Can pain be self-managed?:Pain change in vulnerable participants to a health education programme

Chronic pain exerts a significant impact on the quality of life, giving rise to both physical and psycho-social vulnerabilities. It not only leads to direct costs associated with treatments, but also results in indirect costs due to the reduced productivity of affected individuals. Chronic conditions can be improved by reducing modifiable risk factors. Various educational programs, including the Chronic Disease Self-Management Programme (CDSMP), have demonstrated the advantages of enhancing patient empowerment and health literacy. Nevertheless, their efficacy in addressing pain symptoms has received limited attention, especially concerning vulnerable populations. This research aims to assess the effectiveness of the CDSMP in alleviating pain among socio-economically vulnerable participants with chronic conditions. By accounting for a wide range of variables, and using data from the EFFICHRONIC project (EU health programme), we investigated the changes in pain levels after the intervention, among 1070 participants from five European countries. Our analyses revealed a significant reduction in pain following the intervention. This finding supports the notion that training programs can effectively ameliorate pain and alleviate its impact on the quality of life, particularly in vulnerable populations. Younger participants, as well as those with higher education levels and individuals experiencing higher levels of pain at baseline, were more likely to experience a reduction in their pain levels. These findings underscore the importance of recognising the social determinants of health. The study was registered at ClinicalTrials.gov (ISRCTN70517103).</p

Long-term outcomes of CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) in a consecutive series of 12 patients.

BACKGROUND: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a central nervous system inflammatory disease. OBJECTIVE: To describe the disease course of CLIPPERS. DESIGN: A nationwide study was implemented to collect clinical, magnetic resonance imaging, cerebrospinal fluid, and brain biopsy specimen characteristics of patients with CLIPPERS. SETTING: Academic research. PATIENTS: Twelve patients with CLIPPERS. MAIN OUTCOME MEASURES: The therapeutic management of CLIPPERS was evaluated. RESULTS: Among 12 patients, 42 relapses were analyzed. Relapses lasted a mean duration of 2.5 months, manifested frequent cerebellar ataxia and diplopia, and were associated with a mean Expanded Disability Status Scale (EDSS) score of 4. Besides typical findings of CLIPPERS, magnetic resonance imaging showed brainstem mass effect in 5 patients, extensive myelitis in 3 patients, and closed ring enhancement in 1 patient. Inconstant oligoclonal bands were found on cerebrospinal fluid investigation in 4 patients, with an increased T-cell ratio of CD4 to CD8. Among 7 available brain biopsy specimens, staining was positive for perivascular CD4 T lymphocytes in 5 samples. Thirty-eight of 42 relapses were treated with pulse corticosteroid therapy, which led to improvement, with a mean residual EDSS score of 1.9 (range, 0-7). In 1 patient with untreated relapses, scores on the EDSS progressively increased to a score of 10 at death. Among 5 patients without long-term corticosteroid therapy, the mean annualized relapse rate was 0.5 (range, 0.25-2.8). Among 7 patients taking oral corticosteroids, no relapses occurred in those whose daily dose was 20 mg or higher. No progressive course of CLIPPERS was observed. Four patients with a final EDSS score of 4 or higher had experienced previous severe relapses (EDSS score, ≥5) and brainstem and spinal cord atrophy. CONCLUSIONS: CLIPPERS is a relapsing-remitting disorder without progressive forms. Long-term disability is correlated with the severity of previous relapses. Further studies are needed to confirm that prolonged corticosteroid therapy prevents further relapses.journal article2012 Julimporte

A Comparative Study of Policy Specification Languages for Secure Distributed Applications

This paper presents a comparative study of policy specification languages. Our objective is to find policy language or notation that is the most suitable to express the security aspects of distributed applications running on policy-based networks. We first made a selection of languages and we compare them on several criteria: their suitability to specify security, their ability to express both user and network oriented security aspects, the representation technique they use and the notions they are able to express. This paper concludes on a discussion on what would be the ideal policy language for distributed applications that have strong security constraints

LF 1H NMR T2 relaxation rate as affected by water addition, NaCl and pH in fresh, frozen and cooked minced hake

Low-Field Nuclear Magnetic Resonance of proton transverse relaxation signal (T2) was monitored in hake (Merluccius merluccius) mince with different thermal histories (fresh, frozen, cooked) as affected by pH, water and NaCl addition, and it was related to water holding capacity (WHC). Modifications of T2 signals were found in terms of changes in relaxation times and relative abundance of the relaxation components. The relaxation rate of the major component (1/T21) increased significantly upon frozen storage or pH increase, whereas water or NaCl addition had the opposite effect. WHC decreased with freezing or water addition and increased with NaCl or basic pH; thus, T2 and WHC best correlated when each factor was analysed separately. Linearity found for pH and protein concentration with 1/T21 was consistent with chemical exchange being responsible for these changes. The significance of these results for technological situations where compositional and biochemical changes are occurring is discussed.This work has been performed under project ANIRISK funded by the Spanish Ministry of Economy and Competitiveness (MINECO) and the European Regional Development Fund (FEDER) Grant number AGL2015-68248-C2-1-R (MINECO/FEDER).Peer reviewe

LF 1H NMR T2 relaxation rate as affected by water addition, NaCl and pH in fresh, frozen and cooked minced hake

Trabajo presentado al 48th West European FishTechnologists Association Meeting (WEFTA), celebrado en Lisboa (Portugal) del 15 al 18 de octubre de 2018.The applications of low field nuclear magnetic resonance relaxometry of proton (LF 1H NMR) to the study of seafood are increasing. The transverse relaxation times (T2) provide information about the physical-chemical nature and spatial organization of muscle components and T2 has been suggested to be particularly useful as a probe to estimate changes in water distribution in a variety of cases. However, the interpretation of T2 in fish muscle is not straightforward. In order to gain a better understanding of the significance of these changes observed in situations of interest in fish technology, there is a need for a systematic study of the changes of T2 as affected by protein concentration, NaCl addition, pH or denaturation of muscle proteins, since many of the scenarios in which LF 1H NMR is applied involve modification of one or more of the above factors. This in turn makes it possible to establish the relation of T2 with other parameters known to give relevant information about muscle changes. LF 1H NMR T2 was monitored in hake (Merluccius merluccius) mince with different thermal histories (unfrozen, frozen, cooked) as affected by pH, water and NaCl addition, and it was related to water holding capacity (WHC). T2 changed in terms of bands shape, relaxation times and relative abundance of the bands. The relaxation rate of the major band (1/T21) increased significantly upon frozen storage or pH increase, whereas water or NaCl addition had the opposite effect. WHC decreased with freezing or water addition and increased with NaCl or basic pH. Linearity found for pH and protein concentration with 1/T21 was consistent with chemical exchange being responsible for these changes. The significance of these results for technological situations where compositional and biochemical changes are occurring is discussed.This work was supported by the Project ANIRISK (AGL2015-68248-C2-1-R), funded by the Spanish Ministry of Economy and Competitiveness (MINECO) and European Regional Development Fund (FEDER).Peer Reviewe

Proficiency test scheme for histamine analysis in fishery products in Morocco using the fluorometric method and comparison of results with those obtained with the HPLC reference method

A Proficiency Test Scheme (PTS) for histamine analysis in fishery products using the Lerke and Bell (1976) fluorometric method was conducted in 26 different Moroccan laboratories. The goal of this PTS was to assess the abilities of a network of seven government laboratories and 19 laboratories performing auto-controls on fish processing units in Morocco. The samples used in the PTS were prepared from canned ground mackerel flesh, to which was added two significant concentrations (levels 1 and 2) of histamine. The homogeneity of the PTS samples was verified by a repeatability test and their stability by an intermediate fidelity test. The Cochran test was used to eradicate anomalous scattering and the Grubbs test to eradicate the anomalous averages observed in the results of the participating laboratories. The average and the usual deviations determined for levels 1 and 2 were used to calculate the Z-scores. For level 1 therefore, 23 out of 26 laboratories had satisfactory PTS results, and for level 2, 21 out of 26 laboratories had satisfactory PTS results. An analysis of the PTS samples using the HPLC reference method gave similar results for levels 1 and 2

A Comparative Study of Policy Specification Languages for Secure Distributed Applications

This paper presents a comparative study of policy specification languages. Our objective is to find policy language or notation that is the most suitable to express the security aspects of distributed applications running on policy-based networks. We first made a selection of languages and we compare them on several criteria: their suitability to specify security, their ability to express both user and network oriented security aspects, the representation technique they use and the notions they are able to express. This paper concludes on a discussion on what would be the ideal policy language for distributed applications that have strong security constraints