovery of the Dead Sea Scrolls in 1947 (Dupont-Sommer, Allegro, Thiering, the purpose of the contribution is to put the Jesus movement into relief in the context of first-century Judaism. The identity of the Qumranites is argued to be Essene scribes. The identity, ideology and practices of the latter are compared with those of Jesus of Nazareth and the movement he elicited using the following rubrics: (1 Jesus, the teacher of righteousness and the powers that be; (2 asceticism versus itinerary charismaticism; (3 caring versus lack of caring for the sick, poor and marginalised; (4 elitist priests and scribes versus lower-class peasants; (5 the interpretation of the law; (6 religious and daily practices (baptism, ritual meal, sacrifice, prayer, community of possessions, scribal activity; (7 religious views or ideology (kingdom of God, the new covenant, light and darkness, politics. The result is a picture of Jesus (with his focus on human suffering in sharp relief versus Qumran and facets of the early church.

  8. Submarine tectonic relief off Enshunada. Enshunadaoki no hendo chikei

    Energy Technology Data Exchange (ETDEWEB)

    Iwabuchi, Y; Sasahara, N; Hamamoto, F [Maritime Safety Agency, Tokyo (Japan); Yoshioka, S [10th Resional Maritime Safety Headquarters, Kagoshima (Japan); Kondo, T [Maritime Safety School, Kyoto (Japan)

    1991-08-15

    This paper reports on the results of investigations on the submarine relief structure off the Enshunada (a sea area which is on the south of the Tenryu River mouth and has about 50km east and west and about 100km north and south) using a bathymetric surveying ship equipped with a narrow multibeam echo sounder. The submarine relief structure of this sea area is clarified into the following topographical districts arranged north to south (each extends roughly in the northeast-southwest direction): the Enshu trough and Tenryu submarine canyon upper valley located in the center thereof, ridges represented by No.l and No.2 Tenryu knolls, the ridge and trough zone where minor ridges and troughes appear complicatedly and repeatedly, and the Nankai trough. The paper contains causes of formation of the Tenryu submarine canyon, the Ryuyo submarine canyon which is located in the northwestern slope of No.2 Tenryu knoll and has a distinct shape, oval-shaped domes scattered in the bottom of Nankai trough, etc. and also opinions on landslide topography seen in the ridge and trough zone. 13 refs., 5 figs., 1 tab.

  9. Pain relief in childbirth: changing historical and feminist perspectives.

    Science.gov (United States)

    Skowronski, G A

    2015-07-01

    Pain during human childbirth is ubiquitous and severe. Opium and its derivatives constitute the oldest effective method of pain relief and have been used in childbirth for several thousand years, along with numerous folk medicines and remedies. Interference with childbirth pain has always been criticised by doctors and clergy. The 19th century saw the introduction of three much more effective approaches to childbirth pain; diethyl ether, chloroform and nitrous oxide. Access to pain relief was demanded by the first wave of feminist activists as a woman's right. They popularised the use of 'twilight sleep', a combination of morphine and scopolamine, which fell into disrepute as its adverse effects became known. From the 1960s, as epidural analgesia became more popular, a second wave of feminists took the opposite position, calling for a return to non-medicalised, female-controlled, 'natural' childbirth and, in some cases, valorising the importance of the pain experience as empowering for women. However, from the 1990s, a third wave of feminist thought has begun to emerge, revalidating a woman's right to choose a 'technological', pain-free birth, rather than a 'natural' one, and regarding this as a legitimate feminist position.

  10. Analytical modeling of bwr safety relief valve blowdown phenomenon

    International Nuclear Information System (INIS)

    Hwang, J.G.; Singh, A.

    1984-01-01

    An analytical, qualitative understanding of the pool pressures measured during safety relief valve discharge in boiling water reactors equipped with X-quenchers has been developed and compared to experimental data. A pressure trace typically consists of a brief 25-35 Hz. oscillation followed by longer 5-15 Hz. oscillation. In order to explain the pressure response, a discharge line vent clearing model has been coupled with a Rayleigh bubble dynamic model. The local conditions inside the safety relief valve discharge lines and inside of the X-quencher were simulated successfully with RELAP5. The simulation allows one to associate the peak pressure inside the quencher arm with the onset of air discharge into the suppression pool. Using the pressure and thermodynamic quality at quencher exit of RELAP5 calculation as input, a Rayleigh model of pool bubble dynamics has successfully explained both the higher and lower frequency pressure oscillations. The higher frequency oscillations are characteristic of an air bubble emanating from a single row of quencher holes. The lower frequency pressure oscillations are characteristic of a larger air bubble containing all the air expelled from one side of an X-quencher arm

  11. Anthropogenic transformation of the relief of the Aegean Islands

    Directory of Open Access Journals (Sweden)

    Tsermegas Irena

    2015-06-01

    Full Text Available The purpose of this article is to present the role of human impact in the forming and transformation of the relief of the Aegean Islands. The most significant changes (with a displacement of more than 10 bln m3 of rock material are related to the creation of road infrastructure and the construction of agricultural terraces. In order to create stone buildings, 20 mln m3 of rock material was used; for the purposes of air transport a surface area of nearly 2.5 km2 was levelled; many kilometres of artificial shorelines were created and at least 4.5 mln m3 of material was displaced for the purposes of the construction of artificial reservoirs of a total capacity of more than 25 mln m3. A huge amount of material was removed as a result of mining activities. The indirect impact of economic activities on the relief of the discussed area includes mainly slope, fluvial and coastal processes.

  12. Research on the water hammer protection of the long distance water supply project with the combined action of the air vessel and over-pressure relief valve

    International Nuclear Information System (INIS)

    Li, D D; Jiang, J; Zhao, Z; Yi, W S; Lan, G

    2013-01-01

    We take a concrete pumping station as an example in this paper. Through the calculation of water hammer protection with a specific pumping station water supply project, and the analysis of the principle, mathematical models and boundary conditions of air vessel and over-pressure relief valve we show that the air vessel can protect the water conveyance system and reduce the transient pressure damage due to various causes. Over-pressure relief valve can effectively reduce the water hammer because the water column re-bridge suddenly stops the pump and prevents pipeline burst. The paper indicates that the combination set of air vessel and over-pressure relief valve can greatly reduce the quantity of the air valve and can eliminate the water hammer phenomenon in the pipeline system due to the vaporization and water column separation and re-bridge. The conclusion could provide a reference for the water hammer protection of long-distance water supply system

  13. Research on the water hammer protection of the long distance water supply project with the combined action of the air vessel and over-pressure relief valve

    Science.gov (United States)

    Li, D. D.; Jiang, J.; Zhao, Z.; Yi, W. S.; Lan, G.

    2013-12-01

    We take a concrete pumping station as an example in this paper. Through the calculation of water hammer protection with a specific pumping station water supply project, and the analysis of the principle, mathematical models and boundary conditions of air vessel and over-pressure relief valve we show that the air vessel can protect the water conveyance system and reduce the transient pressure damage due to various causes. Over-pressure relief valve can effectively reduce the water hammer because the water column re-bridge suddenly stops the pump and prevents pipeline burst. The paper indicates that the combination set of air vessel and over-pressure relief valve can greatly reduce the quantity of the air valve and can eliminate the water hammer phenomenon in the pipeline system due to the vaporization and water column separation and re-bridge. The conclusion could provide a reference for the water hammer protection of long-distance water supply system.

  14. In-Depth Review of Symptoms, Triggers, and Treatment of Occipital Migraine Headaches (Site IV).

    Science.gov (United States)

    Ascha, Mona; Kurlander, David E; Sattar, Abdus; Gatherwright, James; Guyuron, Bahman

    2017-06-01

    This study reports the surgical technique and efficacy of deactivation of occipital-triggered migraine headaches. In addition, it reports the effect of surgical deactivation of occipital-triggered migraine headaches on migraine triggers and associated symptoms other than pain. One hundred ninety-five patients undergoing surgery for occipital-triggered migraine headaches performed by a single surgeon, and followed for at least 1 year, were analyzed. Median regression adjusted for age, sex, and follow-up time was used to determine postoperative reduction in occipital-specific Migraine Headache Index, which is the product of migraine duration, frequency, and severity. Reduction in migraine-days was also measured. The association between symptom or trigger resolution and occipital-specific Migraine Headache Index reduction was studied by logistic regression. Details of surgical treatment are discussed and complication rates reported. Eighty-two percent of patients (n = 160) reported successful surgery at least 12 months postoperatively (mean follow-up, 3.67 years). Eighty-six percent (n = 168) had successful surgery as measured by migraine-days. Fifty-two percent reported complete occipital-triggered migraine headaches elimination. Symptoms resolving with successful surgery beyond headache include being bothered by light and noise, feeling lightheaded, difficulty concentrating, vomiting, blurred/double vision, diarrhea, visual aura, numbness and tingling, speech difficulty, and limb weakness (p occipital-triggered migraine headaches provides long-lasting migraine relief. Successful site IV surgery is associated with changes in specific symptoms and triggers. This can assist in trigger avoidance and aid occipital-triggered migraine headache trigger-site identification. Therapeutic, IV.

  15. Between pain and pleasure: Pregnant women's knowledge and preferences for pain relief in labor, a pilot study from Zaria, Northern Nigeria.

    Science.gov (United States)

    Ogboli-Nwasor, Elizabeth O; Adaji, Sunday E

    2014-11-01

    Pain relief in labor remains a hot topic and these debates get louder by the day as more women become aware of their rights to better quality of care in labor. This study was conceived in a background where the practice of pain relief in labor is evolving and where women are seeking to fulfill their need for pain-free labor. To investigate the knowledge, utilization and preferences of methods of pain relief in labor by expectant mothers in order to design a labor analgesia program. A questionnaire-based descriptive study involving 124 antenatal clients in a teaching hospital over a 1 week period. Descriptive statistics were carried out using SPSS for windows version 17. The mean age of clients was 28.8 years (standard deviation = 5.17) with median parity of two and mean gestational age was 31.5 weeks. Majority of the respondents (47.9%) were of Hausa/Fulani ethnicity and 97.6% had primary school level education. Majority (87.3%) had heard about pain relief methods with the hospital being the source in 79% of cases. The most common method ever heard about was epidural analgesia (69.4%). Only 4% (n = 5) of respondents remembered ever using any form of pain relief agent in labor, of which three received parenteral opioids. In their current pregnancies, 45.2% consented to the use of pain relief in labor; of which, epidural analgesia was preferred by 92.9% (n = 52). Fear of adverse effects on self and infants were cited as reasons for non-consent by some respondents while others had no reason. The study reveals a high awareness of pain relief methods which is not matched by utilization and low knowledge about side-effects, although fear of side-effects is a factor for under-utilization. There is a need to educate adequately as well provide high quality pain relief services in labor in order to dispel with myths, misconceptions and fears associated with the use of methods of pain relief in labor.

  16. Modeling attitude towards drug treament: the role of internal motivation, external pressure, and dramatic relief.

    Science.gov (United States)

    Conner, Bradley T; Longshore, Douglas; Anglin, M Douglas

    2009-04-01

    Motivation for change has historically been viewed as the crucial element affecting responsiveness to drug treatment. Various external pressures, such as legal coercion, may engender motivation in an individual previously resistant to change. Dramatic relief may be the change process that is most salient as individuals internalize such external pressures. Results of structural equation modeling on data from 465 drug users (58.9% male; 21.3% Black, 34.2% Hispanic/Latino, and 35.1% White) entering drug treatment indicated that internal motivation and external pressure significantly and positively predicted dramatic relief and that dramatic relief significantly predicted attitudes towards drug treatment: chi (2) = 142.20, df = 100, p relief is also likely to be high. When dramatic relief is high, attitudes towards drug treatment are likely to be positive. The findings indicate that interventions to get individuals into drug treatment should include processes that promote Dramatic Relief. Implications for addictions health services are discussed.

  17. Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?

    International Nuclear Information System (INIS)

    Deshmukh, Ajit J.; Rodriguez, Jose A.; Panagopoulos, Georgia; Alizadeh, Ahmadreza; Klein, Devon A.

    2011-01-01

    Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration. This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren-Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient. Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80, p < 0.001). 94% of patients reporting immediate relief also reported relief 2 weeks later. Univariate and multivariate analysis revealed that neither gender nor age was related to immediate or delayed pain relief. Only severity of OA (based on radiographic analysis) was observed to be predictive of pain relief. Pain relief following intra-articular hip injection correlated with radiographic severity of OA. This intervention may be of therapeutic and prognostic value in patients awaiting hip arthroplasty. (orig.)

  18. Lessons from DoD Disaster Relief Efforts in the Asia-Pacific Region

    Science.gov (United States)

    2013-01-01

    Orientation & Review,” USARPAC briefing, undated; “USARPAC OSInt Support to Cyclone nargis Relief Efforts in Burma 2008,” USARPAC briefing, undated; phone...all organizations relied, to a large extent, on the staff and national partners they already had 71 “USARPAC OSINT Support to Cyclone Nargis Relief...undated. As of September 8, 2012: http://www.kadena.af.mil/shared/media/document/AFD-120426-002.pdf “USARPAC OSINT Support to Cyclone Nargis Relief

  19. Optimization and Simulation Modeling of Disaster Relief Supply Chain: A Literature Review

    OpenAIRE

    Feng, Keli; Bizimana, Emmanuel; Agu, Deedee D.; Issac, Tana T.

    2012-01-01

    Recent natural and man-made disasters underscore the need of a resilient and agile disaster relief supply chain to mitigate the damages and save people’s lives. Optimization and simulation modeling have become powerful and useful tools to help decision makers tackle problems related to disaster relief supply chain. This paper reviews optimization and simulation models used in the field of disaster relief supply chain. We review the literature of the facility location optimization problems of ...

  20. Psychiatric comorbidity of headache in a medical relief camp in a rural area.

    Science.gov (United States)

    Sharma, Himanshu; Shah, Savan

    2006-07-01

    Headache is one of the most common complaints seen by primary care physicians, but very few well-planned studies have been conducted to know its prevalence. To study the prevalence of headache and associated psychiatric morbidity. A medical relief camp was held in village Mavta (near Ratlam in Madhya Pradesh) in 2002. Of a total of 1350 registered subjects, 80 with primary complaints of headache were referred to our expert team of psychiatrists. Sixty-nine subjects (86.25%) had psychiatric morbidity-mainly affective disorders (depression) and panic disorder, dysthymia, alcohol and nicotine dependence. Subjects with migraine and depression were mostly women with onset of symptoms at an early age. Subjects with less education; who were unmarried or had lost a spouse; those with a nuclear family; who were unemployed and those with a family history and past history of mental illness, were all susceptible to headache and depression. Disturbed sleep, free floating anxiety, sad mood, lack of pleasure, body ache and fatigue were the main presenting complaints along with headache.

  1. Randomized Trial of Desktop Humidifier for Dry Eye Relief in Computer Users.

    Science.gov (United States)

    Wang, Michael T M; Chan, Evon; Ea, Linda; Kam, Clifford; Lu, Yvonne; Misra, Stuti L; Craig, Jennifer P

    2017-11-01

    Dry eye is a frequently reported problem among computer users. Low relative humidity environments are recognized to exacerbate signs and symptoms of dry eye, yet are common in offices of computer operators. Desktop USB-powered humidifiers are available commercially, but their efficacy for dry eye relief has not been established. This study aims to evaluate the potential for a desktop USB-powered humidifier to improve tear-film parameters, ocular surface characteristics, and subjective comfort of computer users. Forty-four computer users were enrolled in a prospective, masked, randomized crossover study. On separate days, participants were randomized to 1 hour of continuous computer use, with and without exposure to a desktop humidifier. Lipid-layer grade, noninvasive tear-film breakup time, and tear meniscus height were measured before and after computer use. Following the 1-hour period, participants reported whether ocular comfort was greater, equal, or lesser than that at baseline. The desktop humidifier effected a relative difference in humidity between the two environments of +5.4 ± 5.0% (P .05). However, a relative increase in the median noninvasive tear-film breakup time of +4.0 seconds was observed in the humidified environment (P computer use.Trial registration no: ACTRN12617000326392.

  2. Novel therapeutics for gastro-esophageal reflux symptoms.

    Science.gov (United States)

    Zerbib, Frank; Simon, Mireille

    2012-09-01

    Approximately 20-30% of patients with gastro-esophageal reflux symptoms report inadequate symptom relief while on proton-pump inhibitor therapy. The mechanisms involved are failure of the antireflux barrier (transient lower esophageal sphincter relaxations), high proximal extent of the refluxate, esophageal hypersensitivity and impaired mucosal integrity. Persisting acid or nonacid reflux can be demonstrated in 40-50% of cases, suggesting that there is room for antireflux therapy in these patients. New antireflux compounds have been shown to decrease the occurrence of transient lower esophageal sphincter relaxations. The most promising classes of compounds are GABA type B agonists and metabotropic glutamate receptor 5 antagonists, which can reduce both reflux episodes and symptoms, but the development of these compounds has been abandoned for either safety issues or lack of efficacy. Esophageal hypersensitivity and impaired mucosal integrity may prove to be relevant therapeutic targets in the future.

  3. Fructose and lactose intolerance and malabsorption testing: the relationship with symptoms in functional gastrointestinal disorders.

    Science.gov (United States)

    Wilder-Smith, C H; Materna, A; Wermelinger, C; Schuler, J

    2013-06-01

    The association of fructose and lactose intolerance and malabsorption with the symptoms of different functional gastrointestinal disorders (FGID) remains unclear. To investigate the prevalence of fructose and lactose intolerance (symptom induction) and malabsorption and their association with clinical gastrointestinal (GI) as well as non-GI symptoms in FGID and the outcome of dietary intervention. Fructose and lactose intolerance (defined by positive symptom index) and malabsorption (defined by increased hydrogen/methane) were determined in 1372 FGID patients in a single centre using breath testing. Results were correlated with clinical symptoms in different FGID Rome III subgroups. The effectiveness of a targeted saccharide-reduced diet was assessed after 6-8 weeks. Intolerance prevalence across all FGIDs was 60% to fructose, 51% to lactose and 33% to both. Malabsorption occurred in 45%, 32% and 16% respectively. There were no differences in intolerance or malabsorption prevalence between FGID subgroups. FGID symptoms correlated with symptoms evoked during testing (r = 0.35-0.61. P intolerances. Methane breath levels were not associated with constipation using several cut-off thresholds. Adequate symptom relief was achieved in >80% of intolerant patients, irrespective of malabsorption. Fructose and lactose intolerances are common in FGID and associated with increased non-GI symptoms, but not with specific FGID subtypes. Symptoms experienced during breath testing, but not malabsorption, correlate with FGID symptoms. Effective symptom relief with dietary adaptation is not associated with malabsorption. Mechanisms relating to the generation of GI and non-GI symptoms due to lactose and fructose in FGID need to be explored further. © 2013 Blackwell Publishing Ltd.

  4. Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth.

    Science.gov (United States)

    Bailey, Edmund; Worthington, Helen V; van Wijk, Arjen; Yates, Julian M; Coulthard, Paul; Afzal, Zahid

    2013-12-12

    Both paracetamol and ibuprofen are commonly used analgesics for the relief of pain following the surgical removal of lower wisdom teeth (third molars). In 2010, a novel analgesic (marketed as Nuromol) containing both paracetamol and ibuprofen in the same tablet was launched in the United Kingdom, this drug has shown promising results to date and we have chosen to also compare the combined drug with the single drugs using this model. In this review we investigated the optimal doses of both paracetamol and ibuprofen via comparison of both and via comparison with the novel combined drug. We have taken into account the side effect profile of the study drugs. This review will help oral surgeons to decide on which analgesic to prescribe following wisdom tooth removal. To compare the beneficial and harmful effects of paracetamol, ibuprofen and the novel combination of both in a single tablet for pain relief following the surgical removal of lower wisdom teeth, at different doses and administered postoperatively. We searched the Cochrane Oral Health Group'sTrials Register (to 20 May 2013); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 4); MEDLINE via OVID (1946 to 20 May 2013); EMBASE via OVID (1980 to 20 May 2013) and the metaRegister of Controlled Trials (to 20 May 2013). We checked the bibliographies of relevant clinical trials and review articles for further studies. We wrote to authors of the identified randomised controlled trials (RCTs), and searched personal references in an attempt to identify unpublished or ongoing RCTs. No language restriction was applied to the searches of the electronic databases. Only randomised controlled double-blinded clinical trials were included. Cross-over studies were included provided there was a wash out period of at least 14 days. There had to be a direct comparison in the trial of two or more of the trial drugs at any dosage. All trials used the third molar pain model. All trials

  5. CCF analysis of high redundancy systems safety/relief valve data analysis and reference BWR application

    International Nuclear Information System (INIS)

    Mankamo, T.; Bjoere, S.; Olsson, Lena

    1992-12-01

    Dependent failure analysis and modeling were developed for high redundancy systems. The study included a comprehensive data analysis of safety and relief valves at the Finnish and Swedish BWR plants, resulting in improved understanding of Common Cause Failure mechanisms in these components. The reference application on the Forsmark 1/2 reactor relief system, constituting of twelve safety/relief lines and two regulating relief lines, covered different safety criteria cases of reactor depressurization and overpressure protection function, and failure to re close sequences. For the quantification of dependencies, the Alpha Factor Model, the Binomial Probability Model and the Common Load Model were compared for applicability in high redundancy systems

  6. Modeling subsurface stormflow initiation in low-relief landscapes

    Science.gov (United States)

    Hopp, Luisa; Vaché, Kellie B.; Rhett Jackson, C.; McDonnell, Jeffrey J.

    2015-04-01

    Shallow lateral subsurface flow as a runoff generating mechanism at the hillslope scale has mostly been studied in steeper terrain with typical hillside angles of 10 - 45 degrees. These studies have shown that subsurface stormflow is often initiated at the interface between a permeable upper soil layer and a lower conductivity impeding layer, e.g. a B horizon or bedrock. Many studies have identified thresholds of event size and soil moisture states that need to be exceeded before subsurface stormflow is initiated. However, subsurface stormflow generation on low-relief hillslopes has been much less studied. Here we present a modeling study that investigates the initiation of subsurface stormflow on low-relief hillslopes in the Upper Coastal Plain of South Carolina, USA. Hillslopes in this region typically have slope angles of 2-5 degrees. Topsoils are sandy, underlain by a low-conductivity sandy clay loam Bt horizon. Subsurface stormflow has only been intercepted occasionally in a 120 m long trench, and often subsurface flow was not well correlated with stream signals, suggesting a disconnect between subsurface flow on the hillslopes and stream flow. We therefore used a hydrologic model to better understand which conditions promote the initiation of subsurface flow in this landscape, addressing following questions: Is there a threshold event size and soil moisture state for producing lateral subsurface flow? What role does the spatial pattern of depth to the impeding clay layer play for subsurface stormflow dynamics? We reproduced a section of a hillslope, for which high-resolution topographic data and depth to clay measurements were available, in the hydrologic model HYDRUS-3D. Soil hydraulic parameters were based on experimentally-derived data. The threshold analysis was first performed using hourly climate data records for 2009-2010 from the study site to drive the simulation. For this period also trench measurements of subsurface flow were available. In addition

  7. Silodosin: treatment of the signs and symptoms of benign prostatic hyperplasia.

    Science.gov (United States)

    Curran, Monique P

    2011-05-07

    Silodosin is an α-adrenoceptor antagonist with high selectivity for α(1A)- relative to α(1B)- adrenoceptors. In men aged >50 years with benign prostatic hyperplasia (BPH), silodosin 8 mg once daily, compared with placebo, was associated with a significantly more rapid and effective improvement in the total International Prostate Symptom Score (IPSS) and the storage and voiding IPSS subscores in three 12-week, phase III trials conducted in Europe and the US. In the European trial, silodosin was at least as effective as tamsulosin 0.4 mg once daily in improving the total IPSS. Silodosin was significantly more effective than placebo (all three phase III trials) and tamsulosin (European phase III trial) in simultaneously improving nocturia, frequency and incomplete emptying, according to a post hoc analysis. Long-term, open-label extension trials demonstrated that silodosin provided sustained relief of the signs and symptoms of BPH for up to 1 year. Silodosin was generally well tolerated, and was associated with minimal cardiovascular adverse effects. Abnormal ejaculation, a class effect of α(1A)-adrenoceptor antagonists, was the most common silodosin-associated adverse reaction, but resulted in treatment withdrawal of only a limited number of patients. © 2011 Adis Data Information BV. All rights reserved.

  8. Depression Research - The STAR*D Study - Relief in Hours?

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Depression Research Past Issues / Summer 2007 Table of Contents ... multiple treatment options, two-thirds of those with depression can become symptom-free. Dr. A. John Rush ( ...

  9. Estimating the impact of royalty relief on oil and gas production on marginal state leases in the US

    International Nuclear Information System (INIS)

    Dismukes, David E.; Burke, Jeffrey M.; Mesyanzhinov, Dmitry V.

    2006-01-01

    An emerging challenge for several energy-producing states will be the development of policies that encourage the continued economic development of maturing oil and gas properties. Production rates naturally decline as wells age. This is particularly true for properties approaching 'marginal' status in many energy-producing states where continued operation under expected economic conditions becomes questionable. Premature shut-in of these wells may entail loss of production, economic output, employment, and state revenues. This paper examines the potential impact of royalty relief on state leases and economic production using Louisiana as a case study. Two production related measures for state leases are estimated: (1) current production position relative to the age of the property and (2) the current costs of production for the given property at a given or anticipated level of output. Those wells/leases that are estimated as having negative profitability (i.e., losses) or operating at break-even levels are candidates for 'marginal' classification. The number of wells and production associated with these marginal leases will then be estimated. The economic impacts of offering royalty relief at the 25% level are considered. Under the royalty relief scenario, a minimal amount of increased revenues is realized by the state and the discount provides only incremental production from marginal wells relative to total state production

  10. Survivor needs or logistical convenience? Factors shaping decisions to deliver relief to earthquake-affected communities, Pakistan 2005-06.

    Science.gov (United States)

    Benini, Aldo; Conley, Charles; Dittemore, Brody; Waksman, Zachary

    2009-03-01

    In Bureaucratizing the Good Samaritan, Waters (2001) argues that bureaucratic rationality distracts humanitarian agencies from the needs of the people they are supposed to assist, in favour of other values that their institutional frameworks dictate. We test his claim by investigating the response to the Pakistan 2005 earthquake. One of us (Dittemore) worked with the United Nations Joint Logistics Centre in the theatre, managing a relief cargo shipment database. The response, known as 'Operation Winter Race', was hampered by extreme logistical challenges, but ultimately succeeded in averting a second disaster resulting from cold and starvation. We use statistical models to probe whether survivor needs significantly guided decisions to deliver relief to affected communities. Needs assessments remained incomplete and incoherent. We measure needs through proxy indicators and integrate them, on a Geographic Information System (GIS) platform, with logistics and relief delivery data. We find that, despite strong logistics effects, needs orientations were significant. However, the strength of decision factors varies between commodity types (food versus clothing and shelter versus reconstruction materials) as well as over the different phases of the response. This study confirms Thomas's observation that logistics databases are rich 'repositories of data that can be analyzed to provide post-event learning' (Thomas, 2003, p. 4). This article is an invitation for others to engage in creative humanitarian data management.

  11. Epidural Analgesia Versus Patient-Controlled Analgesia for Pain Relief in Uterine Artery Embolization for Uterine Fibroids: A Decision Analysis

    International Nuclear Information System (INIS)

    Kooij, Sanne M. van der; Moolenaar, Lobke M.; Ankum, Willem M.; Reekers, Jim A.; Mol, Ben Willem J.; Hehenkamp, Wouter J. K.

    2013-01-01

    Purpose: This study was designed to compare the costs and effects of epidural analgesia (EDA) to those of patient-controlled intravenous analgesia (PCA) for postintervention pain relief in women having uterine artery embolization (UAE) for systematic uterine fibroids. Methods: Cost-effectiveness analysis (CEA) based on data from the literature by constructing a decision tree to model the clinical pathways for estimating the effects and costs of treatment with EDA and PCA. Literature on EDA for pain-relief after UAE was missing, and therefore, data on EDA for abdominal surgery were used. Outcome measures were compared costs to reduce one point in visual analogue score (VAS) or numeric rating scale (NRS) for pain 6 and 24 h after UAE and risk for complications. Results: Six hours after the intervention, the VAS was 3.56 when using PCA and 2.0 when using EDA. The costs for pain relief in women undergoing UAE with PCA and EDA were €191 and €355, respectively. The costs for EDA to reduce the VAS score 6 h after the intervention with one point compared with PCA were €105 and €179 after 24 h. The risk of having a complication was 2.45 times higher when using EDA. Conclusions: The results of this indirect comparison of EDA for abdominal surgery with PCA for UAE show that EDA would provide superior analgesia for post UAE pain at 6 and 24 h but with higher costs and an increased risk of complications

  12. Acupuncture as pain relief during delivery: a randomized controlled trial

    DEFF Research Database (Denmark)

    Borup, Lissa; Wurlitzer, Winnie; Hedegaard, Morten

    2009-01-01

    BACKGROUND: Many women need some kind of analgesic treatment to relieve pain during childbirth. The objective of our study was to compare the effect of acupuncture with transcutaneous electric nerve stimulation (TENS) and traditional analgesics for pain relief and relaxation during delivery...... with respect to pain intensity, birth experience, and obstetric outcome. METHODS: A randomized controlled trial was conducted with 607 healthy women in labor at term who received acupuncture, TENS, or traditional analgesics. Primary outcomes were the need for pharmacological and invasive methods, level of pain...... with the intention-to-treat principle. RESULTS: Use of pharmacological and invasive methods was significantly lower in the acupuncture group (acupuncture vs traditional, p acupuncture vs TENS, p = 0.031). Pain scores were comparable. Acupuncture did not influence the duration of labor or the use of oxytocin...

  13. Human milk for neonatal pain relief during ophthalmoscopy

    Directory of Open Access Journals (Sweden)

    Laiane Medeiros Ribeiro

    2013-10-01

    Full Text Available Ophthalmoscopy performed for the early diagnosis of retinopathy of prematurity (ROP is painful for preterm infants, thus necessitating interventions for minimizing pain. The present study aimed to establish the effectiveness of human milk, compared with sucrose, for pain relief in premature infants subjected to ophthalmoscopy for the early diagnosis of ROP. This investigation was a pilot, quasi-experimental study conducted with 14 premature infants admitted to the neonatal intensive care unit (NICU of a university hospital. Comparison between the groups did not yield a statistically significant difference relative to the crying time, salivary cortisol, or heart rate (HR. Human milk appears to be as effective as sucrose in relieving acute pain associated with ophthalmoscopy. The study’s limitations included its small sample size and lack of randomization. Experimental investigations with greater sample power should be performed to reinforce the evidence found in the present study.

  14. Numerical study of emergency cryogenics gas relief into confined spaces

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    The presented work focuses on the risk analysis and the consequences of the unexpected leak to the tunnel of cryogenics gases. Formation of the gas mixture and its propagation along tunnels is an important issue for the safe operation of cryogenic machines, including superconducting accelerators or free electron lasers. As the cryogenics gas the helium and argon will be considered. A minimal numerical model will be presented and discussed. Series of numerical results related to emergency helium relief to the CERN tunnel and related to unexpected leak of the argon to an underground tunnel, will be shown. The numerical results will show temperature distribution, oxygen deficiency and gas cloud propagation in function of intensity of the leak and intensity of the ventilation.

  15. Occupational accidents among ambulance drivers in the emergency relief.

    Science.gov (United States)

    Takeda, Elisabete; do Carmo Cruz Robazzi, Maria Lúcia

    2007-01-01

    We analyzed the occurrence of occupational accidents (OA) among ambulance drivers in Emergency Relief (ER), with a view to disclosing the types of events and their causes. A quantitative-qualitative study was carried out through the interview of 22 workers in a city in São Paulo, Brazil. The subjects were male, between 36 and 40 years old (40.9%), married (81.82%), with uncompleted primary education (40.9%), individual (90.9%) and family (54.55%) income between two and four Brazilian minimum wages, not performing any other paid occupation (45.45%). The majority of the OA were typical, due to an excess of exercises and vigorous and repeated movements (42.11%) and aggression through body strength and other means (26.33%). The OA occurs mainly because drivers carry out tasks that do not suit their professional formation.

  16. Pemanfaatan Frekuensi Untuk Public Protection and Disaster Relief (PPDR

    Directory of Open Access Journals (Sweden)

    Diah Yuniarti

    2014-03-01

    Full Text Available Penanganan kejadian yang terkait dengan Public Protection and Disaster Relief (PPDR di Indonesia yang merupakan negara yang rawan terhadap bencana dan permasalahan sosial membutuhkan komunikasi yang intensif. Penelitian ini mengkaji mengenai kondisi pemanfaatan frekuensi PPDR di Indonesia dan strategi pengembangan ke depannya dengan menggunakan analisis SWOT. Hasil penelitian menunjukkan bahwa sistem komunikasi pada instansi PPDR di Indonesia tidak mendukung interoperabilitas dalam penanganan kejadian PPDR yang terkoordinasi. Selain itu, pita frekuensi yang digunakan merupakan pita sempit yang tidak mendukung aplikasi video dan data kecepatan tinggi yang dibutuhkan dalam penanganan kejadian PPDR yang lebih efektif. Oleh karena itu, dalam perencanaan alokasi frekuensi ke depannya, pemerintah perlu mengintegrasikan pita lebar ke dalam perencanaan sistem Government Radio Network (GRN.

  17. The roles of special proresolving mediators in pain relief.

    Science.gov (United States)

    Zhang, Lan-Yu; Jia, Ming-Rui; Sun, Tao

    2018-02-08

    The resolution of acute inflammation, once thought to be a passive process, is now recognized as an active one. The productions of endogenous special proresolving mediators (SPMs) are involved in this process. SPMs, including lipoxins, resolvins, protectins, and maresins, are endogenous lipid mediators generated from ω-6 arachidonic acid or ω-3 poly-unsaturated fatty acids during the resolution phase of acute inflammation. They have potent anti-inflammatory and proresolving actions in various inflammatory disorders. Due to the potent proresolving and anti-inflammatory effects, SPMs are also used for pain relief. This review focuses on the mechanisms by which SPMs act on their respective G-protein-coupled receptors in immune cells and nerve cells to normalize pain via regulating inflammatory mediators, transient receptor potential ion channels, and central sensitization. SPMs may offer novel therapeutic approaches for preventing and treating pain conditions associated with inflammation.

  18. Experimental Validation of the LHC Helium Relief System Flow Modeling

    CERN Document Server

    Fydrych, J; Riddone, G

    2006-01-01

    In case of simultaneous resistive transitions in a whole sector of magnets in the Large Hadron Collider, the helium would be vented from the cold masses to a dedicated recovery system. During the discharge the cold helium will eventually enter a pipe at room temperature. During the first period of the flow the helium will be heated intensely due to the pipe heat capacity. To study the changes of the helium thermodynamic and flow parameters we have simulated numerically the most critical flow cases. To verify and validate numerical results, a dedicated laboratory test rig representing the helium relief system has been designed and commissioned. Both numerical and experimental results allow us to determine the distributions of the helium parameters along the pipes as well as mechanical strains and stresses.

  19. The Americans with Disabilities Act: prescription for tax relief.

    Science.gov (United States)

    Cook, E D; Judice, A K; Hazelwood, A C

    1996-01-01

    As employers, healthcare organizations must comply with Title I of the Americans with Disabilities Act of 1990-Employment Discrimination by Private Entities-which covers virtually all aspects of employment and prohibits employers from discriminating against otherwise qualified job applicants and workers who have disabilities or who become disabled. Further, healthcare organizations must comply with the provisions of Title III of the act-Nondiscrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities-which requires places of public accommodations and commercial facilities to be designed, constructed, and altered in compliance with the accessibility standards of the act. While compliance with the ADA can be costly, four specific sections of the Internal Revenue Code offer tax relief to organizations that meet the guidelines of Titles I and III.

  20. Expediency of application of explosion-relief constructions to ensure explosion resistance of production buildings

    Directory of Open Access Journals (Sweden)

    Lyapin Anton

    2016-01-01

    Full Text Available The article presents a model of economic evaluation and selection of explosion-relief constructions (ERC, as well as determination of explosion protection efficiency of buildings and structures provided on a stage of construction. It has been shown that definition of economic efficiency of ERС is the evaluation of its application for buildings with remote or automatically controlled production. It has been determined that an important role in design of explosive industrial facilities is played by selection of the economically feasible and effective materials for ERC. When selecting materials it is necessary to consider probability and yield of explosions. Necessity to create the methods allow considering such probability has been revealed.

  1. Social Media for Enhancing Civil Society and Disaster Relief: Usage by Local Municipalities in Japan

    Directory of Open Access Journals (Sweden)

    Muneo Kaigo

    2015-10-01

    Full Text Available This main focus of this article is a case study that analyzes social media usage by a local municipality in Japan, and on the possibilities and problems of complementary communication channels such as social networking services for promoting civil society activities and linking civil society organizations. We examine how in the past, Japanese municipalities have been using social media and social networking services for enhancing civil society and how social networking services are a potential tool that can provide vital information and connect citizens, municipal governments and civil society. This article focuses on the first phase of the Tsukuba Civic Activities Cyber-Square [Tsukuba Shimin Katsudō no Hiroba] on Facebook Experiment in 2012 and how it functioned during and after the May 6, 2012 Tsukuba city tornado disaster for the subsequent relief and support activities during May 2012.

  2. Clinically relevant pain relief with an ibuprofen-releasing foam dressing

    DEFF Research Database (Denmark)

    Fogh, Karsten; Andersen, Maibritt B; Bischoff-Mikkelsen, Morten

    2012-01-01

    The objective of this 6-week, 120-patient, double-blind, randomized, controlled trial was to investigate if a foam dressing with ibuprofen provided clinically relevant pain relief (PAR) for exuding, painful venous leg ulcers in comparison with a similar foam dressing without ibuprofen. Primary......) and the corresponding number needed to treat (NNT). Wound-related parameters such as ulcer healing, ulcer area reduction, and peri-ulcer skin condition as well as adverse events were recorded during all 6 weeks of the investigation. PAR was significantly greater in the ibuprofen foam group than the comparator group (p...... = 0.0438). There were 34% responders in the ibuprofen foam group vs. 19% in the comparator group (NNT = 6.8). When evening data were analyzed separately to evaluate PAR over daytime, NNT was 5.3. Wound healing parameters and adverse events were comparable. In conclusion, in this study, the ibuprofen...

  3. Arctic-nesting birds find physiological relief in the face of trophic constraints.

    Science.gov (United States)

    McKinnon, Laura; Nol, Erica; Juillet, Cédric

    2013-01-01

    A climate-induced phenological mismatch between the timing of reproduction and the timing of food resource peaks is one of the key hypothesized effects of climate change on wildlife. Though supported as a mechanism of population decline in birds, few studies have investigated whether the same temperature increases that drive this mismatch have the potential to decrease energetic costs of growth and compensate for the potential negative effects of reduced food availability. We generated independent indices of climate and resource availability and quantified their effects on growth of Dunlin (Calidris alpina) chicks, in the sub-arctic tundra of Churchill, Manitoba during the summers of 2010-2011 and found that when resource availability was below average, above average growth could be maintained in the presence of increasing temperatures. These results provide evidence that chicks may find physiological relief from the trophic constraints hypothesized by climate change studies.

  4. Deepwater royalty relief product of 3 1/2 year U.S. political effort

    International Nuclear Information System (INIS)

    Davis, R.E.; Neff, S.

    1996-01-01

    Against the backdrop of more than 20 years of increasingly stringent environmental regulation, ever-expanding exploration and development moratoria on the Outer Continental Shelf (OCS), and reductions in producer tax incentives, oil and natural gas exploration companies active in deep waters of the Gulf of Mexico recently won a significant legislative victory. On Nov. 28, 1995, President Clinton signed into law S.395, the Alaska Power Administration Sale Act. Title 3 of S.395 embodies the Outer Continental Shelf Deep Water Royalty Relief Act. This landmark legislation provides substantial incentives for oil and natural gas production in the gulf of Mexico by temporarily eliminating royalties on certain deepwater leases. It is the first direct incentive for oil and gas production enacted at the federal level in many years. This paper reviews the elements used to arrive at this successful legislation including the congressional leadership. It describes debates, cabinet level discussions, and use of parlimentary procedures

  5. Design of the US-CRBRP sodium/water reaction pressure relief system

    International Nuclear Information System (INIS)

    Kruger, G.B.; Murdock, T.B.; Rodwell, E.; Sane, J.O.

    1976-01-01

    Protection against intermediate sodium system overpressure from the sodium/water reaction associated with large leaks within the CRBRP Steam Generators is provided by the sodium/water reaction pressure relief system (SWRPRS). This system consists of rupture disks connected to the intermediate sodium piping adjacent to the inlet to the superheater and outlet from the evaporator modules. The rupture discs relieve into piping that leads to reaction produce separator tanks, which in turn are vented to a centrifugal separator and flare stack arranged to burn hydrogen gas exhausting into the atmosphere. Analyses have been conducted using the TRANSWRAP Computer Code to predict the system pressures and flow rates during the large leak event. Experimental tests to be conducted in the large leak test rig (LLTR) will be used to confirm the analysis techniques used in the design

  6. Bilateral CT-guided percutaneous cordotomy for cancer pain relief

    International Nuclear Information System (INIS)

    Yegul, I.; Erhan, E.

    2003-01-01

    AIM: CT-guided percutaneous cordotomy is a useful procedure for treating unilateral cancer pain, however, bilateral cordotomy can be required on some occasions. We evaluated the effectiveness and complications of bilateral cordotomy. MATERIALS AND METHODS: Two hundred and thirty-four patients who suffered from unilateral cancer pain underwent CT-guided percutaneous cordotomy. The procedure was repeated in 22 patients, and nine patients had bilateral cordotomy. Effectiveness and complications were recorded after each procedure. RESULTS: Of nine patents (three women and six men) having bilateral percutaneous cordotomy in our study, four patients had mirror pain after the first procedure. In the remaining five patients the contralateral pain was due to new pain sites. The pain scores before and after the first procedure were 9.3 (range 7-10) and 1.2 (range 0-3), respectively. After the first procedure complete or satisfactory pain relief was achieved in all patients. The duration between the two procedures ranged from 7-243 days (mean 59.8 days). The pain scores before and after the second procedure were 8.4 (range 5-10) and 1.6 (range 0-4), respectively. After the second procedure complete or satisfactory pain relief was reported in all patients. There were no complications in four patients. One patient developed transient motor deficit after the first procedure. Other complications (nausea/vomiting, headache, ipsilateral neck pain, postcordotomy dysesthesia) were mild and transient. CONCLUSION: CT-guided percutaneous cordotomy is a useful procedure for the treatment of severe unilateral cancer pain syndromes. The procedure can be repeated on the other side at least 1 week later. These results show that the success on the second side appears to be similar to the first side with low complication rate for both procedures

  7. The importance of context: When relative relief renders pain pleasant

    Science.gov (United States)

    Leknes, Siri; Berna, Chantal; Lee, Michael C.; Snyder, Gregory D.; Biele, Guido; Tracey, Irene

    2013-01-01

    Context can influence the experience of any event. For instance, the thought that “it could be worse” can improve feelings towards a present misfortune. In this study we measured hedonic feelings, skin conductance, and brain activation patterns in 16 healthy volunteers who experienced moderate pain in two different contexts. In the “relative relief context,” moderate pain represented the best outcome, since the alternative outcome was intense pain. However, in the control context, moderate pain represented the worst outcome and elicited negative hedonic feelings. The context manipulation resulted in a “hedonic flip,” such that moderate pain elicited positive hedonics in the relative relief context. Somewhat surprisingly, moderate pain was even rated as pleasant in this context, despite being reported as painful in the control context. This “hedonic flip” was corroborated by physiological and functional neuroimaging data. When moderate pain was perceived as pleasant, skin conductance and activity in insula and dorsal anterior cingulate were significantly attenuated relative to the control moderate stimulus. “Pleasant pain” also increased activity in reward and valuation circuitry, including the medial orbitofrontal and ventromedial prefrontal cortices. Furthermore, the change in outcome hedonics correlated with activity in the periacqueductal grey (PAG) of the descending pain modulatory system (DPMS). The context manipulation also significantly increased functional connectivity between reward circuitry and the PAG, consistent with a functional change of the DPMS due to the altered motivational state. The findings of this study point to a role for brainstem and reward circuitry in a context-induced “hedonic flip” of pain. PMID:23352758

  8. Bilateral CT-guided percutaneous cordotomy for cancer pain relief

    Energy Technology Data Exchange (ETDEWEB)

    Yegul, I. E-mail: iyegul@med.ege.edu.tr; Erhan, E. E-mail: elvanerhan@yahoo.com

    2003-11-01

    AIM: CT-guided percutaneous cordotomy is a useful procedure for treating unilateral cancer pain, however, bilateral cordotomy can be required on some occasions. We evaluated the effectiveness and complications of bilateral cordotomy. MATERIALS AND METHODS: Two hundred and thirty-four patients who suffered from unilateral cancer pain underwent CT-guided percutaneous cordotomy. The procedure was repeated in 22 patients, and nine patients had bilateral cordotomy. Effectiveness and complications were recorded after each procedure. RESULTS: Of nine patents (three women and six men) having bilateral percutaneous cordotomy in our study, four patients had mirror pain after the first procedure. In the remaining five patients the contralateral pain was due to new pain sites. The pain scores before and after the first procedure were 9.3 (range 7-10) and 1.2 (range 0-3), respectively. After the first procedure complete or satisfactory pain relief was achieved in all patients. The duration between the two procedures ranged from 7-243 days (mean 59.8 days). The pain scores before and after the second procedure were 8.4 (range 5-10) and 1.6 (range 0-4), respectively. After the second procedure complete or satisfactory pain relief was reported in all patients. There were no complications in four patients. One patient developed transient motor deficit after the first procedure. Other complications (nausea/vomiting, headache, ipsilateral neck pain, postcordotomy dysesthesia) were mild and transient. CONCLUSION: CT-guided percutaneous cordotomy is a useful procedure for the treatment of severe unilateral cancer pain syndromes. The procedure can be repeated on the other side at least 1 week later. These results show that the success on the second side appears to be similar to the first side with low complication rate for both procedures.

  9. Disability and health-related rehabilitation in international disaster relief

    Science.gov (United States)

    Reinhardt, Jan D.; Li, Jianan; Gosney, James; Rathore, Farooq A.; Haig, Andrew J.; Marx, Michael; Delisa, Joel A.

    2011-01-01

    Background Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention. Objectives To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability. Design Qualitative literature review and secondary data analysis. Results Absolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested. Conclusion Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health

  10. Creating global comparative analyses of tectonic rifts, monogenetic volcanism and inverted relief

    Science.gov (United States)

    van Wyk de Vries, Benjamin

    2016-04-01

    I have been all around the world, and to other planets and have travelled from the present to the Archaean and back to seek out the most significant tectonic rifts, monogenetic volcanoes and examples of inverted relief. I have done this to provide a broad foundation of the comparative analysis for the Chaîne des Puys - Limagne fault nomination to UNESCO world Heritage. This would have been an impossible task, if not for the cooperation of the scientific community and for Google Earth, Google Maps and academic search engines. In preparing global comparisons of geological features, these quite recently developed tools provide a powerful way to find and describe geological features. The ability to do scientific crowd sourcing, rapidly discussing with colleagues about features, allows large numbers of areas to be checked and the open GIS tools (such as Google Earth) allow a standardised description. Search engines also allow the literature on areas to be checked and compared. I will present a comparative study of rifts of the world, monogenetic volcanic field and inverted relief, integrated to analyse the full geological system represented by the Chaîne des Puys - Limagne fault. The analysis confirms that the site is an exceptional example of the first steps of continental drift in a mountain rift setting, and that this is necessarily seen through the combined landscape of tectonic, volcanic and geomorphic features. The analysis goes further to deepen the understanding of geological systems and stresses the need for more study on geological heritage using such a global and broad systems approach.

  11. [Family functioning of elderly with depressive symptoms].

    Science.gov (United States)

    Souza, Rosely Almeida; Desani da Costa, Gislaine; Yamashita, Cintia Hitomi; Amendola, Fernanda; Gaspar, Jaqueline Correa; Alvarenga, Márcia Regina Martins; Faccenda, Odival; Oliveira, Maria Amélia de Campos

    2014-06-01

    To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms). The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items) and the Family Apgar. An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.

  12. Family functioning of elderly with depressive symptoms

    Directory of Open Access Journals (Sweden)

    Rosely Almeida Souza

    2014-06-01

    Full Text Available Objective: To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. Method: This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms. The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items and the Family Apgar. Results: An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. Conclusion: The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.

  13. Early psychosis symptoms

    International Nuclear Information System (INIS)

    Naqvi, H.A.; Hussain, S.; Islam, M.

    2014-01-01

    Objective: To determine the prodromal symptoms of schizophrenia in the pathways to help-seeking. Study Design: A cross-sectional study. Place and Duration of Study: The Department of Psychiatry, the Aga Khan University, Karachi, from 2008 to 2009. Methodology: A total of 93 patients were interviewed in the pathways to care of schizophrenia. The diagnosis was based on ICD-10 criteria. The pathways to care were assessed through a semi-structured questionnaire. The onset, course and symptoms of psychosis were assessed through Interview for Retrospective Assessment at Age at Onset of Psychosis (IROAS). Results: Fifty five (59%) participants were male while 41% (n=38%) were female. Using IROAS, 108 symptoms were identified as concerning behaviour. Alternatively, 60 (55%) concerning behaviours were reported in the open-ended inquiry of the reasons for help seeking as assessed by the pathways to care questionnaire with a statistically significant difference between most symptoms category. The difference was most pronounced (p < 0.001) for depressed mood (66%), worries (65%), tension (63%), withdrawal/mistrust (54%) and loss of self-confidence (53%). Thought withdrawal (22%) and passivity (15%) were elicited only through structured interview (IROAS). When symptoms were categorized together, about 83% of the subjects presented with affective and non-specific prodromal symptoms. Roughly, 10% of the subjects presented with positive symptoms and 3% presented with the negative symptoms of psychosis. The non-specific, affective symptoms appear to predominate the prodromal phase of the illness. Conclusion: Prodromal symptoms of schizophrenia include non-specific, affective symptoms. Attention needs to be paid on identifying the prodromal symptoms and change in social functioning in order to identify those who are at risk of long term psychosis. (author)

  14. Somatic symptom disorder

    Science.gov (United States)

    ... related disorders; Somatization disorder; Somatiform disorders; Briquet syndrome; Illness anxiety disorder References American Psychiatric Association. Somatic symptom disorder. Diagnostic and Statistical Manual of Mental Disorders . ...

  15. The inter-relationship of premenstrual symptoms.

    Science.gov (United States)

    Mira, M; Abraham, S; McNeil, D; Vizzard, J; Macaskill, P; Fraser, I; Llewellyn-Jones, D

    1995-09-01

    The prospective symptom reports of women seeking treatment for premenstrual symptoms and control subjects was investigated. In order to compare symptom reports from premenstrual symptom sufferers and control subjects a method of combining and analysing prospectively collected menstrual cycle symptom data is required. A technique that uses the time of onset of menses and the time of ovulation (as measured by urinary luteinizing hormone excretion) to standardize each cycle into 14 time points was developed. Summary factors were then empirically derived from data collected prospectively from 30 premenstrual symptom sufferers and 19 control subjects. Twenty-two mood symptoms were summarized into a single factor and the 29 most frequently occurring physical symptoms were summarized into two factors. Factor scores were calculated on the basis of these factors and the effect of time during the menstrual cycle on these scores examined. Both physical symptom factor scores increased significantly in the luteal phase for both the premenstrual symptom sufferer group and the control group. The single mood factor score increased significantly in the luteal phase for the premenstrual sufferer group but not for the control group, suggesting that the only qualitative difference between the groups was the presence of cyclic mood symptoms in the premenstrual symptom sufferer group. The premenstrual symptom sufferer group recorded significantly higher scores on each of the three factors than the control group. The correlation between the scores on each of the factors over three cycles was high both in the follicular and luteal phase suggesting that these factor scores provide a reproducible measure of menstrual cycle symptomatology.

  16. Fructose and lactose intolerance and malabsorption testing: the relationship with symptoms in functional gastrointestinal disorders

    Science.gov (United States)

    Wilder-Smith, C H; Materna, A; Wermelinger, C; Schuler, J

    2013-01-01

    Background The association of fructose and lactose intolerance and malabsorption with the symptoms of different functional gastrointestinal disorders (FGID) remains unclear. Aim To investigate the prevalence of fructose and lactose intolerance (symptom induction) and malabsorption and their association with clinical gastrointestinal (GI) as well as non-GI symptoms in FGID and the outcome of dietary intervention. Methods Fructose and lactose intolerance (defined by positive symptom index) and malabsorption (defined by increased hydrogen/methane) were determined in 1372 FGID patients in a single centre using breath testing. Results were correlated with clinical symptoms in different FGID Rome III subgroups. The effectiveness of a targeted saccharide-reduced diet was assessed after 6–8 weeks. Results Intolerance prevalence across all FGIDs was 60% to fructose, 51% to lactose and 33% to both. Malabsorption occurred in 45%, 32% and 16% respectively. There were no differences in intolerance or malabsorption prevalence between FGID subgroups. FGID symptoms correlated with symptoms evoked during testing (r = 0.35–0.61. P 80% of intolerant patients, irrespective of malabsorption. Conclusions Fructose and lactose intolerances are common in FGID and associated with increased non-GI symptoms, but not with specific FGID subtypes. Symptoms experienced during breath testing, but not malabsorption, correlate with FGID symptoms. Effective symptom relief with dietary adaptation is not associated with malabsorption. Mechanisms relating to the generation of GI and non-GI symptoms due to lactose and fructose in FGID need to be explored further. PMID:23574302

  17. Changes in Australian women's perception of the menopause and menopausal symptoms before and after the climacteric.

    Science.gov (United States)

    Abraham, S; Llewellyn-Jones, D; Perz, J

    1994-12-01

    The symptoms and perceptions of menopause of 60 Australian women were studied, by questionnaire, when they were premenopausal and 10 years later when they were postmenopausal. Menopausal symptoms expected and experienced by the women were compared, fewer women experiencing hot flushes, headache, depression and nervousness and more experiencing insomnia, increase in appetite, abdominal fullness, numbness and muscular problems. The symptoms women thought were due to hormonal changes at menopause were compared. In 1993 more women cited osteoporosis, insomnia, loss of libido, obesity and loss of muscle tone as due to hormone change while fewer cited depression. The premenstrual symptoms and their severity experienced by a woman when she was premenopausal significantly predicts the type and severity of the menopausal symptoms experienced by the woman. The expected menopausal symptoms and their severity cited by a woman also significantly predicts the type of severity of the menopausal symptoms experienced. More premenstrual symptoms predict the menopausal symptoms than those menopausal symptoms the women expected. The expectation menopause will be 'a relief' or 'a nuisance' significantly predicted the overall menopause experience described by the women. Their negative attitudes about doctors' understanding and information available about menopause remained unchanged but they forget menstrual cycle problems over the 10 years. The results suggest a possible physiological basis for premenstrual and menopausal symptoms. Assistance for women with their premenstrual and menstrual cycle symptoms may improve their quality of life at menopause.

  18. An audit of aspects of informed consent and pain relief in general ...

    African Journals Online (AJOL)

    They were asked what they knew or had been informed about their diagnosis, operation and complications of surgery. On pain relief, patients were asked about their experiences on the first post-operative day and what relief they had from analgesics. Twenty four did not know the diagnosis and 36 were not told what ...

  19. 21 CFR 882.5870 - Implanted peripheral nerve stimulator for pain relief.

    Science.gov (United States)

    2010-04-01

    ....5870 Implanted peripheral nerve stimulator for pain relief. (a) Identification. An implanted peripheral nerve stimulator for pain relief is a device that is used to stimulate electrically a peripheral nerve... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted peripheral nerve stimulator for pain...

  20. 30 CFR 203.3 - Do I have to pay a fee to request royalty relief?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Do I have to pay a fee to request royalty... MINERALS REVENUE MANAGEMENT RELIEF OR REDUCTION IN ROYALTY RATES General Provisions § 203.3 Do I have to pay a fee to request royalty relief? When you submit an application or ask for a preview assessment...

  1. 19 CFR 210.69 - Approval of complainant's temporary relief bond.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Approval of complainant's temporary relief bond. 210.69 Section 210.69 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.69 Approval of...

  2. 19 CFR 210.70 - Forfeiture or return of complainant's temporary relief bond.

    Science.gov (United States)

    2010-04-01

    ... relief bond. 210.70 Section 210.70 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.70... and the Commission will be guided by practice under Rule 65 of the Federal Rules of Civil Procedure...

  3. 78 FR 8691 - Notice of Availability of Emergency Relief Funds in Response to Hurricane Sandy

    Science.gov (United States)

    2013-02-06

    ...-competitive basis, subject to the priorities set forth below. The Disaster Relief Appropriations Act of 2013..., reconstruct, or replace equipment and facilities of a public transportation system operating in the United... affects public transportation systems. The Emergency Relief Program allows FTA to make grants for eligible...

  4. knowledge, attitude and use of pain relief in labour among women

    African Journals Online (AJOL)

    2014-07-01

    Jul 1, 2014 ... Objective: To find out the knowledge, attitude and practice of pain relief methods during labour among ... all of which could adversely affect uterine blood flow. Pain relief in ... knowledge was low among women who did not use any form of ... Niven et al found that memories of labour pains can evoke intense ...

  5. An Engineered Resupply System for Humanitarian Assistance and Disaster Relief Operations

    Science.gov (United States)

    2017-09-01

    relevant and timely relief. Conduct Supply refers to the procurement, warehousing, and managing of relief supplies. Conduct Deployment and Distribution ...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release. Distribution is unlimited. AN ENGINEERED...Approved OMB No. 0704–0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time

  6. Counterfactually Mediated Emotions: A Developmental Study of Regret and Relief in a Probabilistic Gambling Task

    Science.gov (United States)

    Habib, M.; Cassotti, M.; Borst, G.; Simon, G.; Pineau, A.; Houde, O.; Moutier, S.

    2012-01-01

    Regret and relief are related to counterfactual thinking and rely on comparison processes between what has been and what might have been. In this article, we study the development of regret and relief from late childhood to adulthood (11.2-20.2 years), and we examine how these two emotions affect individuals' willingness to retrospectively…

  7. The effect of soy intake on menopausal symptoms

    Directory of Open Access Journals (Sweden)

    Andrea Pérez-Rovira

    2014-05-01

    Full Text Available The menopause is characterized by a reduction in ovarian function and estrogen production. Altogether, these changes together lead to a series of disorders that may affect the woman’s life style. Currently, medicine, influenced by the pharmaceutical industry, is prone to act aggressively against any symptoms, resulting in. polymedicated population. Doctors usually prescribe treatments such as hormone replacement therapy (HRT, to help them manage menopause symptoms. However, recently, several studies have reported adverse effects associated with this treatment. The influence of diet on several chronic diseases in western societies is currently well known. Therefore, dietary therapies, including dietary soy and isoflavone supplements, have been proposed for the reduction of menopause symptoms. Several published studies have suggested isoflavones, which have a great estrogenic power, as an HRT alternative for the relief of menopause symptoms. However, our current understanding on the effects of isoflavone supplements on the menopause symptoms is limited, and scientific publications show heterogenous results. Due to those arguments, the objective of this review is to address some of the mechanisms of isoflavones and their role in the menopausal period, postulating that, as food supplements, they could be used as a complementary therapy for menopause symptoms.

  8. Psychiatric and addictive symptoms of young adult female indoor tanners.

    Science.gov (United States)

    Heckman, Carolyn J; Cohen-Filipic, Jessye; Darlow, Susan; Kloss, Jacqueline D; Manne, Sharon L; Munshi, Teja

    2014-01-01

    Indoor tanning (IT) increases risk for melanoma and is particularly common among young adult women. IT has also been linked with some psychiatric symptoms, and frequent tanning may indicate tanning dependence (addiction) associated with endorphin release during ultraviolet radiation exposure. The objective of the current study was to investigate associations between IT, tanning dependence, and psychiatric and substance use symptoms in young adult women. Cross-sectional survey and psychiatric interview. Online, except for the Mini International Neuropsychiatric Interview (MINI), which was completed over the telephone. Participants were 306 female university students aged 18 to 25 years. MINI, Seasonal Scale Index, tanning dependence scales, reporting ever having used a tanning bed or booth with tanning lamps (single item), reporting smoking a cigarette in the last 30 days (single item). Descriptive statistics, χ(2) analysis, multivariate logistic regression. Forty-six percent of the sample reported a history of IT, and 25% were classified as tanning dependent. Multivariate logistic regression analyses showed that IT was significantly associated with symptoms of alcohol use disorders, generalized anxiety, and not having social anxiety. Tanning dependence was associated with symptoms of alcohol use disorders. Tanning is of concern not only for its association with skin cancer but for its association with psychiatric and substance use symptoms. Young women with certain psychological problems may seek relief from their symptoms by IT. These findings suggest that indoor tanners may benefit from health behavior and other psychosocial interventions.

  9. Bell's Palsy Symptoms

    Science.gov (United States)

    ... Stories Español Eye Health / Eye Health A-Z Bell's Palsy Sections What Is Bell's Palsy? Bell's Palsy Symptoms Bell's Palsy Treatment Bell's Palsy Symptoms Leer en Español: Síntomas de la parálisis ...

  10. Symptoms, Diagnosis & Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story: Leukemia/Lymphoma Symptoms, Diagnosis & Treatment Past Issues / Summer 2008 Table of Contents For an enhanced version of this page please turn Javascript on. Leukemia Symptoms Frequent infections Fever and chills Anemia Easy ...

  11. Studies on the visualization of the fine relief of the colon

    International Nuclear Information System (INIS)

    Persigehl, M.; Niemann, G.; Klose, K.C.

    1983-01-01

    The possibility of visualizing the fine relief of the colon was examined by studying human intestinal segments removed post mortem. The visualization depends, among other things, on the extent of expansion of the colon wall. The visualization of the fine relief structure becomes progressively poorer, the greater the extension of the wall. This might indicate that fold formation of the mucosa through a state of contraction of the tunica mucosa is done of the responsible factors for the visualization of the fine relief structures. The article discusses, apart from this factor, the course of the vessels as an anatomical basic pattern determining the manifestation of the fine relief structure; for this purpose, the course of the vessels in the intestine of the dog was visualized by intra-arterial contrast medium injection and then compared with the human fine relief. (orig.) [de

  12. Mental health risks in the local workforce engaged in disaster relief and reconstruction.

    Science.gov (United States)

    Wang, Xiao L; Chan, Cecilia L W; Shi, Zhan B; Wang, Bin

    2013-02-01

    To build a sustainable workforce for long-term disaster relief and reconstruction, more effort must be made to promote local relief workers' mental health. We conducted 25 semistructured interviews with local relief officials 10 months after the 2008 earthquake in China to investigate the stress and coping experiences in their personal lives as survivors. We conducted thematic analysis of interview transcripts. Traumatic bereavement and grief, housing and financial difficulties, and work-family conflict were the three main sources of stress in the respondents' personal lives. The coping themes were finding meaning and purpose in life through relief work, colleagues' support and understanding, suppression or avoidance of grief, appreciation for life, hardiness, optimism, letting nature take its course, and making up for loss. We suggest that relief work has a double-edged-sword effect on workers' coping abilities. We discuss the implications of this effect for work-life balance measures and trauma and grief counseling services.

  13. Audiovisual distraction for pain relief in paediatric inpatients: A crossover study.

    Science.gov (United States)

    Oliveira, N C A C; Santos, J L F; Linhares, M B M

    2017-01-01

    Pain is a stressful experience that can have a negative impact on child development. The aim of this crossover study was to examine the efficacy of audiovisual distraction for acute pain relief in paediatric inpatients. The sample comprised 40 inpatients (6-11 years) who underwent painful puncture procedures. The participants were randomized into two groups, and all children received the intervention and served as their own controls. Stress and pain-catastrophizing assessments were initially performed using the Child Stress Scale and Pain Catastrophizing Scale for Children, with the aim of controlling these variables. The pain assessment was performed using a Visual Analog Scale and the Faces Pain Scale-Revised after the painful procedures. Group 1 received audiovisual distraction before and during the puncture procedure, which was performed again without intervention on another day. The procedure was reversed in Group 2. Audiovisual distraction used animated short films. A 2 × 2 × 2 analysis of variance for 2 × 2 crossover study was performed, with a 5% level of statistical significance. The two groups had similar baseline measures of stress and pain catastrophizing. A significant difference was found between periods with and without distraction in both groups, in which scores on both pain scales were lower during distraction compared with no intervention. The sequence of exposure to the distraction intervention in both groups and first versus second painful procedure during which the distraction was performed also significantly influenced the efficacy of the distraction intervention. Audiovisual distraction effectively reduced the intensity of pain perception in paediatric inpatients. The crossover study design provides a better understanding of the power effects of distraction for acute pain management. Audiovisual distraction was a powerful and effective non-pharmacological intervention for pain relief in paediatric inpatients. The effects were

  14. IMPACT OF INTERFERENTIAL CURRENT ON PAIN RELIEF AMONG PATIENTS WITH ORCHIALGIA

    Directory of Open Access Journals (Sweden)

    Hany M.I. Elgohary

    2016-08-01

    Full Text Available Background: Scrotal discomfort can contribute to unusual impact on body scheme and result in behavioral alterations, as well as changes in sexual function such as delay of sexual ability that may affect both man and his companion. There are many physiotherapy modalities to reduce the intratesticular pain such as pelvic floor muscle training, hydrotherapy, ultrasound and electrotherapy. Interferential current therapy is a noninvasive therapy used to reduce acute and chronic, post-operative and post-trauma acute pain. It provides a safe and effective alternative to pharmacological approaches to pain control. The purpose of the current study was to investigate the efficacy of interferential current in alleviating testicular pain. Methods: Randomized clinical study conducted on 50 participants. They divided into two equal groups: Group A received interferential current with two electrodes placed over the upper medial aspects of thighs and the other two electrodes were positioned over the suprapubic area. While group B received placebo interferential current. The treatment protocol was applied 3 times/ week for six successive weeks, in a total of 18 sessions. Patients were evaluated before and after the six weeks of the treatment by visual analogue scale and pain intensity while pain relief scale was measured after the treatment. Results: Group A showed a significant pain improvement in both inter and intra group comparison in all measured parameters (visual analogue scale and pain intensity while pain relief scale (p <0.05. Conclusion: The findings show that interferential current is an effective modality and can be recommended for the treatment of testicular pain.

  15. Trial of Music, Sucrose, and Combination Therapy for Pain Relief during Heel Prick Procedures in Neonates.

    Science.gov (United States)

    Shah, Swapnil R; Kadage, Shahajahan; Sinn, John

    2017-11-01

    To compare the effectiveness of music, oral sucrose, and combination therapy for pain relief in neonates undergoing a heel prick procedure. This randomized, controlled, blinded crossover clinical trial included stable neonates >32 weeks of postmenstrual age. Each neonate crossed over to all 3 interventions in random order during consecutive heel pricks. A video camera on mute mode recorded facial expressions, starting 2 minutes before until 7 minutes after the heel prick. The videos were later analyzed using the Premature Infant Pain Profile-Revised (PIPP-R) scale once per minute by 2 independent assessors, blinded to the intervention. The PIPP-R scores were compared between treatment groups using Friedman test. For the 35 participants, the postmenstrual age was 35 weeks (SD, 2.3) with an average weight of 2210 g (SD, 710). The overall median PIPP-R scores following heel prick over 6 minutes were 4 (IQR 0-6), 3 (IQR 0-6), and 1 (IQR 0-3) for the music, sucrose, and combination therapy interventions, respectively. The PIPP-R scores were significantly lower at all time points after combination therapy compared with the groups given music or sucrose alone. There was no difference in PIPP-R scores between the music and sucrose groups. In relatively stable and mature neonates, the combination of music therapy with sucrose provided better pain relief during heel prick than when sucrose or music was used alone. Recorded music in isolation had a similar effect to the current gold standard of oral sucrose. www.anzctr.org.au ACTRN12615000271505. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms Than Placebo and Sham Mindfulness Meditation-Induced Analgesia

    Science.gov (United States)

    Emerson, Nichole M.; Farris, Suzan R.; Ray, Jenna N.; Jung, Youngkyoo; McHaffie, John G.; Coghill, Robert C.

    2015-01-01

    modulation. SIGNIFICANCE STATEMENT Recent findings have demonstrated that mindfulness meditation significantly reduces pain. Given that the “gold standard” for evaluating the efficacy of behavioral interventions is based on appropriate placebo comparisons, it is imperative that we establish whether there is an effect supporting meditation-related pain relief above and beyond the effects of placebo. Here, we provide novel evidence demonstrating that mindfulness meditation produces greater pain relief and employs distinct neural mechanisms than placebo cream and sham mindfulness meditation. Specifically, mindfulness meditation-induced pain relief activated higher-order brain regions, including the orbitofrontal and cingulate cortices. In contrast, placebo analgesia was associated with decreased pain-related brain activation. These findings demonstrate that mindfulness meditation reduces pain through unique mechanisms and may foster greater acceptance of meditation as an adjunct pain therapy. PMID:26586819

  17. Mindfulness Meditation-Based Pain Relief Employs Different Neural Mechanisms Than Placebo and Sham Mindfulness Meditation-Induced Analgesia.

    Science.gov (United States)

    Zeidan, Fadel; Emerson, Nichole M; Farris, Suzan R; Ray, Jenna N; Jung, Youngkyoo; McHaffie, John G; Coghill, Robert C

    2015-11-18

    significantly reduces pain. Given that the "gold standard" for evaluating the efficacy of behavioral interventions is based on appropriate placebo comparisons, it is imperative that we establish whether there is an effect supporting meditation-related pain relief above and beyond the effects of placebo. Here, we provide novel evidence demonstrating that mindfulness meditation produces greater pain relief and employs distinct neural mechanisms than placebo cream and sham mindfulness meditation. Specifically, mindfulness meditation-induced pain relief activated higher-order brain regions, including the orbitofrontal and cingulate cortices. In contrast, placebo analgesia was associated with decreased pain-related brain activation. These findings demonstrate that mindfulness meditation reduces pain through unique mechanisms and may foster greater acceptance of meditation as an adjunct pain therapy. Copyright © 2015 the authors 0270-6474/15/3515308-19$15.00/0.

  18. Anaesthetic injection versus ischemic compression for the pain relief of abdominal wall trigger points in women with chronic pelvic pain.

    Science.gov (United States)

    Montenegro, Mary L L S; Braz, Carolina A; Rosa-e-Silva, Julio C; Candido-dos-Reis, Francisco J; Nogueira, Antonio A; Poli-Neto, Omero B

    2015-12-01

    Chronic pelvic pain is a common condition among women, and 10 to 30 % of causes originate from the abdominal wall, and are associated with trigger points. Although little is known about their pathophysiology, variable methods have been practiced clinically. The purpose of this study was to evaluate the efficacy of local anaesthetic injections versus ischemic compression via physical therapy for pain relief of abdominal wall trigger points in women with chronic pelvic pain. We conducted a parallel group randomized trial including 30 women with chronic pelvic pain with abdominal wall trigger points. Subjects were randomly assigned to one of two intervention groups. One group received an injection of 2 mL 0.5 % lidocaine without a vasoconstrictor into a trigger point. In the other group, ischemic compression via physical therapy was administered at the trigger points three times, with each session lasting for 60 s, and a rest period of 30 s between applications. Both treatments were administered during one weekly session for four weeks. Our primary outcomes were satisfactory clinical response rates and percentages of pain relief. Our secondary outcomes are pain threshold and tolerance at the trigger points. All subjects were evaluated at baseline and 1, 4, and 12 weeks after the interventions. The study was conducted at a tertiary hospital that was associated with a university providing assistance predominantly to working class women who were treated by the public health system. Clinical response rates and pain relief were significantly better at 1, 4, and 12 weeks for those receiving local anaesthetic injections than ischemic compression via physical therapy. The pain relief of women treated with local anaesthetic injections progressively improved at 1, 4, and 12 weeks after intervention. In contrast, women treated with ischemic compression did not show considerable changes in pain relief after intervention. In the local anaesthetic injection group, pain threshold

  19. Refuge alternatives relief valve testing and design with updated test stand.

    Science.gov (United States)

    Lutz, T J; Bissert, P T; Homce, G T; Yonkey, J A

    2018-03-01

    Underground refuge alternatives require an air source to supply breathable air to the occupants. This requires pressure relief valves to prevent unsafe pressures from building up within the refuge alternative. The U.S. Mine Safety and Health Administration (MSHA) mandates that pressure relief valves prevent pressure from exceeding 1.25 kPa (0.18 psi), or as specified by the manufacturer, above mine atmospheric pressure when a fan or compressor is used for the air supply. The U.S. National Institute for Occupational Safety and Health (NIOSH) tested a variety of pressure relief valves using an instrumented test fixture consisting of data acquisition equipment, a centrifugal blower, ductwork and various sensors to determine if the subject pressure relief valves meet the MSHA requirement. Relief pressures and flow characteristics, including opening pressure and flow rate, were measured for five different pressure relief valves under a variety of conditions. The subject pressure relief valves included two off-the-shelf modified check valves, two check valves used in MSHA-approved built-in-place refuge alternatives, and a commercially available valve that was designed for a steel refuge alternative and is currently being used in some built-in-place refuge alternatives. The test results showed relief pressures ranging from 0.20 to 1.53 kPa (0.03 to 0.22 psi) and flow rates up to 19.3 m 3 /min (683 scfm). As tested, some of the pressure relief valves did not meet the 1.25 kPa (0.18 psi) relief specification.

  20. EVALUATION OF NURSING STUDENTS' PREMENSTRUAL SYMPTOMS

    Directory of Open Access Journals (Sweden)

    Kerime Derya TASCI

    2006-12-01

    Full Text Available This study was conducted as a descriptive study for the purpose of determining the kinds of premenstrual symptoms that Denizli Health Sciences School Nursing Students experience and what they do to treat them. The research population included the 126 female students in the Pamukkale University Denizli Health Sciences School Nursing School. Data collects in the classroom. In the examination of the students' menstrual complaints, 47.5% experienced back pain, 59% experienced abdominal pain, 44.3% experienced irritability, 39.3% experienced breast sensitivity/pain, 41% experienced facial or body acne and 32.8% experienced increased appetite every cycle. An examination of the students' responses about procedures during menstruation, 86.9% stated that having a bath was not contraindicated and 60.7% that aspirin-type analgesics should not be used for dysmenorrhea. 77.9% of the students stated that it was normal to have pain during menstruation and 63.9% that walking is beneficial for decreasing menstrual pain. There was a significant difference in the students' answers based on age group and class for experience of menstrual complaints and procedures used (p<0.05. The students' were lived premenstrual symptoms and they had insufficient knowledge of procedures for relief. [TAF Prev Med Bull 2006; 5(6.000: 434-443

  1. Clinical Characteristic Picture and Impact of Symptoms on Quality of Life of Interstitial Cystitis Patients in Taiwan.

    Science.gov (United States)

    Lee, Ming-Huei; Lin, Alex Tong-Long; Kuo, Hann-Chorng; Chen, Yung-Fu

    2014-01-01

    No clinical characteristic picture and impact of symptoms on quality of life (QOL) of interstitial cystitis (IC) patients in Taiwan had been reported. This paper is intended to provide preliminary descriptive results of IC research in Taiwan. A total of 319 patients, based on National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases (NIDDK) criteria, were enrolled in the study from February 2004 through March 2006. Evaluation data included baseline demographic information, patient and family medical history, dietary effects, pregnancy data, sexual relationships with symptoms, and impact of symptoms on quality of life. The main responsibility of the hospitals discussed was patient care and data collection. Taichung Hospital presents the results. The Interstitial Cystitis Database (ICDB) patients were predominantly female, that is, 86% of the total, with an average enrollment age of 46. The analysis of various symptoms indicates the following distribution: (i) 94% frequency; (ii) 80% pain; (iii) 53% nocturia; (iv) 43% urgency; and (v) 10% associated incontinence. Approximately 83% reported pain over the bladder while in full stage, and 74% reported pain relief after voiding. The predominant characteristic of pain was full sensation (54%) with the predominant position on low abdominal area (52%). Moreover, 80% reported sleeping disturbance due to disease, and 66% reported difficulty in performing daily work. Interstitial cystitis patients in Taiwan have lower economic status but lower impact on QOL than Western patients. However, the sexual-related pain and sleeping disorder were higher than previously thought and deserve our attention. Accordingly, this research provides a foundation for further investigations of baseline associations and longitudinal trends. © 2013 Wiley Publishing Asia Pty Ltd.

  2. Transcutaneous electrical nerve stimulation (TENS) for pain relief in labour.

    Science.gov (United States)

    Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

    2009-04-15

    Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. The TENS unit is frequently operated by women, which may increase sense of control in labour. To assess the effects of TENS on pain in labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). Randomised controlled trials comparing women receiving TENS for pain relief in labour versus routine care, alternative pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. The search identified 25 studies; we excluded six and included 19 studies including 1671 women. Fifteen examined TENS applied to the back, two to acupuncture points and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (risk ratio 0.41, 95% confidence interval 0.32 to 0.55). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No adverse events were reported. There is only limited evidence that TENS reduces pain in labour and it does not seem to have any impact (either positive or

  3. Preventive maintenance basis: Volume 16 -- Power operated relief valves, solenoid actuated. Final report

    International Nuclear Information System (INIS)

    Worledge, D.; Hinchcliffe, G.

    1997-07-01

    US nuclear plants are implementing preventive maintenance (PM) tasks with little documented basis beyond fundamental vendor information to support the tasks or their intervals. The Preventive Maintenance Basis project provides utilities with the technical basis for PM tasks and task intervals associated with 40 specific components such as valves, electric motors, pumps, and HVAC equipment. This report provides an overview of the PM Basis project and describes use of the PM Basis database. This volume 16 of the report provides a program of PM tasks suitable for application to power operated relief valves (PORV's) that are solenoid actuated. The PM tasks that are recommended provide a cost-effective way to intercept the causes and mechanisms that lead to degradation and failure. They can be used, in conjunction with material from other sources, to develop a complete PM program or to improve an existing program. Users of this information will be utility managers, supervisors, craft technicians, and training instructors responsible for developing, optimizing, or fine-tuning PM programs

  4. Increased thalamic gamma band activity correlates with symptom relief following deep brain stimulation in humans with Tourette's syndrome.

    Directory of Open Access Journals (Sweden)

    Nicholas Maling

    Full Text Available Tourette syndrome (TS is an idiopathic, childhood-onset neuropsychiatric disorder, which is marked by persistent multiple motor and phonic tics. The disorder is highly disruptive and in some cases completely debilitating. For those with severe, treatment-refractory TS, deep brain stimulation (DBS has emerged as a possible option, although its mechanism of action is not fully understood. We performed a longitudinal study of the effects of DBS on TS symptomatology while concomitantly examining neurophysiological dynamics. We present the first report of the clinical correlation between the presence of gamma band activity and decreased tic severity. Local field potential recordings from five subjects implanted in the centromedian nucleus (CM of the thalamus revealed a temporal correlation between the power of gamma band activity and the clinical metrics of symptomatology as measured by the Yale Global Tic Severity Scale and the Modified Rush Tic Rating Scale. Additional studies utilizing short-term stimulation also produced increases in gamma power. Our results suggest that modulation of gamma band activity in both long-term and short-term DBS of the CM is a key factor in mitigating the pathophysiology associated with TS.

  5. Music therapy in relief of pain in oncology patients

    Directory of Open Access Journals (Sweden)

    Mariana Franco

    2009-03-01

    Full Text Available Objective: To evaluate the perception of oncology patients with chronic pain as to the effects of music in alleviating pain, to identify if there are changes in the vital signs of these patients before and after the musicotherapy session, and to identify whether the intensity of pain is diminished after the music session as per an analogic scale of pain. Methods: This level II, descriptive-exploratory and cross-sectional study used a quantitative and qualitative approach. The sample consisted of ten oncology patients with chronic pain. Rresults: There was a reduction in vital signs and in intensity of pain in ten patients of the sample; after the music sessions, the patients reported a sensation of relief of pain, relaxation, and a belief in the power of music as a supplementary therapy. Cconclusions: Music showed an influence in reducing vital signs and pain intensity, and the patients perceived a reduction of pain and anxiety, and began to believe in music as a form of therapy.

  6. Stress relief of austenitic weldments: microstructural and mechanical property effects

    International Nuclear Information System (INIS)

    Thomas, R.G.

    1982-01-01

    Two consumables suitable for welding AISI 316 have been studied. Both contained 3-8% delta-ferrite in the as-welded state but were of different nominal compositions, namely 19Cr-12Ni-3Mo and 17Cr-8Ni-2Mo. The results of a series of uniaxial stress relaxation tests carried out over a range of temperatures from 650 to 850 0 C indicate that it was practicable to achieve acceptable residual stress levels even at the lower end of this temperature range; the inference was, therefore, that the final choice of stress relief treatment will be determined by the metallurgical changes that simultaneously occur. The isothermal transformation kinetics of the delta-ferrite were determined over the temperature range 600-800 0 C for both weld metals and the nature and morphology of the phases formed was studied. Transformation proceeded more rapidly in the 19Cr-12Ni-3Mo deposit than in the 17Cr-8Ni-2Mo deposit. Electron microscopy revealed that in both weld metals the delta-ferrite acted as a focus for a series of complex precipitation reactions involving initially the simultaneous formation of M 23 C 6 and reversion of delta to #betta# followed by precipitation of intermetallic phases chi and σ. Tensile impact and creep properties of aged material have been determined and are discussed in terms of the structural features observed. (author)

  7. Residual stress relief in MAG welded joints of dissimilar steels

    International Nuclear Information System (INIS)

    Seodek, P.; Brozda, J.; Wang, L.; Withers, P.J.

    2003-01-01

    This paper addresses the relief of residual stress in welded joints between austenitic and non-alloyed ferritic-pearlitic steels. A series of similar and dissimilar steel joints based on the 18G2A (ferritic-pearlitic) and 1H18N10T (austenitic) steels were produced, some of which were stress relieved by annealing and some by mechanical prestressing. For the as-welded and stress relieved test joints the residual stresses were measured by trepanning. To aid the interpretation of these results, 2D plane stress finite element analysis has been performed to simulate the residual stress relieving methods. Analysis of the results has shown that thermal stress relieving of welded joints between dissimilar steels is not effective and may even increase residual stresses, due to the considerable difference in thermal expansion of the joined steels. It was found that, for the loads imposed, the effectiveness of the mechanical stress relieving of dissimilar steel welded joints was much lower than that of similar steel joints

  8. Earthquake-relief APWR (Advanced Pressurized Water Reactor) plants

    International Nuclear Information System (INIS)

    Yoshinaga, Hidekazu; Oshibe, Toshihiro; Yamaura, Yoshihisa; Kokubo, Eiji

    1999-01-01

    The anti-seismic design conditions for nuclear power stations are extremely severe in Japan. Therefore, various measures, including the increase in building wall thickness and in the number of equipment supports, need to be implemented to satisfy the necessary anti-seismic design. This is one of the causes of the increase in the construction cost of power stations. Meanwhile, a seismic isolation system, which mitigates an input earthquake motion, has been attracting attention in the general construction industry since the Great Hansin Earthquake in 1995. An increasing number of buildings employing such a system have been constructed. The system is being more popular and socially accepted. At the same time, the anti-seismic nuclear power stations have already been operated in France and South Africa. Various reviews and researches are promoted in Japan to adopt the seismic isolation system in nuclear power stations. The building and equipment designs when the seismic isolation system is applied to APWR are reviewed based on the experience in Japan and overseas. Specifically, reviews were conducted on the following items and their technical and economical feasibility has been well confirmed: Earthquake-relief equipment properties. Building design. Equipment design. The reliability and economy on the building and equipment designs shall further be enhanced in order to maximize the advantages of seismic isolation system in the future. (author)

  9. CFD analysis of gas explosions vented through relief pipes.

    Science.gov (United States)

    Ferrara, G; Di Benedetto, A; Salzano, E; Russo, G

    2006-09-21

    Vent devices for gas and dust explosions are often ducted to safe locations by means of relief pipes. However, the presence of the duct increases the severity of explosion if compared to simply vented vessels (i.e. compared to cases where no duct is present). Besides, the identification of the key phenomena controlling the violence of explosion has not yet been gained. Multidimensional models coupling, mass, momentum and energy conservation equations can be valuable tools for the analysis of such complex explosion phenomena. In this work, gas explosions vented through ducts have been modelled by a two-dimensional (2D) axi-symmetric computational fluid dynamic (CFD) model based on the unsteady Reynolds Averaged Navier Stokes (RANS) approach in which the laminar, flamelet and distributed combustion models have been implemented. Numerical test have been carried out by varying ignition position, duct diameter and length. Results have evidenced that the severity of ducted explosions is mainly driven by the vigorous secondary explosion occurring in the duct (burn-up) rather than by the duct flow resistance or acoustic enhancement. Moreover, it has been found out that the burn-up affects explosion severity due to the reduction of venting rate rather than to the burning rate enhancement through turbulization.

  10. Moxibustion for pain relief in patients with primary dysmenorrhea: A randomized controlled trial.

    Science.gov (United States)

    Yang, Mingxiao; Chen, Xiangzhu; Bo, Linna; Lao, Lixing; Chen, Jiao; Yu, Siyi; Yu, Zheng; Tang, Hongzhi; Yi, Ling; Wu, Xi; Yang, Jie; Liang, Fanrong

    2017-01-01

    Though moxibustion is frequently used to treat primary dysmenorrhea in China, relevant evidence supporting its effectiveness is still scanty. This study was a pragmatic randomized, conventional drug controlled, open-labeled clinical trial. After initial screen, 152 eligible participants were averagely randomized to receive two different treatment strategies: Moxibustion and conventional drugs. Participants and practitioners were not blinded in this study. The duration of each treatment was 3 months. The primary outcome was pain relief measured by the Visual Analogue Scale. The menstrual pain severity was recorded in a menstrual pain diary. 152 eligible patients were included but only 133 of them eventually completed the whole treatment course. The results showed that the menstrual pain intensity in experimental group and control group was reduced from 6.38±1.28 and 6.41±1.29, respectively, at baseline, to 2.54±1.41 and 2.47±1.29 after treatment. The pain reduction was not significantly different between these two groups (P = 0.76), however; the pain intensity was significantly reduced relative to baseline for each group (Ppain-related symptoms. The serum levels of pain mediators, such as PGF2α, OT, vWF, β-EP, PGE2, were significantly improved after treatment in both groups (Ppain, given their treatment effects and economic costs. This study as a pragmatic trial only demonstrates the effectiveness, not the efficacy, of moxibustion for menstrual pain. It can't rule out the effect of psychological factors during treatment process, because no blind procedure or sham control was used due to availability. In clinical practice, moxibustion should be used at the discretion of patients and their physicians. ClinialTrials.gov NCT01972906.

  11. Social Sensations of Symptoms

    DEFF Research Database (Denmark)

    Meinert, Lotte; Whyte, Susan Reynolds

    2017-01-01

    The interpretation of sensations and the recognition of symptoms of a sickness, as well as the movement to seek treatment, have long been recognized in medical anthropology as inherently social processes. Based on cases of HIV and trauma (PTSD) in Uganda, we show that even the first signs....../symptoms; differential recognition of symptoms; and the embodied sociality of treatment....... and sensations of sickness can be radically social. The sensing body can be a ‘social body’ – a family, a couple, a network – a unit that transcends the individual body. In this article we focus on four aspects of the sociality of sensations and symptoms: mode of transmission; the shared experience of sensations...

  12. Flu Symptoms & Complications

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other Flu Symptoms & Complications Language: English (US) Español Recommend on ... not everyone with flu will have a fever. Flu Complications Most people who get influenza will recover ...

  13. Prostate Cancer Symptoms

    Science.gov (United States)

    ... Fundraise for PCF: Many vs Cancer Contact Us Prostate Cancer Symptoms and Signs Prostate Cancer Basics Risk Factors ... earlier. So what are the warning signs of prostate cancer? Unfortunately, there usually aren’t any early warning ...

  14. Medically Unexplained Symptoms

    Science.gov (United States)

    ... overview of three specific MUS’s: Chronic Fatigue Syndrome, Fibromyalgia, and Irritable Bowel Syndrome and discusses things you can do to minimize the symptoms and improve your quality of life. It is possible that these syndromes can all ...

  15. Cholera Illness and Symptoms

    Science.gov (United States)

    ... Share Compartir Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium Vibrio cholerae and is spread by ingestion of contaminated food or water. The infection is often mild or without symptoms, ...

  16. Premonitory symptoms in migraine

    DEFF Research Database (Denmark)

    Laurell, Katarina; Artto, Ville; Bendtsen, Lars

    2016-01-01

    AIM: To describe the frequency and number of premonitory symptoms (PS) in migraine, the co-occurrence of different PS, and their association with migraine-related factors. METHODS: In this cross-sectional study, a validated questionnaire was sent to Finnish migraine families between 2002 and 2013...... to obtain data on 14 predefined PS, migraine diagnoses, demographic factors, and migraine characteristics. The estimated response rate was 80%. RESULTS: Out of 2714 persons, 2223 were diagnosed with migraine. Among these, 77% reported PS, with a mean number of 3.0 symptoms compared to 30% (p ....5 symptoms (p migraine headaches. Yawning was the most commonly reported symptom (34%) among migraineurs. Females reported PS more frequently than males (81 versus 64%, p 

  17. Gynecological cancer alarm symptoms:

    DEFF Research Database (Denmark)

    Balasubramaniam, Kirubakaran; Ravn, Pernille; dePont Christensen, René

    2016-01-01

    INTRODUCTION: To determine the proportion of patients who were referred to specialist care after reporting gynecological cancer alarm symptoms to their general practitioner. To investigate whether contact with specialist care was associated with lifestyle factors or socioeconomic status. MATERIAL...... and odds ratios (ORs) for associations between specialist care contact, lifestyle factors and socioeconomic status. RESULTS: The study included 25 866 non-pregnant women; 2957 reported the onset of at least one gynecological cancer alarm symptom, and 683 of these (23.1%) reported symptoms to their general......: Educational level influence contact with specialist care among patients with gynecological cancer alarm symptoms. Future studies should investigate inequalities in access to the secondary healthcare system. This article is protected by copyright. All rights reserved....

  18. Suicide Prevention for Local Public and Volunteer Relief Workers in Disaster-Affected Areas.

    Science.gov (United States)

    Wang, Xiao Lu; Yip, Paul S F; Chan, Cecilia L W

    2016-01-01

    Local workforces play a critical role in disaster relief and reconstruction. However, the mental health of local relief workers might be affected by disasters, threatening the sustainability of local workforces. In this study, we tried to address this concern by investigating the well-being of local relief workers and its association with suicidal ideation. A retrospective study was conducted. Surveys were designed to collect data from a purposive sample of local disaster relief workers who survived a disaster. Binary logistic regression analysis was performed to test hypotheses. The study sample was from a population of local relief workers in the worst quake-hit regions in China in 2008. The respondents were local relief workers from a town in these regions. All of the 83 local relief workers were invited 11 months after the earthquake, and 70 joined the study, resulting in a response rate of 84.3%. The dependent variable was postdisaster suicidal ideation. The independent variables were bereavement, depression and posttraumatic stress, daily work hours, job burnout, work-family conflict, and work engagement. Approximately 21.4% of participants reported suicidal ideation after the earthquake in comparison with 7.1% before the earthquake. One potential risk factor was an interaction effect of job burnout and work-family conflict (odds ratio [OR] = 3.738; 95% confidence interval [CI], 1.086-12.868). Potential protective factors included daily work hours (OR = 0.317; 95% CI, 0.106-0.952) and work engagement (OR = 0.297; 95% CI, 0.091-0.969). Findings suggest that for local relief workers who are also disaster survivors, meaningful engagement such as participation in disaster relief could be salutary to their mental health, but overwork and interference with personal life could be harmful and increase the risk of suicidal ideation. Discretion is needed in managing local workforces, particularly with long work hours and work-family balance.

  19. Evaluating acute pain intensity relief: challenges when using an 11-point numerical rating scale.

    Science.gov (United States)

    Chauny, Jean-Marc; Paquet, Jean; Lavigne, Gilles; Marquis, Martin; Daoust, Raoul

    2016-02-01

    Percentage of pain intensity difference (PercentPID) is a recognized way of evaluating pain relief with an 11-point numerical rating scale (NRS) but is not without flaws. A new metric, the slope of relative pain intensity difference (SlopePID), which consists in dividing PercentPID by the time between 2 pain measurements, is proposed. This study aims to validate SlopePID with 3 measures of subjective pain relief: a 5-category relief scale (not, a little, moderate, very, complete), a 2-category relief question ("I'm relieved," "I'm not relieved"), and a single-item question, "Wanting other medication to treat pain?" (Yes/No). This prospective cohort study included 361 patients in the emergency department who had an initial acute pain NRS > 3 and a pain intensity assessment within 90 minutes after analgesic administration. Mean age was 50.2 years (SD = 19.3) and 59% were women. Area under the curves of receiver operating characteristic curves analyses revealed similar discriminative power for PercentPID (0.83; 95% confidence interval [CI], 0.79-0.88) and SlopePID (0.82; 95% CI, 0.77-0.86). Considering the "very" category from the 5-category relief scale as a substantial relief, the average cutoff for substantial relief was a decrease of 64% (95% CI, 59-69) for PercentPID and of 49% per hour (95% CI, 44-54) for SlopePID. However, when a cutoff criterion of 50% was used as a measure of pain relief for an individual patient, PercentPID underestimated pain-relieved patients by 12.1% (P pain intensity at baseline was an odd number compared with an even number (32.9% vs 45.0%, respectively). SlopePID should be used instead of PercentPID as a metric to evaluate acute pain relief on a 0 to 10 NRS.

  20. 30 CFR 204.207 - Who will approve, deny, or modify my request for accounting and auditing relief?

    Science.gov (United States)

    2010-07-01

    ... for accounting and auditing relief? 204.207 Section 204.207 Mineral Resources MINERALS MANAGEMENT... Accounting and Auditing Relief § 204.207 Who will approve, deny, or modify my request for accounting and auditing relief? (a) If there is not a State concerned for your marginal property, only MMS will decide...