Suggestion, hypnosis and hypnotherapy: a survey of use, knowledge and attitudes of anaesthetists

Publisher's copy made available with the permission of the publisher © Australian Society of AnaesthetistsClinical hypnosis is a skill of using words and gestures (frequently called suggestions) in particular ways to achieve specific outcomes. It is being increasingly recognised as a useful intervention for managing a range of symptoms, especially pain and anxiety. We surveyed all 317 South Australian Fellows and trainees registered with ANZCA to determine their use, knowledge of, and attitudes towards positive suggestion, hypnosis and hypnotherapy in their anaesthesia practice. The response rate was 218 anaesthetists (69%). The majority of respondents (63%) rated their level of knowledge on this topic as below average. Forty-eight per cent of respondents indicated that there was a role for hypnotherapy in clinical anaesthesia, particularly in areas seen as traditional targets for the modality, i.e. pain and anxiety states. Nearly half of the anaesthetists supported the use of hypnotherapy and positive suggestions within clinical anaesthesia. Those respondents who had experience of clinical hypnotherapy were more likely to support hypnosis teaching at undergraduate or postgraduate level when compared with those with no experience.http://www.aaic.net.au/Article.asp?D=200408

Bragg soybeans grown on a Southern Coastal Plain soil. IV. Seasonal changes in nodal N and P concentrations

Determinate soybean [Glycine max (L.) Merr.] has been characterized by few detailed nitrogen and phosphorous partitioning studies. Knowledge of the variation in N and P concentrations with plant part, nodal position, and plant age is needed for a better understanding of plant functions. In this field study, 'Bragg' soybean was grown on an Aquic Paleudult soil (series Goldsboro loamy sand). Plants were sampled at 10 to 14 day intervals beginning 44 days after planting (July 7) until harvest. Maximum observed N concentrations were 3.1, 2.8, 5.8, and 5.4% for stem internodes, petioles (+branches), leaf blades, and pods, respectively. Maximum observed P concentrations were 0.34, 0.48, 0.78, and 0.52 for the same respective plant parts. Nodal and temporal mean N and P concentrations varied considerably with plant age and nodal position in all plant parts. These data show that mean N and concentrations in all four plant parts can vary several fold, depending upon plant age and nodal position for the sample. This suggests caution should be exercised in tissue sampling and interpretation of plant analysis. Concentrations of N and P generally decreased with time for stem internode, petioles (+branches), and leaf blades, but increased with time for pods. Except for N concentration in stem internodes, which increases with internode number, the N and P concentrations remain nearly constant throughout the growing season. The relationships provide insight for developing accurate plant models depicting N and P concentrations and translocations over time and among plant parts in determinate soybean

Morphological, temporal, and nodal accumulation of nutrients by determinate soybean

Crop growth models that account for nutrient accumulation offer insight into soil fertility and plant nutrition interactions. This understanding provides opportunities to develop improved management practices. During the 1980s, several process-level growth models were developed for soybean [Glycine max (I..) Merr.). Model validation and application to different locations and weather require detailed, independent data sets. An extensive data set describing the nutrient status of a determinate soybean ('Bragg') was collected in 1979 on a Goldsboro (Aquic Paleudult) loamy sand near Florence, SC, USA. Because of its importance to subsequent model development, we concluded that providing this entire data set in a readily accessible form was a logical step in the course of this experiment. We report here, in tabular form, mean and standard deviation data for aerial accumulation of dry matter and eight nutrients (N, P, K, Ca, Mg, Mn, Fe, and Zn) for 10 dates, for four plant components (stems, leaves, petioles, pods, and total), and for each node (and whole plant). We will provide, upon arrangement, these same data on diskette for use in simulation models or other applications

Identifying patients at risk for high-grade intra-abdominal hypertension following trauma laparotomy

Background: Abdominal Compartment Syndrome (ACS) is an uncommon but deleterious complication after trauma laparotomy. Early recognition of patients at risk of developing ACS is crucial for their outcome. The aim of this study was to compare the characteristics of patients who developed high-grade intra-abdominal hypertension (IAH) (i.e., grade III or IV; intra-abdominal pressure, IAP >20. mmHg) following an injury-related laparotomy versus those who did not (i.e., IAP ≤20. mmHg). Methods: A retrospective analysis of consecutive trauma patients admitted to a level 1 trauma centre in Australia between January 1, 1995 and January 31, 2010 was performed. A comparison was made between characteristics of patients who developed high-grade IAH following trauma laparotomy versus those who did not. Results: A total of 567 patients (median age 31 years) were included in this study. Of these patients 10.2% (58/567) developed high-grade IAH of which 51.7% (30/58) developed ACS. Patients with high-grade IAH were older (p <. 0.001), had a higher Injury Severity Score (p <. 0.001), larger base deficit (p <. 0.001) and lower temperature at admission (p = 0.011). In the first 24. h of admission, patients with high-grade IAH received larger volumes of crystalloids (p <. 0.001), larger volumes of colloids (p <. 0.001) and more units of packed red blood cells (p <. 0.001). Following surgery prolonged prothrombin (p <. 0.001) and partial thromboplastin times (p <. 0.001) were seen. The patients with high-grade IAH suffered higher mortality rates (25.9% (15/58) vs. 12.2% (62/509); p = 0.012). Conclusion: Of all patients who underwent a trauma laparotomy, 10.2% developed high-grade IAH, which increases the risk of mortality. Patients with acidosis, coagulopathy, and hypothermia were especially at risk. In these patients, the abdomen should be left open until adequate resuscitation has been achieved, allowing for definitive surgery. Level of evidence: This is a level III retrospective study

Access to substance use treatment among young adults who use prescription opioids non-medically

BACKGROUND: Non-medical prescription opioid (NMPO) use is a substantial public health problem in the United States, with 1.5 million new initiates annually. Only 746,000 people received treatment for NMPO use in 2013, demonstrating substantial disparities in access to treatment. This study aimed to assess correlates of accessing substance use treatment among young adult NMPO users in Rhode Island, a state heavily impacted by NMPO use and opioid overdose. METHODS: This analysis uses data from a study of 200 Rhode Island residents aged 18 to 29 who reported NMPO use in the past 30 days. We compared individuals who had ever successfully enrolled in a substance use treatment program without ever facing barriers, individuals who had ever attempted to enroll but were unable, and individuals who never attempted to enroll. We used multinomial logistic regression to determine the independent correlates of never attempting and unsuccessfully attempting to access substance use treatment. RESULTS: Among 200 participants, the mean age was 24.5, 65.5% were male, and 61.5% were white. Nearly half (45.5%) had never attempted to enroll in substance use treatment, while 35.0% had successfully enrolled without ever facing barriers and 19.5% were unsuccessful in at least one attempt to enroll. In multivariable models, non-white participants were more likely to never have attempted to enroll compared to white participants. Previous incarceration, experiencing drug-related discrimination by the medical community, and a monthly income of $501 -$1500 were associated with a decreased likelihood of never attempting to enroll. A history of overdose and a monthly income of $501 -$1500 were associated with an increased likelihood of unsuccessfully accessing treatment. The most commonly reported barriers to accessing treatment were waiting lists (n = 23), health insurance not approving enrollment (n = 20), and inability to pay (n = 16). CONCLUSIONS: This study demonstrates significant disparities in access to treatment among young adults who report NMPO use. A history of overdose was shown to correlate with experiencing barriers to substance use treatment utilization. Interventions are needed to reduce drug-related discrimination in clinical settings and to provide mechanisms that link young adults (particularly with a history of overdose) to evidence-based treatment

Stress Transmission through Three-Dimensional Ordered Granular Arrays

We measure the local contact forces at both the top and bottom boundaries of three-dimensional face-centered-cubic and hexagonal-close-packed granular crystals in response to an external force applied to a small area at the top surface. Depending on the crystal structure, we find markedly different results which can be understood in terms of force balance considerations in the specific geometry of the crystal. Small amounts of disorder are found to create additional structure at both the top and bottom surfaces.Comment: 9 pages including 9 figures (many in color) submitted to PR

Secondary somatic mutations restoring RAD51C and RAD51D associated with acquired resistance to the PARP inhibitor rucaparib in high-grade ovarian carcinoma

High-grade epithelial ovarian carcinomas (OC) containing mutated BRCA1 or BRCA2 (BRCA1/2) homologous recombination (HR) genes are sensitive to platinum-based chemotherapy and poly(ADP-ribose) polymerase inhibitors (PARPi), while restoration of HR function due to secondary mutations in BRCA1/2 has been recognized as an important resistance mechanism. We sequenced core HR pathway genes in 12 pairs of pre-treatment and post-progression tumor biopsy samples collected from patients in ARIEL2 Part 1, a phase 2 study of the PARPi rucaparib as treatment for platinum-sensitive, relapsed OC. In six of 12 pre-treatment biopsies, a truncation mutation in BRCA1, RAD51C or RAD51D was identified. In five of six paired post-progression biopsies, one or more secondary mutations restored the open reading frame. Four distinct secondary mutations and spatial heterogeneity were observed for RAD51C. In vitro complementation assays and a patient-derived xenograft (PDX), as well as predictive molecular modeling, confirmed that resistance to rucaparib was associated with secondary mutations

Dark soliton states of Bose-Einstein condensates in anisotropic traps

Dark soliton states of Bose-Einstein condensates in harmonic traps are studied both analytically and computationally by the direct solution of the Gross-Pitaevskii equation in three dimensions. The ground and self-consistent excited states are found numerically by relaxation in imaginary time. The energy of a stationary soliton in a harmonic trap is shown to be independent of density and geometry for large numbers of atoms. Large amplitude field modulation at a frequency resonant with the energy of a dark soliton is found to give rise to a state with multiple vortices. The Bogoliubov excitation spectrum of the soliton state contains complex frequencies, which disappear for sufficiently small numbers of atoms or large transverse confinement. The relationship between these complex modes and the snake instability is investigated numerically by propagation in real time.Comment: 11 pages, 8 embedded figures (two in color