Continuing Methadone for Pain in Palliative Care

BACKGROUND: Methadone is one of the most important medications used for the treatment of refractory pain in the palliative care setting, and is usually initially prescribed by one of a limited number of physicians who have acquired authorization for its use. A lack of authorized physicians able to take over prescribing when the patient is stable is a barrier to accessing methadone for analgesia

Misleading Suggestions Can Alter Later Memory Reports Even Following a Cognitive Interview

Taking an immediate recall test prior to misinformation exposure can increase eyewitness suggestibility—a finding termed retrieval-enhanced suggestibility. Here, we examined whether retrieval-enhanced suggestibility would occur when participants were administered an immediate Cognitive Interview (CI). The CI is an investigative interviewing technique that consistently elicits more correct details in memory reports than standard interviews. In this study, participants watched a video of a crime and then completed a distractor task (control condition), a free recall test, or the CI. They then heard misinformation presented in a narrative. Participants produced more accurate memory details in the CI than in free recall despite spending equal time on both tasks. However, the CI also increased the later report of misinformation relative to the control condition. These results show that initial retrieval can increase subsequent suggestibility even when such retrieval occurs under relatively ideal conditions. Copyright © 2013 John Wiley & Sons, Ltd.This is the accepted version of the following article: "Misleading Suggestions can Alter later Memeory Reports even Following a Cognitive Interview," Applied Cognitive Psychology Volume 28, Issue 1, pages 1–9, January/February 2014, which has been published in final form at http:// onlinelibrary.wiley.com/doi/10.1002/acp.2950/full.</p

Pulse Intensity Effects of Burst and Tonic Spinal Cord Stimulation on Neural Responses to Brushing in Patients With Neuropathic Pain.

ObjectivesTonic spinal cord stimulation (SCS) is accompanied by paresthesia in affected body regions. Comparatively, the absence of paresthesia with burst SCS suggests different involvement of the dorsal column system conveying afferent impulses from low-threshold mechanoreceptors. This study evaluated cortical activation changes during gentle brushing of a pain-free leg during four SCS pulse intensities to assess the effect of intensity on recruitment of dorsal column system fibers during burst and tonic SCS.Materials and methodsTwenty patients using SCS (11 burst, nine tonic) for neuropathic leg pain participated. Brushing was administered to a pain-free area of the leg during four SCS intensities: therapeutic (100%), medium (66%), low (33%), and no stimulation. Whole-brain electroencephalography was continuously recorded. Changes in spectral power during brushing were evaluated using the event-related desynchronization (ERD) method in theta (4-7 Hz), alpha (8-13 Hz), and beta (16-24 Hz) frequency bands.ResultsBrushing was accompanied by a suppression of cortical oscillations in the range 4-24 Hz. Stronger intensities of burst and tonic SCS led to less suppression of 4-7 Hz and 8-13 Hz bands in parietal electrodes, and in central electrodes in the 16-24 Hz band, with the strongest, statistically significant suppression at medium intensity. Tonic SCS showed a stronger reduction in 4-7 Hz oscillations over right sensorimotor electrodes, and over right frontal and left sensorimotor electrodes in the 8-13 Hz band, compared to burst SCS.ConclusionsResults suggest that burst and tonic SCS are mediated by both different and shared mechanisms. Attenuated brushing-related ERD with tonic SCS suggests a gating of cortical activation by afferent impulses in the dorsal column, whereas burst may engage different pathways. Diminished brushing-related ERD at medium and therapeutic intensities of burst and tonic SCS points towards a nonlinear effect of SCS on somatosensory processing

'A Divided Soul'? the Cold War odyssey of O. John Rogge

In 1948 O. John Rogge, a prominent American liberal, was a contender for the Progressive Party's vice-presidential nomination. He was then a man of the Left: an activist in the international peace movement, a champion of radical causes and a defender of organizations deemed subversive by the Department of Justice. In 1951 he persuaded his\ud client to turn government witness in the Rosenberg espionage trial and was converted into 'Rogge the Rat' by his former allies. In tracing this transformation, this paper will argue that Rogge was neither a typical Cold War apostate nor a typical anti-Stalinist intellectual. Instead, his political trajectory was the outcome of a failed attempt to steer global politics away from Cold War dichotomies. The paper will therefore throw new light\ud both on the movement to find a 'third way' between East and West, and on the phenomenon of non-communist Left activism during the early Cold War

A Multilocus Molecular Phylogeny of the Parrots (Psittaciformes): Support for a Gondwanan Origin during the Cretaceous

The question of when modern birds (Neornithes) first diversified has generated much debate among avian systematists. Fossil evidence generally supports a Tertiary diversification, whereas estimates based on molecular dating favor an earlier diversification in the Cretaceous period. In this study, we used an alternate approach, the inference of historical biogeographic patterns, to test the hypothesis that the initial radiation of the Order Psittaciformes (the parrots and cockatoos) originated on the Gondwana supercontinent during the Cretaceous. We utilized broad taxonomic sampling (representatives of 69 of the 82 extant genera and 8 outgroup taxa) and multilocus molecular character sampling (3,941 bp from mitochondrial DNA (mtDNA) genes cytochrome oxidase I and NADH dehydrogenase 2 and nuclear introns of rhodopsin intron 1, tropomyosin alpha-subunit intron 5, and transforming growth factor ß-2) to generate phylogenetic hypotheses for the Psittaciformes. Analyses of the combined character partitions using maximum parsimony, maximum likelihood, and Bayesian criteria produced well-resolved and topologically similar trees in which the New Zealand taxa Strigops and Nestor (Psittacidae) were sister to all other psittaciforms and the cockatoo clade (Cacatuidae) was sister to a clade containing all remaining parrots (Psittacidae). Within this large clade of Psittacidae, some traditionally recognized tribes and subfamilies were monophyletic (e.g., Arini, Psittacini, and Loriinae), whereas several others were polyphyletic (e.g., Cyclopsittacini, Platycercini, Psittaculini, and Psittacinae). Ancestral area reconstructions using our Bayesian phylogenetic hypothesis and current distributions of genera supported the hypothesis of an Australasian origin for the Psittaciformes. Separate analyses of the timing of parrot diversification constructed with both Bayesian relaxed-clock and penalized likelihood approaches showed better agreement between geologic and diversification events in the chronograms based on a Cretaceous dating of the basal split within parrots than the chronograms based on a Tertiary dating of this split, although these data are more equivocal. Taken together, our results support a Cretaceous origin of Psittaciformes in Gondwana after the separation of Africa and the India/Madagascar block with subsequent diversification through both vicariance and dispersal. These well-resolved molecular phylogenies will be of value for comparative studies of behavior, ecology, and life history in parrots

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes