Management of complex symptoms in multiple sclerosis (MS)

People with MS can present with a complex range of symptoms. Some of these include dysautonomia (autonomic dysfunction), fatigue, cognitive impairment, and mood disorders. These symptoms must be managed in order to optimise intervention outcomes

Increasing Skin Infections and Staphylococcus aureus Complications in Children, England, 1997-2006

During 1997-2006, general practitioner consultations for skin conditions for children <18 years of age in England increased 19%, from 128.5 to 152.9/1,000 child-years, and antistaphylococcal drug prescription rates increased 64%, from 17.8 to 29.1/1,000 child-years. During the same time period, hospital admissions for Staphylococcus aureus infections rose 49% from 53.4 to 79.3/100,000 child-years.link_to_subscribed_fulltex

Global Climate Change, Food Security and the U.S. Food System

Climate change influences on the major pillars of food security. Each of the four elements of food security (availability,access,utilization,andstability) is vulnerable to changes in climate. For example,reductions in production related to regional drought influence food availability at multiple scales. Changes in price influences the ability of certain populations to purchase food (access). Utilization maybe affected when production zones shift, reducing the availability of preferred or culturally appropriate types of food within a region. Stability of the food supply may be highly uncertain given an increased incidence of extreme climatic events and their influence on production patterns

Cluster-randomized, crossover trial of head positioning in acute stroke

The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. METHODS In a pragmatic, cluster-randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying-flat position or a sitting-up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours. The primary outcome was degree of disability at 90 days, as assessed with the use of the modified Rankin scale (scores range from 0 to 6, with higher scores indicating greater disability and a score of 6 indicating death). RESULTS The median interval between the onset of stroke symptoms and the initiation of the assigned position was 14 hours (interquartile range, 5 to 35). Patients in the lying-flat group were less likely than patients in the sitting-up group to maintain the position for 24 hours (87% vs. 95%, P\u3c0.001). In a proportional-odds model, there was no significant shift in the distribution of 90-day disability outcomes on the global modified Rankin scale between patients in the lying-flat group and patients in the sitting-up group (unadjusted odds ratio for a difference in the distribution of scores on the modified Rankin scale in the lying-flat group, 1.01; 95% confidence interval, 0.92 to 1.10; P = 0.84). Mortality within 90 days was 7.3% among the patients in the lying-flat group and 7.4% among the patients in the sitting-up group (P = 0.83). There were no significant betweengroup differences in the rates of serious adverse events, including pneumonia. CONCLUSIONS Disability outcomes after acute stroke did not differ significantly between patients assigned to a lying-flat position for 24 hours and patients assigned to a sitting-up position with the head elevated to at least 30 degrees for 24 hours

Brief treatment for disturbing memory: a neuro-linguistic programming submodality procedure

Neuro-Linguistic Programming (NLP) claims for quick and permanent relief from the unpleasant affect associated with a disturbing memory were tested by examining several subject-rated, and one counselor-rated measure of improvement following a submodality treatment procedure. The NLP submodality treatment group scores were compared to the scores of an attentional control group (ACG) of subjects who received a light trance. Two experienced licensed psychologists who are experts in NLP procedures and trance induction administered both treatments. Sixteen male and twenty-eight female adults from a large protestant church volunteered to participant in the experiment which included a Target Complaint Discomfort Box Scale administered pre- and post-treatment and at 2 weeks post-treatment. Other dependent measures were the Client Post-Therapy Questionnaire, which was administered immediately post-treatment and 2 weeks follow-up, the counselor-rated Global Improvement Rating Scale, and the Counselor Rating Form (Short-Form), which were each administered only immediately post-treatment. There were significant differences (p\u3c.05) in the participants\u27 ratings of change as a result of treatment in favor of the NLP submodality procedure. The NLP group also scored significantly higher (p\u3c.05) on a measure of satisfaction with treatment than did the ACG. Differences on the counselor-rated Global Improvement Rating Scale made the strongest contribution to the significance of the multi-variate main effect. No other significant differences were found on any of the remaining dependent measures. As well, no significant differences were found between the two therapists, using the Counselor Rating Form (Short-Form) immediately post-treatment and for the 2 week follow-up analysis. The results of this study provide partial support for the predictions made, in that the NLP submodality participants did report that they experienced change and that they were more satisfied with their treatment significantly more than the ACG. NLP claims for permanent cure were not supported. Incidental findings from a procedural check bring into question an a priori assumption of this study that people do, in fact, want to feel better about a disturbing memory. These findings further bring into question the accuracy of participants\u27 self-reporting of improvement with paper and pencil measuring tools. Several suggestions for future research are included

K-Band Spectroscopy of (Pre-)Cataclysmic Variables: Are Some Donor Stars Really Carbon Poor?

We present a new sample of $K$-band spectral observations for CVs: non-magnetic and magnetic as well as present day and pre CVs. The purpose of this diverse sample is to address the recent claim that the secondary stars in dwarf novae are carbon deficient, having become so through a far more evolved evolution than the current paradigm predicts. Our new observations, along with previous literature results, span a wide range of orbital period and CV type. In general, dwarf novae in which the secondary star is seen show weak to no CO absorption while polar and pre-CV donor stars appear to have normal CO absorption for their spectral type. However, this is not universal. The presence of normal looking CO absorption in the dwarf nova SS Aur and the hibernating CV QS Vir and a complete lack of CO absorption in the long period polar V1309 Ori cloud the issue. A summary of the literature pointing to non-solar abundances including enhanced NV/CIV ratios is presented. It appears that some CVs have non-solar abundance material accreting onto the white dwarf suggesting an evolved secondary star while for others CO emission in the accretion disk may play a role. However, the exact mechanism or combination of factors causing the CO absorption anomaly in CVs is not yet clear.Comment: Accepted in A

Threonine 149 Phosphorylation Enhances ΔFosB Transcriptional Activity to Control Psychomotor Responses to Cocaine

Stable changes in neuronal gene expression have been studied as mediators of addicted states. Of particular interest is the transcription factor ΔFosB, a truncated and stable FosB gene product whose expression in nucleus accumbens (NAc), a key reward region, is induced by chronic exposure to virtually all drugs of abuse and regulates their psychomotor and rewarding effects. Phosphorylation at Ser[superscript 27] contributes to ΔFosB's stability and accumulation following repeated exposure to drugs, and our recent work demonstrates that the protein kinase CaMKIIα phosphorylates ΔFosB at Ser[superscript 27] and regulates its stability in vivo. Here, we identify two additional sites on ΔFosB that are phosphorylated in vitro by CaMKIIα, Thr[superscript 149] and Thr[superscript 180], and demonstrate their regulation in vivo by chronic cocaine. We show that phosphomimetic mutation of Thr[superscript 149] (T149D) dramatically increases AP-1 transcriptional activity while alanine mutation does not affect transcriptional activity when compared with wild-type (WT) ΔFosB. Using in vivo viral-mediated gene transfer of ΔFosB-T149D or ΔFosB-T149A in mouse NAc, we determined that overexpression of ΔFosB-T149D in NAc leads to greater locomotor activity in response to an initial low dose of cocaine than does WT ΔFosB, while overexpression of ΔFosB-T149A does not produce the psychomotor sensitization to chronic low-dose cocaine seen after overexpression of WT ΔFosB and abrogates the sensitization seen in control animals at higher cocaine doses. We further demonstrate that mutation of Thr[superscript 149] does not affect the stability of ΔFosB overexpressed in mouse NAc, suggesting that the behavioral effects of these mutations are driven by their altered transcriptional properties

A Phenomenology of Working With Youth Sex-Trafficked Survivors in Florida

The purpose of this qualitative phenomenological study was to describe the experiences of health care professionals (HCPs) and other service providers (SPs) who work or worked with children and adolescent survivors of domestic minor sex trafficking (DMST) and the commercial sexual exploitation of children (CSEC) in Florida. The Conceptual Model for Factors Affecting Well-Being and Resilience devised by the National Academy of Medicine (NAM) and the Five Ways to Well-Being Model developed by Catherine Gilliver were used to guide this study. These models helped the researcher gain a better understanding of how participants experienced working with survivors and victims of DMST and its effect on them. Data collection was conducted through the use of an initial demographic questionnaire as well as the completion of both the Depression Anxiety Stress Scale (DASS-21) and a PTSD Symptom Checklist (PSS-I-5). Responses from these instruments helped include and exclude participants during the screening process of the study. Upon acceptance, face-to-face interviews were conducted online via Zoom and were recorded then transcribed. For data analysis, open coding was used to categorize responses into themes, and the researcher used notetaking and color coding to protect the anonymity of participants and to highlight common themes found in participants’ responses. Initial impressions were noted using memoing in addition to inductive analysis to make judgements