Blockade of Digestion by Famotidine\ud Pretreatment Does Not Interfere With the Opioid-Enhancing\ud Effect of Ingested Amniotic Fluid

Ingestion of placenta or amniotic fluid by rats has been shown to enhance ongoing opioid-mediated antinociception, but does not, by itself, produce antinociception. This enhancement is produced by an active substance(s) in placenta and amniotic fluid that we have termed POEF for placental opioid-enhancing factor. Previous research has shown that enhancement requires mediation by the gastrointestinal system: gastric vagotomy blocks enhancement produced by ingested placenta; amniotic fluid injected SC or IP does not produce enhancement. The present study was designed to distinguish between two possible explanations for the blockade of the POEF effect produced by gastric vagotomy: that afferent information arising in vagal gastric receptors conveys the critical information to the CNS, or that disruption of vagal efferent action on digestion blocks the manufacture or activation of the POEF molecule in the gut. Famotidine is an H2-histamine receptor antagonist that reduces gastric acid and pepsin secretion to an extent at least as great as gastric vagotomy. Rats treated with either famotidine or a vehicle were fed placenta or a control substance, then stimulated with vaginal/cervical probing to produce antinociception that is partly opioid mediated. Famotidine did not block POEF enhancement of vaginal/cervical stimulation-induced analgesia in a tail flick latency test. These results suggest that enhancement by POEF does not require normal digestive processes or other processes inhibited by famotidine

Ingestion of Amniotic Fluid Enhances\ud Opiate Analgesia in Rats

Placenta ingestion has recently been shown to enhance opiate-mediated analgesia produced by morphine injection, footshock, or vaginal/cervical stimulation. The enhancement of the effect of endogenous opiates (especially analgesia) may be one of the principal benefits to mammalian mothers of placentophagia at delivery. During labor and delivery, however, mothers also ingest amniotic fluid (AF) which, unlike placenta, becomes available during, or even before expulsion of the infant. The present experiments were undertaken to determine (a) whether AF ingestion, too, enhances analgesia; if so, (b) whether the effect requires ingestion of, or merely exposure to, AF; (c) whether the effect can be produced by AF delivered directly to the stomach by tube; and (d) whether the enhancement, if it exists, can be blocked by administering an opiate antagonist. Nulliparous Long-Evans rats were tested for analgesia using tail-flick latency. We found that (a) rats that ingested AF after receiving a morphine injection showed significantly more analgesia than did rats that ingested a control substance;' (b) AF ingestion, alone, did not produce analgesia; (c) ingestion of AF, rather than just smelling and seeing it, was necessary to produce analgesia enhancement; (d) AF produced enhancement\ud when oropharyngeal factors were eliminated by delivering it through an orogastric tube; and (e) treatment of the rats with naltrexone blocked the enhancement of morphine-induced analgesia that results from AF ingestion

The Effectiveness and Clinical Usability of a Handheld Information Appliance

Clinical environments are complex, stressful, and safety critical—heightening the demand for technological solutions that will help clinicians manage health information efficiently and safely. The industry has responded by creating numerous, increasingly compact and powerful health IT devices that fit in a pocket, hook to a belt, attach to eyeglasses, or wheel around on a cart. Untethering a provider from a physical “place” with compact, mobile technology while delivering the right information at the right time and at the right location are generally welcomed in clinical environments. These developments however, must be looked at ecumenically. The cognitive load of clinicians who are occupied with managing or operating several different devices during the process of a patient encounter is increased, and we know from decades of research that cognitive overload frequently leads to error. “Technology crowding,” enhanced by the plethora of mobile health IT, can actually become an additional millstone for busy clinicians. This study was designed to gain a deeper understanding of clinicians' interactions with a mobile clinical computing appliance (Motion Computing C5) designed to consolidate numerous technological functions into an all-in-one device. Features of usability and comparisons to current methods of documentation and task performance were undertaken and results are described

Dose-Dependent Enhancement of Morphine-Induced Analgesia\ud by Ingestion of Amniotic Fluid and Placenta

Ingestion of amniotic fluid and placenta by rats has been shown to enhance opioid-mediated analgesia. The present studies were designed to examine the effect of several doses and volumes of placenta and amniotic fluid on tail-flick latency in rats treated with 3 mg/kg morphine. The optimal dose of amniotic fluid was found to be 0.25 ml, although 0.50 and 1.0 ml also produced significant enhancement. Doses of 0.125 and 2 ml of amniotic fluid were ineffective, as was a dose of 0.25 ml diluted to 2 ml with saline. The optimal dose of placenta was found to be 1 placenta, although the resulting enhancement was not significantly greater than that produced by 0.25, 0.50, 2.0 or 4.0 placentas. Doses smaller than 0.25 placenta or larger than 4.0 placentas were ineffective. The most effective doses of amniotic fluid and placenta correspond to the amounts delivered with each pup during parturition

The Effect of Adjuvants on Apple Disease Management

The management of common apple diseases such as apple scab ( Venturia inaequalis) and bitter rot (Colletotrichum spp.) relies heavily on effective fungicide applications. However, the development of fungicide resistance to newer fungicides has resulted in management failures and significant economic losses. This has led to a greater reliance on captan, an older fungicide, because there is a low risk of pathogens developing resistance. Label restrictions limit growers to 18 kg of captan per season, which may not provide sufficient control of both apple scab and bitter rot in wet years. Consequently, apple growers are faced with two equally difficult scenarios, inadequate management of diseases due to resistant pathogen strains from the use of newer fungicides or insufficient management due to restrictions on captan. The goal of this research was to identify new approaches to reduce the amount of captan needed throughout the growing season without decreasing disease control. One potential tactic is to incorporate adjuvants into management strategies. Adjuvants are tank additives that increase the coverage and retention of sprays and correct issues with the tank water by affecting the pH. The incorporation of adjuvants into current apple disease management strategies has the potential to improve disease control by increasing the efficacy of captan sprays at reduced rates and reducing initial inoculum by enhancing urea-driven leaf litter decomposition. To assess the improvement of captan sprays, adjuvants were combined with the lowest rate of captan and applied to apple trees every 10-14 days from bloom to harvest. Disease and phytotoxicity incidence and severity were observed on apple fruit to measure the effectiveness of the treatments. Results showed that Li700 plus captan and Bond Max plus captan consistently reduced disease incidence in high-pressure years by increasing the coverage and retention of captan and lowering the pH of the tank water. Based on the data found in this study, a grower could potentially save up to $3,481-$4,667 ha -1 due to reduction of disease incidence. In order to examine if adjuvants improved urea-driven decomposition of scab-infected leaves, adjuvants were combined with urea and applied to infected leaves. These leaves were then left to overwinter on the orchard floor. Leaf area decomposition and pseudothecia and ascospore reduction were observed to measure the effectiveness of the treatments. Results showed that Li700 plus urea and Wet Betty plus urea improved urea-driven leaf decomposition and pseudothecia and ascospore reduction by increasing the nitrogen content in the leaves. Based on this study, the addition of these adjuvants to urea could delay an apple scab epidemic, saving fungicide applications and postponing initial infection past the point when apples are most susceptible to V. inaequalis. The addition of adjuvants to captan or urea has the potential to improve disease management by reducing fungicide rates and reducing overwintering inoculum. Together these factors may reduce the number and dose of fungicide sprays required for apple scab and bitter rot management throughout the growing season and ultimately increase a grower’s net return in apple production

Women’s experiences of breastfeeding in prison

The benefit of breastfeeding on the long-term health and wellbeing for mother and baby is abundant. The effects on bonding between mother and baby are significant and physiological immunity is paramount in protecting the child in later life. Women are free to choose whether they wish to carry out this activity however, perinatal women in prison are less able to make this decision due to systems of power and control enforced within the prison estate and which too frequently render these new mothers powerless in this decision. This paper forms part of wider research to explore women’s perinatal experiences whilst in prison and aims to consider how women learn about breastfeeding and the post-natal experience of breastfeeding, lactation and, expressing milk for separated babies in prison. During 2015-2016 audio-recorded semi-structured interviews sought to discover the experiences of 28 pregnant women and new mothers in prison in England. Women were either pregnant in prison at the time of interview, residing with their babies on a Mother and Baby Unit (MBU) within a prison, separated post-natal from their babies or interviewed post release. NVivo assisted data analysis enabled the deconstruction of events and interactions associated with their experience of breastfeeding. Extracts from interview transcripts highlight the women’s voices regarding their breastfeeding experiences coupled with the interwoven reflections of the midwife as researcher. There is a clear need to more fully consider the benefits of breastfeeding for these women and how this essential human function may be maximized in the prison setting.Peer reviewe

Can the US Minimum Data Set Be Used for Predicting Admissions to Acute Care Facilities?

This paper is intended to give an overview of Knowledge Discovery in Large Datasets (KDD) and data mining applications in healthcare particularly as related to the Minimum Data Set, a resident assessment tool which is used in US long-term care facilities. The US Health Care Finance Administration, which mandates the use of this tool, has accumulated massive warehouses of MDS data. The pressure in healthcare to increase efficiency and effectiveness while improving patient outcomes requires that we find new ways to harness these vast resources. The intent of this preliminary study design paper is to discuss the development of an approach which utilizes the MDS, in conjunction with KDD and classification algorithms, in an attempt to predict admission from a long-term care facility to an acute care facility. The use of acute care services by long term care residents is a negative outcome, potentially avoidable, and expensive. The value of the MDS warehouse can be realized by the use of the stored data in ways that can improve patient outcomes and avoid the use of expensive acute care services. This study, when completed, will test whether the MDS warehouse can be used to describe patient outcomes and possibly be of predictive value

Can the US Minimum Data Set Be Used for Predicting Admissions to Acute Care Facilities?

This paper is intended to give an overview of Knowledge Discovery in Large Datasets (KDD) and data mining applications in healthcare particularly as related to the Minimum Data Set, a resident assessment tool which is used in US long-term care facilities. The US Health Care Finance Administration, which mandates the use of this tool, has accumulated massive warehouses of MDS data. The pressure in healthcare to increase efficiency and effectiveness while improving patient outcomes requires that we find new ways to harness these vast resources. The intent of this preliminary study design paper is to discuss the development of an approach which utilizes the MDS, in conjunction with KDD and classification algorithms, in an attempt to predict admission from a long-term care facility to an acute care facility. The use of acute care services by long term care residents is a negative outcome, potentially avoidable, and expensive. The value of the MDS warehouse can be realized by the use of the stored data in ways that can improve patient outcomes and avoid the use of expensive acute care services. This study, when completed, will test whether the MDS warehouse can be used to describe patient outcomes and possibly be of predictive value