Biopsychosocial implications of living with multiple sclerosis: a qualitative study using interpretative phenomenological analysis

Background: Multiple sclerosis (MS) is estimated to affect 2.8 million people worldwide, with increasing prevalence in all world regions (Walton et al). While there is no cure for MS, medication and lifestyle modifications can slow disease progression and enhance patients’ quality of life. The biopsychosocial model of health recognises important interactions among biological, psychological and social factors in illness, including those relating to illness management, which contribute to the experience of those diagnosed with MS. Objective: This qualitative, idiographic study aimed to explore the lived experiences of patients in the United Arab Emirates (UAE) diagnosed with S. Methods: Semistructured interviews were conducted with a purposive sample of eight patients with MS ranging in age from 25 to 56 years. All participants were residing in the UAE at the time of data collection. Interpretative phenomenological analysis was used to analyse the data. Results: Three superordinate themes were identified from patients’ candid accounts of their lives with MS, highlighting issues of illness management, acceptance and gratitude, and adaptive coping. These themes broadly illustrate biological, psychological and social aspects of patients’ MS experiences. Conclusion: The study emphasised the importance of adopting the biopsychosocial model to treat and manage MS. Additionally, it highlights the need for routine assessment and early, multidimensional approach with multidisciplinary team efforts to improve patients’ quality of life

Mind-set Matters: Exercise and the Placebo Effect

In a study testing whether the relationship between exercise and health is moderated by one's mind-set, 84 female room attendants working in seven different hotels were measured on physiological health variables affected by exercise. Those in the informed condition were told that the work they do (cleaning hotel rooms) is good exercise and satisfies the Surgeon General's recommendations for an active lifestyle. Examples of how their work was exercise were provided. Subjects in the control group were not given this information. Although actual behavior did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before. As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.Psycholog

POLYMER CHEMISTRY OF DENTAL ADHESIVES

Dental adhesives are water soluble, non-toxic materials that bind composite resins to dentin and enamel. Adhesive systems are dependent on a polymerization process at the interface and require different moieties to prepare the substrate to effectively interact with the tooth surface. Due to their critical role in restorative procedures, many chemists are interested in strengthening the adhesive bond strength at the interface. This review paper covers the evolution of dental adhesive systems over time and provides an extensive overview of what components make up a dental adhesive system. Additionally, this article explores the common issues found in adhesive systems, and how current researchers are working to approach these complications to increase the success rate of dental restorations

Harnessing the placebo effect: Exploring the influence of physician characteristics on placebo response

Reports an error in "Harnessing the placebo effect: Exploring the influence of physician characteristics on placebo response" by Lauren C. Howe, J. Parker Goyer and Alia J. Crum (Health Psychology, 2017[Nov], Vol 36[11], 1074-1082). In the original article, changes were needed to clarify the timeframe over which allergic reactions were measured after the skin prick test (SPT) and the administration of the placebo cream, which was erroneously misrepresented in some cases being “0 to 6 minutes after cream application” when it should have stated “3 to 9 minutes after cream application.” Corrections have been made to reflect this in the “Analytic Strategy for Physiological Results” section and in Figures 2 and 3 and the Figure Notes that accompany them. An additional supplemental figure (Figure S7) has also been added to the supplemental material available online to further clarify the timing of measurements, both in terms of time post-SPT and time post-cream application. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2017-10534-001). Objective: Research on placebo/nocebo effects suggests that expectations can influence treatment outcomes, but placebo/nocebo effects are not always evident. This research demonstrates that a provider’s social behavior moderates the effect of expectations on physiological outcomes. Methods: After inducing an allergic reaction in participants through a histamine skin prick test, a health care provider administered a cream with no active ingredients and set either positive expectations (cream will reduce reaction) or negative expectations (cream will increase reaction). The provider demonstrated either high or low warmth, or either high or low competence. Results: The impact of expectations on allergic response was enhanced when the provider acted both warmer and more competent and negated when the provider acted colder and less competent. Conclusion: This study suggests that placebo effects should be construed not as a nuisance variable with mysterious impact but instead as a psychological phenomenon that can be understood and harnessed to improve treatment outcomes

Analisis Program Pembangunan dan Pemberdayaan Kewilayahan di Kota Bandung

Perbedaan hasil penyerapan anggaran PIPPK Di Kelurahan Cihapit dan Kelurahan Merdeka dapat dijadikan dasar berjalan dengan baiknya suatu program.Terjadinya perbedaan perbedaan penyerapan anggaran antara dua kelurahan antara kelurahan merdeka dan cihapit menjadi fondasi penulis melakukan analis akan inovasi program yang sedang berjalan saat ini, yaitu program PIPPK di kota Bandung. Metode penelitian menggunakan pendekatan kualitatif dan data diperoleh dengan studi kepustakaan dan studi lapangan. Hasil penelitian menunjukkan salah satu penyebab perbedaan penyerapan anggaran antara dua kelurahan tersebut terdapat pada kegiatan dan program yang dilakukan oleh kelurahan dan dukungan yang optimal dari pihak Aparatur dan Masyarakat, sehingga menghasilkan kelurahan Cihapit dengan dukungan aparatur dan desa dapat mengoptimalkan dana dari program PIPPK beda dengan kelurahan Merdeka di mana yaitu kurangnya partisipasi masyarakat dan juga masih kurangnya aparatur di kelurahan merdeka membuat sosialisasi kepada masyarakat menjadi kurang. mengemukakan saran Pemerintah Kota Bandung Perlu peninjauan ulang mengenai tambahan SDM ahli sebagai tenaga pendamping di Kelurahan khusus untuk menangani PIPPK agar hasilnya lebih maksimal mengingat dengan adanya PIPPK tentunya memberikan tambahan beban kerja bagi SDM yang ada di Kelurahan yang jumlah personil nya hanya 7 sampai 8 orang

Assessment Strategy for Implementation of Evidence-Based Protocol for Antibiotics in Appendicitis

Introduction: Evidence-based protocols (EBP) exist to guide clinicians in decision-making, however, EBP are often delayed and not optimally implemented [1]. Antibiotic stewardship is heavily guided by EBP and highly relevant to surgical practice. Antibiotic regimens for one of the most common surgical diseases, acute appendicitis (AA) can be highly variable. Post-operative antibiotic (POA) use in non-perforated AA has been largely shown to be non-beneficial and potentially harmful [2]; 4 days of POA in cases where source control is obtained has shown to be non-inferior to commonly prescribed longer courses [3]. We identified lack of consistent antibiotic usage for AA at our academic institution, driving development of an assessment strategy for implementation of an EBP for antibiotic use on the acute care surgical (ACS) service. Methods: Literature review was used to develop an EBP for antibiotic use for AA. Notable aspects of the protocol involved the development of a classification system to aid in more objective reporting of adequacy of source control, a known factor that guides the duration of antibiotic therapy. An assessment strategy was designed characterizing historical practice patterns and the development of a data structure to classify patient outcomes, including complications related to prolonged or unneeded antibiotic use. An education process was designed to inform the ACS staff of the EBP, including a strategy for prospective assessment of its implementation. Results: Based on historical case volume for appendectomies an 18 month pre- and post-adoption interval was chosen for assessment. The data fields for patient characteristics were guided by the developed EBP, specifically noting: status of the appendix (inflamed, gangrenous, perforated), complicating features of operation, duration of the operation, and degree of source control (localization/extent of pus, residual amount of fibrinous exudate). Outcome measures include rates of surgical site infection, recurrent intra abdominal infection, readmission, reoperation, and duration of hospital course. Given the degree of detail needed to categorize degree of source control for the newly implemented EBP, we are unable to retrospectively assess historical compliance, therefore assessment of efficacy of the EBP will focus on outcome measures. Conclusion: Although the goal of EBP is improvement in patient care, this goal cannot be met without implementation, which has historically been delayed and suboptimal. Formal categorization of patient condition based on measurable metrics can help to place them on an appropriate treatment trajectory, which we hypothesize will lead to shorter antibiotic duration and fewer associated complications. Additionally, provider education and awareness surrounding EBP implementation can help to improve compliance. 1. BMC Psychology 2015; 3:32. 2. J Am Coll Surg 2011;213(6):778‐783. 3. NEJM 2015; 372:1996-2005

Mirrors: \u27Bleeding\u27 the Creation of Alternative Organization through a Liberating Ideology of Transformative Humanism

In this paper, we propose a new way of explaining the everyday practices of communities who socially organize to create sustainable grass-roots engagement. We discuss how this collective engagement is based on principles and values of socio-economic engagement that are fundamentally different to those associated with capitalism. We theorise that these community engagements are sustained by an organizational ideology of \u27transformative humanism\u27 that is founded on an ongoing struggle for emancipation. Our perspective is constructed through a combination of Frantz Fanon\u27s ideas on humanism, Manfred Max-Neef\u27s barefoot economics, and Paulo Freire\u27s pedagogies of hope and transformation. We suggest that movements such as this embody alternative ways for disenfranchised individuals to shape grass-roots social transformation from within because they are based on an alternative system of beliefs. We present examples of grass-roots engagement in Argentina and South Africa to demonstrate how disenfranchised communities organize together through transformative humanism

Non supersymmetric strong coupling background from the large N quantum mechanics of two matrices coupled via a Yang-Mills interaction

We derive the planar large N non-supersymmetric background of the quantum mechanical hamiltonian of two hermitean matrices coupled via a Yang-Mills interaction, in terms of the density of eigenvalues of one of the matrices. This background satisfies an implicit non linear integral equation, with a perturbative small coupling expansion and a solvable large coupling solution, which is obtained. The energy of system and the expectation value of several correlators are obtained in this strong coupling limit. They are free of infrared divergences.Comment: Latex, 13 page

Analysis of standard DNA procedures on feathers of late 19th to late 20th century Osprey (Pandion haliaetus)

Species with well-documented demographic histories and well known perturbations to gene flow provide good models for understanding how historic events impact contemporary population genetic structure1,2. Osprey (Pandion haliaetus), a marine bird-of-prey, experienced steep declines after widespread organochloride pesticide (e.g. DDT) use in the mid-twentieth century 3, however, population genetic consequences remain unknown. Use of historic specimens can aid population genetic studies4,5, however, these samples can degrade over time impacting quantity and quality of extracted DNA5. We compared the concentrations of extracted DNA of Osprey feathers from museum and research collections to those of contemporary samples collected according to standard field collection protocols

15N Photo-CIDNP MAS NMR To Reveal Functional Heterogeneity in Electron Donor of Different Plant Organisms

In plants and cyanobacteria, two light-driven electron pumps, photosystems I and II (PSI, PSII), facilitate electron transfer from water to carbon dioxide with quantum efficiency close to unity. While similar in structure and function, the reaction centers of PSI and PSII operate at widely different potentials with PSI being the strongest reducing agent known in living nature. Photochemically induced dynamic nuclear polarization (photo-CIDNP) in magic-angle spinning (MAS) nuclear magnetic resonance (NMR) measurements provides direct excess to the heart of large photosynthetic complexes (A. Diller, Alia, E. Roy, P. Gast, H.J. van Gorkom, J. Zaanen, H.J.M. de Groot, C. Glaubitz, J. Matysik, Photosynth. Res. 84, 303–308, 2005; Alia, E. Roy, P. Gast, H.J. van Gorkom, H.J.M. de Groot, G. Jeschke, J. Matysik, J. Am. Chem. Soc. 126, 12819–12826, 2004). By combining the dramatic signal increase obtained from the solid-state photo-CIDNP effect with 15N isotope labeling of PSI, we were able to map the electron spin density in the active cofactors of PSI and study primary charge separation at atomic level. We compare data obtained from two different PSI proteins, one from spinach (Spinacia oleracea) and other from the aquatic plant duckweed (Spirodella oligorrhiza). Results demonstrate a large flexibility of the PSI in terms of its electronic architecture while their electronic ground states are strictly conserved