Chellappan, Sheeba; Ezhilarasu, Punitha; Gnanadurai, Angela; George, Reena; Christopher, Solomon
A large proportion of cancer deaths occur in the developing world, with limited resources for palliative care. Many patients dying at home experience difficult symptoms. The objective of this study was to assess the feasibility of a structured training program on symptom management along with an acute symptom management kit for primary caregivers of cancer patients receiving home care. Descriptive design was used. Thirty primary caregivers of cancer patients attending the palliative care clinic in Vellore, South India, were provided training on the administration of drugs for acute symptoms. A plastic box with partitions for drugs specific to symptom was provided. On follow-up visits, the usage of the kit, drugs used, and routes of administration were noted. A structured questionnaire with a 4-point scale was used to assess primary caregiver views and satisfaction. Of primary caregivers, 96.7% used a kit. The common medications used were morphine, metoclopramide, dexamethasone, and benzodiazepines. Seventy-three percent of primary caregivers administered subcutaneous injections at home. Hospital visits for acute symptoms reduced by 80%; 90% were satisfied with the training received; 73% stated it was not a burden to treat the patient at home. The training program and acute symptom management kit were favorably received and appropriately used by caregivers of diverse backgrounds. Rural backgrounds and illiteracy were not barriers to acceptance. Healthcare professionals should train caregivers during hospital visits, empowering them to manage acute symptoms and provide simple nursing care. This is doubly important in countries where resources are limited and palliative care facilities scarce.
Michael C. Pitter
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.
Sádaba Díaz de Rada, B; Azanza Perea, J R; Gomez-Guiu Hormigos, A
Bilastine is a potent inhibitor of the histamine H1 receptor. It was recently approved in 28 countries of the European Union for the symptomatic treatment of allergic rhinoconjunctivitis and urticaria in adults and children older than 12 years. Data from preclinical studies confirmed its selectivity for the histamine H1 receptor over other receptors, and demonstrated antihistaminic and antiallergic properties in vivo. Studies in healthy volunteers and patients have shown that bilastine does not affect driving ability, cardiac conduction or alertness. Bilastine has demonstrated a good safety profile, without serious adverse effects or antimuscarinic effects in clinical trials. There were no significant changes in laboratory tests, electrocardiograms or vital signs. In clinical studies, oral treatment with bilastine 20 mg once daily improved allergic rhinitis with greater efficacy than placebo and comparable to cetirizine and desloratadine. Bilastine 20 mg was more effective than placebo and equivalent to levocetirizine in chronic urticaria, relieving symptoms, improving quality of life and controlling sleep disorders. 2011 Prous Science, S.A.U. or its licensors. All rights reserved.
Rao, Deepa; Nainis, Nancy; Williams, Lisa; Langner, Daughon; Eisin, Audra; Paice, Judith
Symptom management for persons living with HIV/AIDS is an extremely important component of care management. The importance of pharmacologic interventions for management of symptoms is well recognized, and non-pharmacologic strategies such as art therapy are gaining interest in lay and professional communities. The aim of this research project was to test the feasibility and effectiveness of art therapy for relief of symptoms experienced by people living with HIV/AIDS. In this randomized clinical trial of art therapy, the primary objective was to assess change in physical and psychological symptoms. Participants were recruited from a large urban hospital's inpatient population and outpatient HIV clinic. Seventy-nine people with a diagnosis of HIV infection provided socio-demographic information, participated in either a one-hour art therapy session or viewed a videotape about art therapy, and completed pre- and posttest measures of psychological and physical symptoms. Two separate analysis of covariance models were used to identify if the treatment condition influenced psychological and physical symptoms, after adjusting for pretest score, age, gender, and race/ethnicity. The analyses showed that physical symptom mean scores were better for those who participated in the art therapy compared to those who viewed the videotape, and this difference between conditions was statistically significant (part therapy in relation to symptoms associated with HIV/AIDS.
Background: Tegaserod is a promotility agent with proven efficacy and safety in patients with irritable bowel syndrome with constipation (IBS-C). AIM: Assess tegaserod's effect on quality of life (QOL) and symptom relief in South African patients. Methods: Women >18 years old meeting Rome II criteria for IBS-C were enrolled ...
Utian, Wulf H; Jones, Michelle; Setchell, Kenneth D R
Many women suffering from vasomotor symptoms (VMS) are now seeking nonpharmaceutical treatments for symptom relief. Recently, S-equol, an intestinal bacterial metabolite of the soybean isoflavone daidzein has received attention for its ability to alleviate VMS and provide other important health benefits to menopausal women. S-equol is found in very few foods and only in traces. About 50% of Asians and 25% of non-Asians host the intestinal bacteria that convert daidzein into S-equol. Clinical trials that evaluated the efficacy of an S-equol-containing product found that VMS were alleviated but these trials were limited in scope and primarily involved Japanese women for whom hot flashes are a minor complaint. The only trial in the United States evaluating hot flashes found symptoms were significantly reduced by S-equol, but the study lacked a placebo group, although it did include a positive control. The daily dose of S-equol used in most trials was 10 mg, and because the half-life of S-equol is 7-10 hours, to maximize efficacy, it was taken twice daily. Subanalysis of epidemiologic studies suggests that equol producers are more likely to benefit from soyfood consumption than nonproducers with respect to both cardiovascular disease and osteoporosis, although the data are inconsistent. The limited safety data for S-equol do not suggest cause for concern, especially with regard to its effects on breast and endometrial tissue. Further studies are needed before definitive conclusions of its effectiveness for VMS can be made, but the preliminary evidence warrants clinicians discussing the potential of S-equol for the alleviation of VMS with patients.
Perkins, Kenneth A; Karelitz, Joshua L; Michael, Valerie C
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).
Koola, Maju Mathew; Boggs, Douglas Lee; Kelly, Deanna Lynn; Liu, Fang; Linthicum, Jared Allen; Turner, Hailey Elaine; McMahon, Robert Patrick; Gorelick, David Alan
This study examined the response to cannabis withdrawal symptoms and use of quitting strategies to maintain abstinence in people with schizophrenia. A convenience sample of 120 participants with schizophrenia who had at least weekly cannabis use and a previous quit attempt without formal treatment were administered the 176-item Marijuana Quit Questionnaire to characterize their "most serious" (self-defined) quit attempt. One hundred thirteen participants had withdrawal symptoms, of whom 104 (92.0%) took some action to relieve a symptom, most commonly nicotine use (75%). 90% of withdrawal symptoms evoked an action for relief in a majority of participants experiencing them, most frequently anxiety (95.2% of participants) and cannabis craving (94.4%). 96% of participants used one or more quitting strategies to maintain abstinence during their quit attempt, most commonly getting rid of cannabis (72%) and cannabis paraphernalia (67%). Religious support or prayer was the quitting strategy most often deemed "most helpful" (15%). Use of a self-identified most helpful quitting strategy was associated with significantly higher one-month (80.8% vs. 73.6%) and one-year (54.9% vs. 41.3%) abstinence rates. Actions to relieve cannabis withdrawal symptoms in people with schizophrenia are common. Promotion of effective quitting strategies may aid relapse prevention. Published by Elsevier Ireland Ltd.
To clarify whether there is any difference in the symptom relief in patients with reflux esophagitis following the administration of four Proton pump inhibitors (PPIs). Two hundred and seventy-four patients with erosive reflux esophagitis were randomized to receive 8 wk of 20 mg omeprazole (n = 68), 30 mg of lansoprazole (n = 69), 40 mg of pantoprazole (n = 69), 40 mg of esomeprazole (n = 68) once a day in the morning. Daily changes in heartburn and acid reflux symptoms in the first 7 d of administration were assessed using a six-point scale (0: none; 1: mild; 2: mild-moderate; 3: moderate; 4: moderate-severe; 5: severe). The mean heartburn score in patients treated with esomeprazole more rapidly decreased than those receiving other PPI. Complete resolution of heartburn was also more rapid in patients treated with esomeprazole for 5 d compared with omeprazole (P = 0.0018, P = 0.0098, P = 0.0027, P = 0.0137, P = 0.0069, respectively), lansoprazole (P = 0.0020, P = 0.0046, P = 0.0037, P = 0.0016, P = 0.0076, respectively), and pantoprazole (P = 0.0006, P = 0.0005, P = 0.0009, P = 0.0031, P = 0.0119, respectively). There were no significant differences between the four groups in the rate of endoscopic healing of reflux esophagitis at week 8. Esomeprazole may be more effective than omeprazole, lansoprazole, and pantoprazole for the rapid relief of heartburn symptoms and acid reflux symptoms in patients with reflux esophagitis.
AIM: To clarify whether there is any difference in the symptom relief in patients with reflux esophagitis following the administration of four Proton pump inhibitors (PPIs). METHODS: Two hundred and seventy-four patients with erosive reflux esophagitis were randomized to receive 8 wk of 20 mg omeprazole (n = 68), 30 mg of lansoprazole (n = 69), 40 mg of pantoprazole (n = 69), 40 mg of esomeprazole (n = 68) once a day in the morning. Daily changes in heartburn and acid reflux symptoms in the first 7 d of administration were assessed using a six-point scale (0: none; 1: mild; 2: mild-moderate; 3: moderate; 4: moderate-severe; 5: severe). RESULTS: The mean heartburn score in patients treated with esomeprazole more rapidly decreased than those receiving other PPI. Complete resolution of heartburn was also more rapid in patients treated with esomeprazole for 5 d compared with omeprazole (P = 0.0018, P = 0.0098, P = 0.0027, P = 0.0137, P = 0.0069, respectively), lansoprazole (P = 0.0020, P = 0.0046, P = 0.0037, P = 0.0016, P = 0.0076, respectively), and pantoprazole (P = 0.0006, P = 0.0005, P = 0.0009, P = 0.0031, P = 0.0119, respectively). There were no significant differences between the four groups in the rate of endoscopic healing of reflux esophagitis at week 8. CONCLUSION: Esomeprazole may be more effective than omeprazole, lansoprazole, and pantoprazole for the rapid relief of heartburn symptoms and acid reflux symptoms in patients with reflux esophagitis. PMID:19248200
Fan, Kenneth L; Avashia, Yash J; Dayicioglu, Deniz; DeGennaro, Vincent A; Thaller, Seth R
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.
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.
Shin, Ein-Soon; Seo, Kyung-Hwa; Lee, Sun-Hee; Jang, Ji-Eun; Jung, Yu-Min; Kim, Min-Ji; Yeon, Ji-Yun
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
Khambati, Aziz; Lau, Susan; Gordon, Allan; Jarvi, Keith A
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 Botox cord blocks provide pain reduction for 3 months or more for most men with CSP. © 2014 International Society for Sexual Medicine.
Full Text Available The use of complementary and alternative medicine methods such as acupuncture in palliative care has increased over the past years. Well-planned trials are warranted to show its effectiveness in relieving distressing symptoms. The development of treatment schemes to be used in the trial for both acupuncture and medical symptom control is challenging, as both acupuncture and palliative care are highly individualized. Thus, standardized care plans of a randomized controlled trial will have difficulties in producing treatment results that compare to the clinical practice. As an alternative, treatment protocols for both acupuncture and medical symptom control of dyspnea, pruritus, hypersalivation, depression, anxiety, and xerostomia were designed with the input of experts. They are designed to provide sufficient symptom control and comparability for a three-arm, randomized controlled trial. Medical symptom control will be provided to all groups. The two control groups will be medical treatment and sham-laser acupuncture.
Kramer, Sybille; Irnich, Dominik; Lorenzl, Stefan
The use of complementary and alternative medicine methods such as acupuncture in palliative care has increased over the past years. Well-planned trials are warranted to show its effectiveness in relieving distressing symptoms. The development of treatment schemes to be used in the trial for both acupuncture and medical symptom control is challenging, as both acupuncture and palliative care are highly individualized. Thus, standardized care plans of a randomized controlled trial will have difficulties in producing treatment results that compare to the clinical practice. As an alternative, treatment protocols for both acupuncture and medical symptom control of dyspnea, pruritus, hypersalivation, depression, anxiety, and xerostomia were designed with the input of experts. They are designed to provide sufficient symptom control and comparability for a three-arm, randomized controlled trial. Medical symptom control will be provided to all groups. The two control groups will be medical treatment and sham-laser acupuncture. Copyright © 2017. Published by Elsevier B.V.
Full Text Available Effective treatments of congestive heart failure (CHF must not only reduce mortality, but should also reduce the severity of the signs and symptoms of the syndrome, as these can have a major impact on quality of life. Early intervention can help to make everyday activities easier for patients with CHF and may slow disease progression. This review provides an overview of the efficacies of various therapies in improving the signs and symptoms of CHF, with particular reference to recent data from randomised, double-blind studies of patients receiving the AT 1-receptor blocker, candesartan cilexetil.
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.
Varner, Derrick F; Foutch, Brian K
This study investigated the prevalence of depression and burnout symptoms among family medicine providers on active duty in the US Air Force. Results demonstrated that 84% of those surveyed scored positive for degrees of depression symptoms; only sex differences were significant.
Turner, Kea; Samuel, Cleo A; Donovan, Heidi As; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J
Providers' communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care. We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13). Themes were organized using Epstein and Street's (2007) Framework for Patient-Centered Communication in Cancer Care. The findings of this study suggest providers' communication behaviors including managing survivors' uncertainty, responding to survivors' emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers' discipline. There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers' roles in symptom assessment, and determine best practices for AET symptom communication.
Lin, Ching-Hua; Yang, Wei-Cheng
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
Lepine, Sam; Jo, Junyoung; Metwally, Mostafa; Cheong, Ying C
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
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
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.
Jin, Lihua; Van Yperen, Nico W.; Sanderman, Robbert; Hagedoorn, Mariet
In this research, we argue and demonstrate that the association between enacted (un)supportive behaviour and depressive symptoms is a function of the providers' levels of unmitigated communion (UC). UC is characterized by overinvolvement in others' problems, self-neglect and externalized
"I feel your disgust and relief": can the action understanding system (mirror neuron system) be recruited to induce disgust and relief from contamination vicariously, in individuals with obsessive-compulsive disorder symptoms?
Jalal, Baland; Ramachandran, Vilayanur S
Research has shown that brain regions mediating disgust (e.g., the insula) become activated when viewing others' disgust, a response mediated, perhaps by the mirror neuron system or the Theory of Mind module. In a novel behavioral experiment, we explore vicarious disgust and relief, in individuals with obsessive-compulsive disorder (OCD) symptoms. Participants (N = 10) provided disgust ratings to self-contamination or watching the contamination of an experimenter; and to the experimenter washing his own hands after the subjects had been contaminated. To our surprise, we found that subjects experienced disgust from merely watching the experimenter contaminating himself. More intriguingly, after subjects had contaminated themselves, they obtained relief from merely watching the experimenter washing his own hands; even while recognizing the logical absurdity of this. The result is counterintuitive since neither the subjects nor anyone else would have predicted this. These preliminary findings - if confirmed in placebo-controlled studies - might pave the way toward novel therapeutic approaches for OCD.
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.
Quigley, E M M
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.
... from this type of care. What is palliative care? Palliative care is comprehensive treatment of the discomfort, symptoms ... of life. Palliative care is different from hospice care. Palliative care is available to you at any time ...
Conclusion: This study suggests that the presence of Chiari I malformation in a patient conceals the symptoms of PTC which may become apparent following posterior decompression surgery. Other possibilities could be that the patients are misdiagnosed for Chiari I malformation when they are in fact suffering from PTC, or that PTC is a complication of surgery.
Full Text Available Michael P Wakeman School of Cancer Sciences, University of Birmingham, Edgbaston, Birmingham, West Midlands, UK Abstract: An open-label pilot study over 4 months to evaluate the effectiveness of a compound formulation of ingredients, which individually have been demonstrated to be implicated in the pathogenesis of premenstrual syndrome to ameliorate the most troublesome symptoms of the condition. The supplement provided thiamine, riboflavin, pyridoxine, vitamin D, soy isoflavones, rosemary extract, and krill oil and was taken each day for the 3 months of the trial. Statistically significant effect was reported by the 29 women who completed the study in relief of anxiety, bloating, mood swings, breast tenderness, skin outbreaks, food cravings, fatigue, forgetfulness, insomnia, and headache after 3 months of treatment compared with baseline. This pilot study indicates the formulation to be effective, and a larger placebo-controlled trial is now planned. Keywords: thiamine, riboflavin, pyridoxine, vitamin D, soy isoflavones, rosemary extract, premenstrual syndrome
Kim, Yeong; Patel, Nilam; Diehl, Glen; Richard, Patrick
There is a scarcity of research establishing a relationship between mental illness and the U.S. military service members who participate in the field of military humanitarian assistance/disaster relief (HA/DR). One of the few studies in this area showed that participation in military HA/DR was not associated with depressive symptoms, however, the study was limited by sample size. This study examined (1) the relationship between participation in military HA/DR and mental health symptoms and military stress and (2) the relationship between HA/DR and mental health treatment and therapy. Data from the 2011 Health Related Behaviors Survey was used. The analytic sample consisted of U.S. military service members who participated in HA/DR (the Haiti earthquake and Deepwater Horizon oil spill in the Gulf) (n = 573) compared to those who participated in non-HA/DR deployments from 2007 to 2011 (n = 986). Multivariate models were used to examine the relationship between the independent variables and dependent variables while controlling for a set of variables that may confound the relationship between the two. The logistic regression model found that participating in HA/DR deployments decreased the likelihood of service members reporting post-traumatic stress disorder (PTSD) symptoms by 3% (p members were more likely to report symptoms of PTSD than senior officers (p members (p members. Further research needs to understand the mechanism of these associations for better planning and implementation of HA/DR and delivery of care to service members who participate in these missions. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
Fellowes, Deborah; Barnes, Kelly; Wilkinson, Susie Sm
Aromatherapy massage is a commonly used complementary therapy, and is employed in cancer and palliative care largely to improve quality of life and reduce psychological distress. To investigate whether aromatherapy or massage, or both, decreases psychological morbidity, lessens symptom distress and/or improves the quality of life in patients with a diagnosis of cancer. We searched CENTRAL (The Cochrane Library, Issue 1, 2002), MEDLINE (1966 to May week 3 2002), CINAHL (1982 to April 2002), British Nursing Index (1994 to April 2002), EMBASE (1980 to Week 25 2002), AMED (1985 to April 2002), PsycINFO (1887 to April week 4 2002), SIGLE (1980 to March 2002), CancerLit (1975 to April 2002) and Dissertation Abstracts International (1861 to March 2002). Reference lists of relevant articles were searched for additional studies. We sought randomised controlled trials (RCTs); controlled before and after studies; and interrupted time series studies of aromatherapy or massage, or both, for patients with cancer, that measured changes in patient-reported levels of physical or psychological distress or quality of life using reliable and valid tools. Two review authors independently assessed trials for inclusion in the review, assessed study quality and extracted data. Study authors were contacted where information was unclear. The search strategy retrieved 1322 studies. Ten studies met the inclusion criteria and these represented eight RCTs (357 participants). The most consistently found effect of massage or aromatherapy massage was on anxiety. Four trials (207 participants) measuring anxiety detected a reduction post intervention, with benefits of 19 to 32% reported. Contradictory evidence exists as to any additional benefit on anxiety conferred by the addition of aromatherapy. The evidence for the impact of massage/aromatherapy on depression was variable. Of the three trials (120 participants) that assessed depression in cancer patients, only one found any significant
Nagahara, Akihito; Suzuki, Tsuyoshi; Nagata, Naoyoshi; Sugai, Nozomu; Takeuchi, Yoshiaki; Sakurai, Kouichi; Miyamoto, Masaki; Inoue, Kazuhiko; Akiyama, Junichi; Mabe, Katsuhiro; Konuma, Ichiro; Kamada, Tomoari; Haruma, Ken
Proton pump inhibitors (PPIs) are affected by cytochrome P450 2C19 (CYP2C19) polymorphisms. This study compared the effect of two PPIs on early symptom relief in Japanese patients with reflux esophagitis, classified by the CYP2C19 phenotype. Patients with reflux esophagitis were randomised to treatment with omeprazole 20 mg or rabeprazole 10 mg once daily. The CYP2C19 phenotype [homozygous extensive metaboliser (homoEM), heterozygous extensive metaboliser (heteroEM) or poor metaboliser (PM)] of each patient was determined. The primary efficacy endpoint was early, sufficient (Global Overall Symptom scale score 1 or 2), sustained (maintained for ≥7 days) reflux symptom relief. Of the 199 patients included in this analysis, the proportion achieving sufficient, sustained reflux symptom relief was higher with omeprazole than with rabeprazole on day 1 (35.6 vs. 22.4%; p = 0.041) and day 2 (43.6 vs. 28.6%; p = 0.028); there was no significant difference between the two groups on days 3-7. Among patients with the CYP2C19 PM phenotype, sufficient, sustained reflux symptom relief was higher with omeprazole than with rabeprazole on days 4-7 (62.5-66.9 vs. 31.6%; p ≤ 0.03); differences were not significant on days 1-3, or among those with the homoEM or heteroEM phenotypes on days 1-7. In Japanese patients with reflux esophagitis, omeprazole 20 mg is more effective than rabeprazole 10 mg at achieving early, sufficient, sustained reflux symptom relief in individuals with the CYP2C19 PM phenotype, and is similarly effective to rabeprazole 10 mg in those with heteroEM or homoEM phenotypes.
Treldal, Charlotte; Jacobsen, C B; Mogensen, Stine
OBJECTIVE: 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....... 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. RESULTS: The bupivacaine lozenge significantly reduced the burning oral pain (P ... of taste disturbances (P xerostomia, when adjusted for the treatment period. CONCLUSIONS: 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...
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.
Aggarwal, S K; Carter, G T; Sullivan, M D; Zumbrunnen, C; Morrill, R; Mayer, J D
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.
Witham, Randy L
.... Precision direct delivery promises to slash in-transit time, minimize hub and spoke shuttle operations, reduce handling costs and save lives early in a relief operation before larger forces can arrive on scene...
Kvist, Linda J; Hall-Lord, Marie Louise; Rydhstroem, Hakan; Larsson, Bodil Wilde
to further compare acupuncture treatment and care interventions for the relief of inflammatory symptoms of the breast during lactation and to investigate the relationship between bacteria in the breast milk and clinical signs and symptoms. randomised, non-blinded, controlled trial of acupuncture and care interventions. a midwife-led breast feeding clinic in Sweden. 205 mothers with 210 cases of inflammatory symptoms of the breast during lactation agreed to participate. The mothers were randomly assigned to one of three treatment groups, two of which included acupuncture among the care interventions and one without acupuncture. All groups were given essential care. Protocols, which included scales for erythema, breast tension and pain, were maintained for each day of contact with the breast feeding clinic. A Severity Index (SI) for each mother and each day was created by adding together the scores on the erythema, breast tension and pain scales. The range of the SI was 0 (least severe) to 19 (most severe). no significant difference was found in numbers of mothers in the treatment groups, with the lowest possible score for severity of symptoms on contact days 3, 4 or 5. No statistically significant differences were found between the treatment groups for number of contact days needed until the mother felt well enough to discontinue contact with the breast feeding clinic or for number of mothers prescribed antibiotics. Significant differences were found in the mean SI scores on contact days 3 and 4 between the non-acupuncture group and the two acupuncture groups. Mothers with less favourable outcomes (6 contact days, n=61) were, at first contact with the midwife, more often given advice on correction of the baby's attachment to the breast. An obstetrician was called to examine 20% of the mothers, and antibiotic treatment was prescribed for 15% of the study population. The presence of Group B streptococci in the breast milk was related to less favourable outcomes. if
Vlemincx, Elke; Meulders, Michel; Luminet, Olivier
Research has suggested that sighs may serve a regulatory function during stress and emotions by facilitating relief. Evidence supports the hypotheses that sighs both express and induce relief from stress. To explore the potential role of sighs in the regulation of symptoms, the present study aimed to investigate the relationship between sighs and relief of symptoms, and relief of dyspnea, specifically. Healthy volunteers participated in two studies (N = 44, N = 47) in which dyspnea was induced by mild (10 cmH2 O/l/s) or high (20 cmH2 0/l/s) inspiratory resistances. Dyspnea relief was induced by the offset of the inspiratory resistances (transitions from high and mild inspiratory resistance to no resistance). Control comparisons included dyspnea increases (transitions from no or mild inspiratory resistance to high inspiratory resistance) and dyspnea continuations (continuations of either no resistance or a high resistance). In Experiment 1, dyspnea levels were cued. In Experiment 2, no cues were provided. Sigh rate during dyspnea relief was significantly higher compared to control conditions, and sigh rate increased as self-reported dyspnea decreased. Additionally, sigh rate was higher during cued dyspnea relief compared to noncued dyspnea relief. These results suggest that sighs are important markers of dyspnea relief. Moreover, sighs may importantly express dyspnea relief, as they are related to experiential dyspnea decreases and occur more frequently during expected dyspnea relief. These findings suggest that sighs may not only be important in the regulation of stress and emotions, but also may be functional in the regulation of dyspnea. © 2017 Society for Psychophysiological Research.
Klinedinst, N Jennifer; Clark, Patricia C; Dunbar, Sandra B
The purposes of this study were to examine the relationship between the poststroke depressive symptoms, older adult stroke survivors' perceptions of the depressive symptoms, and the congruence with an informal caregiver about the presence of depressive symptoms, and comfort talking to the health care provider with whether or not older stroke survivors discussed their depressive symptoms with a health care provider. A cross-sectional study where 44 caregiver/older adult stroke survivor dyads completed questionnaires including the Center for Epidemiologic Studies Depression Scale, Symptom Perception Questionnaire, and reporting of depressive symptoms to the health care provider via one time interview. Thirty-seven percent (n = 16) of all older stroke survivors reported depressive symptoms to their health care provider. Of the stroke survivors who had high levels of depressive symptoms (CESD ≥ 16; n = 11), seven reported the depressive symptoms to their health care provider. Identifying the symptoms as possible depression and attributing the cause of the depressive symptoms to the stroke were related to stroke survivors reporting the depressive symptoms to a health care provider. High functioning, older stroke survivors may benefit from strategies to help them identify when they experience depressive symptoms, in order to be able to play an active role in their recovery by appropriately discussing their symptoms with a health care provider. (c) 2013 APA, all rights reserved.
THE USE OF SUPEROXIDE DISMUTASE IN ACCELERATING SYMPTOM RELIEF IN ASTHMATIC AND HOUSE DUST MITE ALLERGIC CHILDREN RECEIVING HOUSE DUST MITE IMMUNOTHERAPY: DOUBLE BLIND RANDOMIZED CONTROLLED CLINICAL TRIAL
Full Text Available Objective: To evaluate the efficacy of superoxide dismutase (SOD in lung function (FEV1 reversibility and respiratory symptoms (drug scores, symptoms scores in asthmatic and house dust mite allergic children receiving house dust mites immunotherapy. Methods: Forty subjects aged 6–17 years old with asthma, tested positive for house dust mite allergy on skin prick test, and received immunotherapy were enrolled in this study. All subjects completed clinical based assessments and diary-based assessments for drug and symptom scores. Following a four-week baseline assessment, all subjects were randomized to receive SOD or placebo. Respiratory symptoms (drug and symptoms score and FEV1 were evaluated at the end of the 1st, 2nd, 3rd, and 4th weeks after randomization. Drug score, symptoms score, and FEV1 reversibility test results were analyzed using a Paired t test and repeated measure of ANOVA. Results: There was a significant difference in drug scores, symptoms score, and FEV1 reversibility test outcomes between SOD and placebo. SOD group showed a significant decrease in all outcome measures compared to those in placebo group. Conclusions: The use of SOD as antioxidants is effective in accelerating symptom relief for children with asthma and house dust mite allergy receiving house dust mite immunotherapy.
An evaluation of butoconazole nitrate 2% site release vaginal cream (Gynazole-1) compared to fluconazole 150 mg tablets (Diflucan) in the time to relief of symptoms in patients with vulvovaginal candidiasis
Seidman, Larry S; Skokos, Campbell K
.... 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...
Spangehl, Mark J; Clarke, Henry D; Hentz, Joseph G; Misra, Lopa; Blocher, Joshua L; Seamans, David P
Two of the more common methods of pain management after TKA are peripheral nerve blocks and intraarticular/periarticular injections. However, we are not aware of any study directly comparing the commonly used combination of a continuous femoral block given with a single-shot sciatic block with that of a periarticular injection after TKA. This randomized clinical trial compared a combined femoral and sciatic nerve block with periarticular injection as part of a multimodal pain protocol after total knee arthroplasty with respect to (1) pain; (2) narcotic use; (3) quadriceps function and length of stay; and (4) peripheral nerve complications. One hundred sixty patients completed randomization into two treatment arms: (1) peripheral nerve blocks (PNB; n=79) with an indwelling femoral nerve catheter and a single shot sciatic block; or (2) periarticular injection (PAI; n=81) using ropivacaine, epinephrine, ketorolac, and morphine. All patients received standardized general anesthesia and oral medications. The primary outcome was postoperative pain, on a 0 to 10 scale, measured on the afternoon of postoperative day 1 (POD 1). Secondary outcomes were narcotic use, quadriceps function, length of stay, and peripheral nerve complications. Mean pain scores on the afternoon of POD 1 were not different between groups (PNB group: 2.9 [SD 2.4]; PAI group: 3.0 [SD 2.2]; 95% confidence interval, -0.8 to 0.6; p=0.76). Mean pain scores taken at three times points on POD 1 were also similar between groups. Hospital length of stay was shorter for the PAI group (2.44 days [SD 0.65] versus 2.84 days [SD 1.34] for the PNB group; p=0.02). Narcotic consumption was higher the day of surgery for the PAI group (PAI group: 11.7 mg morphine equivalents [SD 13.1]; PNB group: 4.6 mg [SD 9.1]; pblocks. Periarticular injections provide adequate pain relief, are simple to use, and avoid the potential complications associated with nerve blocks. Level I, therapeutic study. See Guidelines for Authors for
Canaris, Gay J; Tape, Thomas G; Smith, Lynette M; Nickol, Devin R; Wigton, Robert S
Men and women communicate differently, but it is unclear whether this influences health care outcomes. Because women patients frequently choose women health care providers, we examined whether this preference was affected by communication styles. We focused on communication of disease-specific symptoms, hypothesizing that symptom agreement between women patients and women health care providers would be greater than between other patient-provider gender combinations. Patients attending outpatient clinics were recruited as part of a study of respiratory illness at 7 university-affiliated sites during 3 consecutive influenza seasons (2000-2003). Individuals aged > or = 19 years were offered enrollment if they sought care for cold or flu symptoms at a participating study site. Patients were eligible to participate in the study if they reported any 1 of 6 symptoms: cough, runny nose, fever (subjective), muscle aches, sore throat, and/or exhaustion. Using separate questionnaires, patients and their health care providers recorded the patients' respiratory symptoms (as present or absent). Patients recorded their symptoms before visiting their health care provider, and providers recorded patient symptoms after the visit. Symptom agreement was compared using general estimating equations across all gender combinations. A total of 327 patients (220 women, 107 men) and 84 health care providers (37 women, 47 men) participated in the study. Overall symptom agreement for all patient-provider gender combinations was 81.9% (95% CI, 79.6%-84.2%). For each symptom, the observed agreement significantly exceeded the agreement expected by chance alone (P difference in symptom agreement for most symptoms between the male-male and female-female patient-provider combinations. Based on these findings, symptom agreement alone does not explain why women patients select women health care providers.
Saulino, M; Burton, A W; Danyo, D A; Frost, S; Glanzer, J; Solanki, D R
Seven cases of combination of intrathecal (IT) ziconotide and baclofen therapy in patients with refractory neuropathic pain and spasticity were reviewed. Five of the seven adult patients were receiving IT baclofen treatment when ziconotide was initiated. All five patients had experienced at least one previous failed IT treatment regimen. Pain intensity scores improved by a mean of 50.3% with the use of ziconotide-baclofen therapy. Mean time to onset of pain relief was 15 weeks, at a mean ziconotide dose of 3.7 microg/day. Within this group of patients, adverse events were observed in one patient, but they were not considered to be ziconotide related and subsequently resolved. The remaining two patients were receiving ziconotide treatment when baclofen was initiated. Pain intensity scores improved by 75% and 30%, respectively. Pain relief was evident at two weeks and one week, with corresponding ziconotide doses of 2.4 microg/day and 14.4 microg/day, respectively. One patient in this group reported adverse events, but all resolved during continued treatment with the study drugs. Treatment regimens varied between patients in these case series; each regimen used a different titration strategy and different concentrations of ziconotide and baclofen. Combination IT ziconotide and baclofen therapy may be a treatment option for patients with neuropathic pain and spasticity. Future studies are warranted to determine the optimal dosing and titration schedules for ziconotide-baclofen usage.
Manchikanti, Laxmaiah; Benyamin, Ramsin M; Falco, Frank J E; Kaye, Alan D; Hirsch, Joshua A
As part of a comprehensive nonsurgical approach, epidural injections often are used in the management of lumbar disc herniation. Recent guidelines and systematic reviews have reached different conclusions about the efficacy of epidural injections in managing lumbar disc herniation. In this systematic review, we determined the efficacy (pain relief and functional improvement) of the three anatomic approaches (caudal, lumbar interlaminar, and transforaminal) for epidural injections in the treatment of disc herniation. We performed a literature search from 1966 to June 2013 in PubMed, Cochrane library, US National Guideline Clearinghouse, previous systematic reviews, and cross-references for trials studying all types of epidural injections in managing chronic or chronic and subacute lumbar disc herniation. We wanted only randomized controlled trials (RCTs) (either placebo or active controlled) to be included in our analysis, and 66 studies found in our search fulfilled these criteria. We then assessed the methodologic quality of these 66 studies using the Cochrane review criteria for RCTs. Thirty-nine studies were excluded, leaving 23 RCTs of high and moderate methodologic quality for analysis. Evidence for the efficacy of all three approaches for epidural injection under fluoroscopy was strong for short-term (long-term (≥ 6 months) based on the Cochrane rating system with five levels of evidence (best evidence synthesis), with strong evidence denoting consistent findings among multiple high-quality RCTs and moderate evidence denoting consistent findings among multiple low-quality RCTs or one high-quality RCT. The primary outcome measure was pain relief, defined as at least 50% improvement in pain or 3-point improvement in pain scores in at least 50% of the patients. The secondary outcome measure was functional improvement, defined as 50% reduction in disability or 30% reduction in the disability scores. Based on strong evidence for short-term efficacy from
... function, you don't find relief from OTC drugs, or you experience allergy symptoms over a long period. You may need ... available OTC and in generic form. The prescription drugs Astelin ... sprays approved to treat allergy symptoms. They can be used several times a ...
Laugsand, E.A.; Sprangers, M.A.G.; Bjordal, K.; Skorpen, F.; Kaasa, S.; Klepstad, P.
ABSTRACT: BACKGROUND: Many patients with advanced cancer depend upon health care providers for symptom assessment. The extent of agreement between patient and provider symptom assessments and the association of agreement with demographic- and disease-related factors was examined. METHODS: This
Green, Esther; Ballantyne, Barbara; Tarasuk, Joy; Skrutkowski, Myriam; Carley, Meg; Chapman, Kim; Kuziemsky, Craig; Kolari, Erin; Sabo, Brenda; Saucier, Andréanne; Shaw, Tara; Tardif, Lucie; Truant, Tracy; Cummings, Greta G.; Howell, Doris
ABSTRACT Background The pan‐Canadian Oncology Symptom Triage and Remote Support (COSTaRS) team developed 13 evidence‐informed protocols for symptom management. Aim To build an effective and sustainable approach for implementing the COSTaRS protocols for nurses providing telephone‐based symptom support to cancer patients. Methods A comparative case study was guided by the Knowledge to Action Framework. Three cases were created for three Canadian oncology programs that have nurses providing telephone support. Teams of researchers and knowledge users: (a) assessed barriers and facilitators influencing protocol use, (b) adapted protocols for local use, (c) intervened to address barriers, (d) monitored use, and (e) assessed barriers and facilitators influencing sustained use. Analysis was within and across cases. Results At baseline, >85% nurses rated protocols positively but barriers were identified (64‐80% needed training). Patients and families identified similar barriers and thought protocols would enhance consistency among nurses teaching self‐management. Twenty‐two COSTaRS workshops reached 85% to 97% of targeted nurses (N = 119). Nurses felt more confident with symptom management and using the COSTaRS protocols (p nursing requires a tailored approach. A multifaceted intervention approach increased nurses’ use of evidence‐informed protocols during telephone calls with patients about symptoms. Training and other interventions improved nurses’ confidence with using COSTaRS protocols and their uptake was evident in some documented telephone calls. Protocols could be adapted for use by patients and nurses globally. PMID:27243574
Bjorne, Assar; Agerberg, Göran
This study describes the coordinated treatment of temporomandibular disorders (TMD) and cervical spine disorders in patients diagnosed with Meniere's disease. The aim was to follow up treatment outcomes for three years with regular follow-up examinations every six months. Of the 31 patients with Meniere's disease who participated in a controlled comparative study on the signs and symptoms of TMD, 24 participated in a subsequent controlled comparative study on the signs and symptoms of cervical spine disorders (CSD). These 24 Meniere's disease patients (ten males and 14 females) agreed to participate in this longitudinal study. At each follow-up, their symptoms were evaluated using self-administered questionnaires and visual analog scales (VAS). The results of the coordinated treatment showed simultaneous decreases in the intensities of vertigo, nonwhirling dizziness, tinnitus, feeling of fullness in the ear, pain in the face and jaws, pain in the neck and shoulders, and headache that were both longitudinal and highly significant. Significant longitudinal reductions in the frequencies of vertigo, nonwhirling dizziness, and headache were also reported by the patients as well as a complete disappearance of pain located in the vertex area. A significant relief of TMD symptoms and a decrease in nervousness was also achieved. The results showed that a coordinated treatment of TMD and CSD in patients with Meniere's disease is an effective therapy for symptoms of this disease. The results also suggested that Meniere's disease has a clear association with TMD and CSD and that these three ailments appeared to be caused by the same stress, nervousness, and muscular tension.
Fiz, Jimena; Durán, Marta; Capellà, Dolors; Carbonell, Jordi; Farré, Magí
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.
Samuel, Cleo A; Turner, Kea; Donovan, Heidi A S; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J
Adjuvant endocrine therapy (AET) utilization is linked to improved clinical outcomes among breast cancer survivors (BCS); yet, AET adherence rates remain suboptimal. Little is known about provider perspectives regarding barriers and facilitators to AET-related symptom management (SM). In this study, we examined provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. We conducted three focus groups (FGs) with a multidisciplinary group of healthcare providers (n = 13) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM. FGs were audiotaped, transcribed, and analyzed using qualitative software to identify key themes. Providers described patient-, provider-, and system-level barriers and facilitators to AET-related SM. At the patient-level, barriers included competing demands, limited time/resources, and possible misattribution of some symptoms to AET, while family/social relationships and insurance emerged as important facilitators. Discomfort with SM, limited time, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Provider-level facilitators included routine symptom documentation and strong provider relationships. Care fragmentation and complexity of the cancer care delivery system were described as system-level barriers; however, survivor clinics were endorsed by providers. Provider perspectives on AET-related SM can shed light on SM barriers and facilitators spanning multiple levels of the cancer care delivery system. Strategies for improving AET-related SM in BCS include increasing patients' knowledge and engagement in SM, equipping providers with efficient SM strategies, and improving coordination of symptom-related services through survivorship programs.
Pustelnik, Frederik Schultz; Gronbek, Casper; Døssing, Helle
before and 6 months after hemithyroidectomy in 44 patients. Thyroid volumes were determined by two independent and blinded observers using magnetic resonance imaging (MRI). Inter- and intra-observer variability was visualized by Bland-Altman plots. Goiter symptoms were assessed by the Thyroid......According to previous studies, hemithyroidectomy results in growth of the remaining thyroid lobe by up to 30% in first 12 months after surgery. However, this estimate is based on imprecise methods, high inter- and intra-observer variability, and lack of blinding of the measurements. Furthermore......-Specific Patient-Reported-Outcome Questionnaire (ThyPRO) on a scale from 0 to 100 points. After hemithyroidectomy, the remaining thyroid lobe was 13.7 ± 6.4 mL, and enlarged by a mean of 1.8 mL over 6 months [95% confidence interval (CI) (1.6; 2.1), p
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.
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.
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
Klinedinst, N. Jennifer; Clark, Patricia C.; Dunbar, Sandra B.
Purpose The purposes of this study were to examine the relationship between the post-stroke depressive symptoms, older adult stroke survivors’ perceptions of the depressive symptoms, and the congruence with an informal caregiver about the presence of depressive symptoms, and comfort talking to the healthcare provider with whether or not older stroke survivors discussed their depressive symptoms with a healthcare provider. Method A cross-sectional study where 44 caregiver/older adult stroke survivor dyads completed questionnaires including the Center for Epidemiologic Studies Depression Scale, Symptom Perception Questionnaire, and reporting of depressive symptoms to the healthcare provider via one time interview. Results Thirty-seven percent (n=16) of all older stroke survivors reported depressive symptoms to their healthcare provider. Of the stroke survivors who had high levels of depressive symptoms (CESD≥16; n=11), seven reported the depressive symptoms to their healthcare provider. Identifying the symptoms as possible depression and attributing the cause of the depressive symptoms to the stroke were related to stroke survivors reporting the depressive symptoms to a health care provider. Conclusions High functioning, older stroke survivors may benefit from strategies to help them identify when they experience depressive symptoms, in order to be able to play an active role in their recovery by appropriately discussing their symptoms with a healthcare provider. PMID:23855380
Haar, Rohini J; Naderi, Sassan; Acerra, John R; Mathias, Maxwell; Alagappan, Kumar
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.
Strand, Vibeke; Smolen, Josef S; van Vollenhoven, Ronald F; Mease, Philip; Burmester, Gerd R; Hiepe, Falk; Khanna, Dinesh; Nikaï, Enkeleida; Coteur, Geoffroy; Schiff, Michael
Objective To assess the impact of certolizumab pegol (CZP) on patient-reported outcomes (PROs) in rheumatoid arthritis (RA), and to interpret these results using number needed to treat (NNT), and associations between PRO responses and longer term outcomes. Methods A total of 619 patients with active RA were randomised to CZP 200 or 400 mg, or placebo plus methotrexate (MTX). PROs assessed included pain, patient's global assessment of disease activity (PtGA), physical function, fatigue and health-related quality of life. Treatment impact on PROs, NNT to achieve simultaneous improvements in multiple PROs and correlations between PROs were calculated. Times to onset of improvements greater than or equal to minimum clinically important differences (MCIDs) in pain as a determinant of clinical outcomes at week 24 were compared between week 6 and 12 responders, and in patients with improvements in pain ≥MCID at week 12 (week 12 responders/non-responders). Results CZP 200 and 400 mg plus MTX were associated with rapid, clinically meaningful improvements in all PROs. The NNT for subjects to report changes ≥MCID in up to five PROs was two to three, and five for all six PROs (pain, PtGA, physical function, fatigue and short-form 36-item Physical and Mental Component Summary Scores). More patients with improvements ≥MCID in pain at week 6 than those at week 12 had lower disease activity at week 24. Week 12 pain responders had better clinical outcomes at week 24 than non-responders. Conclusions The data demonstrate that CZP provides broad relief from the burden of RA. Trial registration number NCT00160602. PMID:21415050
Shukla, Arvind Kumar; Ratnasekhar, Ch; Pragya, Prakash; Chaouhan, Hitesh Singh; Patel, Devendra Kumar; Chowdhuri, Debapratim Kar; Mudiam, Mohana Krishna Reddy
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.
Ridder, Hanne Mette Ochsner
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......Music is much more than a simple stimulus bringing individual pleasure; it also facilitates interpersonal synchrony. In this chapter professor of music therapy, Hanne Mette Ridder, brings together evidence from various disciplines to provide a new perspective on how music stimulates social...
Michiels, Whitney B; McGlthlen, Gail L; Platt, Benjamin J; Grigsby, Eric J
We report a case of a 59-year-old female with severe TN who experienced satisfactory symptom relief from a single-shot trial of intrathecal ziconotide. Performed a 1 μg single-shot trial of Prialt. Report of satisfaction, no side effects, and complete face and back relief briefly but most notably relief from the TN. Ziconotide should be considered for treatment of TN, although further investigation is recommended.
Walker, Dave; Ng Kwet Shing, Richard; Jones, Deborah; Gruss, Hans-Jurgen; Reguła, Jarosław
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
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
Sainoh, Takeshi; Orita, Sumihisa; Miyagi, Masayuki; Inoue, Gen; Yamauchi, Kazuyo; Suzuki, Miyako; Sakuma, Yoshihiro; Kubota, Go; Oikawa, Yasuhiro; Inage, Kazuhide; Sato, Jun; Nakata, Yukio; Aoki, Yasuchika; Takahashi, Kazuhisa; Ohtori, Seiji
Inflammatory cytokines, such as interleukin-6 and tumor necrosis factor-α, are gaining attention as important etiologic factors associated with discogenic low back pain. We conducted a prospective cohort study to evaluate the efficacy and safety of intradiscal injection of the interleukin-6 receptor antibody tocilizumab in patients with discogenic low back pain. Thirty-two consecutive patients were intradiscally injected with 2 mL of 0.5% bupivacaine (control group). Another 31 consecutive patients were intradiscally injected with 40 mg tocilizumab and 1-2 mL of 0.5% bupivacaine (tocilizumab group) at the same time. Prior to treatment, the vertebral origin of low back pain was confirmed in all patients based on pain provocation during discography and pain relief with 1 mL of 1% xylocaine. Numeric rating scale and Oswestry disability index scores were used to evaluate pain level before and after treatment between the 2 groups. The association between pain relief with tocilizumab and intervertebral disc degeneration grade was also determined. At the end of the study (8 weeks after treatment), 30 patients in each group were evaluable. In the tocilizumab group, numeric rating scale and Oswestry disability index scores improved significantly at 2 and 4 weeks after treatment, respectively. Intervertebral disc degeneration was not associated with improvement of numeric rating scale score in the tocilizumab group. Local infection (i.e., discitis) was observed in 1 patient in the tocilizumab group. The results demonstrate the clinical relevance of interleukin-6 in discogenic low back pain. Intradiscal tocilizumab injection was shown to exert a short-term analgesic effect in patients with discogenic low back pain. Further research is required to determine the long-term effects of intradiscal tocilizumab therapy in patients with discogenic low back pain. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
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).
Ikeda, Dianne M; McGill, Stuart M
A quantitative biomechanical analysis of mechanism of pain alteration in 4 cases of low back pain. To investigate the contributions of a number of biomechanical factors associated with pain alteration. Some clinicians use mechanically based manual interventions in attempt to reduce low back pain. However, the mechanism of pain alteration remains unknown. A sample was formed with 4 patients with low back pain seeking consults for pain relief. All could produce "catches" of pain with movement. Manual interventions involving coached changes in motion and muscle activation attempted to reduce pain. Electromyographic and kinematic data were collected before and after intervention. These data were input to an anatomically detailed spine model that calculated muscle force, joint compression and shear, and spine stability. Using a clinically significant criterion of pain reduction of 2 or more, 3 of 4 subjects reduced pain immediately upon the intervention. Using a change of 10% as a criterion for biological significance for kinematic and kinetic variables, each subject demonstrated a different reaction. For example, subject 1 demonstrated increased stability, subject 2 increased mediolateral shear, subject 3 increased mediolateral shear and decreased spine flexion, and subject 4 increased stability. The pain-reducing interventions required to obtain these results were also different for each individual. Immediate pain reduction can be achieved by altering muscle-activation and movement patterns. However, the combination for optimal success seems to be different for every individual. Pain provocation tests help to "tune" the intervention. This also suggests that patient-classification schemes may need more refinement to address this heterogeneity.
Hoffman, Amy J; Brintnall, Ruth Ann; von Eye, Alexander; Jones, Lee W; Alderink, Gordon; Patzelt, Lawrence H; Brown, Jean K
Post-thoracotomy non-small cell lung cancer (NSCLC) patients report cancer-related fatigue (CRF) as a severe symptom that may increase the occurrence and severity of other symptoms while decreasing functional status and quality of life (QOL). The aim of this pilot study was to describe the effects of a home-based rehabilitative exercise intervention on CRF, other symptoms, functional status, and QOL for post-surgical NSCLC patients starting within days after hospital discharge. Seven post-thoracotomy NSCLC patients completed the Brief Fatigue Inventory (BFI) measuring CRF severity, and the M.D. Anderson Symptom Inventory measuring symptom severity at pre- and post-surgery, and at the end of each week of the six-week intervention. Additionally, the Medical Outcomes Short-Form-36 measuring physical and mental functional status; and the Quality of Life Index (QLI) measuring QOL were completed pre- and post-surgery, after week 3, and at the end of the intervention (week 6). Participants had a mean age of 65 years, a mean of 6 co-morbid conditions, and initiated the intervention within 4 days after hospital discharge. Participants' CRF severity scores were reduced to mild levels while the mean number of symptoms decreased from 10.4 post-surgery to 7.0 at week 6 with lower levels of severity and interference. Likewise, participants' post-intervention functional status and QOL improved to near or above pre-surgical levels. The exercise intervention for post-surgical NSCLC patients showed promising preliminary efficacy in improving CRF, other symptom severity, functional status, and QOL. Further testing via a two-arm randomized controlled trial is being conducted.
... an Allergic Reaction to Food Symptoms of an Allergic Reaction to Food Learn about the mild and severe ... the food to which you are allergic. An allergic reaction to food can affect the skin, the gastrointestinal ...
Full Text Available In the given systematic review, the authors evaluated the efficiency of the amino acid based mixtures among the patients, suffering from the cow's milk protein allergy. They have studied the electronic and bibliographic databases. The researchers accounted for the patients of any age, suffering from the cow's milk protein allergy or similar symptoms. The task was to compare the aminoacid based mixtures with highly hydrolyzed mixtures, soy mixtures and cow's milk/cow's milk based mixtures. They showed that the use of the amino acid based mixtures is safe and efficient among the infants with the confirmed or suspected cow's milk protein allergy. The data of the randomized controlled studies, comparing amino acid based mixtures with highly hydrolyzed mixtures, witnesses that both types of mixtures are equally efficient in reducing the symptoms of the cow's milk protein allergy in the confirmed or alleged allergy cases. This review demonstrates the clinical impact of the amino acid based mixtures both upon certain symptoms and growth of the infants and children with the cow's milk protein allergy, who have zero tolerance towards the highly hydrolyzed mixtures.Key words: aminoacid-based mixtures, cow's milk protein allergy, highly hydrolyzed mixtures, soy mixtures, systematic review.
Gil, Thierry; Aoun, Fouad; Cabri, Patrick; Perrot, Valérie; van Velthoven, Roland
Lower urinary tract symptoms (LUTSs) may develop in men with prostate cancer (PCa) and can impact quality of life (QoL). Gonadotropin-releasing hormone (GnRH) agonists as androgen deprivation therapy are standard treatment for PCa, however, data are limited on their effects on LUTSs. A grouped analysis of national observational, non-interventional studies initiated in clinical practice was performed to assess the effectiveness of triptorelin in reducing moderate or severe LUTSs, measured using the International Prostate Symptom Score (IPSS) in men with advanced or metastatic PCa. Men with PCa and LUTSs scheduled to receive triptorelin (3-month or 1-month extended release formulation) were recruited into prospective, non-interventional studies at centres in Algeria, Australia, Belgium, China, Hungary, Romania and South Korea. The primary effectiveness endpoint was the proportion of patients with moderate or severe LUTSs, assessed by IPSS, after 48 weeks. Secondary endpoints included: total IPSS, QoL due to urinary symptoms (IPSS Question 8) and prostate-specific antigen (PSA) levels at 24 and 48 weeks. A total of 2701 patients were recruited; 1851 patients with moderate or severe LUTSs at baseline (IPSS > 7), received triptorelin and had follow-up IPSS (efficacy population). The proportion of patients with moderate or severe LUTSs was reduced to 67.2% from baseline at week 48, following a reduction to 75.9% at week 24: the overall time effect was significant ( p < 0.001). QoL due to urinary symptoms significantly improved from a mean score of 3.7 at baseline, to adjusted means of 2.5 and 2.1, at weeks 24 and 48, respectively ( p < 0.001 versus baseline). Mean PSA levels were reduced from 158.8 ng/ml at baseline to 11.5 and 16.0 ng/ml at weeks 24 and 48, respectively. Within the limitations of these observational studies, improvements in LUTSs and QoL observed after 24 weeks and maintained at 48 weeks indicate that triptorelin-induced effects improve LUTSs in
Chen, Bee F; Powell, Martin C; O'Beirne, Courtney
This was an observational study investigating the efficacy and side effects associated with ulipristal acetate (UPA), a progesterone receptor modulator, and the possible benefits to women who have co-existing pre-menstrual syndrome (PMS). 80 women returned a questionnaire on the bleeding, menstrual pain and side effects, and changes on PMS were recorded. 67 women (84%) showed improvement in their menses. 54 women (67%) became amenorrhoeic. Of those, 67% were within 10 days of commencing UPA. Menses returned in 33 amenorrhoeic women within 4 weeks of stopping UPA. 58 women (70%) reported an improvement in their pain score but 41 women had a return of their pain after stopping UPA. The majority of the women had no or infrequent side effects. 80% had demonstrable improvement in their PMS symptoms. UPA is effective in controlling symptoms due to uterine fibroids with infrequent side effects. Our data also showed new evidence of a concurrent dramatic improvement in PMS in these women. Impact statement The observational study explored the drug profile of ulipristal acetate (UPA), a selective progesterone receptor modulator, which has been licenced as pre-treatment for surgical therapies of fibroids since 2012. We aimed to investigate the efficiency and side effects of UPA. Since the introduction of UPA in clinical practice, there has yet to be a study looking at the drug profile outside a research setting. We have also decided to investigate the effect of UPA on pre-menstrual syndrome (PMS) in this group of women with symptomatic fibroids. As such this case report should be of interest to a broad readership including those interested in the medical management of symptomatic fibroids.
Andresen, Viola; Montori, Victor M.; Keller, Jutta; West, Colin P.; Layer, Peter; Camilleri, Michael
Background & Aims We performed a systematic review and meta-analyses to estimate treatment efficacy and constipation rate of 5-HT3 antagonists in patients with non-constipated (NC) or diarrhea-predominant (D) -IBS. Methods Two reviewers independently searched MEDLINE, EMBASE, and Web of Science (1966 to December 15th 2006) for randomized controlled trials (RCTs) of 5-HT3 antagonists in IBS reporting clinical endpoints of the IBS symptom complex and safety parameters. Study characteristics, markers of methodological quality, and outcomes for the intention-to-treat population for each RCT were extracted independently. Results We found 14 eligible RCTs of alosetron (n=3024) or cilansetron (n=1116) vs. placebo (n=3043) or mebeverine (n=304). Random effects meta-analyses found 5-HT3 antagonists more effective than the comparators in achieving global improvement in IBS symptoms (pooled relative risk 1.60, 95% CI 1.49, 1.72; I2=0%) and relief of abdominal pain and discomfort (pooled relative risk 1.30, 95% CI 1.22, 1.39, I2=22%). Benefit was apparent for both agents, in patients of either sex. These agents were more likely to cause constipation (pooled relative risk 4.28, 95% CI 3.28, 5.60, I2=65%); there was less constipation with 5-HT3 antagonists in D-IBS patients than in mixed populations (NC- and D-IBS; ratio of RR 0.65, 95% CI 0.41, 0.99). Nine patients (0.2%) using 5-HT3 antagonists had, at least, possible ischemic colitis versus none in control groups. Conclusions 5-HT3 antagonists significantly improve symptoms of NC- or D-IBS in men and women. There is increased risk of constipation with 5-HT3 antagonists, although the risk is lower in those with D-IBS. PMID:18242143
Effects of 5-hydroxytryptamine (serotonin) type 3 antagonists on symptom relief and constipation in nonconstipated irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials.
Andresen, Viola; Montori, Victor M; Keller, Jutta; West, Colin P; Layer, Peter; Camilleri, Michael
We performed a systematic review and meta-analyses to estimate treatment efficacy and constipation rate of 5-hydroxytryptamine (serotonin) (5-HT(3)) antagonists in patients with nonconstipated (NC) or diarrhea-predominant (D)-irritable bowel syndrome (IBS). Two reviewers independently searched MEDLINE, EMBASE, and Web of Science (January 1, 1966 to December 15, 2006) for randomized controlled trials of 5-HT(3) antagonists in IBS reporting clinical end points of the IBS symptom complex and safety parameters. Study characteristics, markers of methodologic quality, and outcomes for the intention-to-treat population for each randomized controlled trial were extracted independently. We found 14 eligible randomized controlled trials of alosetron (n = 3024) or cilansetron (n = 1116) versus placebo (n = 3043) or mebeverine (n = 304). Random-effects meta-analyses found 5-HT(3) antagonists more effective than the comparators in achieving global improvement in IBS symptoms (pooled relative risk, 1.60; 95% confidence interval [CI], 1.49-1.72; I(2) = 0%) and relief of abdominal pain and discomfort (pooled relative risk, 1.30; 95% CI, 1.22-1.39; I(2) = 22%). Benefit was apparent for both agents, in patients of either sex. These agents were more likely to cause constipation (pooled relative risk, 4.28; 95% CI, 3.28-5.60, I(2) = 65%); there was less constipation with 5-HT(3) antagonists in D-IBS patients than in mixed populations (NC-IBS and D-IBS; relative risk ratio, 0.65; 95% CI, 0.41-0.99). Nine patients (0.2%) using 5-HT(3) antagonists had possible ischemic colitis versus none in control groups. 5-HT(3) antagonists significantly improve symptoms of NC-IBS or D-IBS in men and women. There is an increased risk of constipation with 5-HT(3) antagonists, although the risk is lower in those with D-IBS.
Full Text Available http://dx.doi.org/10.5007/1677-2954.2014v13n2p283I have two goals in this paper. First, I want to determine whether Kant’s justification for state programs for poverty relief in The Doctrine of Right is based on 1 Kantian duties of virtue, 2 Kantian duties of right, or instead merely on 3 instrumental arguments regarding the preservation of a State as such. I claim that the last alternative is the correct one. Second, I will argue, against Kant himself, that even his merely instrumental arguments for public programs for poverty relief are ruled out by his doctrine of right. My conclusion is that, perhaps surprisingly, the only genuinely Kantian way to provide poverty relief is privately, just as Libertarians have argued.
Santa Ana Tellez, Y.; Teeuwisse, A.K.; Leufkens, H.G.M.; Wirtz, Veronika J
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
Combined perianal-intrarectal (PI) lidocaine-prilocaine (LP) cream and lidocaine-ketorolac gel provide better pain relief than combined PI LP cream and periprostatic nerve block during transrectal prostate biopsy.
Cormio, Luigi; Pagliarulo, Vincenzo; Lorusso, Fabrizio; Selvaggio, Oscar; Perrone, Antonia; Sanguedolce, Francesca; Bufo, Pantaleo; Carrieri, Giuseppe
What's known on the subject? and What does the study add? Study Type - Harm Reduction RCT Level of Evidence 1b The combination of perianal-intrarectal lidocaine-prilocaine cream and periprostatic nerve block effectively counteracts probe and sampling related pain during transrectal prostate biopsy, but not pain due to periprostatic infiltration. The novel combination of lidocaine-prilocaine cream and lidocaine-ketorolac gel, both administered perianal-intrarectally, provides the same probe and sampling-related pain relief than combined perianal-intrarectal lidocaine-prilocaine cream and periprostatic nerve block and prevents the non-negligible pain due to periprostatic infiltration, thus leading to better overall patients' compliance to the procedure. • To compare the efficacy and safety of combined perianal-intrarectal (PI) lidocaine-prilocaine (LP) cream and lidocaine-ketorolac (LK) gel with combined PI LP cream and periprostatic nerve block (PPNB) in relieving pain during transrectal ultrasonography guided prostate biopsy (TPB). • In all, 200 patients were randomized to receive combined PI LP cream and LK gel (group 1) or combined PI LP cream and PPNB (group 2) before TPB. • The 0-10-point visual analogue scale (VAS) was used for assessing pain at probe insertion and movements (VAS-1), periprostatic infiltration (VAS-2) when applied, and prostate sampling (VAS-3), as well as maximal procedural pain (MPP). • Complications occurring ≤ 20 days after the TPB were recorded. • The groups were comparable for patients' age, serum PSA level, prostate volume, and cancer detection rate. • All patients tolerated the procedure well. The two anaesthetic regimens provided almost equal mean VAS-1 (0.33 vs 0.37; P= 0.701) and VAS-3 (0.52 vs 0.51; P= 0.954) scores, but patients in group 2 reported significantly greater MPP scores (0.68 vs 1.53; P PI LP cream and LK gel provided the same probe- and sampling- related pain relief as combined PI LP and PPNB; moreover
Oud, MJT; de Groot, MH
Relief for surviving relatives following a suicide. - After the suicide of a 43-year-old woman with known depression, a 41-year-old paraplegic man who recently developed diarrhoea and a 41-year-old woman with probable depression with symptoms of psychosis, the general practitioners of the surviving
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
Edward J. Septimus, MD, FIDSA, FACP, FSHEA
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.
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...
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...
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
Jorge Manuel Canena
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
Donna J. Duerst
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.
Tielemans, M.M.; van Oijen, M.G.H.; Mulder, C.J.J.; Vos, K.J.; Lems, W.F.
Objective: To investigate whether esomeprazole can provide relief for nonsteroidal anti-inflammatory drug (NSAID)-associated upper gastrointestinal symptoms in patients at different gastrointestinal risk. METHODS: A multicentre, prospective, open-label study was conducted, wherein NSAID users
Tielemans, M.M.; Oijen, M.G.H. van; Mulder, C.J.; Vos, K.J.; Lems, W.F.
OBJECTIVE: To investigate whether esomeprazole can provide relief for nonsteroidal anti-inflammatory drug (NSAID)-associated upper gastrointestinal symptoms in patients at different gastrointestinal risk. METHODS: A multicentre, prospective, open-label study was conducted, wherein NSAID users
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
Hoben, Matthias; Chamberlain, Stephanie A; Knopp-Sihota, Jennifer A; Poss, Jeffrey W; Thompson, Genevieve N; Estabrooks, Carole A
Burdensome symptoms and potentially inappropriate care practices are common at the end of life for nursing home residents. Appropriately managing symptoms and limiting aggressive care practices is key to high-quality end-of-life care. Little research is available, however, on the opinions of nursing home care providers about the impact of symptoms and practices for both residents and care facilities. Our objectives were to (1) identify common burdensome symptoms and potentially inappropriate practices at the end of life for nursing home residents, (2) develop and assess the feasibility of a procedure to have various groups of nursing home care providers rate impact of symptoms and practices, and (3) generate recommendations for action and further research, with key policy and decision makers. Proof-of-concept study. Partnered research by researchers, health professionals, and decision makers to identify and explore the impact of burdensome symptoms and potentially inappropriate care practices for nursing home residents at the end of life. Thirty-six nursing homes from Alberta, Manitoba, and Saskatchewan. A total of 6007 residents (prevalence rating); 4 medical directors, 5 directors of care, 4 nurse practitioners, 4 registered nurses, 5 licensed practical nurses, 5 care aides (impact rating); and 13 key policy or decision makers from Alberta, British Columbia, and Manitoba (expert panel). Based on a literature search and data in the Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0, we generated lists of burdensome symptoms and potentially inappropriate care practices for nursing home residents at the end of life. We rated prevalence of those symptoms and practices in the last quarter before death as high, medium, or low. Care providers rated the burden of symptoms and inappropriateness of practices as high, medium, or low. Directors of care rated the unnecessary cost of those symptoms and practices to a nursing home as high, medium, or low. We ranked
Schatz, Philip; Neidzwski, Katherine; Moser, Rosemarie Scolaro; Karpf, Robin
Subjective feedback about distractions or problems encountered during computerized assessment was provided by 538 out of a pool of 1659 high-school athletes who completed baseline testing using ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). Three types of feedback were included: (a) environmental, (b) computer-based (mechanical), and (c) instruction-based (associated with difficulty understanding test instructions). One-way analyses of variance were conducted and revealed relationships between greater symptom reporting and any type of feedback, environmental feedback, and instruction-based feedback. Increased symptom reporting was noted for female students. Additional relationships were noted between providing computer-based feedback and faster reaction time; and between history of concussion and providing instruction-based feedback. Athletes endorsing more symptoms at baseline scored significantly worse on ImPACT, as reflected in decreased visual memory performance. Results suggest that feedback provided during computerized assessment may yield information about symptom reporting and test-taking style, which may also be of particular interpretive utility when athletes minimize their symptoms.
Jacobson, Terry A; Khan, Abdullah; Maki, Kevin C; Brinton, Eliot A; Cohen, Jerome D
Statin-associated muscle symptoms are reported by 10% to 29% of patients in clinical practice and are a major determinant of statin nonadherence, discontinuation, and switching. Little is known about what advice patients receive from their providers when dealing with these symptoms. The objective of the study was to assess patient's reports of provider advice when experiencing new or worsened muscle symptoms while taking a statin. Data were analyzed from the Understanding Statin Use in America and Gaps in Education survey, a self-administered internet-based survey of 10,138 adults with a reported history of high cholesterol and statin use. Of the respondents, 60% of former statin users (n = 1220) reported ever experiencing new or worsened muscle pain on a statin, in contrast to 25% of current users (n = 8918; P < .001). Former statin users reported stopping more statins because of muscle symptoms (mean ± standard deviation, 2.2 ± 1.7) compared with current users (mean 1.6 ± 1.5, P < .0001). For those with muscle-related symptoms while on a statin, participants reported that providers most often suggested switching to another statin (33.8%), stopping the statin (15.9%), continuing the statin with further monitoring of muscle symptoms (12.2%), reducing the statin dose (9.8%), or getting a blood test for signs of muscle damage (9.2%). A lower percentage were advised to add either vitamin D (7.0%) or coenzyme Q10 (5.8%), or to switch to nonstatin therapy (6.1%) or red yeast rice (2.6%). This study highlights patient experience with statin-associated muscle symptoms and the strategies recommended by providers in managing these symptoms. More research is needed to develop patient-centric and evidence-based approaches to managing statin-associated muscle symptoms, which is especially important in light of recent data showing increased cardiovascular risk among those who discontinue statin therapy. Copyright © 2017 National Lipid Association. Published by
Nieminen, Katri; Berg, Ida; Frankenstein, Katri; Viita, Lina; Larsson, Kamilla; Persson, Ulrika; Spånberger, Loviisa; Wretman, Anna; Silfvernagel, Kristin; Andersson, Gerhard; Wijma, Klaas
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 quality of life. The results need to be verified in larger trials. Further studies are also needed to examine long-term effects.
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.
Rantonen, J; Karppinen, J; Vehtari, A; Luoto, S; Viikari-Juntura, E; Hupli, M; Malmivaara, A; Taimela, S
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. A cohort of employees (N = 312, aged 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. 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. 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 system. ClinicalTrials.gov NCT00908102.
Crow, René; Cooper, Mark; Dallas, Jamie
Teachers of students with chronic challenging behaviors need relief, and they need it quickly. While they may appreciate the sympathy of others, what they really need is some genuine help. Challenging children can make a teacher's day difficult. In this article, the authors share some strategies that can provide "emergency relief" to…
Cepeda, M S; Carr, D B; Lau, J; Alvarez, H
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
Distress, Psychotic Symptom Exacerbation, and Relief in Reaction to Talking about Trauma in the Context of Beneficial Trauma Therapy: Perspectives from Young People with Post-Traumatic Stress Disorder and First Episode Psychosis.
Tong, Janet; Simpson, Katrina; Alvarez-Jimenez, Mario; Bendall, Sarah
Of young people with first episode psychosis (FEP), over half report exposure to childhood trauma and consequent co-morbid post-traumatic stress disorder (PTSD) or symptoms. Currently no evidence-based interventions exist for PTSD in FEP. Clinicians report concerns that trauma-focused interventions with young people with FEP could result in distress and symptom exacerbation. Scant research suggests that talking about trauma in therapy can be distressing for some people. To explore young people's reactions to a trauma-focused treatment for PTSD in FEP. Semi-structured interviews were conducted with eight participants (age 18-27 years) with co-morbid PTSD and FEP, after completing a trauma-focused intervention. Transcripts were analysed using an interpretative phenomenological approach. Participants' baseline and end-of-treatment PTSD and psychotic symptoms were assessed. Three themes related to participants' reactions were identified from the analysis: (1) distress in session; (2) feeling relieved in and out of session; and (3) symptom exacerbation out of session. All but one participant reported experiencing increased distress in session. Four participants described PTSD, psychotic symptoms and/or suicidal ideation worsening in immediate reaction to talking about trauma in therapy sessions. 86% of participants showed improvement in their PTSD and psychotic symptoms at end of treatment. All participants described the intervention as beneficial and worthwhile. Results suggest that feelings of distress are to be expected from individuals with PTSD and FEP during trauma-focused treatment. Psychotic and PTSD symptom exacerbation can occur in PTSD treatment in FEP. Clinicians should be aware of, plan for, and clearly inform their clients of treatment risks.
Carli Buttenschoen, Daniela; Stephan, Jarad; Watanabe, Sharon; Nekolaichuk, Cheryl
The ESAS is a clinical symptom assessment tool developed for patients receiving palliative care for pain and symptom control. Recent studies have indicated that patients have difficulty understanding terminology and correct use of the ESAS, and that they appreciate the presence of a health care provider (HCP) to assist with ESAS completion. As appropriate assessment translates into effective treatment, it is important that HCPs have a good understanding of the tool. The purpose of this study was to assess HCPs' use, knowledge, and training needs of the ESAS. One hundred ninety-three HCPs in palliative care and chronic pain, who used the ESAS, were invited to participate in a survey. The response rate was 43 % (n = 83), with 62 % nurses, 26 % physicians, and 12 % other specialties. Most participants were palliative care specialists (79 %). The majority (77 %) had a good understanding of the ESAS terms. Knowledge problems included distinguishing tiredness and drowsiness (25 %), interpreting shortness of breath as a combination of subjective and objective symptoms (19 %), not indicating current symptom level (14 %), and reverse scoring of well-being (13 %) and appetite (9 %). Reported challenges were misinterpretation of some ESAS terms, assessing patients with impaired communication, and lack of time and reliability of caregiver assessments. Participants offered suggestions regarding how their knowledge and use of the ESAS could be improved. Suggestions for improving ESAS administration and training were to include term definitions and examples of how to ask about terms that might be challenging for patients. Furthermore, initial and ongoing training sessions might help to clarify issues with the tool.
... Federal Transit Administration Allocation of Public Transportation Emergency Relief Funds in Response to...,000 under the Public Transportation Emergency Relief Program (Emergency Relief Program, Catalogue of... disaster that affects public transportation systems. The Appropriations Act provides $10.9 billion for FTA...
Prasicek, Günther; Herman, Frederic; Robl, Jörg
The limiting effect of a climatically-induced glacial buzz-saw on the height of mountain ranges has been extensively discussed in the geosciences. The buzz-saw concept assumes that solely climate controls the amount of topography present above the equilibrium line altitude (ELA), while the rock uplift rate plays no relevant role. This view is supported by analyses of hypsometric patterns in orogens worldwide. Furthermore, numerical landscape evolution models show that glacial erosion modifies the hypsometry and reduces the overall relief of mountain landscapes. However, such models often do not incorporate tectonic uplift and can only simulate glacial erosion over a limited amount of time, typically one or several glacial cycles. Constraints on glacial end-member landscapes from analytical, time-independent models are widely lacking. Here we present a steady-state solution for a glacier equilibrium profile in an active orogen modified from the mathematical conception presented by Headley et al. (2012). Our approach combines a glacial erosion law with the shallow ice approximation, specifically the formulations of ice sliding and deformation velocities and ice flux, to calculate ice surface and bed topography from prescribed specific mass balance and rock uplift rate. This solution allows the application of both linear and non-linear erosion laws and can be iteratively fitted to a predefined gradient of specific mass balance with elevation. We tested the influence of climate (fixed rock uplift rate, different ELAs) and tectonic forcing (fixed ELA, different rock uplift rates) on steady-state relief. Our results show that, similar to fluvial orogens, both climate and rock uplift rate exert a strong influence on glacial relief and that the relation among rock uplift rate and relief is governed by the glacial erosion law. This finding can provide an explanation for the presence of high relief in high latitudes. Headley, R.M., Roe, G., Hallet, B., 2012. Glacier
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...
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...
... that carry feeling to the vagina , vulva , and perineum . Local anesthetics provide relief from pain in these ... spine. Episiotomy: A surgical incision made into the perineum (the region between the vagina and the anus) ...
The prevalence and management of angina among patients with chronic coronary artery disease across US outpatient cardiology practices: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study.
Kureshi, Faraz; Shafiq, Ali; Arnold, Suzanne V; Gosch, Kensey; Breeding, Tracie; Kumar, Ashwath S; Jones, Philip G; Spertus, John A
Although eliminating angina is a primary goal in treating patients with chronic coronary artery disease (CAD), few contemporary data quantify prevalence and severity of angina across US cardiology practices. The authors hypothesized that angina among outpatients with CAD managed by US cardiologists is low and its prevalence varies by site. Among 25 US outpatient cardiology clinics enrolled in the American College of Cardiology Practice Innovation and Clinical Excellence (PINNACLE) registry, we prospectively recruited a consecutive sample of patients with chronic CAD over a 1- to 2-week period at each site between April 2013 and July 2015, irrespective of the reason for their appointment. Eligible patients had documented history of CAD (prior acute coronary syndrome, prior coronary revascularization procedure, or diagnosis of stable angina) and ≥1 prior office visit at the practice site. Angina was assessed directly from patients using the Seattle Angina Questionnaire Angina Frequency score. Among 1257 patients from 25 sites, 7.6% (n = 96) reported daily/weekly, 25.1% (n = 315) monthly, and 67.3% (n = 846) no angina. The proportion of patients with daily/weekly angina at each site ranged from 2.0% to 24.0%, but just over half (56.3%) were on ≥2 antianginal medications, with wide variability across sites (0%-100%). One-third of outpatients with chronic CAD managed by cardiologists report having angina in the prior month, and 7.6% have frequent symptoms. Among those with frequent angina, just over half were on ≥2 antianginal medications, with wide variability across sites. These findings suggest an opportunity to improve symptom control. © 2016 Wiley Periodicals, Inc.
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...
Full Text Available This research article explores the concept that libraries as communication centres in sub-Saharan Africa can play a vital role in bringing poverty relief by providing greater access to information through modern technology. It discusses the patrons who can benefit from community information centres and explores their particular needs. I have researched how modern tools like the Internet, computers, e-readers and cell phones can bring valuable information to impoverished citizens. My research was conducted through reading research papers using article databases, books and Internet websites. The future for libraries in sub-Saharan Africa is bright, as new technology opens up vast opportunities to share information in a way that is accessible, affordable and adaptable to the needs of the African people. I recommend that librarians and relief organisations in Southern Africa seriously consider using modern technology to provide information that will empower its citizens.
Pinkerton, JoAnn V; Stovall, Dale W; Kightlinger, Rebecca S
Vasomotor symptoms and vaginal atrophy are both common menopausal symptoms. Hormone therapy is currently the only FDA-approved treatment for hot flashes. Current recommendations are to use the lowest dose of hormone therapy for the shortest period that will allow treatment goals to be met. Although the reanalysis of the WHI in 2007 by Roussow et al. provided evidence of coronary heart safety for users of hormone therapy under the age of 60 years and within 10 years of the onset of menopause, not all women desire or are candidates for hormone therapy. In this review we present an evidence-based discussion considering the effectiveness of hormonal and nonhormonal therapies for the relief of vasomotor symptoms and vaginal atrophy. Concern exists regarding systemic absorption of vaginal estrogen and possible adverse effects on the breast and uterus. Selective estrogen receptor modulators and estrogen agonists offer benefits through targeted estrogen agonist/antagonistic effects and are being evaluated with and without estrogen for symptomatic menopausal women. Centrally acting nonhormonal therapies that are effective for the relief of vasomotor symptoms include various antidepressants, gabapentin and clonidine. A limited number of clinical trials have been conducted with nonprescription remedies, including paced respiration, yoga, acupuncture, exercise, homeopathy and magnet therapy, and some, but not all of these, have been found to be more effective than placebo. Dietary herbal supplements, such as soy and black cohosh, have demonstrated mixed and inconclusive results in placebo-controlled trials. Potential therapies for vasomotor symptoms and vaginal atrophy require randomized, placebo-controlled trials of sufficient duration to establish efficacy and safety. Agents under investigation for vasomotor symptoms relief include neuroactive agents, such as gabapentin and desvenlafaxine; an estrogen receptor-beta-targeted herbal therapy, MF-101; and the selective estrogen
Johansen, Monika Alise; Henriksen, Eva; Horsch, Alexander; Schuster, Tibor; Berntsen, Gro K Rosvold
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
Jones, Bleddyn; Cominos, Matilda; Dale, Roger G
To investigate the potential for mathematic modeling in the assessment of symptom relief in palliative radiotherapy and cytotoxic chemotherapy. 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. 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 alpha/beta ratios (which confer high fraction sensitivity) and their slow regrowth rates. Cancers that have high alpha/beta 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. 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.
Vastamäki, Heidi; Vastamäki, Martti
Manipulation under anesthesia (MUA) as treatment for idiopathic frozen shoulder increases motion, provides pain relief, and restores function, but it is unclear whether the improvements persist long...
Data is reviewed on premenstrual symptoms which have been related to high suicide and accident rates, employment absentee rates, poor academic performance and acute psychiatric problems. A recent study of healthy young women indicated that 39% had troublesome premenstrual symptoms, 54% passed clots in their menses, 70% had cyclical localized acneiform eruptions and only 17% failed to experience menstrual pain. Common menstrual disorders are classified as either dysmenorrhea or the premenstrual syndrome. Symptoms for the latter usually begin 2-12 days prior to menstruation and include nervous tension, irritability, anxiety, depression, bloated breasts and abdomen, swollen fingers and legs, headaches, dizziness, occasional hypersomia, excessive thirst and appetite. Some women may display an increased susceptibility to migraine, vasomotor rhinitis, asthma, urticaria and epilepsy. Symptoms are usually relieved with the onset of menses. While a definitive etiological theory remains to be substantiated, symptomatic relief has been reported with salt and water restriction and simple diuretics used 7 to 10 days premenstrually. Diazapam or chlordiazepoxide treatment is recommended before oral contraceptive therapy. The premenstrual syndrome may persist after menopause, is unaffected by parity, and sufferers score highly on neuroticism tests. Primary or spasmodic dysmenorrhea occurs in young women, tends to decline with age and parity and has no correlation with premenstrual symptoms or neuroticism. Spasmodic or colicky pain begins and is most severe on the first day of menstruation and may continue for 2-3 days. Treatment of dysmenorrhea with psychotropic drugs or narcotics is discouraged due to the risk of dependence and abuse. Temporary relief for disabling pain may be obtained with oral contraceptives containing synthetic estrogen and progestogen but the inherent risks should be acknowledged. Both disorders have been correlated to menstrual irregularity. Amenorrhea in
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.
Van Doorn, A.J.; De Ridder, H.; Koenderink, J.J.
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
Eccles, Ronald; Turner, Ronald B; Dicpinigaitis, Peter V
Acute viral upper respiratory tract infection, or, the common cold, affects essentially every human being, and cough is reported as its most frequent associated symptom. Billions of dollars are spent worldwide annually by individuals seeking relief from this multi-symptom syndrome. Thousands of non-prescription, over-the-counter products are available worldwide, aimed at relieving the various bothersome symptoms induced by the common cold. Differences of opinion exist as to whether optimal therapy for cough associated with the common cold consists of multi-component, multi-symptom cough/cold preparations, or, whether single-component medications, aimed at relief of specific symptoms, represent the optimal therapeutic approach. The 5th American Cough Conference, held in Washington, D.C. in June, 2015, provided an ideal forum for discussion and debate of this issue between two internationally recognized experts in the field of the common cold and its treatment.
... Job? Start by Visiting the Dentist Pacifiers Have Negative and Positive Effects Are You Biting Off More Than You Can Chew? Learn what those dental words mean. Check out how your teeth and mouth change in every stage of life. More RSS ...
Xia, Lei; Zhong, Jun; Zhu, Jin; Dou, Ning-Ning; Liu, Ming-Xing; Li, Shi-Ting
Microvascular decompression (MVD) has been accepted worldwide as a reasonable treatment for hemifacial spasm (HFS); however, resolution of the HFS is often gradual. To conclude the delayed relief rate of the MVD for the treatment of HFS, we conducted a systematic review. Using the keywords delayed relief, hemifacial spasm, or microvascular decompression, articles published in English-language journals and indexed in PubMed between June 1, 1994 and June 1, 2014 on the treatment of HFS with emphasis on delayed relief were considered for this study. Twelve articles with 2727 patients with HFS were finally enrolled in this review. Among all the patients, the ratio of male versus female was 1:2.7, and left versus right was 1:1.6. The average age at surgery was 52.5 years (49.1-55.9 y), with HFS symptom duration of 68.4 months (38.4-98.4 mo) before the surgery. The average follow-up duration was 49 months (6.4-121.6 mo). After examining all the patients, we obtained a mean postoperative success rate of 85.1% (76.5%-93.5%), but the success rate after the MVD immediately is only 71.8% (59.5%-84%). The mean rate of delayed relief was 25.4% (18.8%-37.1%). Approximately 13.1% (5.9%-19.7%) of the patients with symptom recurrence resorted to repeated MVD during the follow-up period. Accordingly, MVD is the most effective treatment for patients with HFS, but some of the patients may experienced delayed relief, which could be avoided if a thorough decompression of the facial nerve root had been obtained.
Johansen, Monika Alise; Berntsen, Gro K Rosvold; Schuster, Tibor; Henriksen, Eva; Horsch, Alexander
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
... Pricing Flexibility § 69.727 Regulatory relief. (a) Phase I relief. Upon satisfaction of the Phase I... customer. (b) Phase II relief. Upon satisfaction of the Phase II triggers specified in §§ 69.709(c) or 69... similarly situated customers; and (ii) The price cap LEC excludes all contract tariff offerings from price...
Bukley, A.P.; Mulqueen, J.A. [NASA Marshall Space Flight Center, Huntsville, AL (United States)
The decade of the 1990`s has been proclaimed by the United Nations to be the International Decade for Natural Disaster Reduction (IDNDR). There exists a documented need for improved communications and information distribution to provide adequate warning in the face of impending disasters and facilitate the response after a disaster has occurred. The Global Emergency Observation Warning and Relief Network (GEOWARN) is proposed as a system that can potentially fill the existing gaps in the disaster management capabilities by providing a mechanism for the timely processing of information both before and after an event has occurred. A system design is proposed that would utilize existing remote sensing resources augmented by additional satellites and airborne sensor platforms linked together via a computer network. This network would be configured around five control centers called Multi-National Centers which would host an extensive Geographical Information System to perform the task of providing global disaster warning and relief support. To support the potential development of GEOWARN, the NASA Marshall Space Flight Center performed a study to assess concept feasibility. This study has resulted in several recommended modifications to the ISU system concept. It was concluded that a system design which optimizes the use of existing resources can result in significant improvements in disaster warning and management capabilities for most of the world. This paper presents the results of the feasibility study, including a general overview of the GEOWARN concept and the elements comprising the system.
Massage therapy is widely used by patients with fibromyalgia seeking symptom relief. We performed a review of all available studies with an emphasis on randomized controlled trials to determine whether massage therapy can be a viable treatment of fibromyalgia symptoms. Extensive narrative review. PubMed, PsychInfo, CINAHL, PEDro, ISI Web of Science, and Google Scholar databases (inception-December 2009) were searched for the key words "massage", "massotherapy", "self-massage", "soft tissue manipulation", "soft tissue mobilization", "complementary medicine", "fibromyalgia" "fibrositis", and "myofascial pain". No language restrictions were imposed. The reference lists of all articles retrieved in full were also searched. The effects of massage on fibromyalgia symptoms have been examined in two single-arm studies and six randomized controlled trials. All reviewed studies showed short-term benefits of massage, and only one single-arm study demonstrated long-term benefits. All reviewed studies had methodological problems. The existing literature provides modest support for use of massage therapy in treating fibromyalgia. Additional rigorous research is needed in order to establish massage therapy as a safe and effective intervention for fibromyalgia. In massage therapy of fibromyalgia, we suggest that massage will be painless, its intensity should be increased gradually from session to session, in accordance with patient's symptoms; and the sessions should be performed at least 1-2 times a week.
Benign prostatic hyperplasia (BPH) can cause benign prostatic enlargement with subsequent benign prostatic obstruction (BPO) and lower urinary tract symptoms (LUTS). A reduction in the size of the prostate has long been considered one of the most important treatment goals. However, there is a poor correlation between prostate size and both LUTS and BPO, and between BPO and symptoms. Today, the urologist's primary objectives are to minimize symptoms, relieve BPO and decrease the morbidity associated with BPO. From the patient's point of view, rapid relief of LUTS and immediate improvement in associated quality of life (QOL) are the most important factors. Although there is a good correlation between relief of symptoms (as measured by the International Prostate Symptom Score [I-PSS], for example) and associated improvement in bothersomeness and QOL, particularly that associated with filling ('irritative') symptoms, it is still important to quantify LUTS-related bothersomeness and QOL. Various questionnaires have been developed to measure bothersomeness (e.g. Symptom Problem Index [SPI], Danish PSS [DAN-PSS], International Continence Society BPH Study Group [ICSmale] questionnaire) and QOL (e.g. I-PSS-QOL, BPH Impact Index [BII] and QOL9 BPH-specific questionnaire). In addition, the impact of treatment on sexual function should also be taken into account when judging the overall well being or QOL of the patient. A grading system to evaluate the global improvement in patients following treatment has been established. Patients are either graded as showing 'slight', 'moderate' or 'marked' improvement, with the reduction in I-PSS or BII scores required for each classification dependent on baseline symptom severity. Medical treatment strategies designed to alleviate the symptoms of BPH and consequently improve the patient's QOL are now becoming increasingly important.
Becker, Stéphanie J. E.; Makanji, Heeren S.; Ring, David
Purpose This study tested the null hypothesis that there is no difference between expected improvement and actual improvement of symptoms with carpal tunnel release (CTR). Secondary analyses addressed factors associated with both expected relief and actual relief of symptoms with carpal tunnel
Garrity, Christopher P.; Hackley, Paul C.; Urbani, Franco
The Digital Shaded-Relief Map of Venezuela is a composite of more than 20 tiles of 90 meter (3 arc second) pixel resolution elevation data, captured during the Shuttle Radar Topography Mission (SRTM) in February 2000. The SRTM, a joint project between the National Geospatial-Intelligence Agency (NGA) and the National Aeronautics and Space Administration (NASA), provides the most accurate and comprehensive international digital elevation dataset ever assembled. The 10-day flight mission aboard the U.S. Space Shuttle Endeavour obtained elevation data for about 80% of the world's landmass at 3-5 meter pixel resolution through the use of synthetic aperture radar (SAR) technology. SAR is desirable because it acquires data along continuous swaths, maintaining data consistency across large areas, independent of cloud cover. Swaths were captured at an altitude of 230 km, and are approximately 225 km wide with varying lengths. Rendering of the shaded-relief image required editing of the raw elevation data to remove numerous holes and anomalously high and low values inherent in the dataset. Customized ArcInfo Arc Macro Language (AML) scripts were written to interpolate areas of null values and generalize irregular elevation spikes and wells. Coastlines and major water bodies used as a clipping mask were extracted from 1:500,000-scale geologic maps of Venezuela (Bellizzia and others, 1976). The shaded-relief image was rendered with an illumination azimuth of 315? and an altitude of 65?. A vertical exaggeration of 2X was applied to the image to enhance land-surface features. Image post-processing techniques were accomplished using conventional desktop imaging software.
DeBusk, Wesley M.
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.
de Boer, Jacoba; Lok, Anja; van 't Verlaat, Ellen; Duivenvoorden, Hugo J.; Bakker, Arnold B.; Smit, Bert J.
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
Zadeh, Mahdi Hossein
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...... 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...
Full Text Available The presence of glacial relief in the Romanian medium height massifs is still controversial. The medium height mountains, such as theLeaota Mountains (in the Bucegi group, with maximum altitudes of almost 2000 m andmedium altitudes of approximately 1250 m, can display traces of glacial relief dating from theUpper Pleistocene. The aim of this article is to provide evidence about the presence of theglacial morphology in the northern part of the Leaota Peak, the main orographic node in themassif with the same name. Thus, on the basis of field observations, of topographical mapanalysis and by using the geographic information systems which made possible a detailedmorphometric analysis, I was able to gather evidence proving the existence of a glacial cirquein the Leaota Mountains. The arguments put forward in this article show that the glacial reliefis represented in the Leaota Mountains through a small-size suspended glacial cirque, whichdisplays all the morphologic elements proving the existence of glaciation in this massif.
de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J
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
Daya, Shyam K; Paulus, Andrew O; Braxton, Ernest E; Vroman, Penny J; Mathis, Derek A; Lin, Ryan; True, Mark W
Anchoring bias occurs when clinicians hold on to previously known information about a patient, with failure to consider the full realm of possibilities to explain new findings. We present a case of delayed diagnosis of thyroid-stimulating-hormone-secreting pituitary adenoma (TSHoma), a rare disorder, in a military veteran whose symptoms were misconstrued as being caused from worsening of his prior diagnosis of post-traumatic stress disorder (PTSD). Anchoring bias in this case led to 2-year delay in the correct diagnosis. The clinical, laboratory, radiologic, and pathologic results are presented. We report a case of a 44-year-old retired male Army soldier with a prior diagnosis of PTSD who was evaluated for new symptoms including headaches, blurry vision, palpitations, and anxiety. These symptoms were considered by multiple services as worsening of his PTSD, with acknowledgment of normal thyroid hormone levels from 2 years prior, but with no levels at the time of the new presentation. Attempts to treat with standard PTSD therapies were unsuccessful. When thyroid hormone levels were eventually rechecked 2 years later, he was found to have an inappropriately normal level of thyroid-stimulating hormone (1.9 mcIU/mL) in the setting of elevated free thyroxine (2.30 pg/mL) and free triiodothyronine (5.8 ng/dL). With magnetic resonance imaging revealing a 1.4-cm pituitary macroadenoma, he was diagnosed with a TSHoma. A trial of octreotide, a somatostatin analog, was attempted to shrink the tumor size. However, because of the patient's intolerance of this medication, he underwent endoscopic transsphenoidal surgery as definitive treatment. Pathologic analysis of his tumor was consistent with TSHoma. On various follow-up intervals, he had normalization of thyroid function tests, no evidence of residual tumor on 6-month postoperative imaging, and reported improvement in his symptoms. This case highlights the details of a rare diagnosis of TSHoma, which has an estimated 1 to 2
Sudharsanam Manni Balasubramaniam
Full Text Available 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.
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
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.
Sun, Jing; Yuan, Yao-Zong; Hou, Xiao-Hua; Zou, Duo-Wu; Lu, Bin; Chen, Min-Hu; Liu, Fei; Wu, Kai-Chun; Zou, Xiao-Ping; Li, Yan-Qing; Zhou, Li-Ya
To compare symptom control with esomeprazole regimens for non-erosive reflux disease and chronic gastritis in patients with a negative endoscopy. This randomized, open-label study was designed in line with clinical practice in China. Patients with typical reflux symptoms for ≥ 3 mo and a negative endoscopy who had a Gastroesophageal Reflux Disease Questionnaire score ≥ 8 were randomized to initial treatment with esomeprazole 20 mg once daily either for 8 wk or for 2 wk. Patients with symptom relief could enter another 24 wk of maintenance/on-demand treatment, where further courses of esomeprazole 20 mg once daily were given if symptoms recurred. The primary endpoint was the symptom control rate at week 24 of the maintenance/on-demand treatment period. Secondary endpoints were symptom relief rate, success rate (defined as patients who had symptom relief after initial treatment and after 24 wk of maintenance treatment), time-to-first-relapse and satisfaction rate. Based on the data collected in the modified intention-to-treat population (MITT; patients in the ITT population with symptom relief after initial esomeprazole treatment, n = 262), the symptom control rate showed a small but statistically significant difference in favor of the 8-wk regimen (94.9% vs 87.3%, P = 0.0473). Among the secondary endpoints, based on the data collected in the ITT population (n = 305), the 8-wk group presented marginally better results in symptom relief after initial esomeprazole treatment (88.3% vs 83.4%, P = 0.2513) and success rate over the whole study (83.8% vs 72.8%, P = 0.0258). The 8-wk regimen was found to provide a 46% reduction in risk of relapse vs the 2-wk regimen (HR = 0.543; 95%CI: 0.388-0.761). In addition, fewer unscheduled visits and higher patient satisfaction supported the therapeutic benefits of the 8-wk regimen over the 2-wk regimen. Safety was comparable between the two groups, with both regimens being well tolerated. Chinese patients diagnosed with chronic
Henry, James A; Rheinsburg, Betsy; Zaugg, Tara
Tinnitus masking has been a widely used method for treating clinically significant tinnitus. The method, referred to herein as "sound-based relief," typically uses wearable ear-level devices ("maskers") to effect palliative tinnitus relief. Although often effective, this approach is limited to the use of broadband noise with the maskers. We hypothesized that the effectiveness of treatment can be improved by expanding the auditory-stimulus options available to patients. A pilot study was conducted to determine for each of 21 subjects the most effective of custom sounds that are designed to promote tinnitus relief. While sitting in a sound booth, subjects listened to white noise and to custom sounds that are available commercially for providing tinnitus relief. Three sound formats ("E-Water," "E-Nature," and "E-Air") were provided by the Dynamic Tinnitus Mitigation (DTM-6a) system (Petroff Audio Technologies, Inc.). Additionally, seven sounds were provided by the Moses/Lang CD7 system (Oregon Hearing Research Center). Considering group data, all of the sounds provided a significant reduction in tinnitus annoyance relative to the annoyance of tinnitus alone. Two of the commercial sounds (DTM E-Nature and E-Water) were judged significantly more effective than the other sounds.
The Philippine disaster framework recognises the military's role in disaster relief and has existing mechanisms for accepting international assistance and procedures for military-to-military ... The US military's activities were confined to search and rescue and to providing critical logistics, which the Philippines actors lacked.
Weil, K.; Hooper, L.; Afzal, Z.; Esposito, M.; Worthington, H.V.; van Wijk, A.J.; Coulthard, P.
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
Eom, Tae Ho; Duncombe, William; Nguyen-Hoang, Phuong; Yinger, John
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…
Stake-Nilsson, Kerstin; Hultcrantz, Rolf; Unge, Peter; Wengström, Yvonne
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.
Full Text Available The aim of this study was to introduce a new morphometric index named Relief Index (RI. RI is the ratio of the total length of the contour lines and the surface area at which they occur. This easily calculated index provides an objective quantitative measure of relief variability as an important feature in geomorphological studies. To achieve this goal, a highly detailed morphometric analysis was carried out using a high-resolution (1m×1m DEM. Twenty one sample areas in southern Poland were examined. These analyses showed RI, as a good tool for rapidly evaluating topography heterogeneity in division into relief classes. I distinguished 4 classes of the Relief Index that classify earth surface considering the variability of the relief. Results of the calculations demonstrated that there is a significant correlation between RI and the local relief and slopes, but there is no correlation between RI and planar curvatures and TWI. The relief of the sample areas were analysed using geomorphometric parameters (slopes, local relief, planar curvatures. Moreover the influence of the DEM resolution on Relief Index values was examined.
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.
Deutsch, Roland; Smith, Kevin J. M.; Kordts-Freudinger, Robert; Reichardt, Regina
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
Bjerge, Benedikte Alkjærsig; Clark, Nathan Edward; Fisker, Peter Kielberg
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......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...
Full Text Available Mandibular nerve block is periodically used procedure used to treat neuralgic pain in the distribution of trigeminal nerve. It is a commonly performed block in outpatient settings at our institute. We present a case of an elderly edentulous patient with trigeminal neuralgia who suffered recurrent temporomandibular joint (TMJ dislocation following mandibular nerve block. The patient presented with complaints of severe pain, inability to close mouth, and eat food since 2 days. Anterior closed reduction of TMJ resulted in reduction of joint and immediate pain relief. However, the maneuver failed due to recurrent dislocation of the joint. A Barton dressing was applied to prevent another dislocation. This was followed by autologous blood injection into the joint. This case focuses on the preponderance of clinical evaluation and accentuates the need for additional forethought to be taken during pain procedures, particularly in the geriatric population.
Sanu, A; Eccles, R
Hot drinks are a common treatment for common cold and flu but there are no studies reported in the scientific and clinical literature on this mode of treatment. This study investigated the effects of a hot fruit drink on objective and subjective measures of nasal airflow, and on subjective scores for common cold/flu symptoms in 30 subjects suffering from common cold/flu. The results demonstrate that the hot drink had no effect on objective measurement of nasal airflow but it did cause a significant improvement in subjective measures of nasal airflow. The hot drink provided immediate and sustained relief from symptoms of runny nose, cough, sneezing, sore throat, chilliness and tiredness, whereas the same drink at room temperature only provided relief from symptoms of runny nose, cough and sneezing. The effects of the drinks are discussed in terms of a placebo effect and physiological effects on salivation and airway secretions. In conclusion the results support the folklore that a hot tasty drink is a beneficial treatment for relief of most symptoms of common cold and flu.
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.
Doering, Keiko; Patterson, Jean; Griffiths, Christine R
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.
Noor Latif CM
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.
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.
Huang, Yongzhi; Luo, Huichun; Green, Alexander L; Aziz, Tipu Z; Wang, Shouyan
To investigate the link between neuronal activity recorded from the sensory thalamus and periventricular gray/periaqueductal gray (PVAG) and pain relief by deep brain stimulation (DBS). Local field potentials (LFPs) were recorded from the sensory thalamus and PVAG post-operatively from ten patients with neuropathic pain. The LFPs were quantified using spectral and time-frequency analysis, the relationship between the LFPs and pain relief was quantified with nonlinear correlation analysis. The theta oscillations of both sensory thalamus and PVAG correlated inversely with pain relief. The high beta oscillations in the sensory thalamus and the alpha oscillations in the PVAG correlated positively with pain relief. Moreover, the ratio of high-power duration to low-power duration of theta band activity in the sensory thalamus and PVAG correlated inversely with pain relief. The duration ratio at the high beta band in the sensory thalamus correlated positively with pain relief. Our results reveal distinct neuronal oscillations at the theta, alpha, and beta frequencies correlating with pain relief by DBS. The study provides quantitative measures for predicting the outcomes of neuropathic pain relief by DBS as well as potential biomarkers for developing adaptive stimulation strategies. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Fodeh, Samah J; Lazenby, Mark; Bai, Mei; Ercolano, Elizabeth; Murphy, Terrence; McCorkle, Ruth
Symptoms and subsequent functional impairment have been associated with the biological processes of disease, including the interaction between disease and treatment in a measurement model of symptoms. However, hitherto cluster analysis has primarily focused on symptoms. This study among patients within 100 days of diagnosis with advanced cancer explored whether self-reported physical symptoms and functional impairments formed clusters at the time of diagnosis. We applied cluster analysis to self-reported symptoms and activities of daily living of 111 patients newly diagnosed with advanced gastrointestinal (GI), gynecological, head and neck, and lung cancers. Based on content expert evaluations, the best techniques and variables were identified, yielding the best solution. The best cluster solution used a K-means algorithm and cosine similarity and yielded five clusters of physical as well as emotional symptoms and functional impairments. Cancer site formed the predominant organizing principle of composition for each cluster. The top five symptoms and functional impairments in each cluster were Cluster 1 (GI): outlook, insomnia, appearance, concentration, and eating/feeding; Cluster 2 (GI): appetite, bowel, insomnia, eating/feeding, and appearance; Cluster 3 (gynecological): nausea, insomnia, eating/feeding, concentration, and pain; Cluster 4 (head and neck): dressing, eating/feeding, bathing, toileting, and walking; and Cluster 5 (lung): cough, walking, eating/feeding, breathing, and insomnia. Functional impairments in patients newly diagnosed with late-stage cancers behave as symptoms during the diagnostic phase. Health care providers need to expand their assessments to include both symptoms and functional impairments. Early recognition of functional changes may accelerate diagnosis at an earlier cancer stage. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Ullman, Roz; Smith, Lesley A; Burns, Ethel; Mori, Rintaro; Dowswell, Therese
Parenteral opioids are used for pain relief in labour in many countries throughout the world. To assess the acceptability, effectiveness and safety of different types, doses and modes of administration of parenteral opioids given to women in labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2010) and reference lists of retrieved studies. We included randomised controlled trials examining the use of intramuscular or intravenous opioids (including patient controlled analgesia) for women in labour. We looked at studies comparing an opioid with placebo or another opioid. At least two review authors independently assessed study eligibility, collected data and assessed risk of bias. We included 54 studies involving more than 7000 women that compared an opioid with placebo or another opioid administered intramuscularly or intravenously. The 54 studies reported on 27 different comparisons, and for many outcomes only one study contributed data. Overall the evidence was of poor quality regarding the analgesic effect of opioids, satisfaction with analgesia, adverse effects and harm to women and babies. There were few statistically significant results. Many of the studies had small sample sizes, and low statistical power. Overall, findings indicated that parenteral opioids provided some pain relief and moderate satisfaction with analgesia in labour, although up to two-thirds of women who received opioids reported moderate or severe pain and/or poor or moderate pain relief one or two hours after administration. Opioid drugs were associated with maternal nausea, vomiting and drowsiness, although different opioid drugs were associated with different adverse effects. There was no clear evidence of adverse effects of opioids on the newborn. We did not have sufficient evidence to assess which opioid drug provided the best pain relief with the least adverse effects. Parenteral opioids provide some relief from pain in labour but are associated
Belasco, Amy; Nowels, Larry
... (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...
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.
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...
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...
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...
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...
Gaboutchian, A. V.; Knyaz, V. A.
Determining occlusal surface relief indicator plays an important role in odontometric tooth shape analysis. An analysis of the parameters of surface relief indicators provides valuable information about closure of dental arches (occlusion) and changes in structure of teeth in lifetime. Such data is relevant for dentistry or anthropology applications. Descriptive techniques commonly used for surface relief evaluation have limited precision which, as a result, does not provide for reliability of conclusions about structure and functioning of teeth. Parametric techniques developed for such applications need special facilities and are time-consuming which limits their spread and ease to access. Nevertheless the use of 3D models, obtained by photogrammetric techniques, allows attaining required measurements accuracy and has a potential for process automation. We introduce new approaches for determining tooth occlusal surface relief indicator and provide data on efficiency in use of different indicators in natural attrition evaluation.
Henriksen, Marius; Simonsen, Erik B; Alkjaer, T
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...... patients. A group of healthy subjects was included as a reference group. The joint loads were calculated from standard gait analysis data obtained with standardised walking speed (4 km/h). The gait analyses were performed before and after pain relief by intra-articular injections of 10 mL lidocaine (1...
Tomita, Andrew; Kandolo, Ka Muzombo; Susser, Ezra; Burns, Jonathan K
Few studies in developing nations have assessed the use of short messaging services (SMS) to identify psychological challenges in refugee populations. This study aimed to assess the feasibility of SMS-based methods to screen for depression risk among refugees in South Africa attending mental health services, and to compare its reliability and acceptability with face-to-face consultation. Of the 153 refugees enrolled at baseline, 135 were available for follow-up assessments in our cohort study. Depression symptomatology was assessed using the 16-item Quick Inventory of Depressive Symptomatology (QIDS) instrument. Nearly everyone possessed a mobile phone and utilized SMS. Furthermore, low incomplete item response in QIDS and high perceived ease of interacting via SMS with service providers supported the feasibility of this method. There was a fair level of reliability between face-to-face and SMS-based screening methods, but no significant difference in preference rating between the two methods. Despite potential implementation barriers (network delay/phone theft), depression screening using SMS may be viable for refugee mental health services in low-resource settings. © The Author(s) 2015.
Ricca, Alessandra; Rufo, Nicole; Ungari, Silvia; Morena, Francesco; Martino, Sabata; Kulik, Wilem; Alberizzi, Valeria; Bolino, Alessandra; Bianchi, Francesca; Del Carro, Ubaldo; Biffi, Alessandra; Gritti, Angela
Globoid cell leukodystrophy (GLD) is a lysosomal storage disease caused by deficient activity of β-galactocerebrosidase (GALC). The infantile forms manifest with rapid and progressive central and peripheral demyelination, which represent a major hurdle for any treatment approach. We demonstrate here that neonatal lentiviral vector-mediated intracerebral gene therapy (IC GT) or transplantation of GALC-overexpressing neural stem cells (NSC) synergize with bone marrow transplant (BMT) providing dramatic extension of lifespan and global clinical–pathological rescue in a relevant GLD murine model. We show that timely and long-lasting delivery of functional GALC in affected tissues ensured by the exclusive complementary mode of action of the treatments underlies the outstanding benefit. In particular, the contribution of neural stem cell transplantation and IC GT during the early asymptomatic stage of the disease is instrumental to enhance long-term advantage upon BMT. We clarify the input of central nervous system, peripheral nervous system and periphery to the disease, and the relative contribution of treatments to the final therapeutic outcome, with important implications for treatment strategies to be tried in human patients. This study gives proof-of-concept of efficacy, tolerability and clinical relevance of the combined gene/cell therapies proposed here, which may constitute a feasible and effective therapeutic opportunity for children affected by GLD. PMID:25749991
Abu-Saad Huijer, Huda; Abboud, Sarah; Doumit, Myrna
Cancer patients experience a great number of distressing physical and psychological symptoms. In Lebanon, there are no available data on symptom prevalence and symptom management in adults with cancer. The aim of this study was to determine the prevalence of symptoms and the effectiveness of treatment received as reported by patients. The study used a cross-sectional, descriptive survey design. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Memorial Symptom Assessment Scale were translated to Arabic and used; data were collected from adult Lebanese cancer patients at the American University of Beirut Medical Center. A total of 200 cancer patients participated in the study; the majority were female with breast cancer and mean age was 54 years. The cognitive functioning domain of the EORTC QLQ-C30 scale was found to have the highest score and social functioning the lowest. The most prevalent symptom was lack of energy. Nausea and pain were the symptoms most treated. Males reported better quality of life (QoL), physical functioning, and role functioning than females; females reported more fatigue, pain, and appetite loss than males. Higher physical and psychological symptoms were correlated with lower health status, QoL, and functioning. Although this sample reported a fair QoL and social functioning, many symptoms were highly prevalent and inadequately treated. Symptoms were found to negatively affect QoL and functioning. Based on these results, providing adequate symptom management and social support to Lebanese cancer patients is highly recommended. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Mancini, Flavia; Nash, Thomas; Iannetti, Gian Domenico; Haggard, Patrick
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.
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.
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...
... 46 Shipping 5 2010-10-01 2010-10-01 false Alternate pressure relief settings. 154.802 Section 154... Equipment Cargo Vent Systems § 154.802 Alternate pressure relief settings. Cargo tanks with more than one relief valve setting must have one of the following arrangements: (a) Relief valves that: (1) Are set and...
Navratilova, Edita; Porreca, Frank
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.
Henneberg, S W; Hole, P; Haas, Inge Madsen De
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...... 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...... established as yet, but 50 micrograms/kg every 8 h, supplemented with small doses of bupivacaine, provides excellent analgesia in the immediate postoperative period after major abdominal surgery. The side effects are few, but the risk of respiratory depression is always present and observation...
Flook, Nigel W; Moayyedi, Paul; Dent, John; Talley, Nicholas J; Persson, Tore; Karlson, Björn W; Ruth, Magnus
High-quality data regarding the efficacy of acid-suppressive treatment for unexplained chest pain are lacking. The aim of this study was to evaluate the efficacy of esomeprazole in primary-care treatment of patients with unexplained chest pain stratified for frequency of reflux/regurgitation symptoms. Patients with a ≥ 2-week history of unexplained chest pain (unrelated to gastroesophageal reflux) who had at least moderate pain on ≥ 2 of the last 7 days were stratified by heartburn/regurgitation frequency (≤ 1 day/week (stratum 1) vs. ≥ 2 days/week (stratum 2)) and randomized to 4 weeks of double-blind treatment with twice-daily esomeprazole 40 mg or placebo. Chest pain relief during the last 7 days of treatment (≤ 1 day with minimal symptoms assessed daily using a 7-point scale) was analyzed by stratum in keeping with the predetermined analysis plan. Overall, 599 patients (esomeprazole: 297, placebo: 302) were randomized. In stratum 1, more esomeprazole than placebo recipients achieved chest pain relief (38.7% vs. 25.5%; P=0.018); no between-treatment difference was observed in stratum 2 (27.2% vs. 24.2%; P=0.54). However, esomeprazole was superior to placebo in a post-hoc analysis of the whole study population (combined strata; 33.1% vs. 24.9%; P=0.035). A 4-week course of high-dose esomeprazole provided statistically significant relief of unexplained chest pain in primary-care patients who experienced infrequent or no heartburn/regurgitation, but there was no such significant reduction in patients with more frequent reflux symptoms.
Johnson Joy L
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.
Klappa, Susan; Audette, Jennifer; Do, Sandy
This article describes the roles and experiences of rehabilitation therapists involved in disaster relief work (DRW) in Haiti after the 2010 earthquake. The results of a pilot study and phenomenological study are presented. A phenomenological study of rehabilitation providers' experiences in post-disaster relief care is presented along with preliminary pilot study results. The phenomenological study explored the experiences of therapists from a lived experience perspective through the roles they played in DRW. Participants provided disaster relief through direct patient care, adaptive equipment sourcing and allocation, education and training, community outreach and logistic or administrative duties. Barriers and challenges included: (1) emotions: ups and downs; (2) challenges: working at the edge of practice; (3) education: key to success and sustainability; (4) lessons learned: social responsibility is why we go; and (5) difficulty coming home: no one understands. Therapists play a key role in disaster relief situations. Data presented should encourage organizations to include therapists from early planning to implementation of relief services. Further studies are needed to evaluate the impact of rehabilitation interventions in disaster settings. Understanding the roles and experiences of therapists in disaster relief setting is important Certain barriers to providing care in post-disaster settings exist Those participating in disaster response should be well prepared and aware of that they might be asked to do.
Martucci, Katherine T.; Kraft, Robert A.; McHaffie, John G.; Coghill, Robert C.
Anxiety is the cognitive state related to the inability to control emotional responses to perceived threats. Anxiety is inversely related to brain activity associated with the cognitive regulation of emotions. Mindfulness meditation has been found to regulate anxiety. However, the brain mechanisms involved in meditation-related anxiety relief are largely unknown. We employed pulsed arterial spin labeling MRI to compare the effects of distraction in the form of attending to the breath (ATB; before meditation training) to mindfulness meditation (after meditation training) on state anxiety across the same subjects. Fifteen healthy subjects, with no prior meditation experience, participated in 4 d of mindfulness meditation training. ATB did not reduce state anxiety, but state anxiety was significantly reduced in every session that subjects meditated. Meditation-related anxiety relief was associated with activation of the anterior cingulate cortex, ventromedial prefrontal cortex and anterior insula. Meditation-related activation in these regions exhibited a strong relationship to anxiety relief when compared to ATB. During meditation, those who exhibited greater default-related activity (i.e. posterior cingulate cortex) reported greater anxiety, possibly reflecting an inability to control self-referential thoughts. These findings provide evidence that mindfulness meditation attenuates anxiety through mechanisms involved in the regulation of self-referential thought processes. PMID:23615765
Horner, Mark W; Downs, Joni A
Over the last few years, hurricane emergencies have been among the most pervasive major disruptions in the United States, particularly in the south-east region of the country. A key aspect of managing hurricane disasters involves logistical planning to facilitate the distribution and transportation of relief goods to populations in need. This study shows how a variant of the capacitated warehouse location model can be used to manage the flow of goods shipments to people in need. In this application, the model is used with protocols set forth in Florida's Comprehensive Emergency Plan and tested in a smaller city in north Florida. Scenarios explore the effects of alternate goods distribution strategies on the provision of disaster relief. Results show that measures describing people's accessibility to relief goods are affected by the distribution infrastructure used to provide relief, as well as assumptions made regarding the population(s) assumed to be in need of aid.
... 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’ ...
Caltagirone, Carlo; Spoletini, Ilaria; Gianni, Walter; Spalletta, Gianfranco
Elderly patients with cancer are particularly burdened with pain, which has an impact on physical, psychological and cognitive symptoms, and consequently, on the overall quality of life. Here, the existing literature on pain and its consequences in elderly patients with cancer is reviewed, in order to understand the impact of cancer pain and its related symptoms, and the importance of its correct assessment and management, in the geriatric population. From the literature, it emerges that cancer pain has a complex and multidimensional phenomenology in this population, and it is often underestimated and consequently untreated. Furthermore, elderly cancer patients are at higher risk of suffering from pain. Aetiology of cancer pain in elderly patients is still an emergent issue, and immunological findings on the link between pain, cancer and aging may help enlighten the pathophysiological mechanisms underlying pain in elderly cancer patients. Particularly, immune dysfunction may represent a common pathogenic ground of pain and its more common related symptoms (i.e. depression and cognitive decline) in elderly cancer patients. Appropriate pain relief represents a challenge in oncological research, in order to improve patients' and caregivers' quality of life. Copyright 2009 Elsevier Ltd. All rights reserved.
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.
... will result in the dismissal of the Department's appeal. (e) The Department may, by notice to the... conditional restoration of the employee to duty status in the position specified in the decision, pending the outcome of the Department appeal. The employee may decline the offer of interim relief. (b) Service under...
Hoeksema, F.W.; Heskamp, M.; Schiphorst, Roelof; Slump, Cornelis H.
In this paper we present node architecture for a personal node in a cognitive ad-hoc disaster relief network. This architecture is motivated from the network system requirements, especially single-hop distance and jamming-resilience requirements. It is shown that the power consumption of current-day
... accordance with the FCIA (7 U.S.C. 1501-1524) or (ii) Application closing date for NAP. (b) Equitable relief will not be granted to participants in instances of: (1) A scheme or device that had the effect or intent of defeating the purposes of a program of insurance, NAP, or any other program administered under...
Eliasen, Marie; Kreiner, Svend; Ebstrup, Jeanette F
A high number of somatic symptoms have been associated with poor health status and increased health care use. Previous studies focused on number of symptoms without considering the specific symptoms. The aim of the study was to investigate 1) the prevalence of 19 somatic symptoms, 2......) the associations between the symptoms, and 3) the associations between the somatic symptoms, self-perceived health and limitations due to physical health accounting for the co-occurrence of symptoms. Information on 19 somatic symptoms, self-perceived health and limitations due to physical health was achieved from.......9% of the respondents were bothered by one or more of the 19 somatic symptoms. The symptoms were associated in a complex structure. Still, recognisable patterns were identified within organ systems/body parts. When accounting for symptom co-occurrence; dizziness, pain in legs, respiratory distress and tiredness were...
Hawley, Chadwick T.; Hyde, Brian; Carpenter, Tom; Nichols, Steve
A composite signature is a group of signatures that are related in such a way to more completely or further define a target or operational endeavor at a higher fidelity. This paper builds on previous work developing innovative composite signatures associated with civil disasters, including physical, chemical and pattern/behavioral. For the composite signature approach to be successful it requires effective data fusion and visualization. This plays a key role in both preparedness and the response and recovery which are critical to saving lives. Visualization tools enhance the overall understanding of the crisis by pulling together and analyzing the data, and providing a clear and complete analysis of the information to the organizations/agencies dependant on it for a successful operation. An example of this, Freedom Web, is an easy-to-use data visualization and collaboration solution for use in homeland security, emergency preparedness, situational awareness, and event management. The solution provides a nationwide common operating picture for all levels of government through a web based, map interface. The tool was designed to be utilized by non-geospatial experts and is easily tailored to the specific needs of the users. Consisting of standard COTS and open source databases and a web server, users can view, edit, share, and highlight information easily and quickly through a standard internet browser.
pharmaceutical treatment, physical therapy , and/or nutritional supplements to temporarily alleviate their symptoms, with limited effect. The severity of...listed in table 1 for the Acupressure group and Reiki group. A 6-week Acupressure intervention produced fatigue relief and pain alleviation...management in veterans with GWI. The results from the four subjects who have completed the intervention look promising and are indicative of the
agencies and nonprofit organizations to help provide financial education to servicemembers, but limited information on the effectiveness of these...Relief Act DOD has entered into partnerships with many federal agencies and nonprofit organizations to help provide financial education to...servicemembers of their SCRA rights. DOD also has entered into partnerships with many other federal agencies and nonprofit organizations to help provide
U.S. Geological Survey, Department of the Interior — The Bathymetric Shaded Relief of North America map layer shows depth ranges using colors, with relief enhanced by shading. The image was derived from the National...
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...
U.S. Geological Survey, Department of the Interior — The Grayscale Shaded Relief of Hawaii map layer is a 100-meter resolution grayscale shaded relief image of Hawaii, in an Albers Equal-Area Conic projection. Shaded...
U.S. Geological Survey, Department of the Interior — The Grayscale Shaded Relief of Alaska map layer is a 100-meter resolution grayscale shaded relief image of Alaska, in an Albers Equal-Area Conic projection. Shaded...
U.S. Geological Survey, Department of the Interior — The Topographic and Bathymetric Shaded Relief of North America map layer shows depth and elevation ranges using colors, with relief enhanced by shading. The image...
U.S. Geological Survey, Department of the Interior — The Color Shaded Relief of Hawaii map layer is a 100-meter resolution color-sliced elevation image of Hawaii, with relief shading added to accentuate terrain...
U.S. Geological Survey, Department of the Interior — The Color Shaded Relief of Alaska map layer is a 100-meter resolution color-sliced elevation image of Alaska, with relief shading added to accentuate terrain...
Ngai, Shirley Pui-Ching; He, Wanjia; Chow, Jason Ka-Wing; Tsang, Hector Wing-Hong
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
Bruera, E; Neumann, C M
During the past 10 years there have been major changes in the management of the most common symptoms of terminal cancer. Opioid agonists remain the mainstay in the management of cancer pain. Slow-release preparations are currently available for several of these agents. The increased use of opioids has led to the recognition of opioid-induced neurotoxic effects and to the development of effective adjuvant drugs and other strategies to counteract these side effects. A number of drugs are available for the management of symptoms of cachexia, including corticosteroids and progestational drugs. Prokinetic drugs, either alone or in combination with other agents such as corticosteroids, are highly effective in the treatment of chronic nausea. For patients with asthenia, it should first be determined whether there are any reversible causes; if not, corticosteroids and psychostimulants may diminish the symptoms. Haloperidol, other neuroleptics and benzodiazepines may be required to manage hyperactive delirium. Oxygen and opioids are effective in treating dyspnea, whereas there is limited evidence that benzodiazepines provide any relief of this symptom. More research on the assessment and management of these devastating clinical symptoms of cancer is badly needed. PMID:9676549
Dalinda Isabel Sánchez-Vidaña
Full Text Available 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.
Whipple, Kelin X.
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.
Eccles, Ronald; Voelker, Michael
The study investigated the efficacy and safety of a combination therapy of 1,000 mg aspirin (ASA) and 60 mg pseudoephedrine (PSE) on the symptoms of pain (combined score for headache and sore throat) and nasal congestion in 833 patients with acute upper respiratory tract viral infection (URTI), over 4 hours after a single dose in the clinic and over 3 days with multiple doses at home. The study demonstrated that over 4 hours in the clinic the combination ASA plus PSE was superior to PSE or placebo for relief of pain symptoms measured subjectively with pain scores, and was superior to ASA or placebo for relief of nasal congestion as measured objectively with rhinomanometry and subjectively with congestion scores. After 3 days of treatment, ASA plus PSE was superior to PSE but not to placebo or ASA for global pain assessments, and ASA plus PSE was superior to ASA and placebo but not to PSE for congestion assessments. No unexpected adverse events occurred and no serious adverse events were attributed to study medicines. This study demonstrates that a combination therapy of ASA plus PSE provides safe and effective relief of both common cold pain related symptoms and nasal congestion. PMID:26097788
Hammes, Amber E; Wahner-Roedler, Dietlind L; Bauer, Brent A
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.
Deng, Gary; Cassileth, Barrie R; Yeung, K Simon
Relief of cancer-related symptoms is essential in the supportive and palliative care of cancer patients. Complementary therapies such as acupuncture, mind-body techniques, and massage therapy can help when conventional treatment does not bring satisfactory relief or causes undesirable side effects. Controlled clinical trials show that acupuncture and hypnotherapy can reduce pain and nausea. Meditation, relaxation therapy, music therapy, and massage mitigate anxiety and distress. Pilot studies suggest that complementary therapies may treat xerostomia, hot flashes, and fatigue. Botanicals or dietary supplements are popular but often problematic. Concurrent use of herbal products with mainstream medical treatment should be discouraged.
Lin, Ching-Hua; Yen, Yung-Chieh; Chen, Ming-Chao; Chen, Cheng-Chung
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.
Bruno P. Guiard
Full Text Available Over 75% of depressed patients suffer from painful symptoms predicting a greater severity and a less favorable outcome of depression. Imaging, anatomical and functional studies have demonstrated the existence of common brain structures, neuronal pathways and neurotransmitters in depression and pain. In particular, the ascending serotonergic and noradrenergic pathways originating from the raphe nuclei and the locus coeruleus; respectively, send projections to the limbic system. Such pathways control many of the psychological functions that are disturbed in depression and in the perception of pain. On the other hand, the descending pathways, from monoaminergic nuclei to the spinal cord, are specifically implicated in the inhibition of nociception providing rationale for the use of serotonin (5-HT and/or norepinephrine (NE reuptake inhibitors (SSRIs, NRIs, SNRIs, in the relief of pain. Compelling evidence suggests that dopamine (DA is also involved in the pathophysiology and treatment of depression. Indeed, recent insights have demonstrated a central role for DA in analgesia through an action at both the spinal and suprasinal levels including brain regions such as the periaqueductal grey (PAG, the thalamus, the basal ganglia and the limbic system. In this context, dopaminergic antidepressants (i.e., containing dopaminergic activity, such as bupropion, nomifensine and more recently triple reuptake inhibitors (TRIs, might represent new promising therapeutic tools in the treatment of painful symptoms with depression. Nevertheless, whether the addition of the dopaminergic component produces more robust effects than single- or dual-acting agents, has yet to be demonstrated. This article reviews the main pathways regulating pain transmission in relation with the monoaminergic systems. It then focuses on the current knowledge regarding the in vivo pharmacological properties and mechanism of action of monoaminergic antidepressants including SSRIs, NRIs
Du, Huarui; Ma, Rui; Wang, Xiaoying; Zhang, Jue; Fang, Jing
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.
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.
The aim of this paper is to find out, whether the modern music has a relaxing effect on today’s youngsters. The theoretical part will present the period of adolescence and especially all the challenges they face during this time. These challenges can represent a high amount of stress in a youngster’s life, and one of the ways of stress relief is music. In addition to having a relaxing effect, music also enables them to shape their identity and to integrate into groups of people that share the...
Olsen, Mette Frahm; Bjerre, Eik; Damkjær Hansen, Maria
relief. Subgroup analyses showed that the definition of improved patients (one or several categories improvement or meaningful change) and the design of studies (single or multiple measurements) also influenced MCID values. CONCLUSIONS: The MCID in acute pain varied greatly between studies...... and was influenced by baseline pain, definitions of improved patients and study design. MCID is context-specific and potentially misguiding if determined, applied or interpreted inappropriately. Explicit and conscientious reflections on the choice of a reference value are required when using MCID to classify...
Engel, H O
To review the essential principles involved in rescue missions for natural and man-made disasters. A description of the relief of a concentration camp in 1945 as an example of the logistics required in any major disaster or rescue. The arrival of trained Army rescue teams on the first day and dealing systematically with priorities in salvage, treatment and nursing saved many lives, even of desperately ill patients. A centralised administration and organisation of supplies is the first priority. Suitable intravenous and very light nutrients, and the prevention and combating of infections are more urgent than the provision of shelter and clothing.
Laraby, Patrick R; Bourdeaux, Margaret; Casscells, S Ward; Smith, David J; Lawry, Lynn
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.
Alma Lucía Romero-Barrutieta
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.
Liu-Zeng, J.; Tapponnier, P.; Gaudemer, Y.; Ding, L.
elevation produced the low-relief surface of the high plateau. In southeast Tibet, headward retreat of external drainages brought back "in" the global ocean base level, first disrupting then interrupting the relief-reduction process. It produced a transitional topography by dissecting the "old" remnant plateau surface, which introduced younger and steeper incision of this hitherto preserved high base level. This provides a unifying mechanism for the formation of the low-relief plateau interior, and for the origin of the high-elevation, low-relief relict surface in southeastern Tibet. Our analysis brings forth the importance of surface processes, in particular drainage efficiency, in shaping plateau morphology and landscape relief. Such key processes appear to have been mostly ignored in numerical models of plateau deformation. Our results also cast doubt on and provide a more realistic alternative to the fashionable contention that a continuous preuplift, low-relief surface first formed at low elevation, extending all the way to the South China Sea shore, before being warped upward in the late Miocene-Pliocene by lower crustal channel flow.
Weiss, Martin A
.... 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...
Cella, David; Yount, Susan; Brucker, Penny S; Du, Hongyan; Bukowski, Ronald; Vogelzang, Nicholas; Bro, William P
Using patient and expert provider input, we previously developed a 15-item index of the most important symptoms and concerns of people being treated for advanced kidney cancer, the Functional Assessment of Cancer Therapy - Kidney Symptom Index (FKSI). These 15 concerns are a mixture of disease-related symptoms and treatment-related side effects. As a result, it may be difficult to assign an informative label to the score defined as the summation of these 15 most important concerns. Because one of the primary goals of treating advanced kidney cancer is the relief of disease-related symptoms, we set out to differentiate from the list of 15 symptoms those that are predominantly attributable to kidney cancer itself rather than its treatment, and to evaluate this abbreviated FKSI - Disease-Related Symptoms (FKSI-DRS). Survey results from 18 experienced clinical experts were summarized to separate DRS from other concerns more arguably attributable to treatment side effects. This nine-item FKSI-DRS was then validated on a sample of 141 people with kidney cancer. The FKSI-DRS is reliable (internal consistency range = 0.75-0.78; test-retest reliability intraclass correlation = 0.85), and valid, separating groups by performance status and the patient's own global rating of change. The likely minimally important difference in the FKSI-DRS is in the range of 2-3 points. The FKSI-DRS is a reliable, valid, and responsive brief index of the most important symptoms associated with advanced kidney cancer.
The relief produced in the surface of dental amalgam as a result of polishing was studied by scanning electron microscopy in traditional low-copper amalgams, high-copper dispersant-type amalgams, and high-copper single-composition amalgams. Specimens were polished metallographically in two planes at right angles to each other. Micrographs were taken of the edge between the planes; the profile of one of the polished planes could be traced and the microstructural phases recognized. The traced lines were analyzed by a computer that calculated the mean levels of the phases and the mean deviation (roughness) of all the phases along the scanned distance. Recesses were seen in the surface of the gamma-2 phase. The gamma-1 phase attained the highest level, protruding above the phases of the alloy particles. The results indicate that well-polished amalgam surfaces have a structural relief that contributes to the roughness and limits the degree of smoothness that can be obtained in an amalgam surface.
Bytzer, P; van Zanten, S Veldhuyzen; Mattsson, H
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....
Ocean Tsunami Operations off the Coast of Sumatra ...................... 8 Table 5. Cost for Ships and Their Platforms for 2010 Haiti Earthquake ...9 Table 6. USN-Reported Incremental Costs Associated With the 2010 Haiti Earthquake Operations...Indian Ocean tsunami, 2010 earthquake in Haiti , and 2011 Tōhoku earthquake are just three instances when the USN has been a significant relief provider
Pang, Peter S.; Konstam, Marvin A.; Krasa, Holly B.; Swedberg, Karl; Zannad, Faiez; Blair, John E.A.; Zimmer, Christopher; Teerlink, John R.; Maggioni, Aldo P.; Burnett, John C.; Grinfeld, Liliana; Ouyang, John; Udelson, James E.; Gheorghiade, Mihai
Aims To describe the effects of tolvaptan therapy on dyspnoea relief based on timing of delivery, influence of concomitant therapies, and baseline patient and clinical characteristics. Also, the influence of clinical trial design on dyspnoea measurement, from the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trials. Methods and results Post hoc analysis was performed based on the endpoint of patient-assessed dyspnoea. Changes from baseline at inpatient Day 1 were compared between treatment groups by the van Elteren test. Pre-determined subgroup analyses were also performed. Tolvaptan's effects are greatest within 12 h after first dose with an additional, but modest dyspnoea improvement benefit irrespective of time after admission. Overall, patients continue to report dyspnoea improvement up to 60 h after admission. The window of enrolment, up to 48 h after admission, combined with measurement on ‘Day 1’ led to a wide range over when dyspnoea was assessed. Conclusion Post hoc analysis suggests that tolvaptan modestly improves dyspnoea compared with standard therapy alone, regardless if given early or relatively late after hospitalization, and also across major pre-specified subgroups, despite ongoing background therapy aimed at relieving signs and symptoms. Significant variability around when dyspnoea was assessed, in addition to the persistence of dyspnoea despite ongoing background therapy, may influence how future clinical trials assess dyspnoea in acute heart failure syndromes. PMID:19561338
Hutmacher, E.S.; Nesmith, B.J.; Brukiewa, J.B.
A literature survey and analysis project has been performed to determine if recent (since mid-1975) data has been reported which could influence the current approach to predicting PWR relief valve capacity under ATWS conditions. This study was conducted by the Energy Technology Engineering Center for NRC. Results indicate that the current relief valve capacity model tends to predict less capacity than actually obtains; however, no experimental verification at PWR ATWS conditions was found. Other project objectives were to establish the availability of methods for evaluating reaction forces and back pressure effects on relief valve capacity, and to determine if facilities exist which are capable of testing PWR relief valves at ATWS conditions.
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...
.... 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...
Satija, Aanchal; Bhatnagar, Sushma
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.
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.
Kline, Grace A
Inadequate control of acute pain is a well-recognized and serious problem. Distraction is one of the methods used in adjunct with medications to relieve pain. Nature-related sensory stimuli are frequently used for both distraction and relaxation. The human response model that focuses on individual adaptation to health conditions is used in this article to guide an analysis of relevant studies. Four studies in clinical settings evaluated the effect of nature (as a visual stimulus) to determine whether it promoted relief of acute pain. All these studies also used audio stimuli (nature sounds or music). Distracting visual and auditory stimuli used together provided stronger evidence of pain reduction than when either type of stimulus was used alone.
Good, M; Picot, B L; Salem, S G; Chin, C C; Picot, S F; Lane, D
Nurses use music therapeutically but often assume that all patients will equally appreciate the same type of music. Cultural differences in music preferences are compared across five pain studies. Music preferences for pain relief are described as the most frequently chosen type of music for each culture. Findings indicate that in four studies, musical choices were related to cultural background (p = .002 to .049). Although the majority in each group chose among the other types of music, Caucasians most frequently chose orchestra music, African Americans chose jazz, and Taiwanese chose harp music. For culturally congruent care, nurses should become aware of cultural differences in music preference and provide culturally specific selections among other music expected to have a therapeutic effect.
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.
Full Text Available No abstract available. Article truncated at 150 words. On May 30, Eric Shinseki, the Secretary for Veterans Affairs (VA, resigned under pressure amidst a growing scandal regarding falsification of patient wait times at nearly 40 VA medical centers. Before leaving office Shinseki fired Sharon Helman, the former hospital director at the Phoenix VA, where the story first broke, along with her deputy and another unnamed administrator. In addition, Susan Bowers, director of VA Veterans Integrated Service Network (VISN 18 and Helman’s boss, resigned. Robert Petzel, undersecretary for the Veterans Health Administration (VHA, head of the VA hospitals and clinics, had resigned earlier. You could hear the sigh of relief from the VA administrators. With their bosses resigning left and right, the VA leadership in shambles and the reputation of the VA soiled for many years to come, why are the VA administrators relieved? The simple answer is that nothing has really changed. There for a moment it looked ...
Liu, Chaoke; Ren, Jianxi; Zhang, Kun; Chen, Shaojie
After entering deep mining, the roadway is in a high stress state, the deformation of surrounding rock becomes larger, and the roadway floor is particularly significant under unsupported state, which brings great difficulty to the safe production and support of the coal mine. Pressure relief method can change the stress field of surrounding rocks so that the surrounding rock can be in stress-reducing area. The present paper studied the deformation law of the roadway and the changes in the stress state and plastic zone of the surrounding rocks around the roadway before and after the excavation of pressure relief groove on the bottom floor of the high-stress roadway by using FLAC under the engineering background of one mine in Binchang, analyzed the influence of different groove depths and widths on the floor heave, convergence on both sides and roof subsidence. The simulation results show that: after the roadway floor was grooved in the high stress roadway, a larger stress-relaxed area will be formed near the roadway floor, the stress will be transferred to the deep roadway floor, and the pressure relief groove plays a better control effect on the deformation of the high-stress roadway. With the increase of the width and depth of the pressure relief groove, the convergence of the top and bottom of the roadway will be decreased accordingly, but the effect is not significant, while its influence on the convergence on both sides is relatively significant. After applying the simulation results to the engineering practice, the practice shows that: the combined support of anchor rod, anchor rope plus pressure relief groove can control the deformation of the roadway well and the conclusion obtained can provide some reference values for the study and design of the grooving pressure relief control technology.
Friedman, Deborah; Linnemann, Rachel W; Altstein, Lily L; Islam, Suhayla; Bach, Kieu-Tram; Lamb, Chelsea; Volpe, John; Doolittle, Caitlin; St John, Anita; O'Malley, Patricia J; Sawicki, Gregory S; Georgiopoulos, Anna M; Yonker, Lael M; Moskowitz, Samuel M
Current palliative care tools do not address distressing chronic symptoms that are most relevant to cystic fibrosis. A CF-specific structured assessment based on a primary palliative care framework was administered to 41 adolescents and adults with CF. Descriptive and correlational analyses were conducted. Patients reported numerous physical and psychological symptoms (mean of 10 per patient), with psychological symptoms rated as more distressing. Anxiety (34%) and depression (44%) were prevalent and correlated with distress attributable to physical symptoms and difficulty with CF self-management, but did not correlate with disease severity. Individuals with CF, regardless of disease severity, face challenges managing symptom burden. Frequently reported symptoms are not consistently associated with distress, suggesting the importance of individualized evaluation. The CF-CARES (Coping, goal Assessment, and Relief from Evolving CF Symptoms) primary palliative care assessment model provides a framework for patients experiencing chronic symptoms to explore interventional options with their clinicians. Copyright © 2017 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
To provide a brief overview of the diagnosis, epidemiology, etiology and clinical management of dentin hypersensitivity, to discuss technical approaches to relieve sensitivity, with special emphasis on dentin tubule occlusion and the clinical evidence for efficacy of desensitizing toothpastes based upon this approach, and to summarize the science behind a new dentifrice technology, based upon arginine and calcium carbonate, and the clinical evidence which proves that it delivers both instant and lasting relief of dentin hypersensitivity. Clinical studies have shown that a new toothpaste, containing arginine and calcium carbonate (known as Pro-Argin technology) with 1450 ppm fluoride, offers clinically proven instant and lasting relief of dentin hypersensitivity. Three 8-week clinical studies have shown that this new toothpaste provides statistically significantly superior efficacy in reducing sensitivity to market leading desensitizing toothpastes containing 2% potassium ion. Importantly, three further clinical studies have shown that a single direct topical application of toothpaste to sensitive teeth, using a fingertip or cotton swab followed by 1 minute of massage, resulted in instant relief of dentin hypersensitivity and that the relief was maintained with subsequent twice-daily brushing. Mechanism of action studies have shown that this technology physically seals dentin tubules with a plug that contains arginine, calcium carbonate and phosphate. This plug, which is resistant to normal pulpal pressures and to acid challenge, effectively reduces dentin fluid flow and thereby relieves sensitivity. A new whitening variant of this desensitizing toothpaste, containing the Pro-Argin technology, fluoride and a high cleaning calcium carbonate system, has now been clinically and scientifically validated. This toothpaste works by the same mechanism of action as its non-whitening counterpart and is clinically proven to provide both instant and lasting relief of
Cornu, Jean-Nicolas; Grise, Philippe
Lower urinary tract symptoms (LUTS) in men are highly prevalent, and include both storage and voiding symptoms in many cases. The effect of benign prostatic obstruction (BPO) relief on storage symptoms remains unclear. The present review summarizes data about the relation between overactive bladder (OAB), voiding symptoms, and urodynamic characteristics in men with LUTS. Pathomechanisms of OAB in a context of BPO are reviewed. Rates of persistent bladder dysfunction after BPO relief are described along with predictive factors of persisting OAB. OAB is a common clinical feature in a population of male LUTS, often concomitant with voiding symptoms. Although detrusor overactivity is found in some patients with OAB and BPO, there is no absolute correspondence between clinical symptoms and urodynamic findings. In the context of BPO, OAB pathophysiology implicates nitric oxide pathway, bladder ischemia, ageing of the urinary tract, and calcium-activated potassium channels activity. BPO relief can be followed in the medium term by persistence of OAB symptoms, and preoperative detrusor overactivity has been identified as the main predictive factor. However, preoperative urodynamics remain only indicated in specific cases, when it could directly influence clinical decision-making. Antimuscarinics may be the treatment of choice for persistent symptoms after surgery, but there is no firm recommendation in this clinical setting.
... Organization PATH's Rotavirus Vaccine Program American Academy of Pediatrics ... symptoms to appear. Children who get infected may have severe watery diarrhea, often with vomiting, fever, and abdominal pain. Vomiting ...
When the NDCC later shifted to a cluster approach to disaster management, the AFP was assigned .... own relief items and supplies flown in from Tacloban Airport, and distributed them in St Bernard (Pagasartonga ... Tacloban Airport, where most relief goods and supplies from Manila and overseas were flown in using the ...
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What relief will MMS grant? 203.53 Section 203...-Life Leases § 203.53 What relief will MMS grant? (a) If we approve your application and you meet certain conditions, we will reduce the pre-application effective royalty rate by one-half on production up...
The economic impact of the Troubled Assets Relief Programme (TARP) in the USA: an assessment of the level to which an optimal allocation of funds occurred. ... within this model: whether the Troubled Assets Relief Programme (TARP)1 bailout will give rise to greater economic effi ciencies and productivity, which would ...
Oosterhof, Liesbeth; Heuvelman, A.; Peters, O.
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
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Area code relief. 52.19 Section 52.19... Administration § 52.19 Area code relief. (a) State commissions may resolve matters involving the introduction of new area codes within their states. Such matters may include, but are not limited to: Directing...
Most of the women gained knowledge regarding pain relief from past experiences or from friends and relatives. Even though the few women who received information about what to expect during labour found the information useful, most expressed little confidence in labour pain relief. South African Family Practice Vol.
Background: New drugs and new modalities for intraoperative pain relief is the current trend in pain management. Aim: The study aims at examining the current trend in intraoperative pain relief in patients of pediatric age at the. University of Benin Teaching Hospital (UBTH) and its implications for a developing economy ...
Baraka, Jean-Claude Munyaka
Full Text Available This paper reviews some challenges faced by humanitarian logistics and supply chain organisations in the transportation of resources, evacuees, and emergency supplies for disaster relief operations in the SADC region. To identify the appropriate transportation to assist in the region, three models were reviewed and proposed: A typical transportation problem, a genetic algorithm based on a spanning tree, and a linear optimisation using Excel Solver. Reviewing the literature revealed that both man-made and natural disasters have caused over ninety thousand fatalities and affected millions just over the past three decades. A further review shows that most disaster deaths are the result of poor infrastructure, especially in populated areas. This presents a challenge to relief organisations in their efforts to provide on-time relief to victims in pre- and post-disaster periods. Although each proposed transportation problem has particular complexities, each of them could assist the region to decrease the relief operation response time and cost. This paper provides the reader with a greater understanding of the challenges faced by the humanitarian supply chain in the SADC region. This paper proposes a conceptual model based on an actual empirical case.
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...
Esomeprazole 40 mg provides more effective intragastric acid control than lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg and rabeprazole 20 mg in patients with gastro-oesophageal reflux symptoms.
Röhss, Kerstin; Lind, Tore; Wilder-Smith, Clive
To compare the effect of esomeprazole 40 mg with lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg and rabeprazole 20 mg on intragastric pH during single and repeated dosing in four separate studies in patients with symptoms of gastro-oesophageal reflux disorder (GERD). In four randomised crossover studies, patients with symptoms of GERD received once-daily treatment with esomeprazole 40 mg or lansoprazole 30 mg (study A), omeprazole 20 mg (study B), pantoprazole 40 mg (study C) and rabeprazole 20 mg (study D) for 5 days. Continuous 24-h intragastric pH recording was performed on days 1 (except study B) and 5. Percentage of time over 24 h with intragastric pH greater than 4, 24-h median pH and the proportion of patients with pH greater than 4 for greater than or equal to 12 h and 16 h during the 24-h recording periods were investigated. In all four studies, esomeprazole 40 mg OD maintained intragastric pH greater than 4 for a significantly higher mean percentage of the 24-h period compared with all other proton pump inhibitors (PPIs) on days 1 (esomeprazole 40.6% versus lansoprazole 33.4%, P=0.0182; esomeprazole 50.3% versus pantoprazole 29.1%, Pomeprazole 43.7%, Pomeprazole 20 mg, pantoprazole 40 mg and rabeprazole 20 mg in patients with symptoms of GERD.
Suter, Valerie G A; Sjölund, Sophia; Bornstein, Michael M
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, CO2 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 (CO2 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).
Emelonye, AU; Pitkäaho, T; Aregbesola, A; Vehviläinen-Julkunen, K
Background: Childbirth is a period characterized by severe pain, and most women desire to ameliorate their pain among other things by having their spouses present and involved in the birthing process. In developing countries like Nigeria, spousal involvement is still an emerging concept in childbirth. Aim: To investigate and provide an insight into spousal perceptions toward their participation and role in labor pain relief during childbirth in Nigeria. Subjects and Methods: A cross-sectional descriptive study of 142 spouses was conducted in the maternity units of four hospitals in Abuja, Nigeria, from June to December 2014. Data were collected through a pretested interview-administered 24 item questionnaire, the Abuja Instrument for Parturient Spouse. The data were analyzed statistically using Chi-square test for association between the variables and content analysis for open-ended questions. Results: Most (94.4%, 134/142) of the spouses had a positive perception toward labor pain relief. They believed that their presence and activities contributed to labor pain relief and are willing to be present at subsequent births. Conclusion: Findings in this study have revealed a positive trend in spousal perception and involvement during childbirth and pain relief, as contrast to the prevailing assumption that childbirth is an exclusive woman affair. Spousal presence during childbirth can be beneficial not only to the woman but also to the spouse and family. PMID:28540105
Strauss, Ronald P; van Aalst, John A; Fox, Lynn; Stein, Margot; Moses, Michael; Cassell, Cynthia H
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.
Rosendal, Marianne; Hartman, Tim C. Olde; Aamland, Aase
Background: Many patients consult their GP because they experience bodily symptoms. In a substantial proportion of cases, the clinical picture does not meet the existing diagnostic criteria for diseases or disorders. This may be because symptoms are recent and evolving or because symptoms...... 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...... mental disorders, psychological features and demographic data. We discuss how these characteristics may be used to classify symptoms into three groups: self-limiting symptoms, recurrent and persistent symptoms, and symptom disorders. The middle group is especially relevant in primary care...
Mine, Mariko [Nagasaki Univ. (Japan). School of Medicine
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.)
Romeo, Melissa J; Parton, Barbara; Russo, Rachel A; Hays, Lewis S; Conboy, Lisa
Patients enrolled in hospice and palliative care programs experience a vast array of symptoms requiring the expertise of a multidisciplinary team to address. Acupuncture can be an effective addition to a hospice team whose goal is maximum comfort and quality of life (QOL). The objective of this project was to examine the effectiveness of acupuncture to relieve symptoms commonly observed in patients in a hospice program. All over 26 patients participated in the acupuncture trial, receiving a course of weekly treatments that ranged from 1 to 14 weeks. The average number of treatments was five. The Edmonton Symptom Assessment Scale (ESAS) was used to assess the severity of pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and dyspnea. A two-tailed, paired t test was applied to the data to compare symptom scores pre- versus post-acupuncture treatment. Patients enrolled in All Care Hospice's home care program were given the option to receive acupuncture to supplement usual care offered by the hospice team. Treatment was provided by licensed acupuncturists in the patient's place of residence. Seven out of nine symptoms were significantly (P acupuncture, the exceptions being drowsiness and appetite. Although the ESAS scale demonstrated a reduction in symptom severity post-treatment for both drowsiness and appetite, this reduction was not found to be significant. Acupuncture was found to be effective for the reduction and relief of symptoms that commonly affect patient QOL. Acupuncture effectively reduced symptoms of pain, tiredness, nausea, depression, anxiety, and shortness of breath, and enhanced feelings of well-being. More research is required to assess the long-term benefits and symptom reduction of acupuncture in a palliative care setting. Copyright © 2015 Elsevier Inc. All rights reserved.
Outcomes of vaginal hysterectomy for uterovaginal prolapse: a population-based, retrospective, cross-sectional study of patient perceptions of results including sexual activity, urinary symptoms, and provided care
Full Text Available Abstract Background Vaginal hysterectomy is often used to correct uterovaginal prolapse, however, there is little information regarding outcomes after surgery in routine clinical practice. The objective of this study was to investigate complications, sexual activity, urinary symptoms, and satisfaction with health care after vaginal hysterectomy due to prolapse. Methods We analyzed data from the Swedish National Register for Gynecological Surgery (SNRGS from January 1997 to August 2005. Women participating in the SNRGS were asked to complete surveys at two and six months postoperatively. Of 941 women who underwent vaginal hysterectomy for uterovaginal prolapse, 791 responded to questionnaires at two months and 682 at six months. Complications during surgery and hospital stay were investigated. The two-month questionnaire investigated complications after discharge, and patients' satisfaction with their health care. Sexual activity and urinary symptoms were reported and compared in preoperative and six-month postoperative questionnaires. Results Almost 60% of women reported normal activity of daily life (ADL within one week of surgery, irrespective of their age. Severe complications occurred in 3% and were mainly intra-abdominal bleeding and vaginal vault hematomas. Six months postoperative, sexual activity had increased for 20% (p = 0.006 of women and urinary urgency was reduced for 50% (p = 0.001; however, 14% (n = 76 of women developed urinary incontinence, 76% (n = 58 of whom reported urinary stress incontinence. Patients were satisfied with the postoperative result in 93% of cases and 94% recommended the surgery. Conclusion Vaginal hysterectomy is a patient-evaluated efficient treatment for uterovaginal prolapse with swift recovery and a low rate of complication. Sexual activity and symptoms of urinary urgency were improved. However, 14% developed incontinence, mainly urinary stress incontinence (11%. Therefore efforts to disclose latent
Damsgaard, Janne B; Jørgensen, Lene B; Norlyk, Annelise; Birkelund, Regner
During their decision-making process patients perceive surgery as a voluntary yet necessary choice. Surgery initiates hope for a life with less pain but also creates a feeling of existential insecurity in terms of fear, isolation and uncertainty. The aim of this study was to explore how patients experience their situation from the point of making the decision to undergo spinal fusion surgery to living their everyday life after surgery. A phenomenological-hermeneutic study design was applied based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through observations and semi-structured interviews. The recommendation and decision to undergo spinal fusion surgery felt like a turning point for the patients and brought hope of regaining their normal lives, of being a more resourceful parent, partner, friend and colleague with no or less pain. Thus, deciding to undergo surgery created a brief feeling of relief. However, life with back pain had changed the patients' understanding of themselves. Consequently, some patients postoperatively experienced insecurity and a weakened self-image with difficulties creating meaning in their lives. Being recommended and undergoing spinal fusion surgery initiates hope for a life with less pain and altered life conditions. At the same time, paradoxically, this creates a feeling of existential insecurity in terms of facing the surgery and the future to come. It is, therefore, important to recognise and include the patients' everyday life experiences concerning how they give (or may not give) meaning to their illness, i.e. their understanding of how it is affecting them. These aspects are essential for the patients' definition and re-definition of themselves and thus crucial to draw upon in the relationship and communication between patient and healthcare professional. Copyright © 2016 Elsevier Ltd. All rights reserved.
Persons affected,” is the number of total affected according to the EM- DAT definitions. Total affected is the sum of injured, homeless , and affected... Homeless ” is defined as people needing immediate assistance for shelter. ‘“Affected” is defined as people requiring immediate assistance during a...0 0 Netherlands 1 1 0 0 0 0 Solomon Islands 0 0 0 0 0 0 0 0 0 1 Comoros 0 0 0 0 0 1 0 1 0 0 Australia 0
Crespin, Daniel J; Griffin, Kristen H; Johnson, Jill R; Miller, Cynthia; Finch, Michael D; Rivard, Rachael L; Anseth, Scott; Dusek, Jeffery A
Given the risks of opioid medications, nonpharmacological strategies should be considered for total joint replacement patients. We investigated acupuncture as an adjunct therapy for postsurgical pain management in a total joint replacement program by examining which total hip and knee replacement patients elected to receive acupuncture and the effect of acupuncture on short-term pain. A total joint replacement program using fast-track physiotherapy offered elective postsurgical acupuncture to all patients, at no additional cost, as an adjunct therapy to opioids for pain management. The Joint Replacement Center at Abbott Northwestern Hospital, a 630-bed teaching and specialty hospital in Minneapolis, Minnesota from 2010 to 2012. Our sample included 2,500 admissions of total hip (THR) and total knee replacement (TKR) patients. Self-reported pain was assessed before and after acupuncture using a 0-10 scale and categorized as none/mild (0-4) and moderate/severe pain (5-10). Seventy-five percent of admissions included acupuncture. Women (Odds Ratio: 1.48, 95% Confidence Interval (CI): 1.22, 1.81) had higher odds of receiving acupuncture compared to men, and nonwhite patients (Odds Ratio: 0.55, 95% CI: 0.39, 0.78) had lower odds of receiving acupuncture compared to white patients. Average short-term pain reduction was 1.91 points (95% CI: 1.83, 1.99), a 45% reduction from the mean prepain score. Forty-one percent of patients reported moderate/severe pain prior to receiving acupuncture, while only 15% indicated moderate/severe pain after acupuncture. Acupuncture may be a viable adjunct to pharmacological approaches for pain management after THR or TKR. Wiley Periodicals, Inc.
Koenig, J; Sevinc, S; Frohme, C; Heers, H; Hofmann, R; Hegele, A
To measure the effects of real-time visualisation during urethrocystoscopy on pain in patients who underwent ambulatory urethrocystoscopy. An observational study was designed. From June 2012 to June 2013 patients who had ambulatory urethrocystoscopy participated in the study. In order to measure pain perception we used a numeric rating scale (NRS) 0 to 10. Additional data was collected including gender, reason for intervention, use of a rigid or a flexible instrument and whether the patient had had urethrocystoscopy before. 185 patients were evaluated. 125 patients preferred to watch their urethrocystoscopy on a real-time video screen, 60 patients did not. There was no statistically relevant difference in pain perception between those patients who watched their urethrocystoscopy on a real-time video screen and those who did not (p = 0.063). However, men who were allowed to watch their flexible urethrocystoscopy experienced significantly less pain, than those who did not (p = 0.007). No such effects could be measured for rigid urethrocystoscopy (p = 0.317). Furthermore, women experienced significantly higher levels of pain during the urethrocystoscopy than men (p = 0.032). Visualisation during urethrocystoscopy procedures in general does not significantly decrease pain in patients. Nevertheless, men who undergo flexible urethrocystoscopy should be offered to watch their procedure in real-time on a video screen. To make urethrocystoscopy less painful for both genders, especially for women, should be subject to further research.
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
Gill, Glenda A
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...
U.S. Geological Survey, Department of the Interior — The grayscale North America shaded relief data were derived from the GTOPO30 elevation data. GTOPO30 is a global digital elevation model (DEM) with a horizontal grid...
U.S. Geological Survey, Department of the Interior — The grayscale Hawaii shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of Hawaii at a resolution of 200 meters. The...
... percent of the tank test pressure. When relief devices of the fusible plug type are used, the required... exceeding that specified in § 179.301. (d) Fusible plugs shall function at a temperature not exceeding 175...
U.S. Geological Survey, Department of the Interior — The Satellite View of Hawaii, with Shaded Relief map layer is a 200- meter-resolution simulated-natural-color image of Hawaii. Vegetation is generally green, with...
U.S. Geological Survey, Department of the Interior — The color Alaska shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of Alaska at a resolution of 200 meters. The NED is...
U.S. Geological Survey, Department of the Interior — The color Hawaii shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of Hawaii at a resolution of 200 meters. The NED is...
U.S. Geological Survey, Department of the Interior — The Satellite View of Alaska, with Shaded Relief map layer is a 200- meter-resolution simulated-natural-color image of Alaska. Vegetation is generally green, with...
This project focuses on the development of a natural disaster response planning model that determines where to locate points of distribution for relief supplies after a disaster occurs. Advance planning (selecting locations for points of distribution...
Yoshimura, Mitsunobu; Kurokawa, Etsuko; Noda, Takayuki; Hineno, Koji; Tanaka, Yasuo; Kawai, Yuji; Dillbeck, Michael C
This study examined changes in self-reported stress symptoms after instruction in the Transcendental Meditation(®) technique among 171 residents of two cities (Sendai and Ishinomaki) directly affected by the 2011 Japan earthquake and tsunami disaster compared with 326 non-disaster Tokyo participants previously tested before and after learning the technique and a no-treatment control group (n = 68). The participants completed a rating checklist of mental and physical symptoms. Disaster area participants who learned the Transcendental Meditation(®) technique in contrast to controls showed a significant drop in total symptom score from pre-test to post-test (effect size = -1.09). Results were comparable for an ordinal measure of symptom intensity. The findings suggest the potential value of this procedure for relief from disaster trauma.
Wink, Logan K.; Plawecki, Martin H.; Erickson, Craig A.; Stigler, Kimberly A.; McDougle, Christopher J.
Importance of the Field Autism spectrum disorders, or pervasive developmental disorders (PDDs), are neurodevelopmental disorders defined by qualitative impairment in social interaction, impaired communication, and stereotyped patterns of behavior. The most common forms of PDD are autstic disorder (autism), Asperger's disorder, and pervasive developmental disorder not otherwise specified (PDD NOS). Recent surveillance studies reveal an increase in the prevalence of autism and related PDDs. The use of pharmacologic agents in the treatment of these disorders can reduce the impact of interfering symptoms, providing relief for affected individuals and their families. Areas Covered in this Review This review examines results from neurobiologic research in an attempt to both elucidate the pathophysiology of autism and guide the development of pharmacologic agents for the treatment of associated symptoms. The safety and efficacy data of drugs currently in clinical use for the treatment of these symptoms, as well as pharmaceuticals currently under development, are discussed. What the Reader will Gain This comprehensive review will deepen the reader's current understanding of the research guiding the pharmacologic treatment of symptoms associated with autism and related PDDs. Areas of focus for future research are also discussed. The need for large-scale investigation of some commonly used pharmacologic agents, in addition to the development of drugs with improved efficacy and safety profiles, is made evident. Take Home Message Despite progress in the development of pharmacologic treatments for a number of interfering symptom domains associated with autism and other PDDs, a great deal of work remains. PMID:20470188
Paul, Ian M; Beiler, Jessica S; King, Tonya S; Clapp, Edelveis R; Vallati, Julie; Berlin, Cheston M
To determine if a single application of a vapor rub (VR) or petrolatum is superior to no treatment for nocturnal cough, congestion, and sleep difficulty caused by upper respiratory tract infection. Surveys were administered to parents on 2 consecutive days--on the day of presentation when no medication had been given the previous evening, and the next day when VR ointment, petrolatum ointment, or no treatment had been applied to their child's chest and neck before bedtime according to a partially double-blinded randomization scheme. There were 138 children aged 2 to 11 years who completed the trial. Within each study group, symptoms were improved on the second night. Between treatment groups, significant differences in improvement were detected for outcomes related to cough, congestion, and sleep difficulty; VR consistently scored the best, and no treatment scored the worst. Pairwise comparisons demonstrated the superiority of VR over no treatment for all outcomes except rhinorrhea and over petrolatum for cough severity, child and parent sleep difficulty, and combined symptom score. Petrolatum was not significantly better than no treatment for any outcome. Irritant adverse effects were more common among VR-treated participants. In a comparison of VR, petrolatum, and no treatment, parents rated VR most favorably for symptomatic relief of their child's nocturnal cough, congestion, and sleep difficulty caused by upper respiratory tract infection. Despite mild irritant adverse effects, VR provided symptomatic relief for children and allowed them and their parents to have a more restful night than those in the other study groups.
Digital elevation models (DEMs), such as those produced by the Shuttle Radar Topography Mission (SRTM), allow user-controlled visualization of the Earth's landforms that is not possible using satellite imagery alone. This three-view comparison shows Los Angeles, Calif., and vicinity, with a Landsat image (only) on the left, a shaded relief rendering of the SRTM DEM on the right, and a merge of the two data sets in the middle. Note that topographic expression in the Landsat image alone is very subtle due to the fairly high sun angle (63 degrees above the horizon) during the satellite overflight in late morning of a mid-Spring day (May 4, 2001). In contrast, computer generated topographic shading of the DEM provides a pure and bold image of topographic expression with a user specified illumination direction. The middle image shows how combining the Landsat and DEM shaded relief can result in a topographically enhanced satellite image in which the information content of both data sets is merged into a single view.Landsat has been providing visible and infrared views of the Earth since 1972. SRTM elevation data matches the 30-meter (98-foot) resolution of most Landsat images and helps in analyzing the large and growing Landsat image archive, managed by the U.S. Geological Survey (USGS).Elevation data used in this image was acquired by the Shuttle Radar Topography Mission (SRTM) 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 Imagery and Mapping Agency (NIMA) of the U
This article provides an overview of US humanitarian relief efforts in Haiti following the earthquake on January 12, 2010. Humanitarian aid arrived rapidly from many sources and was largely provided by organized and skilled humanitarian volunteers. There are however multiple impacts on the existing health care systems, as well as the pharmaceutical and medical supply chain created by massive relief efforts involving personnel, medicines, supplies and equipment that should be considered even in the immediate post-disaster period. Additionally the consequences of short-term medical missions by secular and non-secular NGOs should be considered carefully both in the post-disaster period and as ongoing support to underserved populations. Copyright © 2010 Elsevier Ltd. All rights reserved.
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...
Ludtka, Gerard M.
A method using of a magnetic field to affect residual stress relief or phase transformations in a metallic material is disclosed. In a first aspect of the method, residual stress relief of a material is achieved at ambient temperatures by placing the material in a magnetic field. In a second aspect of the method, retained austenite stabilization is reversed in a ferrous alloy by applying a magnetic field to the alloy at ambient temperatures.
Sharron L. Docherty
Full Text Available Palliative care for children and adolescents with cancer includes interventions that focus on the relief of suffering, optimization of function, and improvement of quality of life at any and all stages of disease. This care is most effectively provided by a multidisciplinary team. Nurses perform an integral role on that team by identifying symptoms, providing care coordination, and assuring clear communication. Several basic tenets appear essential to the provision of optimal palliative care. First, palliative care should be administered concurrently with curative therapy beginning at diagnosis and assuming a more significant role at end of life. This treatment approach, recommended by many medical societies, has been associated with numerous benefits including longer survival. Second, realistic, objective goals of care must be developed. A clear understanding of the prognosis by the patient, family, and all members of the medical team is essential to the development of these goals. The pediatric oncology nurse is pivotal in developing these goals and assuring that they are adhered to across all specialties. Third, effective therapies to prevent and relieve the symptoms of suffering must be provided. This can only be accomplished with accurate and repeated assessments. The pediatric oncology nurse is vital in providing these assessments and must possess a working knowledge of the most common symptoms associated with suffering. With a basic understanding of these palliative care principles and competency in the core skills required for this care, the pediatric oncology nurse will optimize quality of life for children and adolescents with cancer.
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
...The Legal Services Corporation (LSC) is the national organization charged with administering federal funds provided for civil legal services to low-income Americans. This Request for Applications (RFA) announces the availability of LSC's disaster relief emergency grant funds and solicits grant applications from current LSC recipients located in a federally- declared disaster area seeking financial assistance to mitigate damage sustained and who have experienced a surge in demand for legal services as the result of a federally-declared disaster.
Cohen, Susan M; Rousseau, Mary Ellen; Carey, Bonnie L
In a randomized, 2-group clinical study, acupuncture was used for the relief of menopausal hot flushes, sleep disturbances, and mood changes. The experimental acupuncture treatment consisted of specific acupuncture body points related to menopausal symptoms. The comparison acupuncture treatment consisted of a treatment designated as a general tonic specifically designed to benefit the flow of Ch'i (energy). Results from the experimental acupuncture treatment group showed a decrease in mean monthly hot flush severity for site-specific acupuncture. The comparison acupuncture treatment group had no significant change in severity from baseline over the treatment phase. Sleep disturbances in the experimental acupuncture treatment group declined over the study. Mood changes in both the experimental acupuncture treatment group and the comparison acupuncture treatment group showed a significant difference between the baseline and the third month of the study. Acupuncture using menopausal-specific sites holds promise for nonhormonal relief of hot flushes and sleep disturbances.
Torres, Luis M; Revnic, Julia; Knight, Alastair D; Perelman, Michael
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 (p<0.001); this relationship was also true within individual treatment groups (p<0.01). Similar results were found for overall pain intensity reduction. When treatment groups were compared using within-patient data, FPNS provided earlier onset of pain relief than IRMS or placebo (p<0.05), which translated into better satisfaction at 60 minutes (p<0.01). Earlier onset of pain relief resulted in greater patient satisfaction
Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness A 62 year old man was referred for an abnormal CT scan of the chest. He was found to have an abnormality in the lung as an incidental finding on a CT scan of the abdomen done 6 months earlier for abdominal pain. A CT-guided needle biopsy was performed but revealed only scant tissue and no diagnosis was made. The patient was asymptomatic without dyspnea, wheezing or cough. He had no fevers, chills, history of pneumonia or sinus disease. He denied any symptoms of gastroesophageal reflux disease (GERD, regurgitation, dysphagia or aspiration. PMH, FH, SH The patient had a small melanoma excised from his arm several months earlier. Family history was noncontributory. He smoked a pack per day for 7 years but quit over 30 years earlier. He does not drink. Medications Vitamins Mineral oil laxative Physical Examination Physical examination was unremarkable. Radiography A CT scan ...
Dyer, Jeannie; Thomas, Karen; Sandsund, Cathy; Shaw, Clare
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.
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
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.
Ho, Hsin-Yi; Chen, Chao-Wei; Li, Ming-Chieh; Hsu, Yu-Pao; Kang, Shih-Ching; Liu, Erh-Hao; Lee, Ko-Hung
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 acupuncture intervention, and they could not respond accurately to 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.
Prasad R, Shesha; Pai, Anuradha
To compare immediate pain relief, healing time between minor recurrent aphthous ulcers treated with a single session of carbon dioxide (CO2) laser and a placebo. A prospective clinical study was performed on 25 patients with minor recurrent aphthous stomatitis. Pretreatment pain levels were recorded using a numerical rating scale. Ulcers were randomized to either receive treatment or placebo. Pain levels were assessed immediately after treatment and after 24 h. Healing was assessed on days 3 and 4, and once every 2 days thereafter for 2 weeks. Mean pain scores in the laser group were significantly reduced immediately after treatment (0.68 ± 0.6) compared with pretreatment (8.48 ± 0.71; P recurrent aphthous stomatitis (RAS) provides immediate pain relief sustained over 24 h, along with accelerated healing time. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available Thousands of victims and millions of affected people are hurt by natural disasters every year. Therefore, it is essential to prepare proper response programs that consider early activities of disaster management. In this paper, a multiobjective model for distribution centers which are located and allocated periodically to the damaged areas in order to distribute relief commodities is offered. The main objectives of this model are minimizing the total costs and maximizing the least rate of the satisfaction in the sense of being fair while distributing the items. The model simultaneously determines the location of relief distribution centers and the allocation of affected areas to relief distribution centers. Furthermore, an efficient solution approach based on genetic algorithm has been developed in order to solve the proposed mathematical model. The results of genetic algorithm are compared with the results provided by simulated annealing algorithm and LINGO software. The computational results show that the proposed genetic algorithm provides relatively good solutions in a reasonable time.
Full Text Available Eighty-five paediatric patients (age range: 6 mths-12yrs undergoing lower abdominal surgery were studied for post-operative pain relief following either caudal bupivacaine (GpI: n = 43 or buprenorphine (GpII: n = 42. Bupivacaine was administered as 0.5ml/kg body weight of 0.25% solution and buprenorphine as 4 micrograms/ml and volume of 0.5 ml/Kg body weight in normal saline. Post-operatively pain was graded on a 4-point scale and behaviour on a 5-point scale. Any post-operative complications and need for additional analgesia were also noted. Bupivacaine provided good pain relief in the early post-operative hours but buprenorphine provided pain relief lasting for 24 hrs or more post-operatively. Post-operative behaviour of 10 patients receiving buprenorphine was graded as cheerful as compared to 2 from bupivacaine group. Till the end of observation period (i.e. 8 hr post-operatively, majority of patients receiving buprenorphine remained cheerful.
Pandazi, Ageliki; Kanellopoulos, Ilias; Kalimeris, Konstantinos; Batistaki, Chrysanthi; Nikolakopoulos, Nikolaos; Matsota, Paraskevi; Babis, George C; Kostopanagiotou, Georgia
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 clearly superior to 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.
Full Text Available Physical symptoms without any identifiable structural or biochemical abnormalities on detailed clinical examination and investigations, are common in children. Some children may have persistent physical discomfort which can lead to debilitating impact on their academic and social functioning. These children seek repeated medical consultations and are usually subjected to unnecessary invasive diagnostic procedures. It is extremely important to understand that emotional factors can contribute to the development as well as maintenance of impairing physical symptoms. There is scientific evidence for the association of anxiety and functional somatic symptoms in children. The diagnostic category which was previously called somatoform disorders is now included in somatic symptom disorders. The main feature of the somatic symptom disorders is the excessive concern with somatic symptoms. Detailed clinical examination and investigations will not reveal any abnormalities to explain the symptoms. The somatic symptom disorders are common in childhood. Cognitive behavioural therapy by experts in child guidance, will relieve the somatic symptoms related to anxiety and stress. If not intervened at the earliest, the persistent physical symptoms associated with emotional stress will cause significant functional disability in childhood. Unnecessary invasive medical interventions cause more agony to the child. These children also have high risk for developing anxiety disorders and depressive disorders in young adulthood. Hence, early intervention using cognitive behavioural techniques should be provided to all children with somatic symptom disorders, which will definitely improve their quality of life.
Full Text Available 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
Krych, Aaron J; Pagnano, Mark W
Implications for practice and research: Utilisation of continuous femoral nerve blockade (FNB) following knee replacement surgery can provide superior pain relief and fewer side effects, compared to traditional patient-controlled opioid analgesia. Further research is needed to compare the effectiveness of FNB to other pain management strategies, such as local anaesthetic infiltration and multimodal oral pain medication.
Ren, ZhengJia; Wang, HongTao; Zhang, Wei
The purpose of this study was to begin to generate an exploratory model of the disaster-related mental health education process associated with the training experiences of psychological relief workers active during the Sichuan earthquake in China. The data consisted of semi-structured interviews with 20 psychological relief workers from four different professions (social workers, psychiatric nurses, psychiatrists, and counsellors) regarding their experiences in training and ideas for improvement. The model explains the need to use a people-centred community interprofessional education approach, which focuses on role-modelling of the trainer, caring for relief workers, paying attention to the needs of the trainee, and building systematic interprofessional education strategies. The proposed model identifies areas for the comprehensive training of relief workers and aims to address the importance of people-centred mental health service provisions, ensure intentional and strategic training of relief workers using interprofessional concepts and strategies, and use culturally attuned and community-informed strategies in mental health training practices.
Full Text Available 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.
Müller, Nadia; Lorenz, Isabel; Langguth, Berthold; Weisz, Nathan
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
Collot, Jean-Yves; Sanclemente, Eddy; Nocquet, Jean-Mathieu; Leprêtre, Angélique; Ribodetti, Alessandra; Jarrin, Paul; Chlieh, Mohamed; Graindorge, David; Charvis, Philippe
Whether subducted oceanic reliefs such as seamounts promote seismic rupture or aseismic slip remains controversial. Here we use swath bathymetry, prestack depth-migrated multichannel seismic reflection lines, and wide-angle seismic data collected across the central Ecuador subduction segment to reveal a broad 55 km × 50 km, 1.5-2.0 km high, low height-to-width ratio, multipeaked, sediment-bare, shallow subducted oceanic relief. Owing to La Plata Island and the coastline being located, respectively, 35 km and 50-60 km from the trench, GPS measurements allow us to demonstrate that the subducted oceanic relief spatially correlates to a shallow, 80 km × 55 km locked interplate asperity within a dominantly creeping subduction segment. The oceanic relief geometrical anomaly together with its highly jagged topography, the absence of a subduction channel, and a stiff erosive oceanic margin are found to be long-term geological characteristics associated with the shallow locking of the megathrust. Although the size and level of locking observed at the subducted relief scale could produce an Mw >7+ event, no large earthquakes are known to have happened for several centuries. On the contrary, frequent slow slip events have been recorded since 2010 within the locked patch, and regular seismic swarms have occurred in this area during the last 40 years. These transient processes, together with the rough subducted oceanic topography, suggest that interplate friction might actually be heterogeneous within the locked patch. Additionally, we find that the subducted relief undergoes internal shearing and produces a permanent flexural bulge of the margin, which uplifted La Plata Island.
the IaaS systems to the private community users. Because of societal differences and incomplete design specifications, a discussion of all...deal with privacy and security issues.230 The trusted organization must also ensure that the IaaS service provider provides detailed delineation of...prevent potential future attacks, the organization must monitor for malicious activity, from the IaaS to the interface user, in order to identify and take
Lau, Denys T; Joyce, Brian; Clayman, Marla L; Dy, Sydney; Ehrlich-Jones, Linda; Emanuel, Linda; Hauser, Joshua; Paice, Judith; Shega, Joseph W
Managing and administering medications to relieve pain and symptoms are common, important responsibilities for informal caregivers of patients receiving end-of-life care at home. However, little is known about how hospice providers prepare and support caregivers with medication-related tasks. This qualitative study explores the key approaches that hospice providers use to facilitate medication management for caregivers. Semistructured, open-ended interviews were conducted with 22 providers (14 nurses, four physicians, and four social workers) from four hospice organizations around an urban setting in the midwestern U.S. Based on the interviews, the following five key approaches emerged, constituting how the hospice team collectively helped caregivers manage medications: 1) establishing trust; 2) providing information; 3) promoting self-confidence; 4) offering relief (e.g., provided in-home medication assistance, mobilized supportive resources, and simplified prescriptions); and 5) assessing understanding and performance. Each hospice discipline used multiple approaches. Nurses emphasized tailoring information to individual caregivers and patients, providing in-home assistance to help relieve caregivers, and assessing caregivers' understanding and performance of medication management during home visits. Physicians simplified medication prescriptions to alleviate burden and reassured caregivers using their perceived medical authority. Social workers facilitated medication management by providing emotional support to promote self-confidence and mobilizing resources in caregivers' support networks and the community at large. Hospice nurses, physicians, and social workers identified distinct, yet overlapping, approaches in aiding caregivers with medication management. These findings emphasize the importance of interdisciplinary teamwork among hospice providers. Future research should investigate how common, standardized, effective, and efficient these approaches are in
Yu, Qingmin; Chen, Furong; Li, Ming; Cheng, Huanyu
A wavy configuration is a simple yet powerful structural design strategy, which has been widely used in flexible and stretchable electronics. A buckled structure created from a prestretch-contact-release process represents an early effort. Substrates with engineered surface relief structures (e.g., rectangular islands or tripod structure) have enabled stretchability to the devices without sacrificing their electric performance (e.g., high areal coverage for LEDs/photovoltaics/batteries/supercapacitors). In particular, the substrate with a tripod surface relief structure allows wrinkled devices to be suspended on a soft tripod substrate. This minimizes the contact area between devices and the deformed substrate, which contributes to a significantly reduced interfacial stress/strain. To uncover the underlying mechanism of such a design, we exploit the energy method to analytically investigate the buckling and postbuckling behaviors of stiff films suspended on a stretchable polymeric substrate with a tripod surface relief structure. Validated by finite element analysis, the predications from such an analytical study elucidate the deformed profile and maximum strain in the buckled and postbuckled stiff thin device films, providing a useful toolkit for future experimental designs.
A stress analysis was performed on the LOFT Pressurizer Pressure Relief System to determine if it met the requirements of the ASME Boiler and Pressure Vessel Code, Section III, 1974 Edition, for Class 1 and Class 2 components. Deadweight, thermal expansion, seismic, design LOCE, and LOCA loads were considered. The results of this analysis indicate that the LOFT pressurizer pressure relief system will comply with Code specifications provided modifications are made to the hanger support configuration and one small section of pipe. The recommended changes are listed below. Note that some of these hangers were previously required based upon an analysis which subjected this same piping system to a reduced LOCE (20 millisecond valve opening). (1) Addition of Snubbers as per letter HIK-12-75, LOFT Pipe Hanger Requirements on Main Feed Main Steam Pressurizer and ECC Systems. (2) The 1/2'' Line 1/2''-PCS-10 between the tee and CVP-136-19 must be increased in diameter to 1.050 inches (OD of nominal 3/4'' pipe). (3) Modification of Unibals and flat bars as per letter Muff-2-76, required change of flat bar hangers and unibals on pressure relief and pressurizing piping. 9 refs., 6 figs., 1 tab.
Moos, H L; Bramwell, J D; Roahen, J O
Patients who when initially seen have pain of endodontic origin have a higher incidence of posttreatment pain than those who are pain-free pretreatment. The purpose of this study was to compare two methods of treatment--pulpectomy alone or pulpectomy with trephination--for the reduction of posttreatment pain in patients presenting with acute periradicular pain of pulpal origin. Seventeen patients with pretreatment pain were studied. Eleven received a pulpectomy to the radiographically determined working length. Six patients received a pulpectomy and trephination using a #4 round bur through a vertical incision. Visual analog scales were used preoperatively to measure pain intensity and unpleasantness, and postoperatively to measure intensity, unpleasantness, and pain relief at 4, 8, 16, 24, 48, 72, and 96 h. Analysis of preoperative data showed no difference between control and experimental groups. Posttreatment, at 4 h, the trephination group reported significantly more pain intensity and unpleasantness and less pain relief than the control group. Pulpectomy alone provided significantly better postoperative pain relief at 4 h compared with pulpectomy with trephination. At no time interval did the trephination group have less pain than the group without trephination.
Adiguzel, Emre; Uran, Ayça; Kesikburun, Serdar; Köroğlu, Özlem; Demir, Yasin; Yaşar, Evren
Heterotopic ossification (HO) is the ectopic bone formation in non-osseous tissues. This study aimed to present two patients with traumatic brain injury (TBI) who had HO in knee joint and pain relief after genicular nerve blockage. Case 1: A 14-year-old patient with TBI was admitted with bilateral knee pain and limited range of motion. Physical examination and x-ray graphics revealed calcification which was diagnosed as HO. Ultrasonography (US) guided genicular nerve blockage was performed to both knees with 2 ml lidocaine and 1 ml betamethasone. VAS of pain was decreased to 30 mm from 80 mm. At 6-month follow-up, VAS of pain was still 30 mm. Case 2: A 29-year-old patient with TBI was admitted for rehabilitation. He had right knee pain and his pain was 80 mm according to VAS. Investigation revealed HO. US guided genicular nerve blockage was performed to the right knee and pain was decreased to 20 mm. US guided genicular nerve blockage can provide pain relief in HO and this technique may be effective and alternative for pain relief in patients with neurogenic knee HO to increase patient's compliance.
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.
Full Text Available Abstract Background Despite much research, an immediately available, instantly effective and harmless pain relief technique has not been discovered. This study describes a new manipulation: a "2-minute sciatic nerve press", for rapid short-term relief of pain brought on by various dental and renal diseases. Methods This randomized, single-blind, placebo-controlled trial ran in three hospitals in Anhui Province, China, with an enrollment of 66 out of 111 solicited patients aged 16 to 74 years. Patients were recruited sequentially, by specific participating physicians at their clinic visits to three independent hospitals. The diseases in enrolled dental patients included dental caries, periodontal diseases and dental trauma. Renal diseases in recruits included kidney infections, stones and some other conditions. Patients were randomly assigned to receive the "2-minute sciatic nerve press" or the "placebo press". For the "2-minute sciatic nerve press", pressure was applied simultaneously to the sciatic nerves at the back of the thighs, using the fists while patients lay prone. For the "placebo press", pressure was applied simultaneously to a parallel spot on the front of the thighs, using the fists while patients lay supine. Each fist applied a pressure of 11 to 20 kg for 2 minutes, after which, patients arose to rate pain. Results The "2-minute sciatic nerve press" produced greater pain relief than the "placebo press". Within the first 10 minutes after sciatic pressure, immediate pain relief ratings averaged 66.4% (p Conclusion Two minutes of pressure on both sciatic nerves can produce immediate significant conduction analgesia, providing a convenient, safe and powerful way to overcome clinical pain brought on by dental diseases and renal diseases for short term purposes. Trial registration ACTR 12606000439549
Henneberg, S W; Hole, P; Haas, Inge Madsen De
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...
Henneberg, S W; Hole, P; Haas, Inge Madsen De
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...... 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...
Morales-Bozo, Irene; Ortega-Pinto, Ana; Rojas Alcayaga, Gonzalo; Aitken Saavedra, Juan P; Salinas Flores, Olga; Lefimil Puente, Claudia; Lozano Moraga, Carla; Manríquez Urbina, José M; Urzúa Orellana, Blanca
The aim of this study was to determine the efficacy of a chamomile (Matricaria chamomilla) and linseed (Linum usitatissimum) saliva substitute in the relief of xerostomia in older participants. In elders, xerostomia is a permanent and progressive condition that significantly affects their quality of life. The treatment for progressive xerostomia is currently restricted to palliative measures, and saliva substitutes are indicated. A lack of evidence on the effectiveness of the saliva substitutes in the relief of symptoms of xerostomia has been reported. Seventy-four elderly participants presenting xerostomia of diverse origin were selected. Herbal saliva substitute and carboxymethyl cellulose conventional saliva substitute were tested using a double-blind, randomised, cross-sectional clinical trial. Every participant of the study exhibited dry mouth sensation. A sensation of thick saliva was described in 59.5% of the participants. The need for liquid intake to swallow food, the sensation of difficulty in swallowing and the burning sensation in the tongue were observed in 54.1, 56.8 and 27.0% of the participants, respectively. The most prevalent diseases were hypertension, depressive symptoms and arthritis. Results of the clinical tests showed that the herbal saliva substitute produced a greater relief of dry mouth symptoms, thick saliva sensation and the sensation of difficulty in swallowing than the conventional substitute (Wilcoxon test p substitute was effective in relieving xerostomia symptoms in older participants of this study. © 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
Boyd, Carol J; Young, Amy; McCabe, Sean E
Background This exploratory study examined the psychological and substance abuse symptoms and motivations associated with adolescents’ medical and nonmedical use of opioid analgesics. We compared three groups of adolescents: 1) those who never used an opioid analgesic; 2) those who used a prescribed opioid analgesic (medical users); and 3) those who used someone else’s opioid analgesics (nonmedical users). Nonmedical use was defined as using someone else’s opioid analgesic medication. Comparisons among the groups were made on psychological and substance abuse symptoms as well as motivations to engage in nonmedical use. Methods A web-based survey, the Secondary Student Life Survey (SSLS) was administered to a sample of students who attended one of five secondary schools in southeastern Michigan. The sample included 2,627 respondents and was evenly distributed by sex and grade. Sixty-five percent (65.0%) were White/Caucasian and 29.5% African-American. The average age was 14.8 years (SD=1.9). Results Seventy percent (70.4%, n=1850) reported never using opioid analgesics in their lifetimes. Of the remaining 24.5% (n=644) of opioid analgesic users, most were medical users. However, 3.5% (n=92) were classified as nonmedical users who used someone else’s medication for pain relief only, and 1.6% (n=41) were classified as nonmedical users for reasons other than for pain relief (e.g. to get high). In contrast to never users, both medical users and nonmedical users reported more substance abuse symptoms and symptoms associated with pain. Further, those nonmedical users who used opioids to sensation seek had greater odds of having psychological symptoms. Conclusions These data: 1) provide additional support for the existence of distinct subgroups of adolescent opioid analgesic users; 2) provide evidence of psychological symptoms associated with nonmedical use; and 3) highlight the psychological differences among nonmedical users who self-treat for pain versus
They deem failure to copy such lessons of success to emanate from political antipathy of just not preferring to follow one's preceding political rival's line of ... food self-sufficient country in the world, always providing food aid, that does not practise input subsidy to any degree if not throughout all cropping and marketing levels.
... provide notification will result in the dismissal of the agency's appeal. (5) The agency may, by notice to... extent of the temporary or conditional restoration of the employee to duty status in the position specified in the decision, pending the outcome of the agency appeal. The employee may decline the offer of...
... provide notification will result in the dismissal of the Board's appeal. (5) The Board may, by notice to... to the extent of the temporary or conditional restoration of the employee to duty status in the position specified in the decision, pending the outcome of the Board appeal. The employee may decline the...
... Lyme disease FAQ Health care providers Educational materials Signs and Symptoms of Untreated Lyme Disease Recommend on ... to an area where Lyme disease occurs . Early Signs and Symptoms (3 to 30 days after tick ...
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...
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 ...
Wijesinghe, L.; Coughlin, P; Robertson, I; Kessel, D; Kent, P.; Kester, R
External iliac stenosis due to endofibrosis is a rare condition that predominantly affects top level cyclists. Short term symptomatic relief is reported in an Olympian after percutaneous transluminal angioplasty, which was performed to allow the patient to return to training without delay.
Objective: This study determined women's knowledge of and attitudes to pain relief during labour. Methods: This descriptive study included 151 women, 18 years or older, attending the antenatal clinic of Cecilia Makiwane Hospital. Women were interviewed using a questionnaire that determined their knowledge of and ...
Mead, S; Knott, M
Cold applications are sometimes of pronounced symptomatic benefit in some rheumatic disorders such as acute myalgia; in the temporary relief of spasticity; in helping to release tight structures in poliomyelitis and allied diseases; and in temporary recovery of energy in multiple sclerosis.
Mead, Sedgwick; Knott, Margaret
Cold applications are sometimes of pronounced symptomatic benefit in some rheumatic disorders such as acute myalgia; in the temporary relief of spasticity; in helping to release tight structures in poliomyelitis and allied diseases; and in temporary recovery of energy in multiple sclerosis. PMID:18730022
The aim of this study was to physico-chemically characterise selected geophagic soils from Cameroon and South Africa, ingested for the relief of NVP and to appraise their ability to meet the needs of geophagic individuals. Materials and Methods: Thirteen geophagic soil samples (6 from Cameroon and 7 from South Africa) ...
... the-Counter Pain Relievers and Fever Reducers Careful: Acetaminophen in pain relief medicines can cause liver damage ... More sharing options Linkedin Pin it Email Print Acetaminophen (aâSEETâaâMINâoâfen) is an ...
This article examines engagements between civilian actors, the Philippine security forces and the US military during disaster response operations. The Philippine disaster framework recognises the military's role in disaster relief and has existing mechanisms for accepting international assistance and procedures for ...
... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Extinguishing agent container pressure relief. 125.165 Section 125.165 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS...
... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Extinguishing agent container pressure relief. 121.267 Section 121.267 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS...
Holme, NCR; Nikolova, Ludmila; Hvilsted, Søren
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...
Guerrero, Raphael A., E-mail: email@example.com [Department of Physics, Ateneo de Manila University, Loyola Heights, Quezon City (Philippines); Aranas, Erika B. [Department of Physics, Ateneo de Manila University, Loyola Heights, Quezon City (Philippines)
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.
Dysmenorrhoea: Pain relief strategies among a cohort of undergraduates in Nigeria. Emmanuel A1*, Achema G2, Gimba SM1, Mafuyai MJ1, Afoi BB3, Ifere I.O1. 1Department of Nursing, University of Jos, Plateau, Nigeria, 2School of Nursing and Public. Health, Howard College, University of Kwazulu-Natal, Durban, South ...
IV NSAID, e.g., ketorolac. IV ketamine. IV PCA (PICA). 568. 4. 16. –. 550 (96.8). 2 (50). 14 (87.5). –. Regional blocks: Caudal block. Epidural/ spinal blocks. 41. 5. 41 (100). 5 (100). Local infiltration of local anesthetic. 6. 6 (100). Unspecified. 41. –. Total. *689. 612. Multimodal pain relief methods were used in some patients.
Monk, Aoife B; Harrison, Jayne E; Worthington, Helen V; Teague, Annabel
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
Clemens, C J; Taylor, J A; Almquist, J R; Quinn, H C; Mehta, A; Naylor, G S
To determine whether an antihistamine-decongestant combination (ADC) is superior to placebo in temporarily relieving symptoms of upper respiratory tract infection (URI) in preschool children. Randomized, double-blind, placebo-controlled trial. Four pediatric offices in the Seattle, Wash, area. Children 6 months through 5 years of age with a URI of less than 7 days' duration. Children were randomly assigned to receive an ADC (brompheniramine maleate-phenylpropanolamine hydrochloride) or placebo as needed for URI symptoms. Two hours after each dose of study medication, changes in the child's runny nose, nasal congestion, cough, and sleep status were assessed by means of a standardized questionnaire. A total of 175 responses were recorded for 59 patients. There were no statistically significant differences in symptom improvement between the ADC and the placebo group (runny nose, p = 0.48; nasal congestion, p = 0.94; cough, p = 0.66). However, the proportion of children asleep 2 hours after receiving the ADC was significantly higher than the proportion receiving placebo (46.6% vs 26.5%; p = 0.01). Results were unchanged after control for the correlated nature of repeated responses, age, symptom duration, use of acetaminophen, time that the medication was given, and parental desire for medication. The ADC was equivalent to placebo in providing temporary relief of URI symptoms in preschool children. However, the ADC did have significantly greater sedative effects than did placebo.
Sharman, G. F.; Virden, W. T.; Divins, D. L.; Fox, C. G.; Habermann, T.
The National Oceanic and Atmospheric Administration's (NOAA) National Geophysical Data Center (NGDC), Boulder, Colorado is distributing increasing quantities of data via the Internet. With evolving technology and broader bandwidth, it is possible to deliver large volumes (up to 2 GB) of data directly over the Internet and to provide server-side-generated products and services with more user options. In 2004, NGDC (www.ngdc.noaa.gov) initiated a web-based multibeam bathymetric data system,leveraging off geospatial and relational database technologies being utilized at the Center. The system has an ESRI ArcIMS interface, which handles the geospatial character of the data, and provides a standardized GIS interface and tool suite. All of this rests on a foundation Oracle database containing an inventory and metadata. It also uses software developed at NOAA's Pacific Marine Environmental Laboratory, which scripts the National Science Foundation-supported software packages: MBSystem (for managing multibeam data) and Generic Mapping Tools (GMT) (for mapping and display). In whole, the MultiBeam Bathymetric Data Base (MBBDB) (Virden, et al., "Multibeam Bathymetric Data at NOAA/NGDC," OTO '04) enables the web user to browse, discover, review, select, map, and download multibeam data directly, without human intervention by NGDC. A similar development, the NGDC Coastal Relief Model (CRM), http://www.ngdc.noaa.gov/mgg/coastal/coastal.html, is available for download at a variety of sampling intervals. This data set is built on multibeam and conventional offshore hydrography, resampled into a 3 arc-second lat-lon grid, which is matched to a 3 arc-second version of the USGS National Elevation Database (NED). The resulting fusion gives a continuous elevation surface model from the seafloor, across the coastline and onto the land. These data provide the foundation for a multitude of environmental studies and models, such as Tsunami or storm surge propagation, run up, and inundation
... pills do not have this problem. Immunotherapy. Immunotherapy (allergy shots) might provide relief for patients who don’t find relief with antihistamines or nasal steroids. They alter the body’s immune response to allergens, thereby helping to prevent allergic reactions. ...
... Products Worker Safety Healthcare Providers News and Multimedia Animations and Videos Hungry, Hungry Hippos Florida Retiree Gets—and Survives—Anthrax Archived Press Materials CDC Lab Incident: Anthrax Resources A History of Anthrax Recommendations Anthrax Case Investigation Epi-Info ...
Ameringer, Suzanne; Erickson, Jeanne M; Macpherson, Catherine Fiona; Stegenga, Kristin; Linder, Lauri A
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.
Pereira, Erlick A C; Farwana, Mohammad; Lam, Khai S
Spinal stenosis and low-grade spondylolisthesis produce symptoms of neural compression that can be treated with extreme lateral lumbar interbody fusion (XLIF) via indirect decompression. This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration. Objective measures such as the Visual Analogue Scale (VAS) for back and legs and the Oswestry Disability Index (ODI) were used. Complications were collated post-operatively from clinical notes and outpatient appointments. Twenty-three consecutive patients were included, of whom 91% had spinal stenosis. The cohort presented with multiple comorbidities and 35% of the cohort had undergone previous lumbar surgery. There was a 61% improvement of coronal Cobb angle and an 11% correction of the lordosis sustained 1year after surgery. Clinical outcomes at 1year showed 39%, 50% and 60% improvements in the ODI, back and leg VAS scores respectively. 48% of patients had reduced sensation related to lumbosacral plexus manipulation and one retroperitoneal haematoma was conservatively managed. Minimally invasive spinal (MIS) XLIF resulted in effective restoration of disc dimensions via indirect decompression, providing good relief of clinical symptoms evidenced by significant improvement in clinical outcome scores. XLIF corrected scoliosis and improved lumbar lordosis significantly. Several plexopathies did not hinder long-term recovery. XLIF is highly suited to treating complex patients with multiple comorbidities and degenerative disease. Copyright © 2016 Elsevier Ltd. All rights reserved.
Donald Frederick Smith
Full Text Available Molecular mechanisms in the brain are assumed to cause the symptoms and severity ofneuropsychiatric disorders. This review concerns the elusive nature of relationships between theseverity of depressive disorders and neuromolecular processes studied by positron emissiontomography (PET. The review provides a systematic account of all reports on PET and humandepressive disorders that have been listed in PubMed and published since March 2009, the time ofour last review on the topic. These recently published studies have concerned serotonergic,dopaminergic, muscarinic, nicotinic, and GABAergic receptors, as well as central processesdependent on monoamine oxidase, phosphodieasterase type 4, amyloid plaques, neurofibrillartangles, and P-glycoprotein. We find, however, that reliable causal links between neuromolecularmechanisms and relief from depressive disorders have yet to be convincingly demonstrated. Thissituation may contribute to the currently limited use of PET for exploring the neuropathways thatare currently viewed as being responsible for beneficial effects of antidepressant treatment regimes.
U.S. Geological Survey, Department of the Interior — The Grayscale Shaded Relief of the Conterminous United States map layer is a 100-meter resolution grayscale shaded relief image of the United States, in an Albers...
... claim for liquidated damages for failure to redeliver released merchandise incurred under the provisions... counterfeit trademark, relief from a forfeiture may be granted pursuant to a petition for relief upon the...
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...
U.S. Geological Survey, Department of the Interior — The Satellite View with Shaded Relief of Hawaii map layer is a 100-meter resolution simulated natural-color image of Hawaii, with relief shading added to accentuate...
U.S. Geological Survey, Department of the Interior — The Color Shaded Relief of the Conterminous United States map layer is a 100-meter resolution color-sliced elevation image of the United States, with relief shading...
U.S. Geological Survey, Department of the Interior — The Bathymetric Shaded Relief of North America map layer shows depth ranges using colors, with relief enhanced by shading. The image was derived from the National...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Federal Transit Administration Second Allocation of Public Transportation Emergency Relief Funds in... the Public Transportation Emergency Relief Program to the four FTA recipients most severely affected...
Andrzej W. Przybyszewski
Full Text Available We still do not know how the brain and its computations are affected by nerve cell deaths and their compensatory learning processes, as these develop in neurodegenerative diseases (ND. Compensatory learning processes are ND symptoms usually observed at a point when the disease has already affected large parts of the brain. We can register symptoms of ND such as motor and/or mental disorders (dementias and even provide symptomatic relief, though the structural effects of these are in most cases not yet understood. It is very important to obtain early diagnosis, which can provide several years in which we can monitor and partly compensate for the disease’s symptoms, with the help of various therapies. In the case of Parkinson’s disease (PD, in addition to classical neurological tests, measurements of eye movements are diagnostic. We have performed measurements of latency, amplitude, and duration in reflexive saccades (RS of PD patients. We have compared the results of our measurement-based diagnoses with standard neurological ones. The purpose of our work was to classify how condition attributes predict the neurologist’s diagnosis. For n = 10 patients, the patient age and parameters based on RS gave a global accuracy in predictions of neurological symptoms in individual patients of about 80%. Further, by adding three attributes partly related to patient ‘well-being’ scores, our prediction accuracies increased to 90%. Our predictive algorithms use rough set theory, which we have compared with other classifiers such as Naïve Bayes, Decision Trees/Tables, and Random Forests (implemented in KNIME/WEKA. We have demonstrated that RS are powerful biomarkers for assessment of symptom progression in PD.
Zagir V. Ataev
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
[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
...] Finding of Equivalence; Alternate Pressure Relief Valve Settings on Certain Vessels Carrying Liquefied... announces the availability of CG-ENG Policy Letter 04-12, ``Alternative Pressure Relief Valve Settings on.... The higher stress factors lead to lower maximum allowable relief valve settings (MARVS) than are...
Abstract. This paper models a humanitarian relief chain that includes a relief goods supply chain and an evacuation chain in case of a natural disaster. Optimum network flow is studied for both the chains by con- sidering three conflicting objectives, namely demand satisfaction in relief chain, demand satisfaction in evac-.
... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Truth in Lending Act-Relief from reimbursement... PRACTICE FILING PROCEDURES Other Filings § 303.248 Truth in Lending Act—Relief from reimbursement. (a) Scope. This section applies to requests for relief from reimbursement pursuant to the Truth in Lending...
... 46 Shipping 5 2010-10-01 2010-10-01 false Minimum relief valve setting for refrigerated cargo... Design and Equipment Cargo Venting Systems § 153.371 Minimum relief valve setting for refrigerated cargo tanks. The relief valve setting for a containment system that carries a refrigerated cargo must at least...
Exploring an alternative way to approach famine relief interventions, this paper draws on the work of French philosopher Michel Foucault and David Keen's recent work on south-west Sudan. It suggests that different discourses on 'famine' can lead to the dominance of certain kinds of institutional practices, and the prioritisation of special kinds of knowledge, at the expense of other modes of understanding and action. Using the case of the relief operation to Tigrayan refugees in eastern Sudan in 1984/5, the paper examines the specific ways in which 'power' was elaborated in the midst of the operation, and the manner in which institutional practices-designed to save as many lives as possible-influenced the reaction of international agencies to the spontaneous repatriation of the Tigrayans back to Ethiopia.
Wang, Chuanli; Zhang, Hui; Yu, Caofeng; Wu, Xiaolei
When a working cylinder of the pressing machine working cylinder was stuck and underwent retracted conversion, pressure shock was high in working cylinder cavity and flow pulsation was distinct in the pipeline due to the high working pressure and frequent retracted transformation of the working cylinder, which not only shortened the service life of the pressing machine, but also exerted serious impacts on the machining precision and quality, especially after the pressing machine applied loads and high-pressure oil in work rod end cavity of working cylinder needed to be relieved in a short time. In order to research and analyze the better pressure relief characteristics of the two types of pressure relief circuits of the pressing machine, the paper established models, carried out simulation and analysis and then made contrastive analysis of the working cylinder rod velocity, rod acceleration and port pressure pulsation according to the simulation results.
Full Text Available A quick and simple approach for reactor—emergency relief system design—for runaway chemical reactions is presented. A cookbook for system sizing with all main characteristic dimensions and parameters is shown on one realistic example from process industry. System design was done based on existing theories, standards, and correlations obtained from the literature, which were implemented for presented case. A simple and effective method for emergency relief system is shown, which may serve as an example for similar systems design. Obtained results may contribute to better understanding of blow down system frequently used in industrial plants, for increasing safety, decreasing explosion damage, and alleviating the ecological problems together with environmental pollution in case of industrial accidents.
Keywords: Intraoperative period, pain relief, trends. Arrière-plan: De nouveaux médicaments et nouvelles modalités pour soulager la douleur peropératoire est la tendance actuelle dans la gestion de la douleur. L'étude vise à examiner la tendance actuelle dans le soulagement de la douleur peropératoire chez les patients ...
vaccine [5, 18]. An estimated 10% of children are acutely malnourished and 50% are chronically malnourished [5, 18]. THE CURRENT HUMANITARIAN... malnourished children and partic- ularly those with vitamin A deficiency. Malaria. Malaria is endemic in the country below 1500 m of elevation...typically refugees and IDPs, women, children, the elderly , single women as heads of households, and unaccom- Humanitarian Relief in Afghanistan • CID
Kakigi, R; Shibasaki, H
Mechanisms of pain relief induced by vibration and movement were investigated. A CO2 laser beam, which is useful for pure nociceptive stimulation, was used for recording pain-related somatosensory evoked potentials (pain SEPs) and for measuring pain threshold and reaction time (RT). Concurrently applied vibratory stimuli to and active movements of the fingers significantly reduced and prolonged pain SEPs, increased pain threshold, and prolonged RT, indicating that an increase in the inhibitor...
water pillow tanks (PWPTs) 6. Reverse osmosis water purification units (ROWPUs), pumps (for removal of contaminated well water) 7. Other needed...elimination of on-scene health hazards along with SAR and emergent surgical services may be the highest priority. This type of support is generally...for relief workers? 5. What role did the embarked Navy fleet surgical team (FST) perform? Who tasked them? Personnel 1. Was there a specialized
Earleywine, Mitch; Bolles, Jamie R
Previous work suggests that people might turn to marijuana to alleviate the symptoms of post-traumatic stress disorder (PTSD) and associated distress. Expectancy theories emphasize that the use of drugs correlates with their anticipated effects. The current study examined multivariate links among marijuana use, PTSD symptoms, and expectancies for marijuana-induced changes in those symptoms. Over 650 combat-exposed, male veterans who used marijuana at least once per week completed measures of PTSD symptoms, marijuana expectancies, and marijuana use in an Internet survey. Participants generally expected marijuana to relieve PTSD symptoms, especially those related to intrusions and arousal. Symptoms, expectancies for relief of symptoms, and marijuana consumption correlated significantly. Regressions revealed significant indirect effects of symptoms on use via expectancies, but no significant interactions of expectancies and symptoms. Combat-exposed veterans who use marijuana appear to use more as the magnitude of PTSD symptoms and their expectations of marijuana-induced relief of those symptoms increase. These results emphasize the importance of PTSD treatments in an effort to keep potential negative effects of marijuana to a minimum. They also underscore the import of expectancies in predicting marijuana use.
Henneberg, S W; Hole, P; Haas, Inge Madsen De
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 postop......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...... of respiratory depression was seen and 20% of the children had pruritus. There were four dural punctures and three catheters slipped out accidentally, but otherwise the treatment was continued as long as it was considered necessary (1-11 days). The use of postoperative ventilatory support decreased during...
Sugai, N; Yajima, C; Chinzei, M; Nagase, M; Nishitateno, K
Patient controlled analgesia (PCA) by intravenous pentazocine was performed to determine its efficacy and the dose required for the pain relief after gynecological or obstetric operations. After obtaining informed consent, studies were performed on 28 female patients (ASA I, II: Mean age 38.1 years: Mean weight, 53.8 kg) who had received gynecological or obstetric operations with lower abdominal incision. Anesthesia given was nitrous oxide and isoflurane combined with epidural anesthesia with 1% mepivacaine used only during the operation. Six patients had cesarian section under spinal anesthesia. No patients received opioid during anesthesia. PCA was performed with a Graseby PCA pump. Lockout time was 8 minutes and the bolus dose was 3 mg. In all the patients, satisfactory pain relief was obtained and no other analgesic was necessary. Mean initial dose was 169.4 micrograms.kg-1 and the mean doses used for following each 6 hours until 24 hours were 409.7, 368.6, 279.3 and 211.1 micrograms.kg-1 respectively. Evaluation of PCA by the patients after the procedure showed excellent (13 patients) good (12) and passable (3) analgesia. No significant complication was observed except temporary nausea in two patients. Satisfactory postoperative pain relief could be obtained by relatively small doses of pentazocine and adverse reactions related especially to sigma receptor could be avoided.
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 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.
Tuisku, K; Holi, M M; Wahlbeck, K; Ahlgren, A J; Lauerma, H
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.
Cluster research examines complex interrelationships between multiple concurrent symptoms and their mechanisms. An individual's varying understanding of the cluster concept and variations in assessment tools results in discrepancies. This article will focus on the conceptual and methodological issues associated with definitions, symptom interrelationships, and outcomes of cancer symptom clusters. An important issue in symptom cluster research is to clarify the definition of a cluster. Some evidence suggests that 'symptom pairs' should be treated as clusters. There is substantial evidence (both qualitative and quantitative) to support a psychoneurological symptom cluster in cancer patients. It has been proposed that consistent clusters are those that have similar 'core' symptoms over time. Research has also shown that a 'sentinel' symptom can predict the presence of other relevant symptoms within a cluster. Identification of patient subgroups with higher symptom severity may be useful in targeting the most needy individuals for intervention. Symptom clusters are predictors of patient outcomes, including decreased functional performance and shorter cancer survival. Additional efforts should refine the cluster definition and elucidate the cluster stability and sentinel symptom. Both conceptual and empirical contributions should advance symptom cluster research. The qualitative approaches can explore the experience of symptom clusters and provide a conceptual basis for future research.
Chng, Hui Yi; He, Hong-Gu; Chan, Sally Wai-Chi; Liam, Joanne Li Wee; Zhu, Lixia; Cheng, Karis Kin Fong
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
Festa, G.; Andreani, C.; de Pascale, M. P.; Senesi, R.; Vitali, G.; Porcinai, S.; Giusti, A. M.; Schulze, R.; Canella, L.; Kudejova, P.; Mühlbauer, M.; Schillinger, B.; Ancient Charm Collaboration
A neutron study on two gilded bronze reliefs by Lorenzo Ghiberti is presented. The two reliefs, representing heads of prophets, come from the north and east doors of the Baptistery of Florence. The east door will be permanently located at the Museo dell'Opera di Santa Maria del Fiore museum at the end of its restoration, which is still in progress at the Metals Conservation Department of the Opificio delle Pietre Dure in Florence. The north door is kept in the original site, on the north facade of the Florentine Baptistery. Both reliefs exhibit critical aspects regarding their state of conservation in particular the stability of the gold layer on the bronze surface. Moreover the east head presents a remelting of which extension and composition are still unknown. The present work describes a non-destructive study of the subgilding area and bulk. The two main objectives of such analyses are: (1) to study the manufacturing technique and state of conservation of the reliefs; and (2) to assess the two cleaning techniques (laser cleaning and Rochelle salts chemical cleaning) used by the conservators during the restoration process of the east door. The experiment was carried out using prompt gamma-ray activation imaging combined with neutron radiography and conventional neutron radiography. The former method was applied to map the elemental composition of the two reliefs, while neutron radiography was used to investigate the bulk. The results provide significant information about subsuperficial areas, elemental composition of the objects from the surface down to a depth of 1 mm below gilding, and bulk structure of the remelting. Such information will guide the curators in the selection of the most suitable microclimatic conditions for the exhibition of the east door and for future conservation work on the north door.
This stereoscopic shaded relief image shows Africa's topography as measured by the Shuttle Radar Topography Mission (SRTM) in February 2000. Also shown are Madagascar, the Arabian Peninsula, and other adjacent regions. Previously, much of the topography here was not mapped in detail. Digital elevation data, such as provided by SRTM, are in high demand by scientists studying earthquakes, volcanism, and erosion patterns and for use in mapping and modeling hazards to human habitation. But the shape of Earth's surface affects nearly every natural process and human endeavor that occurs there, so elevation data are used in a wide range of applications. The image shown here is greatly reduced from the original data resolution, but still provides a good overview of the continent's landforms. It is best viewed while panning at full resolution while using image display software. The northern part of the continent consists of a system of basins and plateaus, with several volcanic uplands whose uplift has been matched by subsidence in the large surrounding basins. Many of these basins have been infilled with sand and gravel, creating the vast Saharan lands. The Atlas Mountains in the northwest were created by convergence of the African and Eurasian tectonic plates. The geography of the central latitudes of Africa is dominated by the Great Rift Valley, extending from Lake Nyasa to the Red Sea, and splitting into two arms to enclose an interior plateau and the nearly circular Lake Victoria, visible in the right center of the image. To the west lies the Congo Basin, a vast, shallow depression that rises to form an almost circular rim of highlands. Most of the southern part of the continent rests on a concave plateau comprising the Kalahari Basin and a mountainous fringe, skirted by a coastal plain that widens out in Mozambique in the southeast. Specific noteworthy features one may wish to explore in this scene include (1) the Richat Structure in Mauritania, a 'bull's eye
Makvandi, Somayeh; Latifnejad Roudsari, Robab; Sadeghi, Ramin; Karimi, Leila
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.
Lee, Jeong Il; Lee, Kang Hyun; Kim, Oh Hyun; Cha, Yong Sung; Hwang, Sung Oh; Kim, Hyun; Cha, Kyung Chul
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).
Zhang, Cun; Tu, Shihao; Chen, Min; Zhang, Lei
Pressure relief gas extraction technology (PRGET) has been successfully implemented at many locations as a coal mine methane exploitation and outburst prevention technology. Comprehensive PRGET including gob gas venthole (GGV), crossing seam drilling hole (CSDH), large diameter horizontal long drilling hole (LDHLDH) and buried pipe for extraction (BPE) have been used to extract abundant pressure-relief methane (PRM) during protective coal seam mining; these techniques mitigated dangers associated with coal and gas outbursts in 13-1 coal seam mining in the Huainan coalfield. These extraction technologies can ensure safe protective seam mining and effectively extract coal and gas. This article analyses PRGET production performance and verifies it with the field measurement. The results showed that PRGET drilling to extract PRM from the protected coal seam significantly reduced methane emissions from a longwall ventilation system and produced highly efficient extraction. Material balance analyses indicated a significant decrease in gas content and pressure in the protected coal seam, from 8.78 m3 t-1 and 4.2 MPa to 2.34 m3 t-1 and 0.285 MPa, respectively. The field measurement results of the residual gas content in protected coal seam (13-1 coal seam) indicated the reliability of the material balance analyses and the pressure relief range of PRGET in the protected coal seam is obtained.
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.
Full Text Available Relief fits the definition of a reward. Unlike other reward types the pleasantness of relief depends on the violation of a negative expectation, yet this has not been investigated using neuroimaging approaches. We hypothesized that the degree of negative expectation depends on state (dread and trait (pessimism sensitivity. Of the brain regions that are involved in mediating pleasure, the nucleus accumbens also signals unexpected reward and positive prediction error. We hypothesized that accumbens activity reflects the level of negative expectation and subsequent pleasant relief. Using fMRI and two purpose-made tasks, we compared hedonic and BOLD responses to relief with responses during an appetitive reward task in 18 healthy volunteers. We expected some similarities in task responses, reflecting common neural substrates implicated across reward types. However, we also hypothesized that relief responses would differ from appetitive rewards in the nucleus accumbens, since only relief pleasantness depends on negative expectations. The results confirmed these hypotheses. Relief and appetitive reward task activity converged in the ventromedial prefrontal cortex, which also correlated with appetitive reward pleasantness ratings. In contrast, dread and pessimism scores correlated with relief but not with appetitive reward hedonics. Moreover, only relief pleasantness covaried with accumbens activation. Importantly, the accumbens signal appeared to specifically reflect individual differences in anticipation of the adverse event (dread, pessimism but was uncorrelated to appetitive reward hedonics. In conclusion, relief differs from appetitive rewards due to its reliance on negative expectations, the violation of which is reflected in relief-related accumbens activation.
Ostrander, Roger V; Leddon, Charles E; Hackel, Joshua G; O'Grady, Christopher P; Roth, Charles A
Braces designed to unload the more diseased compartment of the knee have been used to provide symptomatic relief from osteoarthritis (OA). Research on the efficacy of these braces is needed. Thirty-one patients with knee OA were randomized to receive an unloader brace (n = 16) or not to receive a brace (control group, n = 15). Knee Injury and Osteoarthritis Outcomes Score (KOOS) and visual analog scale (VAS) scores were used to evaluate outcomes. KOOS results showed that the brace group had significantly less pain (P knee-related quality of life (P = .718). VAS results showed that the brace group had significantly less pain throughout the day (P = .021) and had improved activity levels (P = .035). There was no difference in ability to sleep (P = .117) or in use of nonsteroidal anti-inflammatory drugs (P = .138). Our study results showed that use of an unloader brace for medial compartment knee OA led to significant improvements in pain, arthritis symptoms, and ability to engage in activities.
Umashankar, Mahesh Kotehal; Reddy, B.S. Jayakrishna
Introduction Low back pain affects every population and is one of world’s foremost debilitating conditions. Clinically significant sciatica due to lumbar disc prolapse occurs in 4-6% of population. Fenestration discectomy as a surgical procedure is less time consuming, with lesser blood loss, lesser post-operative complications and does not compromise with stability of spine when compared to laminectomy. Aim Present study was conducted to determine extent of functional recovery i.e. pain relief and return to work in patients with lumbar disc prolapse treated by fenestration technique. Materials and Methods From October 2010 to March 2012, 50 patients with signs and symptoms of prolapsed lumbar intervertebral disc who failed to respond to conservative treatment were operated for discectomy by fenestration technique and studied prospectively. Functional outcome was evaluated by ‘Back Pain Functional Score (BPFS)’ of Strafford et al., PROLO rating scale to determine preoperative functional and economical status and outcome at final follow up after 6 months. In order to identify physical signs from non organic signs Wadell’s score system was used. Result of surgery was evaluated with help of McNab’s criteria. Results In our study, according to Back Pain Functional Scale by Strafford et al., and PROLO scale, good results were found in 42 (84%) cases, fair result in 8 cases (16%) and none with poor results at follow up of six months. According to PROLO economical and functional scale, 84% cases were able to join their previous occupation at end of six months and 76% cases had complete pain relief. In our study, correlation of age and duration of symptoms to functional outcome was statistically significant (p=0.089 & p = 0.098+ respectively) showing more good results among patients with age less than 30 years and patients having duration of symptoms less than 6 months. Conclusion Functional outcome of fenestration technique in terms of return to work and
Wankhade, Ujjwal Gowardhan; Umashankar, Mahesh Kotehal; Reddy, B S Jayakrishna
Low back pain affects every population and is one of world's foremost debilitating conditions. Clinically significant sciatica due to lumbar disc prolapse occurs in 4-6% of population. Fenestration discectomy as a surgical procedure is less time consuming, with lesser blood loss, lesser post-operative complications and does not compromise with stability of spine when compared to laminectomy. Present study was conducted to determine extent of functional recovery i.e. pain relief and return to work in patients with lumbar disc prolapse treated by fenestration technique. From October 2010 to March 2012, 50 patients with signs and symptoms of prolapsed lumbar intervertebral disc who failed to respond to conservative treatment were operated for discectomy by fenestration technique and studied prospectively. Functional outcome was evaluated by 'Back Pain Functional Score (BPFS)' of Strafford et al., PROLO rating scale to determine preoperative functional and economical status and outcome at final follow up after 6 months. In order to identify physical signs from non organic signs Wadell's score system was used. Result of surgery was evaluated with help of McNab's criteria. In our study, according to Back Pain Functional Scale by Strafford et al., and PROLO scale, good results were found in 42 (84%) cases, fair result in 8 cases (16%) and none with poor results at follow up of six months. According to PROLO economical and functional scale, 84% cases were able to join their previous occupation at end of six months and 76% cases had complete pain relief. In our study, correlation of age and duration of symptoms to functional outcome was statistically significant (p=0.089 & p = 0.098+ respectively) showing more good results among patients with age less than 30 years and patients having duration of symptoms less than 6 months. Functional outcome of fenestration technique in terms of return to work and complete back and leg pain relief at end of six months had been
Champagnac, Jean-Daniel; Valla, Pierre; Herman, fred
The examination of the relationship between Earth's topography and present and past climate (i.e. long-term elevation of glaciers Equilibrium Line Altitude) reveals that the elevation of mountain ranges may be limited or controlled by glaciations. This is of prime importance, because glacial condition would lead to a limit the mountain development, hence the accumulation of gravitational energy and prevent the development of further glacial conditions as well as setting the erosion in (peri)glacial environments. This study examines the relationships between topography and the global Equilibrium Line Altitude of alpine glaciers around the world (long term snowline, i.e. the altitude where the ice mass balance is null). Two main observations can be drawn: 1) The distance between the (averaged and maximum) topography, and the ELA decreases pole ward the poles, and even become reversed (mean elevation above to ELA) at high latitude. Correlatively, the elevation of very large portion of land at mid-latitude cannot be related to glaciations, simply because it was never glaciated (large distance between topography and long-term mean ELA). The maximum distance between the ELA and the topography is greater close to the equator and decreases poleward. In absence of glacial and periglacial erosion, this trend cannot have its origin in glacial and periglacial processes. Moreover, the ELA elevation shows a significant (1000 - 1500m) depression in the intertropical zone. This depression of the ELA is not reflected at all in the topography. 2) The distribution of relief on Earth, if normalized by the mean elevation of mountain ranges (as a proxy for available space to create relief) shows a latitudinal band of greater relief between 40° and 60° (or between ELA of 500m to 2500m a.s.l.). This mid-latitude relatively greater relief challenges the straightforward relationship between glaciations, erosion and topography. Oppositely, it suggests that glacier may be more efficient
Thong, Melissa S. Y.; van Dijk, Sandra; Noordzij, Marlies; Boeschoten, Elisabeth W.; Krediet, Raymond T.; Dekker, Friedo W.; Kaptein, Adrian A.
BACKGROUND: To date, the pathophysiology underlying symptoms in renal patients is still unclear. Symptom management research suggests that identification of related clusters of symptoms could provide insight into underlying determinants associated with multiple symptom experience. Theoretically,
Messinger, David W.; van Aardt, Jan; McKeown, Don; Casterline, May; Faulring, Jason; Raqueño, Nina; Basener, Bill; Velez-Reyes, Miguel
The Wildfire Airborne Sensor Program (WASP) is an imaging system designed, built, and operated by the RIT Center for Imaging Science. The system consists of four cameras: a high resolution color camera and SWIR, MWIR, and LWIR cameras. When flown with our corporate partners, Kucera International, the imaging system is combined with a high-resolution LIDAR. This combination provides a full-spectrum, multimodal data collection platform unique to RIT. Under funding by the World Bank, the WASP system was used to image over 250 sq. mi. in Haiti (approximately 15,000 visible and 45,000 infrared frames) from January 21 - 27, 2010 in support of the earthquake relief efforts. Priorities of collection were the area surrounding Port au Prince, the city of Leogane, several other badly damaged towns, and, at the request of the USGS, a high resolution LIDAR collection over the fault line. The imagery was used in the field by disaster relief workers and by collaborators at the University of Buffalo and ImageCat, Inc. to perform building damage and road network trafficability assessments. Additionally, large area mosaics and semi-automatic processing algorithms were developed for value-added product development. In particular, a methodology was developed to extract the locations of blue tarps (indicative of displaced persons) from the images. All imagery was made available to the public through outlets such as Google Earth, the University of Buffalo, the US Geological Survey, the United Nations, and other sites.
Lee, Ji Eun; Park, Subin; Park, Min; Kim, Myung Hun; Park, Chun Gwon; Lee, Seung Ho; Choi, Sung Yoon; Kim, Byung Hwi; Park, Hyo Jin; Park, Ji-Ho; Heo, Chan Yeong; Choy, Young Bin
Surgical suture is a strand of biocompatible material designed for wound closure, and therefore can be a medical device potentially suitable for local drug delivery to treat pain at the surgical site. However, the preparation methods previously introduced for drug-delivery sutures adversely influenced the mechanical strength of the suture itself - strength that is essential for successful wound closure. Thus, it is not easy to control drug delivery with sutures, and the drug-delivery surgical sutures available for clinical use are now limited to anti-infection roles. Here, we demonstrate a surgical suture enabled to provide controlled delivery of a pain-relief drug and, more importantly, we demonstrate how it can be fabricated to maintain the mechanical strength of the suture itself. For this purpose, we separately prepare a drug-delivery sheet composed of a biocompatible polymer and a pain-relief drug, which is then physically assembled with a type of surgical suture that is already in clinical use. In this way, the drug release profiles can be tailored for the period of therapeutic need by modifying only the drug-loaded polymer sheet without adversely influencing the mechanical strength of the suture. The drug-delivery sutures in this work can effectively relieve the pain at the surgical site in a sustained manner during the period of wound healing, while showing biocompatibility and mechanical properties comparable to those of the original surgical suture in clinical use. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
Alessandra Lopez y Royo Iyer
Full Text Available This article discusses research carried out in 1999 at the School of Performing Arts of the University of Surrey, Dance Studies Department. For this research project, computer animation modelling techniques were used to recreate a series of dance movement sequences depicted in the reliefs around the balustrade of the main temple at the Prambanan temple complex in Central Java, built in the 9th century CE. The reconstruction and re-creation of the dance movements from the reliefs are inseparable from the context of the temple complex. The issues of heritage, its interpretation and conservation are also discussed, particularly since the construction of dance as heritage is widespread in Southeast Asia and is linked with tourist consumption of archaeological sites. The article makes a case for the use of computer technology in research areas previously regarded as distinct and disconnected, such as archaeology, art history and dance, and in this specific case study, computer technology has provided a bridge between these disciplines.
Rezk, Emtithal; Nofal, Yazan H; Hamzeh, Ammar; Aboujaib, Muhammed F; AlKheder, Mohammad A; Al Hammad, Muhammad F
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
Full Text Available Relief valves are widely used in industrial machinery. Due to the outlet of the relief valve being connected to the tank, the pressure drop of the relief valve is frequently equal to the inlet pressure. Accordingly, the energy loss of the relief valve is very high in some cases and this will worsen with an increase in the rated pressure of the hydraulic system. In order to overcome the disadvantage of overflow energy loss in a relief valve, a hydraulic energy regeneration unit (HERU is connected to the outlet of the relief valve to decrease the pressure drop between the inlet and outlet of the relief valve. The overflow loss, which is characterized by the pressure drop, can be reduced accordingly. The approach is to convert the overflow energy loss in hydraulic form and allow for release when needed. The configuration and working principle of the relief valve with HERU is introduced in this present study. The mathematical model is established to obtain the factors influencing the stability of the relief valve. The working pressure of the hydraulic accumulator (HA is explored. Furthermore, the control process of the operating state of the HA is scheduled to decide whether to regenerate the energy via the HERU. The software AMESim is utilized to analyze the performance and characteristics of the relief valve with HERU. Following this, the test rig is built and used to verify the effectiveness of the proposed relief valve with HERU. The experimental results show that the relief valve with the HERU connected to its outlet can still achieve better pressure-regulating characteristics. The energy regeneration efficiency saved by the HA is up to 83.6%, with a higher pre-charge pressure of the HA. This indicates that the proposed structure of the relief valve with HERU can achieve a better performance and higher regeneration efficiency.
Student: Muhammad Abu Bakr UNOSAT is part of the United Nations Institute for Training and Research (UNITAR). It provides a rapid front-line service to turn satellite imagery into information that can aid disaster-response teams. By delivering imagery analysis and satellite solutions to relief and development organizations — both within and outside the UN system — UNOSAT helps to make a difference in critical areas such as humanitarian relief, human security, and development planning. Since 2001, UNOSAT has been based at CERN and is supported by CERN's IT Department in the work it does. This partnership means UNOSAT can benefit from CERN's IT infrastructure whenever the situation requires, enabling the UN to be at the forefront of satellite-analysis technology. Specialists in geographic information systems and in the analysis of satellite data, supported by IT engineers and policy experts, ensure a dedicated service to the international humanitarian and development communities 24 hours a day, seven days a...
Birnbaum, Marvin L; Daily, Elaine K; O'Rourke, Ann P
The principal goal of research relative to disasters is to decrease the risk that a hazard will result in a disaster. Disaster studies pursue two distinct directions: (1) epidemiological (non-interventional); and (2) interventional. Both interventional and non-interventional studies require data/information obtained from assessments of function. Non-interventional studies examine the epidemiology of disasters. Interventional studies evaluate specific interventions/responses in terms of their effectiveness in meeting their respective objectives, their contribution to the overarching goal, other effects created, their respective costs, and the efficiency with which they achieved their objectives. The results of interventional studies should contribute to evidence that will be used to inform the decisions used to define standards of care and best practices for a given setting based on these standards. Interventional studies are based on the Disaster Logic Model (DLM) and are used to change or maintain levels of function (LOFs). Relief and Recovery interventional studies seek to determine the effects, outcomes, impacts, costs, and value of the intervention provided after the onset of a damaging event. The Relief/Recovery Framework provides the structure needed to systematically study the processes involved in providing relief or recovery interventions that result in a new LOF for a given Societal System and/or its component functions. It consists of the following transformational processes (steps): (1) identification of the functional state prior to the onset of the event (pre-event); (2) assessments of the current functional state; (3) comparison of the current functional state with the pre-event state and with the results of the last assessment; (4) needs identification; (5) strategic planning, including establishing the overall strategic goal(s), objectives, and priorities for interventions; (6) identification of options for interventions; (7) selection of the most
Kasten, Meike; Kertelge, Lena; Brüggemann, Norbert
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....
Hayduk, Leslie; Olson, Karin; Quan, Hue; Cree, Marilyn; Cui, Ying
We use longitudinal data to test and extend a structural equation model documenting changes in the causal connections among symptoms experienced in the final weeks of life. Our central thesis is that the relief of suffering and the promotion of quality end of life care require tailoring interventions to reflect the shifting causal foundations of symptoms. Symptom information on pain, anxiety, nausea, shortness of breath, drowsiness, loss of appetite, tiredness, depression, and well-being was extracted from a palliative care database. For each of the 82 study participants, symptom scores measured at 4 full weeks and 1 full week prior to death were used to test a structural equation model of the causal structures underlying symptom clusters. This investigation confirms the reasonableness of our previously developed model. Tiredness, depression, and well-being were sufficiently labile that the observations at one week before death were not significantly dependent on the corresponding observations 3 weeks earlier. Patients' assessments of pain, anxiety, nausea, shortness of breath, drowsiness, and appetite were only moderately stable over this same period. The stability in some, and instability in other, symptoms meshed convincingly with the changes in symptom causal structures previously derived from cross-sectional data. Investigations assessing temporal shifts in palliative symptom coordination over longer periods of time and for specific medical conditions and social contexts seem warranted.
Roering, Joshua J.; Perron, J. Taylor; Kirchner, James W.
Functional relationships between landscape morphology and denudation rate allow for the estimation of sediment fluxes using readily available topographic information. Empirical studies of topography-erosion linkages typically employ data with diverse temporal and broad spatial scales, such that heterogeneity in properties and processes may cloud fundamental process-scale feedbacks between tectonics, climate, and landscape development. Here, we use a previously proposed nonlinear model for sediment transport on hillslopes to formulate 1-D dimensionless functions for hillslope morphology as well as a generalized expression relating steady-state hillslope relief to erosion rate, hillslope transport parameters, and hillslope length. For study sites in the Oregon Coast Range and Gabilan Mesa, CA, model predictions of local relief and average hillslope gradient compare well with values derived from high-resolution topographic data acquired via airborne laser altimetry. Our formulation yields a nondimensional number describing the extent to which the nonlinearity in our gradient-flux model affects slope morphology and landscape response to tectonic and climatic forcing. These results should be useful for inferring rates of hillslope denudation and sediment flux from topography, or for coarse-scale landscape evolution simulations, in that first-order hillslope properties can be calculated without explicit modeling of individual hillslopes.
Zimbeck, Walter R.
This manuscript describes an example of transfer technology from a U.S. Government Laboratory to commercial products that meet national needs in the public safety and health care sectors. Funded by the U.S. Army, the first project is the development of a portable, non-powered food warming device for serving meals to soldiers in the field. The second project is being funded by the National Institutes of Health for development of a heat therapy device for relief from rheumatoid arthritis discomfort in the hands and other affected joints. Both of these heating devices are portable, reusable heat pack products that can be regenerated in a microwave oven or in boiling water. The knowledge developed during these two projects will be applied to many other related products. Applications in support of natural and manmade disaster relief include food warming heat packs for food service to victims and rescue workers in sustained black-out conditions, and heat pack warming blankets for emergency medical situations in which patients are in traumatic shock and the onset of hypothermia is imminent.
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.
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.
Kreitler, S; Kreitler, H; Carasso, R
The study investigated the role of beliefs concerning pain relief after treatment. Following the cognitive orientation theory, we hypothesized that beliefs concerning goals, norms, oneself, and general beliefs would predict the extent of improvement following acupuncture. Subjects were 30 Israeli chronic-pain patients (22 women, 8 men; mean age 41.6 years). They were administered a questionnaire assessing the 4 belief types, and control measures assessing personality traits, demographic variables, and pain characteristics. All underwent 4-6 acupuncture sessions. Improvement was determined by patient and physician ratings, and an index based on medication, subjective evaluations, and duration of resting. There were two follow-ups. Three improvement groups were defined: none (n = 8), slight (n = 12), and high (n = 10). These groups did not differ on any of the variables tested except the 4 belief types. A discriminant analysis with belief types as predictors enabled correct classification of the patients in 83% of the cases. A stepwise regression analysis showed that beliefs accounted for 85% of the variance. Discussion focuses on the nature of pain relief and the role of beliefs in disease.
Mahmud, Tanvir; Prowse, Martin
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 intervi......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 interviews, the article investigates the nature and extent of corruption in pre- and post-disaster interventions in Khulna before and after Cyclone Aila in May 2009. Ninety nine percent of households reported losses from corrupt practices. Post-disaster interventions (such as food aid and public works...... schemes) suffered from greater levels, and worse types, of corruption than pre-disaster interventions (such as cyclone warning systems and disaster-preparedness training). Using an asset index created using principal component analysis, the article assesses how corruption affected wealth quartiles. Ultra...
Wu, Ching-Tang; Fan, Yu-Ming; Sun, Chen-Ming; Borel, Cecil O; Yeh, Chun-Chang; Yang, Chih-Ping; Wong, Chih-Shung
Analyzing changes in regional cerebral blood flow (rCBF) with SPECT in complex regional pain syndrome type 1 (CRPS 1), formerly known as reflex sympathetic dystrophy, is an optimal method for evaluating effective pain relief. We attempted to investigate the correlation of changes in rCBF with pain relief during treatments of sympathetic blockade and multimodal epidural pain control. We describe a patient with severe CRPS 1 in whom conventional treatment failed to relieve the pain. Combined repeated lumbar sympathetic blocks and long-term epidural morphine, bupivacaine, and ketamine administration provided satisfactory pain relief and functional activity recovery. Six normal control subjects having one Tc-99m HMPAO scan each and the patient with CRPS having 3 Tc-99m HMPAO scans (once before treatment and twice at 4 months and 6 months after treatment, respectively). The patient with CRPS showed lower rCBF than normal controls in the left thalamus and higher rCBF than normal controls in the right parietal lobe and left frontal lobe. After subsequent treatment, the subtraction images showed increased rCBF in the left thalamus and decreased rCBF in the right parietal and left frontal lobes. Tc-99m HMPAO SPECT showed a relationship of rCBF in the thalamus, parietal lobe, and frontal lobe with pain relief. rCBF alterations may provide an indicator for the quality of pain management for neuropathic pains. Subtraction analysis between pre- and posttreatment, by using statistical parametric mapping (version 2), can be used as an objective indicator for the effectiveness of therapy.
Full Text Available In order to study the law of pressure relief of upper protective layer mining. Through theoretical analysis and numerical simulation method, studied the distance on the protection layer mining floor stress field evolution and distribution, found a protective layer on the longwall mining goaf bottom coal seam inclination direction is concave, and strike plane was “O” shape of relief ball shell, the pressure relief angle in the cut or end mining line near the corner of the middle bottom is minimum, the scope of protection of coal seam pressure relief effect than on both sides of the pressure relief effect, namely the scope of protection of inclined coal seam central drainage radius than the two larger; in the trend of protected layer pressure relief protection layer mining face lag distance based on this theory, research to guide the protected layer of gas drilling drainage is very important.
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Alino, Justin; Kosatka, Donald; McLean, Brian; Hirsch, Kenneth
Report the efficacious use of stellate ganglion blocks (SGBs) in treating the anxiety symptoms of four patients diagnosed with combat-related post-traumatic stress disorder (PTSD) and discuss possible mechanisms of action to explain these findings. Successful treatment of PTSD with SGB has been demonstrated and reported previously at Walter Reed Army Medical Center. An identical protocol was used at Tripler Army Medical Center to treat four service members diagnosed with combat-related PTSD. All patients reported received an SGB on the right side at the level of C6. The patient's PTSD symptoms were evaluated using the Post-traumatic Stress Disorder Checklist (PCL). This checklist was distributed one day before treatment and again the day following treatment. The patients were also given the PCL at subsequent follow-up visits to quantify sustained benefit. SGB showed acute benefit for the symptoms of PTSD by markedly reduced PCL scores after the procedure. Benefits were also sustained during close outpatient follow-up. Selective blockade of the right stellate ganglion at C6 is a minimally invasive procedure with an excellent safety profile that may provide sustained relief of PTSD symptoms. The procedure may also provide benefit for those who are resistant to psychotropic intervention. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
Deshmukh, Ajit J.; Rodriguez, Jose A. [North Shore LIJ Lenox Hill Hospital, Department of Orthopaedic Surgery, New York, NY (United States); Panagopoulos, Georgia [North Shore LIJ Lenox Hill Hospital, Department of Research, New York, NY (United States); Alizadeh, Ahmadreza; Klein, Devon A. [North Shore LIJ Lenox Hill Hospital, Department of Radiology, New York, NY (United States)
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.)
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
Wang, Michael T M; Chan, Evon; Ea, Linda; Kam, Clifford; Lu, Yvonne; Misra, Stuti L; Craig, Jennifer P
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.
Bailey, Edmund; Worthington, Helen V; van Wijk, Arjen; Yates, Julian M; Coulthard, Paul; Afzal, Zahid
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
Malterud, Kirsti; Guassora, Ann Dorrit Kristiane; Graungaard, Anette Hauskov
The aim of this article is to present a conceptual review and analysis of symptom understanding. Subjective bodily sensations occur abundantly in the normal population and dialogues about symptoms take place in a broad range of contexts, not only in the doctor’s office. Our review of symptom...
Rączkowska, Zofia; Długosz, Michał; Rojan, Elżbieta
Snow avalanches are among the main factors influencing the high-mountain environment of the Tatra Mts. and their denudation system in the three uppermost geoecological belts. Dirty avalanches are assumed to be an important morphogenetic factor but also relief affects spatial differentiation of snow avalanche activity. The research aims to recognize the geomorphological conditions for avalanches and assessment of the morphogenetic role of avalanches in the whole Tatra Mts. For recognition of geomorphological conditions of snow avalanches activity was made map of avalanches paths, based on maps of snow avalanches occurred in the recent past, air- photos and digital terrain model. Starting zone and transition zone were specified within each path. For each type of designated zones the morphometric analysis was made, taking in account slope aspect and inclination. The map presents more than 3700 avalanche paths. The number of avalanche paths is more than double in the High Tatras than in the Western Tatras. Morphometric features and altitudinal range of avalanche paths also differ in individual parts of the Tatras what correspond with the relief differences. Length of avalanche paths reach up to 3138 m and in average is the biggest avalanche in the Bielanske Tatra. The paths are located about 200 m higher in the High Tatras than in other parts of the massif. There is no clear relationship between exposure of the slopes and the distribution of the avalanche path, while relationship with slope inclination is distinct. Over 70% of the avalanche paths occur on slopes 26-55o. Similar patterns were found in the distribution of avalanche accumulation zones. Detailed studies of morphogenetic role of avalanches are conducted in four chosen avalanche paths located both in the Western and the High Tatras. Measuring points of erosion, transport and accumulation installed there in the autumn 2012 are checked two times a year. It was found that effects of snow avalanches on the
Frederico Augusto Guimarães Guilherme
Full Text Available In tropical forests, the environmental heterogeneity can provide niche partitioning at local scales and determine the diversity and plant species distribution. Thus, this study aimed to investigate the variations of tree species structure and distribution in response to relief and soil profile features in a portion of the largest remnant of Brazilian Atlantic rain forest. All trees ³ 5 cm diameter at breast height were recorded in two 0.99 ha plots. Topographic survey and a soil characterization were accomplished in both plots. Topsoil samples (0-20 cm were taken from 88 quadrats and analyzed for chemical and particle size properties. Differences for both diversity and tree density were identified among three kinds of soils. A canonical correspondence analysis (CCA indicated that the specific abundance varied among the three kinds of soils mapped: a shallow Udept - Orthent / Aquent gradient, probably due to differences in soil drainage. Nutrient content was less likely to affect tree species composition and distribution than relief, pH, Al3+, and soil texture. Some species were randomly distributed and did not show restriction to relief and soil properties. However, preferences in niche occupation detected in this study, derived from the catenary environments found, rise up as an important explanation for the high tree species diversity in tropical forests.
Founds, Sandra A; Tsigas, Eleni; Ren, Dianxu; Barmada, M Michael
Preeclampsia is a complex genetic disorder with an incompletely understood pathogenesis. Its phenotype may be better elucidated by integrating symptoms. This study aimed to identify symptoms by gestational age and associations with novel preeclampsia candidate genes. Women with a history of preeclampsia recruited from The Preeclampsia Registry completed clinical/demographic, symptom surveys and provided medical records. DNA extracted from saliva was processed with multiplexed assays for eight single-nucleotide polymorphisms (SNPs) selected to tag candidate genes and/or located in symptom susceptibility regions. Groups with versus without symptoms were compared using χ 2 . Associations between SNPs and symptoms were analyzed as genotype categories and presence/absence of the variant allele. Logistic regression modeling was conducted with exploratory p = .05. In 114 participants, 113 reported at least 1 of the 18 symptoms. Symptoms varied by trimester. Nine symptoms were associated with seven SNPs. Visual disturbances were associated with three SNPs and nausea/vomiting with two SNPs. Modeling adjustment for maternal age and parity resulted in 15 associations between 9 symptoms and 8 SNPs. Medical records demonstrated 100% concordance with self-reported diagnosis and 48% concordance with reported severity. Findings indicated novel symptom-genotype associations in preeclampsia. The small sample was self-selected, but results support future studies including medical records review. When validated, these results may lead to holistic phenotyping of women to characterize subsets of preeclampsia. This approach may optimize health in pregnancy and later life for mothers and offspring through prediction, prevention, and precision nursing care.
Simon, Steffen T; Higginson, Irene J; Booth, Sara; Harding, Richard; Weingärtner, Vera; Bausewein, Claudia
This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD). The primary objective of this review was to determine the efficacy of benzodiazepines for the relief of breathlessness in people with advanced disease. Secondary objectives were to determine the efficacy of different benzodiazepines, different doses of benzodiazepines, different routes of application, adverse effects of benzodiazepines, and the efficacy in different disease groups. This is an update of a review published in 2010. We searched 14 electronic databases up to September 2009 for the original review. We checked the reference lists of all relevant studies, key textbooks, reviews, and websites. For the update, we searched CENTRAL, MEDLINE, and EMBASE and registers of clinical trials for further ongoing or unpublished studies, up to August 2016. We contacted study investigators and experts in the field of palliative care asking for further studies, unpublished data, or study details when necessary. We included randomised controlled trials (RCTs) and controlled clinical trials (CCTs) assessing the effect of benzodiazepines compared with placebo or active control in relieving breathlessness in people with advanced stages of cancer, chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), motor neurone disease (MND), and idiopathic pulmonary fibrosis (IPF
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 ( ...
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.
Fogh, Karsten; Andersen, Maibritt B; Bischoff-Mikkelsen, Morten
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...
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.
Alaranta, H; Hurri, H
The aim of this questionnaire-based 12-month follow-up study of 113 patients was to elucidate patient compliance and subjective help achieved with a first, elastic or semirigid corset in chronic, idiopathic low back pain. Subjective help obtained from the corset was reported as excellent or good in 37% of the returned questionnaires. A total of 60% reported having worn the corset even during the preceding month. Low semirigid and elastic models were found to be better by the males and high semirigid ones by the females (p less than 0.001). Age, height, weight, body mass index, retirement or physical strenuousness of work showed no statistically significant correlation with the subjective relief gained from the corset. It is important that sufficient time be allocated to fitting the corset and that adequate information be provided about wearing the brace and about suitable trunk exercises.
Harris, S.; Gross, R.
The safety integrity level (SIL) of equipment used in safety instrumented functions is determined by the average probability of failure on demand (PFDavg) computed at the time of periodic inspection and maintenance, i.e., the time of proof testing. The computation of PFDavg is generally based solely on predictions or estimates of the assumed constant failure rate of the equipment. However, PFDavg is also affected by maintenance actions (or lack thereof) taken by the end user. This paper shows how maintenance actions can affect the PFDavg of spring operated pressure relief valves (SOPRV) and how these maintenance actions may be accounted for in the computation of the PFDavg metric. The method provides a means for quantifying the effects of changes in maintenance practices and shows how these changes impact plant safety.
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.
Judith H Watt-Watson
Full Text Available The present report outlines key requirements that are central to helping patients manage pain effectively. Although current standards are available as guides for practice, the prevalence of pain suggests that many health professionals do not know and/or cannot relate to these standards. Therefore, a brief, pragmatic statement may be more useful initially for health professionals and patients learning about problematic pain outcomes. The principles in the brief statement produced by the Canadian Pain Society clarify and emphasize key underlying assumptions that have directed the development of many pain standards. The aim of the present paper is to increase awareness of ineffective pain practices and the importance of pain relief, and to stimulate further work in this area.
Full Text Available This research study is an effort to shed light on how transshipment may help improve the management of inventory in a disaster relief system. System dynamics simulation was used to compare inventory control and costs in a humanitarian supply chain without transshipment vs. one with transshipment. A framework for this approach is given along with the results of simulations on a system consisting of two warehouses where transshipment is allowed compared to the alternative where transshipment is not allowed. The preliminary results of this study indicate that transshipment can reduce costs and improve service to disaster victims based on inventory levels maintained in the warehouses. In some cases, transshipment may be more expensive, but this assumes the cost of replenishing inventory as a result of emergency purchase costs.
Borup, Lissa; Wurlitzer, Winnie; Hedegaard, Morten
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......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...
Borup, Lissa; Wurlitzer, Winnie; Hedegaard, Morten
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......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...
Cole, H. J.; Dixit, S. N.; Shore, B. W.; Chambers, D. M.; Britten, J. A.; Kavaya, M. J.
LIDAR systems require a light transmitting system for sending a laser light pulse into space and a receiving system for collecting the retro-scattered light, separating it from the outgoing beam and analyzing the received signal for calculating wind velocities. Currently, a shuttle manifested coherent LIDAR experiment called SPARCLE (SPAce Readiness Coherent Lidar Experiment) includes a silicon wedge (or prism) in its design in order to deflect the outgoing beam 30 degrees relative to the incident direction. The intent of this paper is to present two optical design approaches that may enable the replacement of the optical wedge component (in future, larger aperture, post-SPARCLE missions) with a surface relief transmission diffraction grating. Such a grating could be etched into a lightweight, flat, fused quartz substrate. The potential advantages of a diffractive beam deflector include reduced weight, reduced power requirements for the driving scanning motor, reduced optical sensitivity to thermal gradients, and increased dynamic stability.
Mahéo, Gweltaz; Gourbet, Loraine; Hervé Leloup, Philippe; Sorrel, Philippe; Shuster, David L.; Paquette, Jean-Louis; Quillévéré, Frédéric
The Tibetan plateau is defined as a low relief high elevation zone, resulting from India-Asia convergence. However, its morphology is relatively heterogeneous. Especially the western Tibetan plateau is characterized by a strong relief, numerous peaks higher than 6000 m.a.s.l. and large (up to 10 km), deep (1-2 km) valleys. We investigate the origin of this particular morphology, coupling geomorphologic studies with sedimentary records and (U-Th)/He thermochronometry. The western Tibet Tertiary sedimentation is mostly characterized by conglomerates, red sandstone and siltstones related with alluvial fan deposits. Zircon U-Pb dating of interbedded trachyte flows implies that deposition started before 25 Ma and was still ongoing at 20 Ma. These continental, detrital deposits are filling wide open valleys during probable arid climatic conditions. Such valleys are thus interpreted as inherited basins, paleovalleys, formed before detrital sedimentation i.e. at ~25 Ma. Moreover, rare marine sediments were observed below the detrital deposits. Foraminifera suggest an Oligocene age, which implies that the paleovalleys already existed during the Oligocene, and that the emersion of the Western Tibetan Plateau occurred between the Oligocene and 25 Ma. This emersion thus occurred much later than the India-Asia collision (~50-45Ma) but is compatible with the onset of the main thickening phase of the Indian plate. The orientation of the inherited valley axis appears to be that of active strike slip faults that induced eastward extrusion of Western Tibet. This suggests that such extrusion was already active at the time of sedimentation (both marine and continental). Thus extrusion was also active during the plateau emersion at Oligocene time. The morphology of the valleys, and their sedimentary infilling, suggest that a significant relief, similar to present-day one (about 1000-2000m between valleys floor and surrounding peaks) already existed at the time of sedimentation. This
Laiane Medeiros Ribeiro
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.
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.
Leknes, Siri; Berna, Chantal; Lee, Michael C; Snyder, Gregory D; Biele, Guido; Tracey, Irene
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. Copyright © 2012 International Association for the Study of Pain. All rights reserved.
Blagovolin, N.S.; Pshenin, G.N.
The northern flank of the extended Alpian folded belt (Tetis) which is known under the common name of Paratetis underwent several large tectonic epochs. The article indicates the constant development within the Crimean-Caucasus and Central Asian sectors of the Paratetis of a mountain relief which begins from the epigeosynclinal orgenic structures and is maintained by numerous subsequent phases of tectonic activation. The method in completeness of a known concept regarding the latest tectonic deformations of the socalled preorgenic surface of planation is stressed as the basis of the mountain relief of the Crimea, Caucasus and large part of the Central Asian mountains. A survey is made of the data regarding the distribution of stable carbon isotopes in an insoluble (debituminized) organic matter (IOM). A study is made of the carbon isotope composition in IOM from deposits of the Riphean, Vendian, Paleozoic and Mesozoic of the Siberian platform in the West Siberian plate. The isotope composition of carbon varies from -23 to 35/sup 0//oo. The dependence of the isotope composition of SOM on its original genetic type is complicated to a certain measure by the influence of diagnetic transformations of aquagenic organic matter and the effect of apocatagenesis and metagenesis. It is noted, that contrary to the viewpoint dominant in the literature, the main law governing the distribution of carbon isotopes and SOM of sedimentary rocks of the Phanerozoic at the stages of the proto-and mesocatagenesis is enrichment of the aquagenic SOM with the C /sup 12/ isotope as compared to the terrigenous.
van Wyk de Vries, Benjamin
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.
Intervenção coronariana percutânea (ICP para pacientes estáveis: há algum benefício além do alívio dos sintomas? Intervención coronaria percutánea (icp para pacientes estables: ¿hay algún beneficio además de los síntomas? Percutaneous coronary intervention for stable patients: is there any benefit beyond symptom relief?
to an initial strategy of PCI plus optimal medical therapy versus optimal medical therapy alone. In patients with chronic stable angina, medical therapy remains the cornerstone and should be optimized for all patients, while the major achievable goals of PCI are to affect symptoms, either by decreasing or preventing them, reducing the need for subsequent procedures and relieving ischemia. In patients with stable coronary artery disease, however, no reduction in death or myocardial infarction has been observed, and these limitations of PCI in this clinical setting need to be emphasized. The message from the COURAGE trial may be refined based on recently presented nuclear and angiographic sub-studies, such that patients with substantial residual ischemia on optimal medical therapy should be considered for crossover PCI, as it is associated with greater likelihood of death and myocardial infarction. However, those findings need to be confirmed by prospective evaluation before being widely accepted by the interventional community.
Wilder-Smith, C H; Materna, A; Wermelinger, C; Schuler, J
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 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. 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
Wilder-Smith, C H; Materna, A; Wermelinger, C; Schuler, J
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.
Grunebaum, Michael F.; Keilp, John G.; Ellis, Steven P.; Sudol, Katherin; Bauer, Neal; Burke, Ainsley K.; Oquendo, Maria A.; Mann, J. John
Objective Identifying the depression symptoms most closely associated with suicidal thoughts and which medications provide the fastest relief may help suicide prevention. Method Post hoc analysis of data from a randomized, double-blind, eight-week clinical trial of the serotonin reuptake inhibitor paroxetine (N=36) versus the norepinephrine-dopamine reuptake inhibitor bupropion (N=38) in patients with DSM-IV major depressive disorder and past suicide attempt or current suicidal thoughts. Treatment effects on Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory symptom clusters were compared. We hypothesized a superior effect of paroxetine on non-suicide, affective/cognitive depression symptom clusters that our prior work found to be associated with suicidal thoughts and attempts. Data were collected from February 2005 to January 2010. Results There was a treatment main effect on HDRS Psychic Depression (depressed mood, guilt, retardation, helpless, hopeless, worthless) (estimate = −2.2, 95% CI = −3.2 to −1.1, t = −4.01, df = 67.16, p Psychic Depression scores after one week of paroxetine, compared to bupropion, and was statistically significant until Week 4. Results for other depression scale factors were non-significant (p > 0.05). Conclusion The results require replication, but suggest a pathway by which SSRI treatment may exert a stronger effect compared with NDRI treatment on reduction of suicidal thoughts during initial weeks of pharmacotherapy in these higher risk patients. PMID:24107760
Full Text Available Chronic subjective tinnitus is characterized by abnormal neuronal synchronization in the central auditory system. As shown in a controlled clinical trial, acoustic coordinated reset (CR neuromodulation causes a significant relief of tinnitus symptoms along with a significant decrease of pathological oscillatory activity in a network comprising auditory and non-auditory brain areas, which is often accompanied with a significant tinnitus pitch change. Here, we studied if the tinnitus pitch change correlates with a reduction of tinnitus loudness and/or annoyance as assessed by visual analogue scale (VAS scores. Furthermore, we studied if the changes of the pattern of brain synchrony in tinnitus patients induced by 12 weeks of CR-therapy depend on whether or not the patients undergo a pronounced tinnitus pitch change. For this, we applied standardized low-resolution brain electromagnetic tomography (sLORETA to EEG recordings from two groups of patients with a sustained CR-induced relief of tinnitus symptoms with and without tinnitus pitch change. We found that absolute changes of VAS loudness and VAS annoyance scores significantly correlate with the modulus of the tinnitus pitch change. Moreover, as opposed to patients with weak or no pitch change we found a significantly stronger decrease in gamma power in patients with pronounced tinnitus pitch change in right parietal cortex (BA 1, 40, right frontal cortex (BA 8, 9, 46, and left frontal cortex (BA 4, 6, combined with a significantly stronger increase of alpha (10-12 Hz activity in the right anterior cingulate cortex (BA 32, 24. In addition, we revealed a significantly lower functional connectivity in the gamma band between the right dorsolateral prefrontal cortex (BA 9 and the right anterior cingulate cortex (BA 32 after 12 weeks of CR-therapy in patients with pronounced pitch change. Our results indicate a substantial, CR-induced reduction of tinnitus-related auditory binding in a pitch
The Environmental Technology Verification report discusses the technology and performance of a pressure relief valve for protection of storage tanks that operate at pressures of 15 psig or less. Four Pin-Tech Bubble Tight <500 ppm Relief Vent valves manufactured by the Protectose...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted intracerebral/subcortical stimulator for... 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...
... 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... severe intractable pain. The stimulator consists of an implanted receiver with electrodes that are placed...
Diegelmann, Sören; Preuschoff, Stephan; Appel, Mirjam; Niewalda, Thomas; Gerber, Bertram; Yarali, Ayse
Painful events shape future behaviour in two ways: stimuli associated with pain onset subsequently support learned avoidance (i.e. punishment-learning) because they signal future, upcoming pain. Stimuli associated with pain offset in turn signal relief and later on support learned approach (i.e. relief-learning). The relative strengths of such punishment- and relief-learning can be crucial for the adaptive organization of behaviour in the aftermath of painful events. Using Drosophila, we compare punishment- and relief-memories in terms of their temporal decay and sensitivity to retrograde amnesia. During the first 75 min following training, relief-memory is stable, whereas punishment-memory decays to half of the initial score. By 24 h after training, however, relief-memory is lost, whereas a third of punishment-memory scores still remain. In accordance with such rapid temporal decay from 75 min on, retrograde amnesia erases relief-memory but leaves a half of punishment-memory scores intact. These findings suggest differential mechanistic bases for punishment- and relief-memory, thus offering possibilities for separately interfering with either of them. PMID:23658002
The Milli hat is one of the most elaborately hand-woven crafts created by Kurdish women in Makriyan region. They use diverse ways of symmetry to bring graceful and exquisite reliefs into being and present them to their men. The present study aims to collect, identify and visually analyze the compound recurring reliefs on ...
Background: Reported studies in the African population, on early pain relief in patients with acute abdominal pain are few. The objective of the study was to evaluate the effect of pentazocine (PZ) on pain relief, diagnostic accuracy and treatment decisions in patients with acute abdominal pain. Methods: This was a ...
The attitude of 110 mothers to labour pains and its relief were assessed 24 hours after normal vaginal deliveries in the post-natal ward of the University of Calabar Teaching Hospital. The study was carried out with the view of formally introducing pain relief in labour (epidural analgesia in the University of Calabar Teaching ...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Special relief approval authority for State Executive... SERVICE AGENCY, DEPARTMENT OF AGRICULTURE FARM MARKETING QUOTAS, ACREAGE ALLOTMENTS, AND PRODUCTION... relief approval authority for State Executive Directors. (a) General nature of the special authority...
... for installation on explosion-proof enclosures to relieve pressure, ventilate, or drain will be... metal will prevent discharge of flame in explosion tests. (b) Devices for pressure relief, ventilation.... (c) Devices for pressure relief, ventilation, or drainage will be acceptable for application only on...
... 46 Shipping 5 2010-10-01 2010-10-01 false Minimum relief valve setting for ambient temperature...) CERTAIN BULK DANGEROUS CARGOES SHIPS CARRYING BULK LIQUID, LIQUEFIED GAS, OR COMPRESSED GAS HAZARDOUS... temperature cargo tanks. The relief valve setting for a containment system that carries a cargo at ambient...
In October 2010, Harvard Educational Review editor Raygine DiAquoi interviewed Maryse Desgrottes, the mother of a close friend and a visible presence in the relief efforts in Petit Goave, Haiti. Desgrottes, a former physician's assistant turned educator and school superintendent, shares the story of her involvement in Haiti's relief efforts since…
Hany M.I. Elgohary
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.
Anderson, R; Thomas, D W; Phillips, C J
To compare the effectiveness of four types of out-of-hours emergency dental service, including both 'walk-in' and telephone-access services. Questionnaire survey of patients attending weekend emergency dental services, with measurement of self-reported oral health status and dental pain (at attendance and follow-up) and retrospective judgements of change in oral health status. Two health authorities in South Wales, UK. A total of 783 patients who completed questionnaires at attendance, and 423 who completed follow-up questionnaires. For patients who saw a dentist there were no consistent differences in the effectiveness of the four services, whether measured as pain relief, oral health gain or using patients' retrospective transition judgements about feeling better after their episode of emergency dental care. The proportion of patients reporting no improvement (transition judgements), either an hour after or the day after seeing the dentist, was surprisingly high (30-40% and 23-38% respectively). Although the 'rotas for all' - a telephone-access GDP-provided service for both registered and unregistered patients - achieved both the highest reductions in pain scores and the greatest improvements in dental health status between attendance and follow-up, this effect may reflect health gains due to care received after the episode of emergency dental care. Neither the setting where emergency dental patients are seen, nor the type of dentist who sees them, appear to have any significant effect on patient-reported health outcomes. Although further exploration of the factors that predict poor pain relief or low oral health gain is required, future research on these services should focus on the process of care and accessibility.
Shah, Swapnil R; Kadage, Shahajahan; Sinn, John
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.
Kaunitz, Andrew M.; Manson, JoAnn E.
Most menopausal women experience vasomotor symptoms, with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms, with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women’s Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with...
of functional dyspepsia is less documented and in most studies the symptomatic pattern could not predict the pharmacologic principle of clinical benefit. This may be because a separation between presence of symptoms and presence of symptoms as a major problem has not been taken into account. Cisapride...... complications. The therapeutic goals in GORD are symptom relief, healing of lesions, prevention of complications, and omittance of adverse effects at the lowest possible costs. Patients with functional dyspepsia usually have symptoms of less severe intensity and as, per definition, no organic substrate...
Emerson, Nichole M.; Farris, Suzan R.; Ray, Jenna N.; Jung, Youngkyoo; McHaffie, John G.; Coghill, Robert C.
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
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.
U.S. Geological Survey, Department of the Interior — The Topographic and Bathymetric Shaded Relief of North America map layer shows depth and elevation ranges using colors, with relief enhanced by shading. The image...
U.S. Geological Survey, Department of the Interior — The Grayscale Shaded Relief of Hawaii map layer is a 100-meter resolution grayscale shaded relief image of Hawaii, in an Albers Equal-Area Conic projection. Shaded...
U.S. Geological Survey, Department of the Interior — The Grayscale Shaded Relief of the Conterminous United States map layer is a 100-meter resolution grayscale shaded relief image of the United States, in an Albers...
U.S. Geological Survey, Department of the Interior — The Grayscale Shaded Relief of Alaska map layer is a 100-meter resolution grayscale shaded relief image of Alaska, in an Albers Equal-Area Conic projection. Shaded...
U.S. Geological Survey, Department of the Interior — The Color Shaded Relief of the Conterminous United States map layer is a 100-meter resolution color-sliced elevation image of the United States, with relief shading...
James, J S; Roehr, B
Congress is considering the tax exempt status on money received from a life insurance policy before death of a person with a short life expectancy due to illness. Tax exempt status is being considered for both accelerated benefits and viatical settlement. Accelerated benefits allows for pre-payment in advance of death. A viatical settlement is the purchase of an insurance policy by third parties with the condition of their becoming the irrevocable beneficiary of the policy being purchased. While House Republicans on the House Ways and Means Committee are generally supportive of not taxing viatical settlements, Democrats are divided. Letters to Congress are needed, especially to House Ways and Means Democrats from voters in their districts and states to encourage their support of the reform bill (HR 8, the Senior Citizens' Equity Act) which includes tax relief for both accelerated benefits and viatical settlements. More information can be obtained by calling Gary Rose, National Association of People with AIDS, (202) 898-0414, or Tom McCormack, Affording Care, (202) 479-2543.
Goraus, Matej; Pudis, Dusan; Jandura, Daniel; Berezina, Sofia
In this paper we present fabrication process of waveguides with surface relief Bragg grating (SR-BG) embossed in poly dimethyl diphenyl siloxane (PDMDPS). Generally, the Bragg grating causes spectral selectivity of propagated light in optical fibers and optical waveguides. We prepared the original concept of fabrication of novel optical waveguides with SR-BG using the laser interference lithography in combination with embossing process of liquid polymer. We used laser interference lithography in Mach-Zehnder configuration to create a grating with period of 21 μm in thin photoresist layer. In this manner, we created an array of D-shaped waveguides of 10 μm wide and app. 2.5 μm high. SR-BG was created in the next step, where the one dimensional surface Bragg grating with period 1.64 μm was prepared by interference lithography. This period was designed to reflect narrow spectral band close the telecommunication wavelength of 1.55 μm. Quality of the prepared waveguides and SR-BG was confirmed from atomic force microscope analysis. Transmission and coupling properties of the prepared SR-BG waveguides were finally measured by spectral measurements in infrared spectral region.
Schab-Balcerzak, Ewa; Sobolewska, Anna; Stumpe, Joachim; Hamryszak, Lukasz; Bujak, Piotr
The paper describes formation of new supramolecular azopolymers based on hydrogen bonds as perspective materials for laser induced surface relief gratings (SRGs) and for polarization gratings. Supramolecular films were built on the basis of hydrogen bonds between the functional groups of polymer and azobenzene derivatives, that is 4-[4-(3-hydroxypropyloxy)phenylazo]-pyridine and 4-[4-(6-hydroxyhexyloxy)phenylazo]pyridine. Polymers with imide rings, i.e., poly(esterimide)s and poly(etherimide)s, with phenolic hydroxyl or carboxylic groups were applied as matrixes for polymer-dye supramolecular systems. They revealed glass transition temperatures (Tg) in the range of 170-260 °C, whereas supramolecular systems exhibited lower Tg (88-187 °C). The polymers were easily soluble in aprotic polar solvents and exhibited remarkable good film forming properties. Moreover, new chromophore 4-[4-(3-hydroxypropyloxy)phenylazo]pyridine was synthesized and characterized. The light induced SRGs formation and simultaneous formation of the polarization gratings were explored in prepared polymer-chromophore assembles films using a holographic grating recording technique. First time to the best of our knowledge SRGs were formed in hydrogen-bonded supramolecular systems based on polyimides. The highest SRG amplitude and thus the highest diffraction efficiency were obtained in poly(esterimide)s with the hydroxyl functional group. Additionally, the thermal stability of the photoinduced surface gratings and polarization gratings were tested revealing in the case of the SRGs partial stability and almost complete erasure of the polarization gratings.
Soliman, Hussein H; Gillespie, David F
The purpose of this paper is to apply a stress model drawn from the literature to the relief and social service workers who have been active in refugee camps for a prolonged period of time. Working in difficult environments, social service workers deliver essential services to refugee populations around the world. A model of four work-stress determinants--tasks, management, appreciation and collaboration--was tested on 274 social workers in five regions of the Middle East (Jordan, Lebanon and Syria, as well as the occupied Palestinian territories of the Gaza Strip and the West Bank). Statistical fit indices were adequate but two relationships were statistically insignificant. The collaboration variable was dropped to create a modified model with tasks indirectly and management and appreciation directly affecting work-related stress. The five direct relationships and two indirect relationships of this modified model are consistent with stress theory, and all relationships--direct and indirect--are statistically significant. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.
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.
Kerime Derya TASCI
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
... you be pregnant? The proof is in the pregnancy test. But even before you miss a period, you ... the above signs or symptoms, take a home pregnancy test or see your health care provider. If your ...
Maling, Nicholas; Hashemiyoon, Rowshanak; Foote, Kelly D; Okun, Michael S; Sanchez, Justin C
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.
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.
Maeda, Hideki; Kurokawa, Tatsuo
The compensation scheme for adverse drug reactions in Japan was implemented more than three decades ago as relief system by regulatory agencies. Because of the high frequency of adverse drug reactions, anticancer drugs have been excluded from coverage by the relief system since its implementation. Requests have recently been made by some patient advocates for the expansion of relief coverage to include anticancer drugs. In response to these requests, the Ministry of Health, Labor and Welfare of Japan established a committee to discuss relief from anticancer drug-induced health damages in June 2011. We conducted comprehensive research into the compensation scheme for adverse drug reactions in the world. We also investigated the situation of compensation and the committee for discussing inclusion of anticancer drugs into the relief system in Japan. Many countries including the United States and UK do not have relief or compensation schemes for no-fault compensation. We investigated whether a no-fault compensation system exists in Nordic countries (Sweden, Denmark, Norway and Finland), France, Germany, New Zealand and Taiwan in the world, although they offer different services from Japan. We also reviewed current situation and the fundamental difficulties associated with including anticancer drugs in the systems in Japan. The present study investigated the current situation and the fundamental difficulties associated with including anticancer drugs in the systems in Japan and pointed out part of the reason why the committee could not conclude involvement of anticancer drugs in the relief system.
Chaudhary, Shivang A; Shahiwala, Aliasgar F
Common cold is the most frequently recurring disease in the world and is a leading cause of doctor visits and missed days from school and work. Cold reliever medicated chewing gum (MCG) will be a definitive patient acceptable solution for this condition. Anti-allergic, cetirizine (CTZ) is a BCS class-I (highly soluble and highly permeable) non-sedating antihistaminic drug and this study was based on the hypothesis that CTZ as a BCS class I drug will be easily released from chewing gum into the salivary fluid within few minutes of chewing and can be easily permeated from oral mucosa by the pressure created by the chewing action and absorbed to a larger extent into the systemic circulation. Therefore, ultimately patients will get quick relief from symptoms of common cold with greater compliance compared to other conventional dosage forms. This study mainly focuses on taste masking of CTZ by inclusion complexation method, its formulation development in the MCG form and its quality and performance evaluation with the study of potential factors affecting drug release by 3(2) full factorial experimental design. A "chew out" study is carried out to assess in vivo drug release from MCG, in which residual amount is extracted from the chewed sample. Formulation ingredients, such as elastomers, softeners, bulking agents, play an important role in the feel of the final product and its consistency; while sweeteners and flavors play a very essential character in its sensory properties. Interindividual variation in chewing frequency and chewing intensity is the main factor which affects release of active ingredient from MCG; while salivary dilution and involuntary swallowing are main reasons for variability in the absorption site, i.e., either from buccal mucosa or from gastrointestinal tract.
Pogliacomi, Francesco; Stark, André; Wallensten, Richard
When surgical treatment of dysplastic hip osteoarthrosis is necessary, osteotomy is preferable to fusion or THR. We evaluated periacetabular osteotomy as a method of choice. We treated 36 symptomatic dysplastic hip joints (32 patients) with the Bernese periacetabular osteotomy (PAO) between 1994 and 2001. We used the ilio-inguinal (I-I) approach in 32 hips and a modified Smith-Petersen (S-P) approach in 4. The patients were followed for mean 4 (1.5-8) years. In 1 patient with coxa valga, a varus femoral osteotomy was performed 1 year after PAO. 2 hips, in which we used the modified S-P approach, necessitated a capsulotomy. The median Merle d'Aubignè score increased from 13 points preoperatively to 16 points postoperatively. This improvement in terms of pain, motion and ambulation was accompanied by spatial reorientation and correction. The lateral center edge angle of Wiberg (CE) improved from an average of 7 degrees to 28 degrees. The anterior center edge angle of Lequesne (FP) improved from an average of 18 degrees to 28 degrees. The acetabular index angle (AC) improved from an average of 22 degrees to 10 degrees. Major complications included 1 partial lesion of the sciatic nerve, 1 malunion and 1 combined nonunion of the pubic and ischiatic osteotomy. 2 patients underwent subsequent total hip replacement (THR) for progressive osteoarthrosis with pain. We found good radiographic correction of deformities, improvement of hip function and pain relief with an acceptable complication rate. With appropriate patient selection, this procedure is the most physiological treatment of symptomatic hip dysplasia in young adults. In addition to relieving symptoms, it may prevent and postpone the development of secondary osteoarthrosis.
Full Text Available Abstract: Purpose: Frequent sudden-onset disasters which have threatened the survival of human and the development of society force the public to pay an increasing attention to emergency management. A challenging task in the process of emergency management is emergency dispatch of reliefs. An emergency dispatch model considering the urgency of the requirement for reliefs in different disaster areas is proposed in this paper to dispatch reliefs reasonably and reduce the effect of sudden-onset disasters. Design/methodology/approach: Firstly, quantitative assessment on the urgency of the requirement for reliefs in different disaster areas is done by an evaluation method based on Fuzzy Comprehensive Evaluation and improved Evidence Reasoning which is proposed in this paper. And then based the quantitative results, an emergency dispatch model aiming to minimize the response time, the distribution cost and the unsatisfied rate of the requirement for reliefs is proposed, which reflects the requests of disaster areas under emergency, including the urgency of requirement, the economy of distribution and the equity of allocation. Finally, the Genetic Algorithm is improved based on the adaptive crossover and mutation probability function to solve the emergency dispatch model. Findings and Originality/value: A case that the Y hydraulic power enterprise carries on emergency dispatch of reliefs under continuous sudden-onset heavy rain is given to illustrate the availability of the emergency dispatch model proposed in this paper. The results show that the emergency dispatch model meets the distribution priority requirement of disaster area with the higher urgency, so thatreliefs are supplied more timely. Research limitations/implications: The emergency dispatch model faced to large scale sudden-onset disasters is complex. The quantity of reliefs that disaster area requires and the running time of vehicles are viewed as available information, and the problem
Kondratov Aleksandr P.
Full Text Available The article explains a new method of relief marking of heat-shrinkable tubing and sleeves made of polymer materials with “shape memory effect.” Method of instrument evaluation of relief marking stereometry of installation parts for aviation equipment, made of polyvinyl chloride, polyethyleneterephthalate and polystyrene was developed and the results were explained. Parameters of pin-point relief marking and compliance of point forms to the Braille font standard were determined with the use of the non-destructive method based on the color of interference pattern with precision of 0.02 mm.
In June 1929, the medical charity inspectors (Isauro Torres and Enrique Laval M.) submitted to the Direction of the Institution a plan for the normalization of all hospitals, which was approved by the Central Board at its meeting on 19 July of that year. The plan was to phase in the hospital action from the First-aid Posts or "Relief Houses" to the large referral hospitals. The "Relief House" would become the initial phase of hospital organization, located in rural areas. Finally, we emphasize that the Relief Houses were establishments for preventive and curative medicine in rural areas.
Rogal, Shari S; Bielefeldt, Klaus; Wasan, Ajay D; Szigethy, Eva; Lotrich, Francis; DiMartini, Andrea F
An association between fibromyalgia and hepatitis C virus (HCV) has been previously described. However, the relationship between nonalcoholic steatohepatitis (NASH) and fibromyalgia symptoms has not been assessed, though they share several risk factors. We aimed to assess the factors associated with fibromyalgia symptoms across etiologies of liver disease. Patients with cirrhosis due to HCV, NASH, or alcohol were recruited from an outpatient hepatology clinic and administered the Hospital Anxiety and Depression Score, Pittsburgh Sleep Quality Index, and the modified 2010 American College of Rheumatology Diagnostic Criteria for Fibromyalgia. Serum inflammatory markers were measured with standard luminex assays. Of 193 participants, 53 (27 %) met criteria for fibromyalgia. Fibromyalgia symptoms were significantly associated with etiology of liver disease (HCV: 35 %, NASH: 30 %, alcohol-related liver disease: 12 %, p fibromyalgia symptoms. If abdominal pain was included in the model, etiology became nonsignificant, indicating that it may be central sensitization due to abdominal pain in patients with chronic liver disease that explains fibromyalgia symptoms rather than the etiology of liver disease or inflammation. Fibromyalgia symptoms were significantly associated with HCV and NASH cirrhosis and with psychiatric symptoms. Future work should focus on the underlying pathophysiology and management of widespread pain in patients with cirrhosis.
Bielefeldt, Klaus; Wasan, Ajay D.; Szigethy, Eva; Lotrich, Francis; DiMartini, Andrea F.
Background An association between fibromyalgia and hepatitis C virus (HCV) has been previously described. However, the relationship between nonalcoholic steatohepatitis (NASH) and fibromyalgia symptoms has not been assessed, though they share several risk factors. Aim We aimed to assess the factors associated with fibromyalgia symptoms across etiologies of liver disease. Methods Patients with cirrhosis due to HCV, NASH, or alcohol were recruited from an outpatient hepatology clinic and administered the Hospital Anxiety and Depression Score, Pittsburgh Sleep Quality Index, and the modified 2010 American College of Rheumatology Diagnostic Criteria for Fibromyalgia. Serum inflammatory markers were measured with standard luminex assays. Results Of 193 participants, 53 (27 %) met criteria for fibromyalgia. Fibromyalgia symptoms were significantly associated with etiology of liver disease (HCV: 35 %, NASH: 30 %, alcohol-related liver disease: 12 %, p fibromyalgia symptoms. If abdominal pain was included in the model, etiology became nonsignificant, indicating that it may be central sensitization due to abdominal pain in patients with chronic liver disease that explains fibromyalgia symptoms rather than the etiology of liver disease or inflammation. Conclusions Fibromyalgia symptoms were significantly associated with HCV and NASH cirrhosis and with psychiatric symptoms. Future work should focus on the underlying pathophysiology and management of widespread pain in patients with cirrhosis. PMID:25433921
Bhomi, K K; Subedi, N; Panta, P P
International prostate symptom score is a validated questionnaire used to evaluate the lower urinary tract symptoms in benign prostatic hyperplasia. Visual prostate symptom score is a new simplified symptom score with pictograms to evaluate the same. We evaluated the correlation of visual prostate symptom score with international prostate symptom score and uroflowmetry parameters in Nepalese male patients with lower urinary tract symptoms. Male patients aged ≥40 years attending the Urology clinic were enrolled in the study. They were given international prostate symptom score and visual prostate symptom score questionnaires to complete providing assistance whenever needed. Demographic data, examination findings and uroflowmetry parameters were noted. Correlation and regression analysis was used to identify correlation of the two scoring systems and uroflowmetry parameters. Among the 66 patients enrolled, only 10 (15.15%) patients were able to understand English language. There was a statistically significant correlation between total visual prostate symptom score and international prostate symptom score (r= 0.822; Pcorrelations between individual scores of the two scoring systems related to force of urinary stream, frequency, nocturia and quality of life were also statistically significant. There was also a statistically significant correlation of both scores with maximum flow rate and average flow rate. There is a statistically significant correlation of visual prostate symptom score with international prostate symptom score and uroflowmetry parameters. IPSS can be replaced with simple VPSS in evaluation of lower urinary tract symptoms in elderly male patients.
Johnson Joy L; Bottorff Joan L; Moffat Barbara M; Mulvogue Tamsin
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 reg...
Hansson, Mats G
The empirical basis for this article is three years of experience with ethical rounds at Uppsala University Hospital. Three standard approaches of ethical reasoning are examined as potential explanations of what actually occurs during the ethical rounds. For reasons given, these are not found to be satisfying explanations. An approach called "imaginative ethics", is suggested as a more satisfactory account of this kind of ethical reasoning. The participants in the ethical rounds seem to draw on a kind of moral competence based on personal life experience and professional competence and experience. By listening to other perspectives and other experiences related to one particular patient story, the participants imagine alternative horizons of moral experience and explore a multitude of values related to clinical practice that might be at stake. In his systematic treatment of aesthetics in the Critique of Judgement, Kant made use of an operation of thought that, if applied to ethics, will enable us to be more sensitive to the particulars of each moral situation. Based on this reading of Kant, an account of imaginative ethics is developed in order to bring the ethical praxis of doctors and nurses into sharper relief. The Hebraic and the Hellenic traditions of imagination are used in order to illuminate some of the experiences of ethical rounds. In conclusion, it is argued that imaginative ethics and principle-based ethics should be seen as complementary in order to endow a moral discourse with ethical authority. Kantian ethics will do the job if it is remembered that Kant suggested only a modest, negative role of principle-based deliberation.
Lopez, Gabriel; Liu, Wenli; Milbury, Kathrin; Spelman, Amy; Wei, Qi; Bruera, Eduardo; Cohen, Lorenzo
Massage has shown benefit for symptomatic relief in cancer patients and their caregivers. We explored the effects of a single massage session on self-reported symptoms in an outpatient clinic at a comprehensive cancer center. Patients and caregivers receiving oncology massage treatments (30 or 60-min duration) at our Integrative Medicine Center outpatient clinic from September 2012 to January 2015 completed the Edmonton Symptom Assessment Scale (ESAS; 0-10 scale, 10 most severe) pre and post massage. ESAS individual items and subscales of physical distress (PHS), psychological distress (PSS), and global distress (GDS) were analyzed. We used paired t tests with a p value correction (i.e., p g., pain, sleep, spiritual pain). Massage therapy was associated with statistically (p < .0001) and clinically significant improvements in symptoms of pain, fatigue, anxiety, well-being, and sleep and ESAS subscales for both patients and caregivers. Greater massage duration (30 vs 60 min) did not lead to greater symptom reduction. Patients and caregivers reported a moderately high symptom burden. A single massage treatment resulted in acute relief of self-reported symptoms in both groups. Further study is warranted regarding optimal massage dose and frequency.
Hall, S. R.; Farber, D.; Audin, L.; Finkel, R. C.
Regional low-relief surfaces have long been recognized as key features to understanding the response of landscapes to surface uplift. The canonical models of low-relief surface formation involve an extended period of tectonic quiescence during which, the fluvial systems bevel the landscape to a uniform elevation. This quiescent period is punctuated by a period(s) of surface uplift, which causes fluvial incision thereby abandoning the low-relief landscape. Over time, as rivers continue to incise in response to changes in sediment supply, river discharge, and base level fall, pieces of the relict low-relief landscape are left as abandoned remnants stranded above active channels. By determining the age of abandoned surfaces, previous workers have identified the onset of a change in the tectonic or climatic setting. One key assumption of this model is that the low-relief surfaces are truly abandoned with no current processes further acting on the surface. To improve our understanding of the underlying assumptions and problems of low-relief surface formation, we have used detailed mapping and absolute dating with cosmogenic 10Be to investigate surfaces in the hyperarid forearc region of southern Peru between ~14° and 18°S. Within this region, marine terraces and strath terraces reflect Plio-Pleistocene surface uplift, and together with the hyperarid climate, ongoing surface uplift provides a perfect natural laboratory to examine the processes affecting low-relief surface abandonment and preservation. With our new chronology we address: 1) the space and time correlations of surfaces, 2) incision rates of streams in response to base-level fall, and 3) surface erosion rates. Multiple surfaces have yielded 10Be surface abandonment ages that span >2 Ma - ~35 ka. While most of the surfaces we have dated are considerably less than 1 Ma, we have located two surfaces which are likely older than 2 Ma and constrain regional erosion rates to be current base level are known, we
Myers, Catherine E.; VanMeenen, Kirsten M.; Servatius, Richard J.
Behavioral inhibition (BI), a temperamental bias to respond to novel stimuli with avoidance behaviors, is a risk factor for posttraumatic stress disorder (PTSD). It is unclear whether BI accounts for additional variance in PTSD symptom severity beyond that accounted for by general anxiety. Here, 109 veterans (mean age 50.4 years, 9.2% female) provided self-assessment of PTSD symptoms, state and trait anxiety, combat exposure, and current (adult) and retrospective (childhood) BI. Adult BI was correlated with anxiety and PTSD symptom severity, especially cluster C (avoidance) symptoms, but not with combat exposure. A regression model including adult BI, state and trait anxiety, and combat exposure was able to correctly classify over 80% of participants according to presence or absence of severe PTSD symptoms. Because avoidance behaviors are a core component of PTSD, self-assessments of BI may be an important tool in understanding PTSD and potentially assessing vulnerability to the disorder. PMID:22397911
... Fundraise for PCF: Many vs Cancer Contact Us Prostate Cancer Symptoms and Signs Prostate Cancer Basics About the ... earlier. So what are the warning signs of prostate cancer? Unfortunately, there usually aren’t any early warning ...
... Fundraise for PCF: Many vs Cancer Contact Us Prostate Cancer Symptoms and Signs Prostate Cancer Basics About ... earlier. So what are the warning signs of prostate cancer? Unfortunately, there usually aren’t any early ...
Colds are caused by a virus and can occur year-round. The common cold generally involves a runny nose, nasal congestion, and ... symptoms include sore throat, cough, and headache. A cold usually lasts about 7 days, with perhaps a ...
Meinert, Lotte; Whyte, Susan Reynolds
The interpretation of sensations and the recognition of symptoms of a sickness, as well as the movement to seek treatment, have long been recognised in medical anthropology as inherently social processes. Based on cases of HIV and trauma (PTSD) in Uganda, we show that even the first signs...... 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/symptoms, differential recognition of symptoms, and the embodied sociality of treatment....
Meinert, Lotte; Whyte, Susan Reynolds
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...... 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....../symptoms; differential recognition of symptoms; and the embodied sociality of treatment....
... Young Adult Guidelines For brain tumor information and support Call: 800-886-ABTA (2282) or Complete our contact form Brain Tumor Information Brain Anatomy Brain Tumor Symptoms Headaches Seizures Memory Depression Mood ...
Laurell, Katarina; Artto, Ville; Bendtsen, Lars
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
... Fellowship Training Program Dystonia Coalition Dystonia Study Group Global Dystonia Registry About Us Mission & History How Will We Find a Cure? People Newsletters & Press Releases Dystonia Dialogue Financials Contact What is Dystonia? Symptoms & Diagnosis Forms ...
Shannon, Albert J.
The article reviews proposed causes and observable symptoms that characterize dyslexia, concluding that individualized analysis and specialized treatments are required and that, until an operational definition can be agreed upon, use of the label "dyslexia" is counterproductive. (DB)
Finn, Laura; Green, Alva Roche; Malhotra, Sonia
Despite the evidence for the fundamental need for palliative medicine services in the practice of oncology, integration of these medical specialties remains a clinical challenge. We reviewed the current literature regarding the practice of palliative medicine in the field of oncology, examining randomized clinical trials of palliative medicine services in advanced cancer, models of palliative medicine delivery, studies of cost effectiveness, and national palliative medicine practice and referral guidelines. In this review, we describe the role of palliative medicine in oncology, including the timing of palliative medicine consultation, models of care delivery, and improvements in patient outcomes. Randomized controlled trials and national guidelines support early referral of patients with cancer to palliative medicine. Palliative medicine has a fundamental role in symptom management, distress relief, family and caregiver support, and advance care planning. Integration of palliative medicine in oncology improves patient outcomes and decreases healthcare costs. Early involvement of palliative medicine after the cancer diagnosis is supported by national guidelines, but barriers include variable referral patterns among oncologists and the need for an expanded palliative medicine workforce. Palliative medicine has a wide-ranging role in the spectrum of comprehensive cancer care-from patient diagnosis to survivorship. The entire multidisciplinary care team has a role in providing palliative care in inpatient and outpatient settings. An effective palliative medicine and oncology collaboration improves patient care and quality of life, has broad research and guideline support, and is cost effective.
Good, M; Stanton-Hicks, M; Grass, J A; Cranston Anderson, G; Choi, C; Schoolmeesters, L J; Salman, A
The aim of this randomized controlled trial was to determine the effect of jaw relaxation, music and the combination of relaxation and music on postoperative pain after major abdominal surgery during ambulation and rest on postoperative days 1 and 2. Opioid medication provided for pain, following abdominal surgery, does not always give sufficient relief and can cause undesired side effects. Thus, additional interventions such as music and relaxation may provide more complete relief. Previous studies have found mixed results due to small sample sizes and other methodological problems. In a rigorous experimental design, 500 subjects aged 18-70 in five Midwestern hospitals were randomly assigned by minimization to a relaxation, music, relaxation plus music, or control group. Interventions were taught preoperatively and tested postoperatively. The same amount of time was spent with subjects in the control group. Pain was measured with the visual analogue sensation and distress of pain scales. Demographic and surgical variables, and milligrams of parenteral or oral opioids in effect at the time of testing were not significantly different between the groups, nor did they correlate with pain scores. Controlling for pretest sensation and distress, orthogonal a priori contrasts and multivariate analysis of covariance indicated that the three treatment groups had significantly less pain than the controls, (P = 0.028-0.000) which was confirmed by the univariate analysis of covariance (P = 0.018-0.000). Post hoc multivariate analysis revealed that the combination group had significantly less sensation and distress of pain than the control group on all post-tests (P = 0.035-0.000), and the relaxation and music groups had significantly less on all tests (P = 0.022-0.000) except after ambulation. At post ambulation those using relaxation did not have significantly less pain than the controls on both days and those using music did not on day 1, although there were some univariate
U.S. Geological Survey, Department of the Interior — The Satellite View of Alaska, with Shaded Relief map layer is a 200- meter-resolution simulated-natural-color image of Alaska. Vegetation is generally green, with...
The paper presents the research approach on the numerical simulation applicable to pressure relief valve on the bore gas evacuation device embedded on the high pressure barrels with special destinations...
U.S. Geological Survey, Department of the Interior — The USGS Shaded Relief Large service from The National Map (TNM) was created from the National Elevation Dataset (NED), a seamless dataset of best available raster...
U.S. Geological Survey, Department of the Interior — The color conterminous United States shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of the conterminous United...
U.S. Geological Survey, Department of the Interior — The color Hawaii shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of Hawaii at a resolution of 200 meters. The NED is...
... Minute Massages per Week Offer Relief for Chronic Neck Pain Share: © Bob Stockfield Courtesy: National Center for Complementary ... fewer or shorter sessions for people with chronic neck pain, suggesting that several hour-long massages per week ...
U.S. Geological Survey, Department of the Interior — The Satellite View of the Conterminous United States, with Shaded Relief map layer is a 200-meter-resolution simulated-natural-color image of the United States....
U.S. Geological Survey, Department of the Interior — The North America Shaded Relief data were derived from the GTOPO30 elevation data. GTOPO30 is a global digital elevation model (DEM) with a horizontal grid spacing...
term evolution that brought about significant alterations of the landscape, and especially of the relief, which has acquired different features depending on the intensity of the relationship between the exogenous and endogenous agents. At present ...
U.S. Geological Survey, Department of the Interior — The grayscale conterminous United States shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of the conterminous United...
Full Text Available The problem of electrical sounding of a medium with ground surface relief is modelled using the integral equations method. This numerical method is based on the triangulation of the computational domain, which is adapted to the shape of the relief and the measuring line. The numerical algorithm is tested by comparing the results with the known solution for horizontally layered media with two layers. Calculations are also performed to verify the fulfilment of the “reciprocity principle” for the 4-electrode installations in our numerical model. Simulations are then performed for a two-layered medium with a surface relief. The quantitative influences of the relief, the resistivity ratios of the contacting media, and the depth of the second layer on the apparent resistivity curves are established.
U.S. Geological Survey, Department of the Interior — The color Alaska shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of Alaska at a resolution of 200 meters. The NED is...
U.S. Geological Survey, Department of the Interior — The color Alaska shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of Alaska at a resolution of 200 meters. The NED is...
U.S. Geological Survey, Department of the Interior — The color conterminous United States shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of the conterminous United...
U.S. Geological Survey, Department of the Interior — The Satellite View of Hawaii, with Shaded Relief map layer is a 200- meter-resolution simulated-natural-color image of Hawaii. Vegetation is generally green, with...
U.S. Geological Survey, Department of the Interior — The color Hawaii shaded relief data were derived from National Elevation Dataset (NED) data, and show the terrain of Hawaii at a resolution of 200 meters. The NED is...
Bialas, Adam J; Kaczmarski, Jacek; Kozak, Jozef; Kempinska-Miroslawska, Bogumila
Pectus excavatum is one of the most common congenital deformities of the chest wall. The aim of the study was to analyse 621 artefacts (reliefs, sculptures, paintings) from Ancient Egypt in terms of anatomical defects of the chest. The team which analysed artefacts consisted of historians of medicine and thoracic surgeons. The researchers found a relief, depicting a man with an abnormal shape of the chest. The relief was from Niankhkhnum and Khnumhotep mastaba and dates back to circa 2400 BC. The authors think it is possible that the relief may represent a pectus excavatum deformity and believe the image will open up debate on the occurrence of this deformity in ancient times. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.