Systematically searching for and assessing the literature for self-management of chronic pain: A lay users' perspective

© 2014 Schofield et al.; licensee BioMed Central Ltd. Background: The Engaging with older adults in the development of strategies for the self management of chronic pain (EOPIC) study aims to design and develop self management strategies to enable older adults to manage their own pain. Involving older adults in research into chronic pain management will better enable the identification and development of strategies that are more appropriate for their use, but how can perspectives really be utilised to the best possible outcomes?. Method. Seven older adults were recruited through a local advertising campaign to take part. We also invited participants from the local pain services, individuals who had been involved in earlier phase of the EOPIC study and a previous ESRC funded project. The group undertook library training and research skills training to facilitate searching of the literature and identified sources of material. A grading tool was developed using perceived essential criteria identified by the older adults and material was graded according to the criteria within this scale. Results: Fifty-seven resources from over twenty-eight sources were identified. These materials were identified as being easily accessible, readable and relevant. Many of the web based materials were not always easy to find or readily available so they were excluded by the participants. All but one were UK based. Forty-four items were identified as meeting the key criteria for inclusion in the study. This included five key categories as follows; books, internet, magazines, leaflets, CD's/Tapes. Conclusion: This project was able to identify a number of exemplars of self management material along with some general rules regarding the categories identified. We must point out that the materials identified were not age specific, were often locally developed and would need to be adapted to older adults with chronic pain. For copyright issues we have not included them in this paper. The key message is really related to the format rather than the content. However, the group acknowledge that these may vary according to the requirements of each individual older adult and therefore recommend the development of a leaflet to help others in their search for resources. This leaflet has been developed as part of Phase IV of the EOPIC study

Levosimendan for the prevention of acute organ dysfunction in sepsis

BACKGROUND Levosimendan is a calcium-sensitizing drug with inotropic and other properties that may improve outcomes in patients with sepsis. METHODS We conducted a double-blind, randomized clinical trial to investigate whether levosimendan reduces the severity of organ dysfunction in adults with sepsis. Patients were randomly assigned to receive a blinded infusion of levosimendan (at a dose of 0.05 to 0.2 μg per kilogram of body weight per minute) for 24 hours or placebo in addition to standard care. The primary outcome was the mean daily Sequential Organ Failure Assessment (SOFA) score in the intensive care unit up to day 28 (scores for each of five systems range from 0 to 4, with higher scores indicating more severe dysfunction; maximum score, 20). Secondary outcomes included 28-day mortality, time to weaning from mechanical ventilation, and adverse events. RESULTS The trial recruited 516 patients; 259 were assigned to receive levosimendan and 257 to receive placebo. There was no significant difference in the mean (±SD) SOFA score between the levosimendan group and the placebo group (6.68±3.96 vs. 6.06±3.89; mean difference, 0.61; 95% confidence interval [CI], −0.07 to 1.29; P=0.053). Mortality at 28 days was 34.5% in the levosimendan group and 30.9% in the placebo group (absolute difference, 3.6 percentage points; 95% CI, −4.5 to 11.7; P=0.43). Among patients requiring ventilation at baseline, those in the levosimendan group were less likely than those in the placebo group to be successfully weaned from mechanical ventilation over the period of 28 days (hazard ratio, 0.77; 95% CI, 0.60 to 0.97; P=0.03). More patients in the levosimendan group than in the placebo group had supraventricular tachyarrhythmia (3.1% vs. 0.4%; absolute difference, 2.7 percentage points; 95% CI, 0.1 to 5.3; P=0.04). CONCLUSIONS The addition of levosimendan to standard treatment in adults with sepsis was not associated with less severe organ dysfunction or lower mortality. Levosimendan was associated with a lower likelihood of successful weaning from mechanical ventilation and a higher risk of supraventricular tachyarrhythmia. (Funded by the NIHR Efficacy and Mechanism Evaluation Programme and others; LeoPARDS Current Controlled Trials number, ISRCTN12776039.

Study on Doping Prevention: A map of Legal, Regulatory and Prevention Practice Provisions in EU 28

Historically, anti-doping efforts have focused on the detection and deterrence of doping in elite and competitive sport. There is, however, a growing concern that doping is occurring outside the organised sporting system; giving rise to the belief that the misuse of doping agents in recreational sport has become a societal problem and a public health issue that must be addressed. The EU Commission awarded a contract (EAC/2013/0617) to a Consortium to undertake this Study with the aim of developing the evidence-base for policies designed to combat doping in recreational sport. Fourteen internationally recognised experts shaped the Study which comprised (i) the collection of primary data through a structured survey, and (ii) secondary data through literature searches and website analysis. All 28 Member States participated in the information-gathering process. Specifically, this involved a systematic study of the ethical considerations, legal position, prevention research landscape, and current practise in relation to the prevention of doping in recreational sport. The Study provides a comprehensive overview of current practice and legislation as it applies to the prevention of doping and promotes and supports the sharing of best practices in the EU regarding the fight against doping in recreational sport. It concludes with seven recommendations for future action that focus on the need for a coordinated response in relation to the problems arising from doping in recreational sport

The Off Shell ρ\rho-ω\omega Mixing in the QCD Sum Rules

The $q^2$ dependence of the $\rho-\omega$ mixing amplitude is analyzed with the use of the QCD sum rules and the dispersion relation. Going off shell the mixing decreases, changes sign at $q^2 \simeq 0.4 m_{\rho}^2 > 0$ and is negative in the space like region. Implications of this result to the isospin breaking part of the nuclear force are discussed.Comment: 26 pages + 11 figures (PostScript

Off-Shell Rho-Omega Mixing Through Quark Loops With Non-Perturbative Meson Vertex And Quark Mass Functions

The momemtum dependence of the off-shell $\rho$-$\omega$ mixing amplitude is calculated through a two-quark loop diagram, using non-perturbative meson-quark vertex functions for the $\rho$ and $\omega$ mesons, as well as non-perturbative quark propagators. Both these quantities are generated self-consistently through an interlinked BSE-cum-SDE approach with a 3D support for the BSE kernel with two basic constants which are pre- checked against a wide cross section of both meson and baryon spectra within a common structural framework for their respective 3D BSE's. With this pre-calibration, the on-shell strength works out at -2.434$\delta(m_q^2)$ in units of the change in "constituent mass squared", which is consistent with the $e^+e^-$ to $\pi^+\pi^-$ data for a u-d mass difference of ~4 MeV ,while the relative off-shell strength (0.99 $\pm$ 0.01) lies midway between quark-loop and QCD-SR results. We also calculate the photon-mediated $\rho$-$\omega$ propagator whose off-shell structure has an additional pole at $q^2$=0. The implications of these results vis-a-vis related investigations are discussed.Comment: 12 Pages, latex file, NTUTH-94-0

Electromagnetic Form Factors of the SU(3) Octet Baryons in the semibosonized SU(3) Nambu-Jona-Lasinio Model

The electromagnetic form factors of the SU(3) octet baryons are investigated in the semibosonized SU(3) Nambu--Jona-Lasinio model (chiral quark-soliton model). The rotational $1/N_c$ and strange quark mass corrections in linear order are taken into account. The electromagnetic charge radii of the nucleon and magnetic moments are also evaluated. It turns out that the model is in a remarkable good agreement with the experimental data.Comment: RevTex is used. 37 pages. The final version to appear in Phys. Rev. D. 13 figures are include

Temperature and Density Effects on the Nucleon Mass Splitting

The finite temperature and finite density dependence of the neutron-proton mass difference is analysed in a purely hadronic framework where the $\rho-\omega$ mixing is crucial for this isospin symmetry breakdown. The problem is handled within Thermo Field Dynamics. The present results, consistent with partial chiral and charge symmetry restoration, improve the experimental data fit for the energy difference between mirror nuclei.Comment: 17 pages, revtex fil

Does oral sodium bicarbonate therapy improve function and quality of life in older patients with chronic kidney disease and low-grade acidosis (the BiCARB trial)? Study protocol for a randomized controlled trial

Date of acceptance: 01/07/2015 © 2015 Witham et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Acknowledgements UK NIHR HTA grant 10/71/01. We acknowledge the financial support of NHS Research Scotland in conducting this trial.Peer reviewedPublisher PD

Care and phronesis in teaching and coaching: dealing with personality disorder

My aim in this article is to contribute to the discussion about how teachers and coaches come to act in appropriate ways given the complex nature of both practices. I focus on two specific dispositions or qualities from the philosophical literature, namely the virtue of care and the Aristotelian concept of phronesis (or practical wisdom), which have been put forward as possible explanations. I argue that care and phronesis are fundamental qualities for both good teachers and coaches. Talk of care and phronesis in the literature is welcome, but these concepts are themselves complex. Care and phronesis, like other virtues are context-specific, difficult to acquire (or teach) and their particular expression depends on a host of complex factors, not least one's character and personal and professional experience. I illustrate my argument with reference to a former professional football player who exhibited symptoms of personality disorder from an early age and who presented challenges to his teachers and coaches through his disruptive behaviour

Aspirin reduces lipopolysaccharide induced pulmonary inflammation in human models of ARDS

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