Management of chronic pain

[Extract] Chronic pain is suffered by a significant number of people from all age groups. Most of these people manage the pain themselves in a range of positive and sometimes negative ways - they take analgesics and remedies and modify their lifestyles to accommodate changes that may accrue in elements of life such as function and affect. People who suffer from chronic pain classically refer themselves to general practitioners who now act as agents for a broad range of conventional and complementary specialists to manage chronic pain. The majority of nurses become involved in the care of people with chronic pain when it affects function or psychological wellbeing to such an extent that independence in activities of living (Roper et al,2000) or self-care needs(Orem, 2001)are adversely affected. These nurses take a supportive and educative role to enable people with chronic pain to recognise positive strategies that ameliorate their state of pain and maximise their independence. However, there are nurse practitioners who specifically work with people who are referred to pain clinics and there are specialist nurses who work with people with conditions that are particularly associated with enduring pain, for example people with cancer and specialists in oncology nursing, or people with long-term angina and specialists in cardiac rehabilitation nursing. These nurses work in multidisciplinary teams and have extended knowledge of the aetiology of chronic pain and skills in the assessment, therapy and evaluation of chronic pain management. This chapter is written for nurses and other health professionals as a broad overview of a complex topic. There is no intention to delve into the specifics of specialist diagnosis and treatment but rather to draw a picture of the size and the nature of the problem, and the array of therapies that are available to suit particular individuals with chronic pain. While we refer to nursing and nursing theories of self-care, we recognise that the management of chronic pain is essentially in the hands of individuals and that support for them comes from a range of health professionals whose roles can overlap to a large degree in the offering and delivery of a person-centred philosophy of health care service

Chronic nutrient inputs affect stream macroinvertebrate communities more than acute inputs: An experiment manipulating phosphorus, nitrogen and sediment

peer-reviewedFreshwaters worldwide are affected by multiple stressors. Timing of inputs and pathways of delivery can influence the impact stressors have on freshwater communities. In particular, effects of point versus diffuse nutrient inputs on stream macroinvertebrates are poorly understood. Point-source inputs tend to pose a chronic problem, whereas diffuse inputs tend to be acute with short concentration spikes. We manipulated three key agricultural stressors, phosphorus (ambient, chronic, acute), nitrogen (ambient, chronic, acute) and fine sediment (ambient, high), in 112 stream mesocosms (26 days colonisation, 18 days of manipulations) and determined the individual and combined effects of these stressors on stream macroinvertebrate communities (benthos and drift). Chronic nutrient treatments continuously received high concentrations of P and/or N. Acute channels received the same continuous enrichment, but concentrations were doubled during two 3-hour periods (day 6, day 13) to simulate acute nutrient inputs during rainstorms. Sediment was the most pervasive stressor in the benthos, reducing total macroinvertebrate abundance and richness, EPT (mayflies, stoneflies, caddisflies) abundance and richness. By contrast, N or P enrichment did not affect any of the six studied community-level metrics. In the drift assemblage, enrichment effects became more prevalent the longer the experiment went on. Sediment was the dominant driver of drift responses at the beginning of the experiment. After the first acute nutrient pulse, sediment remained the most influential stressor but its effects started to fade. After the second pulse, N became the dominant stressor. In general, impacts of either N or P on the drift were due to chronic exposure, with acute nutrient pulses having no additional effects. Overall, our findings imply that cost-effective management should focus on mitigating sediment inputs first and tackle chronic nutrient inputs second. Freshwater managers should also take into account the length of exposure to high nutrient concentrations, rather than merely the concentrations themselves

Alterations in glutamatergic signaling contribute to the decline of circadian photoentrainment in aged mice

Robust physiological circadian rhythms form an integral part of well-being. The aging process has been found to negatively impact systems that drive circadian physiology, typically manifesting as symptoms associated with abnormal/disrupted sleeping patterns. Here, we investigated the age-related decline in light-driven circadian entrainment in male C57BL/6J mice. We compared light-driven resetting of circadian behavioral activity in young (1e2 months) and old (14e18 months) mice and explored alterations in the glutamatergic pathway at the level of the circadian pacemaker, the suprachiasmatic nucleus (SCN). Aged animals showed a significant reduction in sensitivity to behavioral phase resetting by light. We show that this change was through alterations in N-Methyl-D-aspartate (NMDA) signaling at the SCN, where NMDA, a glutamatergic agonist, was less potent in inducing clock resetting. Finally, we show that this shift in NMDA sensitivity was through the reduced SCN expression of this receptor’s NR2B subunit. Only in young animals did an NR2B antagonist attenuate behavioral resetting. These results can help target treatments that aim to improve both physiological and behavioral circadian entrainment in aged populations

The future of biotic indices in the ecogenomic era: Integrating (e)DNA metabarcoding in biological assessment of aquatic ecosystems

The bioassessment of aquatic ecosystems is currently based on various biotic indices that use the occurrence and/or abundance of selected taxonomic groups to define ecological status. These conventional indices have some limitations, often related to difficulties in morphological identification of bioindicator taxa. Recent development of DNA barcoding and metabarcoding could potentially alleviate some of these limitations, by using DNA sequences instead of morphology to identify organisms and to characterize a given ecosystem. In this paper, we review the structure of conventional biotic indices, and we present the results of pilot metabarcoding studies using environmental DNA to infer biotic indices. We discuss the main advantages and pitfalls of metabarcoding approaches to assess parameters such as richness, abundance, taxonomic composition and species ecological values, to be used for calculation of biotic indices. We present some future developments to fully exploit the potential of metabarcoding data and improve the accuracy and precision of their analysis. We also propose some recommendations for the future integration of DNA metabarcoding to routine biomonitoring programs.info:eu-repo/semantics/publishedVersio

Regenerative Futures: From Global to Local Development in 2032

The ‘Regenerative Futures: From Global to Local Development in 2032’ project was jointly conceived by the Innovation School at Glasgow School of Art and the School of Cancer Sciences at the University of Glasgow. The project partnership involved a community of experts working across both organisations including the University of Glasgow’s Mazumdar-Shaw Advanced Research Centre (ARC). Regenerative Design is about designing for people and the planet from a socio-ecological perspective. It seeks not merely to do less harm, but rather catalyses a positive force that restores, renews or revitalises products, services and systems to foster resilient and equitable futures for people and the planet. The Regenerative Futures project asked the final year BDes Product Design cohort to consider what happens in this landscape ten years from now, where Global Development has evolved to the extent that new forms of regenerative experiences of health, economies and citizenship transform how we interact with each other, with local and global communities, and the world around us. Working with an expert community of practice from the University of Glasgow’s Advanced Research Centre (the project’s partner) and a wider expert group of academic and professional stakeholders, the students, faculty, and experts co-researched, explored and designed speculative future worlds and experiences of regenerative global and local communities and systems leading towards equitable health, economies and citizenship in ten year’s time. In the first part of the project, the student cohort work in six groups to collectively research the brief, exploring the domains of Health, Economies and Citizenship from a Globally-Centred or Locally-Centred perspective. In-depth insights from the first stage fuel individual design work in Part Two. The second part of the project saw individual students select an aspect of their Future World research to develop as a design direction, which they then prototyped and produced as products, services, and/or systems. These are designed for specific communities, contexts or scenarios of use defined by the students to communicate a future experience. The output from this project is curated and presented as a public exhibition. The exhibition resulting from this research project includes products, services and experiences designed for the people who might live and work within these future contexts. Each ‘future world’ is situated within a discrete design domain: Health (Global + Local), Economies (Global + Local) and Citizenship (Global + Local). Exhibition dates: Tuesday 7th to Friday 10th February, 2023 Venue: Advanced Research Centre, University of Glasgow The deposited materials are arranged as follows: 1 - Regenerative Futures Project Brief. The Project Brief is developed as rationale, context and a guide to the project. 2 - Regenerative Futures Project Exhibition Guide. The Guide catalogues and describes the exhibits presented in the show. It takes you through each ‘Future World’ experience created by the students. It complements the videos and images presented in companion sections. 3 - Videos of the Regenerative Futures Exhibition. Here you will find short videos documenting the set-up of the exhibition and the exhibition itself. 4 - Images of the Regenerative Futures Exhibition. This section documents the Exhibition in images. 5 - Images of Studio Life. This section documents in images, the co-creation studio sessions with experts and the studio development of the show exhibits. 6 - Exhibition guides for each individual World View. These guides take you through each individual ‘Future World’; Health (Global + Local), Economies (Global + Local) and Citizenship (Global + Local)

Prosodic structure and suprasegmental features:Short-vowel stød in Danish

This paper presents a phonological analysis of a glottalization phenomenon in dialects of Danish known as ‘short-vowel stød’. It is argued that both short-vowel stød and common Danish stød involve the attachment of a laryngeal feature to a prosodic node—specifically the mora. In the case of short-vowel stød that mora lacks segmental content, as it is projected top-down due to local prosodic requirements, not bottom-up by segmental material. I show that this device provides an account of the distribution of short-vowel stød as arising from the interplay of constraints on metrical structure (both lexically stored and computed by the grammar) and the requirement for morae to be featurally licensed. The analysis provides further evidence for the analysis of ‘tonal accents’ and related phenomena in terms of metrical structure rather than lexical tone or laryngeal features, and contributes to our understanding of the relationship between segmental and suprasegmental phonology in Germanic languages

Management of chronic pain

[Extract] Chronic pain is suffered by a significant number of people from all age groups. Most of these people manage the pain themselves in a range of positive and sometimes negative ways - they take analgesics and remedies and modify their lifestyles to accommodate changes that may accrue in elements of life such as function and affect. People who suffer from chronic pain classically refer themselves to general practitioners who now act as agents for a broad range of conventional and complementary specialists to manage chronic pain. The majority of nurses become involved in the care of people with chronic pain when it affects function or psychological wellbeing to such an extent that independence in activities of living (Roper et al,2000) or self-care needs(Orem, 2001)are adversely affected. \ud \ud These nurses take a supportive and educative role to enable people with chronic pain to recognise positive strategies that ameliorate their state of pain and maximise their independence. However, there are nurse practitioners who specifically work with people who are referred to pain clinics and there are specialist nurses who work with people with conditions that are particularly associated with enduring pain, for example people with cancer and specialists in oncology nursing, or people with long-term angina and specialists in cardiac rehabilitation nursing. These nurses work in multidisciplinary teams and have extended knowledge of the aetiology of chronic pain and skills in the assessment, therapy and evaluation of chronic pain management. This chapter is written for nurses and other health professionals as a broad overview of a complex topic. There is no intention to delve into the specifics of specialist diagnosis and treatment but rather to draw a picture of the size and the nature of the problem, and the array of therapies that are available to suit particular individuals with chronic pain. While we refer to nursing and nursing theories of self-care, we recognise that the management of chronic pain is essentially in the hands of individuals and that support for them comes from a range of health professionals whose roles can overlap to a large degree in the offering and delivery of a person-centred philosophy of health care service