Morphine and Hydromorphone-Induced Hyperalgesia in a Hospice Patient

Opioids including morphine and hydromorphone are widely used for control of moderate to severe pain and dyspnea in hospice and palliative care patients. Accumulation of the active morphine-3-glucuronide (M3G) and hydromorphone-3-glucuronide (H3G) metabolites is one proposed mechanism for the development of neuroexcitatory effects including allodynia and opioid-induced hyperalgesia (OIH). We report the case of a 43-year-old female hospice patient with metastatic non-small cell lung cancer who initially developed allodynia following morphine administration and again following administration of hydromorphone. The allodynia resolved both times following the discontinuation of the opioid and rotation to a different opioid regimen. Potential opioid-induced neuroexcitatory treatment options include opioid rotation to an agent with inactive metabolites, use of adjuvant pain medications for opioid-sparing effects, management of undesired symptoms (e.g., myoclonus), or increasing opioid clearance with intravenous (IV) fluids. Although the incidence is not well defined in the literature, hospice and palliative care clinicians should suspect OIH in patients with allodynia and/or hyperalgesia, especially when repeated dose escalations do not improve analgesia or pain escalates following opioid dose titration

Tunneling anisotropic magnetoresistance in organic spin valves

We report the observation of tunneling anisotropic magnetoresistance (TAMR) in an organic spin-valve-like structure with only one ferromagnetic electrode. The device is based on a new high mobility perylene diimide-based n-type organic semiconductor. The effect originates from the tunneling injection from the LSMO contact and can thus occur even for organic layers which are too thick to support the assumption of tunneling through the layer. Magnetoresistance measurements show a clear spin-valve signal, with the typical two step switching pattern caused by the magnetocrystalline anisotropy of the epitaxial magnetic electrode.Comment: 10 pages 5 figures Paper has been rewritten, new results have been adde

Controlling magnetic anisotropy in La_0.7Sr_0.3MnO₃ nanostructures

We have developed a chlorine based dry etching process for nanopatterning the ferromagnetic oxide La<sub>0.7</sub>Sr<sub>0.3</sub>MnO<sub>3</sub> (LSMO). Large arrays of millions of identical structures have been fabricated from thin LSMO films by electron-beam lithography and reactive ion etching. SQUID magnetometry demonstrates that patterned nanostructures with lateral dimensions down to 100 nm retain their full magnetization and the Curie temperature of the bulk layer. In addition, their shape anisotropy is sufficient to overcome the crystalline anisotropy of the bulk. High resolution scanning transmission electron microscopy shows that crystallinity is preserved even at the edges of the nanostructures

A Comparison of the Effects of Child Management and Planned Activities Training in Five Parenting Environments

This study compared the effects of two procedures designed to enhance the extra training effects of behavioral parent training. Twenty parents of oppositional children were randomly assigned to either a child management training condition or a combined child management plus planned activities condition. A further 10 non-problem children and their parents served as a social validation group. Observations of both parent and child behavior were conducted in each of five home observation settings (breakfast time, kindy (kindergarten) or school exit, a structured playtime, bathtime, and bedtime). Both training procedures resulted in changes in both child oppositional and parent aversive behavior in all observation settings. In addition, desired positive parenting behaviors also improved in all settings. Treatment effects were maintained in all settings at 3-month follow-up. Comparisons between oppositional children following treatment and children in the social validation group showed that they each displayed similarly low levels of oppositional behavior in all settings. The implications of the results for facilitating generalized changes in behavioral parent training are discussed

Supporting parents of youths with intellectual disabilities and psychopathology

Background: Parents of children and adolescents with both intellectual disabilities (ID) and psychopathology often experience high levels of parenting stress. To support these parents, information is required regarding the types of support they need and whether their needs are met. Method: In a sample of 745 youths (aged 10-24 years) with moderate to borderline ID, 289 parents perceived emotional and/or behavioural problems in their child. They were asked about their needs for support and whether these needs were met. Logistic regression analysis revealed the variables associated with both needing and receiving specific types of support. In addition, we asked those parents who had refrained from seeking support about their reasons. Results: Most parents (88.2%) needed some supports, especially a friendly ear, respite care, child mental health care and information. Parents who perceived both emotional and behavioural problems in their child needed support the most. In addition, parents whose child had any of these problems before the past year, who worried most about their child and suffered from psychopathology themselves, more often needed support. Parents of children with moderate ID or physical problems especially needed 'relief care', that is, respite care, activities for the child and practical/material help. The need for a friendly ear was met most often (75.3%), whereas the need for parental counselling was met least often (35.5%). Not receiving support despite having a need for it was primarily related to the level of need. Parents who indicated to have a stronger need for support received support more often than parents who had a relatively low need for support. The parents' main reasons for not seeking support concerned their evaluation of their child's problems (not so serious or temporary), not knowing where to find support or wanting to solve the problems themselves first. Conclusions: Most parents had various support needs that were frequently unmet. Service providers should especially aim at providing information, activities, child mental health care and parental counselling. Furthermore, parents need to be informed about where and how they can obtain what kind of support. A case manager can be of help in this

Probing the Roughness of Porphyrin Thin Films with X-ray Photoelectron Spectroscopy

Thin-film growth of molecular systems is of interest for many applications, such as for instance organic electronics. In this study, we demonstrate how X-ray photoelectron spectroscopy (XPS) can be used to study the growth behavior of such molecular systems. In XPS, coverages are often calculated assuming a uniform thickness across a surface. This results in an error for rough films, and the magnitude of this error depends on the kinetic energy of the photoelectrons analyzed. We have used this kinetic-energy dependency to estimate the roughnesses of thin porphyrin films grown on rutile TiO2(110). We used two different molecules: cobalt (II) monocarboxyphenyl-10,15,20-triphenylporphyrin (CoMCTPP), with carboxylic-acid anchor groups, and cobalt (II) tetraphenylporphyrin (CoTPP), without anchor groups. We find CoMCTPP to grow as rough films at room temperature across the studied coverage range, whereas for CoTPP the first two layers remain smooth and even; depositing additional CoTPP results in rough films. Although, XPS is not a common technique for measuring roughness, it is fast and provides information of both roughness and thickness in one measurement.Fil: Kataev, Elmar. Universitat Erlangen-Nuremberg; AlemaniaFil: Wechsler, Daniel. Universitat Erlangen-Nuremberg; AlemaniaFil: Williams, Federico José. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química, Física de los Materiales, Medioambiente y Energía. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química, Física de los Materiales, Medioambiente y Energía; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Inorgánica, Analítica y Química Física; ArgentinaFil: Köbl, Julia. Universitat Erlangen-Nuremberg; AlemaniaFil: Tsud, Natalia. Karlova Univerzita (cuni); República ChecaFil: Franchi, Stefano. Istituto di Struttura della Materia; Italia. Consiglio Nazionale delle Ricerche; ItaliaFil: Steinruck, Hans Peter. Universitat Erlangen-Nuremberg; AlemaniaFil: Lytken, Ole. Universitat Erlangen-Nuremberg; Alemani

Social work students as community partners in a family intervention programme

Summary: This paper describes the findings from the evaluation of a UK initiative which engaged social work students as community partners within an educational based family intervention programme. Fourteen social work students in the first year of a BA (Hons) were placed in the programme to meet the volunteering requirements of their 'Community Project'. By engaging with the community-based family programme at an early stage in their education, students experienced the benefits of interventions, focussing on sustainability, citizenship and parent participation. We describe the approach and discuss the evaluation outcomes to illustrate the potential of utilising co-learning with families in social work education. In taking up the role of community partners, students observed first-hand the value of incorporating horizontal relationships into their learning and experienced direct knowledge exchange with service users at an early stage in their training. Findings: The findings suggest that this experience enabled students to connect with conceptualisations of macro alongside micro practice in their professional development as social workers. Further, connecting critical social theories with the direct experience of families promoted the learners own empowerment and conscientization. Application: This provided a means of embedding social work values and aspirations towards social justice in their future practice orientation