Polypharmacy and Symptoms of Pain in Women with Fibromyalgia

Fibromyalgia (FMS), a syndrome characterized by chronic widespread pain (CWP), has no known etiology, and coincides with other life-altering symptoms including fatigue, mood disturbances and non-restorative sleep. Despite the multiple medication classes that are typically used for the treatment of FMS, there are no known studies assessing the efficacy of polypharmacy on symptoms of pain in this patient population. While analgesic medications, including opioid or opioid-like medications, are commonly prescribed, the use of these medications for FMS has not been fully described, including potential incidence of analgesic overuse. The primary purpose of this secondary analysis was to examine how many classes of pharmacologic agents were used in a sample of N=122 women diagnosed with FMS, the relationships among baseline pain levels and medication use, controlling for self-reported levels of fatigue and depression. Data was collected from two separate studies: (a) a cross-sectional study to examine the relationship among stress, symptoms and immune markers in women (N=50) with FM, and (b) an RCT to examine the effect of a 10-week guided imagery intervention on stress, self-efficacy, symptoms and immunity in women (N=72) with FM. In both studies participants were asked to provide lists of currently prescribed medications for treatment of their FMS-related symptoms. Examination of the data revealed that participants were prescribed 6 different classes of medications. These included opioids analgesics, non-opioid analgesics, antidepressants, anticonvulsants, muscle relaxants, and benzodiazepines. Baseline pain severity scores (p=0.0106) and pain interference scores (p=0.0002) were significantly associated with opioid use as compared to those individuals who did not report opioid use. Study findings are considered preliminary data for development of a larger study to examine efficacy of polypharmacy and related potential risks of adverse effects or substance abuse in those with FMS. Supported by grants from NINR #P20 NR008988 (N. McCain, PI); #P30 NR011403 M. J. Grap (PI).https://scholarscompass.vcu.edu/uresposters/1170/thumbnail.jp

Recruiting for Epigenetic Research: Facilitating the Informed Consent Process

Because the effects of epigenetic (gene-environment interaction) changes have been associated with numerous adverse health states, the study of epigenetic measures provides exciting research opportunities for biobehavioral scientists. However, recruitment for studies focusing on any aspect of genetics poses challenges. Multiple factors, including lack of knowledge regarding a research study, have been identified as barriers to recruitment. Strengthening the informed consent process through extended discussion has been found to be effective in recruiting for research studies in general, yet there is a paucity of information that focused on such a recruitment strategy for epigenetic studies. In this paper, we share our experiences with strategies to strengthen the informed consent process as well as provide samples of materials developed to heighten potential participants’ understanding of epigenetics, in 4 epigenetic research studies with women from diverse backgrounds experiencing a range of health issues. The combined enrollment success rate for epigenetic studies using the process was 89% with participants representing a diverse population. We posit that carefully developed recruitment scripts provided a foundation for improving potential participants’ understanding of the research project. Easy to understand illustrations of the epigenetic process provided a basis for active engagement and encouraged individual questions

High level triggers for explosive mafic volcanism: Albano Maar, Italy

Colli Albani is a quiescent caldera complex located within the Roman Magmatic Province (RMP), Italy. The recent Via dei Laghi phreatomagmatic eruptions led to the formation of nested maars. Albano Maar is the largest and has erupted seven times between ca 69-33ka. The highly explosive nature of the Albano Maar eruptions is at odds with the predominant relatively mafic (SiO2=48-52wt.%) foiditic (K2O=9wt.%) composition of the magma. The deposits have been previously interpreted as phreatomagmatic, however they contain large amounts (up to 30%vol) of deep seated xenoliths, skarns and all pre-volcanic subsurface units. All of the xenoliths have been excavated from depths of up to 6km, rather than being limited to the depth at which magma and water interaction is likely to have occurred, suggesting an alternative trigger for eruption. High precision geochemical glass and mineral data of fresh juvenile (magmatic) clasts from the small volume explosive deposits indicate that the magmas have evolved along one of two evolutionary paths towards foidite or phonolite. The foiditic melts record ca. 50% mixing between the most primitive magma and Ca-rich melt, late stage prior to eruption. A major result of our study is finding that the generation of Ca-rich melts via assimilation of limestone, may provide storage for significant amounts of CO2 that can be released during a mixing event with silicate magma. Differences in melt evolution are inferred as having been controlled by variations in storage conditions: residence time and magma volume. © 2013

The burden of intermittent oral corticosteroid use in asthma

Peer reviewe

The visibility of research within mandatory National Health Service Trust Induction programmes in England: an exploratory survey study

Background: Mandatory NHS Trust induction programmes are an integral part of staff orientation processes. Although research is recognised as fundamental to high-quality care, little data exist regarding whether research information is included within hospital induction. Methods: Two online national surveys were developed, with the aim of identifying Trusts which included research within their mandatory induction programme. Survey 1 was distributed to Research and Development managers across England (n = 201). Survey 2 collated information on the research content and delivery methods of induction material. The work was classified as a service evaluation and reported in accordance with CHERRIES reporting standards. Results: Survey 1 generated 124 unique responses (61% response rate). Thirty-nine percent of Trusts (n = 48) featured information about research delivery and 24% (n = 30) about training or support to develop clinical academic careers. There was wide variation in how materials were delivered, by whom and for how long. Conclusions: Currently research has a limited profile within English NHS Trust mandatory induction programmes. This needs to be addressed if research is truly to be considered part of the core National Health Service business. Guidance or a modifiable template could help Trusts communicate about research delivery and clinical academic development and training to all new employees

The visibility of research within mandatory National Health Service Trust Induction programmes in England: An exploratory survey study

Background: Mandatory NHS Trust induction programmes are an integral part of staff orientation processes. Although research is recognised as fundamental to high-quality care, little data exist regarding whether research information is included within hospital induction. Methods: Two online national surveys were developed, with the aim of identifying Trusts which included research within their mandatory induction programme. Survey 1 was distributed to Research and Development managers across England ( n = 201). Survey 2 collated information on the research content and delivery methods of induction material. The work was classified as a service evaluation and reported in accordance with CHERRIES reporting standards. Results: Survey 1 generated 124 unique responses (61% response rate). Thirty-nine percent of Trusts ( n = 48) featured information about research delivery and 24% ( n = 30) about training or support to develop clinical academic careers. There was wide variation in how materials were delivered, by whom and for how long. Conclusions: Currently research has a limited profile within English NHS Trust mandatory induction programmes. This needs to be addressed if research is truly to be considered part of the core National Health Service business. Guidance or a modifiable template could help Trusts communicate about research delivery and clinical academic development and training to all new employees