Geochemical and mineralogical analysis of pre-Columbian stone tools from La Piedra Pintada, Baja California Sur, Mexico

Title from PDF of title page, viewed on January 10, 2012Thesis advisor: Tina NiemiVitaIncludes bibliographic references (p. 58-66)Thesis (M.S.)--Dept. of Geosciences. University of Missouri--Kansas City, 2012Piedra Pintada is located in San Pablo Canyon, one of a series of major canyons that bisect the mountainous interior of the southern Baja California Peninsula, Mexico. Among the resources used by the canyon's prehistoric inhabitants were lithic materials suitable for the production of flaked stone tools. To help better define the spatial scale of resource procurement by the canyon's prehistoric population elemental analysis of samples collected from the dikes and selected stone tools was done by ICPMS (Inductively Coupled Plasma Mass Spectrometry). ICPMS was used because it can provide elemental “fingerprints� that can be used to distinguish source materials and correlate specific stone tools with individual source material sites. Relative abundances of minor elements, including transition metals and rare earth elements, can differ sufficiently between source rocks that elemental ratios can be used to link a stone tool with its source material in many cases. Comparison of elemental spectra from four stone tools with local dike rocks suggests that two of the four tools examined were manufactured from stone obtained from San Pablo Canyon.Introduction -- Tectonic and geologic setting -- Archaeological site setting -- Methodology -- Geochemical analysis -- Discussion and conclusion

Emotional Reactions to Pain Predict Psychological Distress in Adult Patients with Sickle Cell Disease (SCD)

Differentiating somatic from emotional influences on the experience of chronic pain has been of interest to clinicians and researchers for many years. Although prior research has not well specified these pathways at the anatomical level, some evidence, both theoretical and empirical, suggest that emotional reactions influence the experience of disease and non-disease-related pains. Other studies suggest that treatments directed at negative emotional responses reduce suffering associated with pain. The current study was conducted to explore the influence of emotional reactions to pain as a predictor of psychological distress in a sample of adult Blacks with Sickle Cell Disease (SCD). Using cross-sectional survey data, we evaluated whether negative emotional reactions to the experience of pain were predictive of psychological distress after controlling for the somatic dimension of pain and age in n = 67 Black patients with Sickle Cell Disease (SCD). Results showed that greater negative emotion associated with pain predicted Somatization (p < .01), Anxiety (p < .05), Phobic Anxiety (p < .05), and Psychoticism (p < .05). Increased negative emotion associated with pain was also predictive of the General Symptoms Index (p < .05) and the Positive Symptoms Total from the SCL-90-R (p < .01). We believe the current study demonstrates that negative emotional reactions to the experience of pain in adults with SCD are predictive of psychological distress above and beyond the influences of age and the direct nociceptive experience. We also believe these data to be valuable in conceptualizing the allocation of treatment resources toward a proactive approach with early identification of patients who are responding poorly for the purpose of potentially reducing later psychopathology. A deeper understanding of the ways that subpopulations cope with chronic disease-related pain may produce models that can be ultimately generalized to the consumers of the majority of healthcare resources

Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The QuinteT Recruitment Intervention supported five randomized trials to recruit to target: a mixed-methods evaluation

ObjectiveTo evaluate the impact of the Quintet Recruitment Intervention (QRI) on recruitment in challenging randomized controlled trials (RCTs) that have applied the intervention. The QRI aims to understand recruitment difficulties, and then implements ‘QRI-actions’ to address these as recruitment proceeds.Study Design and SettingA mixed-methods study, comprising: a) before-and-after comparisons of recruitment rates and numbers of patients approached, and b) qualitative case studies, including documentary analysis and interviews with RCT investigators.ResultsFive UK-based publicly-funded RCTs were included in the evaluation. All recruited to target. RCT2 and RCT5 both received up-front pre-recruitment training before the intervention was applied. RCT2 did not encounter recruitment issues and recruited above target from its outset. Recruitment difficulties, particularly communication issues, were identified and addressed through QRI-actions in RCTs 1, 3, 4 and 5. Randomization rates significantly improved post-QRI-action in RCTs 1,3, and 4. QRI-actions addressed issues with approaching eligible patients in RCTs 3 and 5, which both saw significant increases in patients approached. Trial investigators reported that the QRI had unearthed issues they had been unaware of, and reportedly changed their practices post QRI-action.ConclusionThere is promising evidence to suggest the QRI can support recruitment to difficult RCTs. This needs to be substantiated with future controlled evaluations

Friendships and Student Success in College

Over the past two decades, a growing body of research has investigated college students’ friendships and how these relationships can both enable and constrain students’ success. I review this body of literature, describing the characteristics and processes of college students’ friendships. First, I review work that describes characteristics of students’ friendships, particularly focused on the roles of similarity and proximity in shaping the friendships students make. Second, I focus on what students do with friends that promote college success. Taking a broad view of success, I focus on how friends facilitate a sense of belonging and identity development as well as specific types of support that students provide, emotionally and academically. Third, I discuss processes related to friendships that impede students from success. I conclude by noting some implications for practice and promising areas of future research on friendships and success for postsecondary students