Catastrophizing mediates the relationship between the personal belief in a just world and pain outcomes among chronic pain support group attendees

Health-related research suggests the belief in a just world can act as a personal resource that protects against the adverse effects of pain and illness. However, currently, little is known about how this belief, particularly in relation to one’s own life, might influence pain. Consistent with the suggestions of previous research, the present study undertook a secondary data analysis to investigate pain catastrophizing as a mediator of the relationship between the personal just world belief and chronic pain outcomes in a sample of chronic pain support group attendees. Partially supporting the hypotheses, catastrophizing was negatively correlated with the personal just world belief and mediated the relationship between this belief and pain and disability, but not distress. Suggestions for future research and intervention development are made

Spanish medical students’ attitudes and views towards Mental Health and Psychiatry: a multicentric cross-sectional study.

Objective The aim of this study is to investigate the attitudes towards mental illness and psychiatry among fifth year Spanish medical students. Methods The study included 171 students from three medical schools located in different areas of Spain: Cádiz; UCA (n= 113), Madrid; San Pablo-CEU (n=22), and Barcelona; UAB (n=36). They responded, prior to their undergraduate medical course in psychiatry, to the AMI questionnaire to measure the attitudes towards mental illness and to Balon’s adapted questionnaire to investigate their view towards psychiatry. Results The students (93.4 %) had a positive attitude towards mental illness (AMI). Attitudes towards psychiatry were fairly positive with a few negative views, specifically regarding the role of psychiatrists (items 11 and 13) and the prestige of the specialty (item 16). There were some statistically significant differences between the three medical schools in the perception of psychiatry as a medical discipline. A better attitude towards mental illness was associated with a better view of the overall merits of psychiatry. Conclusions Findings suggest that Spanish medical students do not have a negative attitude towards mental illness and they have a good perception of psychiatry, although there are still some misconceptions about this specialty. These student’s attitudes could favor an appropriate management of patients suffering from mental illness

Genetics of alternative definitions of feed efficiency in grazing lactating dairy cows

The objective of this study was to estimate genetic parameters for measures of energy conversion efficiency (ECE), energy balance (EB), net energy intake (NEI), net energy of lactation (NEL) and body weight (BW), within lactation stages in grazing dairy cows. Individual measurements of NEI (n=7,675) from 2,445 lactations on 1,245 grazing cows were available. Residual energy intake (REI) was defined as NEI minus predicted energy requirements; residual energy production (REP) was defined as net energy of lactation (NEL) minus predicted energy requirements. Energy conversion efficiency was defined as NEL divided by NEI; EB was defined as the difference between intake and energy required for maintenance plus lactation. Lactation was divided into three stages (8-90, 91-180, and >180 days in milk [DIM]). Genetic and phenotypic (co)variances for EB, NEL and BW were estimated using univariate and bivariate animal repeatability models. The models included the fixed effects of contemporary group (treatment and test-date), parity, DIM, as well as a random additive genetic effect of animal, a within-lactation stage random permanent environmental effect and an across-lactation permanent environmental effect. Heritability across-lactation stages varied from 0.13 (8-90 DIM) to 0.28 (91-180 DIM) for NEI, from 0.16 (8-90 DIM) to 0.33 (91-180 DIM) for NEL, from 0.04 (8-90 DIM) to 0.10 (91-180 and >180 DIM) for EB, from 0.03 (8-90 DIM) to 0.11 (>180 DIM) for REI, and from 0.04 (8-90 DIM) to 0.18 (>180 DIM) for ECE. A strong genetic association between REI and EB was evident when average BW change was close to zero. These genetic parameters from Holstein-Friesian dairy cows fed predominantly grazed grass imply that genetic improvement in selected efficiency traits is achievable.falsePublishe

Cost-effectiveness of tight control of inflammation in early psoriatic arthritis: economic analysis of a multicenter randomized controlled trial

Objective: Treat‐to‐target approaches have proved to be effective in rheumatoid arthritis, but have not been studied in psoriatic arthritis (PsA). This study was undertaken to examine the cost‐effectiveness of tight control (TC) of inflammation in early PsA compared to standard care. Methods: Cost‐effectiveness analyses were undertaken alongside a UK‐based, open‐label, multicenter, randomized controlled trial. Taking the perspective of the health care sector, effectiveness was measured using the 3‐level EuroQol 5‐domain, which allows for the calculation of quality‐adjusted life‐years (QALYs). Incremental cost‐effectiveness ratios (ICERs) are presented, which represent the additional cost per QALY gained over a 48‐week time horizon. Sensitivity analyses are presented assessing the impact of variations in the analytical approach and assumptions on the cost‐effectiveness estimates. Results: The mean cost and QALYs were higher in the TC group: £4,198 versus £2,000 and 0.602 versus 0.561. These values yielded an ICER of £53,948 per QALY. Bootstrapped uncertainty analysis suggests that the TC has a 0.07 probability of being cost‐effective at a £20,000 threshold. Stratified analysis suggests that with certain costs being controlled, an ICER of £24,639 can be calculated for patients with a higher degree of disease severity. Conclusion: A tight control strategy to treat PsA is an effective intervention in the treatment pathway; however, this study does not find tight control to be cost‐effective in most analyses. Lower drug prices, targeting polyarthritis patients, or reducing the frequency of rheumatology visits may improve value for money metrics in future studies.</p

Rhinovirus-induced exacerbations of asthma: How is the β<inf>2</inf>- adrenoceptor implicated?

Rhinovirus (RV) infections are the major cause of asthma exacerbations in children and adults. Under normal circumstances, asthmatic airway obstruction improves spontaneously or characteristically briskly in response to inhaled β2-adrenergic receptor (β2AR) agonists. During virus-associated exacerbations, an impaired response to β2AR agonists is observed; the reason for this is not known. The objective of this study was to determine the effect of RV infection on airway smooth muscle β2AR function. The human cell line Beas-2B and primary human bronchial epithelial cells (HBECs) were infected with RV (multiplicity of infection = 1). After 1 or 5 days for primary and Beas-2B cells, respectively, cell culture supernatants were harvested, UV-irradiated to inactivate RV, and applied to human airway smooth muscle cells for 3 days to assess modifications of β2AR function. RV conditioned medium from Beas-2B and HBECs decreased β2AR agonist-induced cAMP by 50 and 65%, respectively (n = 5; P < 0.05). When cAMP was induced independently of the β2AR using forskolin, no impairment was found. Using flow cytometry, we demonstrated that this decrease was likely the result of β2AR desensitization because membrane but not total cell receptor β2AR was decreased. Pretreatment of HBECs and Beas-2B cells but not human airway smooth muscle cells with the corticosteroids dexamethasone or fluticasone abolished virus-mediated β2AR loss of function. This study shows that epithelial infection with RV induces a decrease of β2AR function on airway smooth muscle cells, potentially explaining the clinical observation of loss of β2AR agonist function during RV-induced asthma exacerbations