Prescribing Medications for Chronic Pain Management: The State of Education in Florida Medical Schools and Residency Programs

The purpose of this study was to assess the state of chronic, non-cancer pain management education in Florida medical schools and residency programs. Surveys were developed and distributed to Florida allopathic and osteopathic medical schools. One survey was specific to students and residents and one to faculty. Confidence in their general education, as well as in treating patients with chronic, non-cancer pain, was measured. A majority of medical students and residents (59.5%), in addition to a majority of faculty (58.1%), agreed or strongly agree that more clinical time needs to be dedicated to chronic, non-cancer pain management education. Students, residents, and faculty suggested offering more lectures, online modules, workshops, and clinical scenarios as ways to improve the current educational environment. Results demonstrate that while Florida medical schools and residency programs provide education on chronic, non- cancer pain management, there is still room for improvement. Increased communication between institutions and standardizing competencies related to pain management may prove beneficial

Predicting avian distributions to evaluate spatiotemporal overlap with locust control operations in eastern Australia

Locusts and grasshoppers cause considerable economic damage to agriculture worldwide. The Australian Plague Locust Commission uses multiple pesticides to control locusts in eastern Australia. Avian exposure to agricultural pesticides is of conservation concern, especially in the case of rare and threatened species. The aim of this study was to evaluate the probability of pesticide exposure of native avian species during operational locust control based on knowledge of species occurrence in areas and times of application. Using presence-absence data provided by the Birds Australia Atlas for 1998 to 2002, we developed a series of generalized linear models to predict avian occurrences on a monthly basis in 0.5 degrees grid cells for 280 species over 2 million km 2 in eastern Australia. We constructed species-specific models relating occupancy patterns to survey date and location, rainfall, and derived habitat preference. Model complexity depended on the number of observations available. Model output was the probability of occurrence for each species at times and locations of past locust control operations within the 5-year study period. Given the high spatiotemporal variability of locust control events, the variability in predicted bird species presence was high, with 108 of the total 280 species being included at least once in the top 20 predicted species for individual space-time events. The models were evaluated using field surveys collected between 2000 and 2005, at sites with and without locust outbreaks. Model strength varied among species. Some species were under- or over-predicted as times and locations of interest typically did not correspond to those in the prediction data set and certain species were likely attracted to locusts as a food source. Field surveys demonstrated the utility of the spatially explicit species lists derived from the models but also identified the presence of a number of previously unanticipated species. These results also emphasize the need for special consideration of rare and threatened species that are poorly predicted by presence-absence models. This modeling exercise was a useful a priori approach in species risk assessments to identify species present at times and locations of locust control applications, and to discover gaps in our knowledge and need for further focused data collection Copyright 2009 by the Ecological Society ot America

Trends and determinants of excess winter mortality in New Zealand: 1980 to 2000

<p>Abstract</p> <p>Background</p> <p>Although many countries experience an increase in mortality during winter, the magnitude of this increase varies considerably, suggesting that some winter excess may be avoidable. Conflicting evidence has been presented on the role of gender, region and deprivation. Little has been published on the magnitude of excess winter mortality (EWM) in New Zealand (NZ) and other Southern Hemisphere countries.</p> <p>Methods</p> <p>Monthly mortality rates per 100,000 population were calculated from routinely collected national mortality data for 1980 to 2000. Generalised negative binomial regression models were used to compare mortality rates between winter (June–September) and the warmer months (October–May).</p> <p>Results</p> <p>From 1980–2000 around 1600 excess winter deaths occurred each year with winter mortality rates 18% higher than expected from non-winter rates. Patterns of EWM by age group showed the young and the elderly to be particularly vulnerable. After adjusting for all major covariates, the winter:non-winter mortality rate ratio from 1996–2000 in females was 9% higher than in males. Mortality caused by diseases of the circulatory system accounted for 47% of all excess winter deaths from 1996–2000 with mortality from diseases of the respiratory system accounting for 31%. There was no evidence to suggest that patterns of EWM differed by ethnicity, region or local-area based deprivation level. No decline in seasonal mortality was evident over the two decades.</p> <p>Conclusion</p> <p>EWM in NZ is substantial and at the upper end of the range observed internationally. Interventions to reduce EWM are important, but the surprising lack of variation in EWM by ethnicity, region and deprivation, provides little guidance for how such mortality can be reduced.</p

The pursuit of happiness: the social and scientific origins of Hans Selye’s natural philosophy of life

© The Author(s) 2012. Open access article.In 1956, Hans Selye tentatively suggested that the scientific study of stress could ‘help us to formulate a precise program of conduct’ and ‘teach us the wisdom to live a rich and meaningful life’. Nearly two decades later, Selye expanded this limited vision of social order into a full-blown philosophy of life. In Stress without Distress, first published in 1974, he proposed an ethical code of conduct designed to mitigate personal and social problems. Basing his arguments on contemporary understandings of the biological processes involved in stress reactions, Selye referred to this code as ‘altruistic egotism’. This article explores the origins and evolution of Selye’s ‘natural philosophy of life’, analysing the links between his theories and adjacent intellectual developments in biology, psychosomatic and psychosocial medicine, cybernetics and socio-biology, and situating his work in the broader cultural framework of modern western societies.Wellcome Trus

Medicinal Plant Use and Health Sovereignty: Findings from the Tajik and Afghan Pamirs

Medicinal plants are indicators of indigenous knowledge in the context of political volatility and sociocultural and ecological change in the Pamir Mountains of Afghanistan and Tajikistan. Medicinal plants are the primary health care option in this region of Central Asia. The main objective of this paper is to demonstrate that medicinal plants contribute to health security and sovereignty in a time of instability. We illustrate the nutritional as well as medicinal significance of plants in the daily lives of villagers. Based on over a decade and half of research related to resilience and livelihood security, we present plant uses in the context of mountain communities. Villagers identified over 58 cultivated and noncultivated plants and described 310 distinct uses within 63 categories of treatment and prevention. Presence of knowledge about medicinal plants is directly connected to their use

Prediction of Bodyweight and Energy Expenditure Using Point Pressure and Foot Acceleration Measurements

Bodyweight (BW) is an essential outcome measure for weight management and is also a major predictor in the estimation of daily energy expenditure (EE). Many individuals, particularly those who are overweight, tend to underreport their BW, posing a challenge for monitors that track physical activity and estimate EE. The ability to automatically estimate BW can potentially increase the practicality and accuracy of these monitoring systems. This paper investigates the feasibility of automatically estimating BW and using this BW to estimate energy expenditure with a footwear-based, multisensor activity monitor. The SmartShoe device uses small pressure sensors embedded in key weight support locations of the insole and a heel-mounted 3D accelerometer. Bodyweight estimates for 9 subjects are computed from pressure sensor measurements when an automatic classification algorithm recognizes a standing posture. We compared the accuracy of EE prediction using estimated BW compared to that of using the measured BW. The results show that point pressure measurement is capable of providing rough estimates of body weight (root-mean squared error of 10.52 kg) which in turn provide a sufficient replacement of manually-entered bodyweight for the purpose of EE prediction (root-mean squared error of 0.7456 METs vs. 0.6972 METs). Advances in the pressure sensor technology should enable better accuracy of body weight estimation and further improvement in accuracy of EE prediction using automatic BW estimates