Transcutaneous electrical nerve stimulation for cancer pain in adults.

Background Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominately used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role for a significant number of patients but the effectiveness of TENS is currently unknown. Objectives The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. Search strategy We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases (11/04/08). Selection criteria Only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults were included. Data collection and analysis The search strategy identified 37 possible published studies which were divided between two pairs of review authors that decided on study selection. A study eligibility form was used to screen each abstract and where study eligibility could not be determined from the abstract, the full paper was obtained and assessed by one pair of review authors. A standardised data extraction sheet was used to collect information on the studies and the quality of the studies was assessed independently by two review authors using the validated five-point Oxford Quality Scale. Final scores were discussed and agreed between all four review authors. The small sample sizes and differences in patient study populations of the two included studies prevented meta-analysis. Main results Only two RCTs met the eligibility criteria (64 participants). These studies were heterogenous with respect to study population, sample size, study design, methodological quality, mode of TENS, treatment duration, method of administration and outcome measures used. In one RCT, there were no significant differences between TENS and placebo in women with chronic pain secondary to breast cancer treatment. In the other RCT, there were no significant differences between acupuncture-type TENS and sham in palliative care patients; this study was underpowered. Authors' conclusions The results of this systematic review are inconclusive due to a lack of suitable RCTs. Large multi-centre RCTs are required to assess the value of TENS in the management of cancer-related pain in adults

Investing in Education: Impact of Student Financial Stress on Self-Reported Health

Through the lens of Human Capital theory, the role of financial aid (both amount and type) is explored in the context of student financial stress, and ultimately general student health. Data are taken from a sample of 232 students from a major Midwestern university who were surveyed about their financial attitudes, behavior and knowledge. The presence and amount of federal loans was associated with self-reported financial stress, and the validated stress measure was further associated with students’ self-reported health. A number of personal life events (i.e. job loss) were also associated with higher stress levels. Implications are discussed

An echocardiographic survey of a random sample of the population of North Glasgow aged 55 to 74 years

The syndrome of chronic heart failure resulting from left ventricular dysfunction, either systolic or diastolic, is a public health problem for the Western world. The study presented in this thesis looked at 1009 individuals aged between 55 and 74 years of age randomly selected from the population of north Glasgow - response rate 59.8%. Within the study cohort there was a significant prevalence of both hypertension (44.1%) and ischaemic heart disease (43.9%). Left ventricular (L.V.) systolic function was measured by calculating an echocardiographic left ventricular ejection fraction (L.V.E.F.) in 75% of participants. The median L.V.E.F. was 50.7% and significant left ventricular systolic dysftinction (L.V.D.) was shown to be represented by an L.V.E.F. of < 35%; being present in 6.7% of the cohort with a measured L.V.E.F. The prevalence of L.V.D. rose with age and was higher in men than in women (9.4% v 4.0% P=0.004). The proportion which was considered symptomatic was 45.0% with no age or gender effect. The principle aetiological associate of L.V.D. was ischaemic heart disease with it accompanying 78% of all cases. Isolated hypertension was no more prevalent in individuals with L.V.D. than in the whole population. The L.V.D. was undertreated with only 16% of cases currently receiving treatment with an angiotensin converting enzyme inhibitor. The presence of L.V.D., even when apparently asymptomatic, was associated with a reduced effort capacity on treadmill testing. Similarly it was associated with impaired quality of life scores in affected individuals, being true for both symptomatic and for treated L.V.D. (using loop diuretics), and there was possibly a small effect seen in asymptomatic L.V.D. Transmitral Doppler indices were used to examine L.V. diastolic filling in participants and showed diastolic filling to be affected by several biological variables including gender, age, body mass index, blood pressure and relative L.V. wall thickness. Disease states such as hypertension, ischaemic heart disease and L.V.D. were all shown to be associated with abnormal L.V. diastolic filling. Looking at a group of individuals who reported breathlessness in the absence of either airways disease or L.V.D. showed that they had a higher prevalence of ischaemic heart disease but without any evidence of abnormal diastolic filling. Removing the individuals with ischaemic heart disease from this group revealed some abnormalities of diastolic filling but also removed any objective impairment of effort capacity. Circulating plasma concentrations of the natriuretic peptides N-terminal atrial natriuretic (N-ANP) and brain natriuretic (BNP) peptides were shown to be elevated in the presence of L.V.D.. Individuals with increased measurements of L.V. mass also had higher levels of both peptides; as did individuals with evidence, by transmitral Doppler indices, of elevated L.V. operating pressures. Examining their potential as screening blood tests for the presence of L.V.D. in the population showed that BNP fared better than N-ANP with a sensitivity of 82.0% and a specificity of 57.6% at a concentration of 15.20 pg./ml. BNP also performed better in a high risk group with ischaemic heart disease (sensitivity - 97.4%, specificity - 20.5%, concentration - 8.30 pg./ml) and had an excellent negative predictive value of 98.2% in this group. It also had a high negative predictive value in a group of breathless individuals for the presence of L.V. systolic dysfunction (97.1%). Natriuretic peptides were shown to lack some discriminatory power with reduced specificities and positive predictive values owing to the presence of confounding factors in the population. Their future role may therefore be to exclude the presence of L.V.D. in individuals. BNP concentrations measured in unextracted plasma using the relatively simpler, and recently commercially available, Shionoria immunoradiometric assay kit also performed well as screening blood tests but not as well those obtained using a standard radioimmunoassay from extracted plasma

Perspectives On The Sources And Eventual Outcome Of The 2008 Economic And Financial Crisis: A Panel Discussion

In October 2008 the Southern Utah University School of Business held a panel discussion on the current economic crisis. This discussion was part of the School’s Business Convocation series and was open to the public. The panel was designed with two components in mind. First, a pair of academics with expertise in financial institutions and business cycles offered historical and theoretical perspectives on the crisis. Second, a pair of professionals – a local banking official and a fund manager – offered perspectives on the current financial situation and practical experience based on the policy responses to past crises. As moderator, Joe Baker asked each panelist to make a short presentation on a question of general interest that was related to their area of expertise; this was followed by an open question and answer session. The participating panelists and opening questions follow. 1. Stephen Evans, Professor of Finance: Dr. Evans teaches courses on financial institutions and was asked to provide background of how the crisis occurred and what the proposed government bailout plan is expected to accomplish. 2. David Tufte, Associate Professor of Economics: Dr. Tufte is a macroeconomist and was asked to discuss the macroeconomic implications of the crisis in such areas as inflation, interest rates, economic growth and unemployment. 3. Mr. Robb Kerry, Chief Credit Officer of ADB Bank: Mr. Kerry has an extensive background in banking as a bank regulator and banker. Mr. Kerry was asked to discuss the implications of the crisis on banking credit and lending. Mr. Steve Harrop, Finance Professional in Residence: Mr. Harrop was a mutual fund manager for several decades before joining the School of Business faculty where he teaches investments and manages (pro bono) an investment fund. Mr. Harrop will discuss the implications of the crisis on the stock and bond markets

Evidence for Horizontal Gene Transfer of Anaerobic Carbon Monoxide Dehydrogenases

Carbon monoxide (CO) is commonly known as a toxic gas, yet both cultivation studies and emerging genome sequences of bacteria and archaea establish that CO is a widely utilized microbial growth substrate. In this study, we determined the prevalence of anaerobic carbon monoxide dehydrogenases ([Ni,Fe]-CODHs) in currently available genomic sequence databases. Currently, 185 out of 2887, or 6% of sequenced bacterial and archaeal genomes possess at least one gene encoding [Ni,Fe]-CODH, the key enzyme for anaerobic CO utilization. Many genomes encode multiple copies of [Ni,Fe]-CODH genes whose functions and regulation are correlated with their associated gene clusters. The phylogenetic analysis of this extended protein family revealed six distinct clades; many clades consisted of [Ni,Fe]-CODHs that were encoded by microbes from disparate phylogenetic lineages, based on 16S rRNA sequences, and widely ranging physiology. To more clearly define if the branching patterns observed in the [Ni,Fe]-CODH trees are due to functional conservation vs. evolutionary lineage, the genomic context of the [Ni,Fe]-CODH gene clusters was examined, and superimposed on the phylogenetic trees. On the whole, there was a correlation between genomic contexts and the tree topology, but several functionally similar [Ni,Fe]-CODHs were found in different clades. In addition, some distantly related organisms have similar [Ni,Fe]-CODH genes. Thermosinus carboxydivorans was used to observe horizontal gene transfer (HGT) of [Ni,Fe]-CODH gene clusters by applying Kullback–Leibler divergence analysis methods. Divergent tetranucleotide frequency and codon usage showed that the gene cluster of T. carboxydivorans that encodes a [Ni,Fe]-CODH and an energy-converting hydrogenase is dissimilar to its whole genome but is similar to the genome of the phylogenetically distant Firmicute, Carboxydothermus hydrogenoformans. These results imply that T carboxydivorans acquired this gene cluster via HGT from a relative of C. hydrogenoformans

Increasing Accessibility for Community Participants at Academic Conferences

Background: To decrease the gulf between academic and community perspectives, there has been an increased call among stakeholder groups to collaborate in solving complex urban health problems. Despite these recent shifts, however, community partners face barriers to participate in conferences, ultimately limiting exchange of ideas and uptake of research data. This paper reports on the evaluation of the strategy used to engage community participants at the 4th International Conference on Urban Health (ICUH) held in Toronto, Canada, in October, 2005. Method: We surveyed participants (n = 98) and conducted follow-up interviews (n = 23) to assess factors that facilitated attendance at ICUH 2005 as well as the impact of the conference on their work. Results: Community registrants were drawn by accessible fee structures, scholarship opportunities, and preconference workshops relevant to their interests. Both community and academic registrants were drawn by the presence of a separate conference stream showcasing high-quality and rigorous community-based participatory research (CBPR). The conference provided valuable opportunities for networking with other community-based researchers by facilitating the development of relationships between community registrants and researchers, increased the profile and legitimacy of CBPR, and reinforced the value of community input in research. It also provided opportunities for capacity building—knowledge sharing and heightened awareness of CBPR. Conclusion: The 4th ICUH had a significant impact on community registrants and provided valuable opportunities to bridge academic and community divides. These data support the need for comprehensive strategies for community engagement at health conferences

WESTERN CONIFER SEED BUG, Leptoglossus occidentalis Heidemann: 2 CHARACTERIZATION AND ATTRACTIVENESS OF 3 MALE-PRODUCED SONIC AND VIBRATIONAL AGGREGATION SIGNALS 4 5 6 7

Abstract: We tested the hypothesis that the western conifer seed bug (WCSB), 17 Leptoglossus occidentali

Lung cancer symptom appraisal among people with chronic obstructive pulmonary disease: A qualitative interview study

© 2019 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd. Objective: The incidence of lung cancer is four times higher in people with chronic obstructive pulmonary disease (COPD) compared with the general population. Promotion of a shorter time from symptom onset to presentation is one potential strategy for earlier lung cancer diagnosis, but distinguishing respiratory symptoms can be difficult. We investigated how the experience of COPD influences symptom appraisal and help seeking for potential lung cancer symptoms. Methods: We conducted qualitative interviews with men (n = 17) and women (n = 23) aged 40 to 83 years with COPD. Topic guides drew on the integrated symptom-response framework and covered symptom experience, interpretation, action, recognition, help seeking, evaluation, and reevaluation. We used the framework method to analyse the data. Results: Participants said that they attributed chest symptoms to their COPD; no other cause was considered. Participants said that family/friends noticed changes in their symptoms and encouraged help seeking. Others felt isolated by their COPD because they could not get out, were fatigued, or were embarrassed. Participants visited health professionals frequently, but increased risk of lung cancer was not discussed. Conclusions: Our study provides insight into different levels of influence on symptom appraisal and targets for intervention. Greater awareness of increased lung cancer risk and support to act on symptom changes is essential and could be achieved through a concerted information campaign. Health professionals working with people with COPD could also optimise appointments to support symptom appraisal of potential lung cancer symptoms

Inhibition of cyclin-dependent kinase 9 downregulates cytokine production without detrimentally affecting human monocyte-derived macrophage viability

Cyclin-dependent kinase (CDK) inhibitor drugs (CDKi), such as R-roscovitine and AT7519, induce neutrophil apoptosis in vitro and enhance the resolution of inflammation in a number of in vivo models. This class of compounds are potential novel therapeutic agents that could promote the resolution of acute and chronic inflammatory conditions where neutrophil activation contributes to tissue damage and aberrant tissue repair. In this study we investigated CDKi effects on macrophage pro-inflammatory mediator production and viability. Treatment of human monocyte-derived macrophages (MDMs) with the CDKi AT7519 and R-roscovitine at concentrations that induce neutrophil apoptosis had no significant effect on control or LPS-activated MDM apoptosis and viability, and did not detrimentally affect MDM efferocytosis of apoptotic cells. In addition, enhanced efferocytosis, induced by the glucocorticoid dexamethasone, was also unaffected after a short time treatment with R-roscovitine. Macrophage cytokine responses to inflammatory stimuli are also of importance during inflammation and resolution. As a key target of CDKi, CDK9, is involved in protein transcription via the RNA polymerase II complex, we investigated the effect of CDKi drugs on cytokine production. Our data show that treatment with AT7519 significantly downregulated expression and release of key MDM cytokines IL-6, TNF, IL-10 and IL-1β, as well as markers of pro-inflammatory macrophage polarisation. R-Roscovitine was also able to downregulate inflammatory cytokine protein secretion from MDMs. Using siRNA transfection, we demonstrate that genetic knock-down of CDK9 replicates these findings, reducing expression and release of pro-inflammatory cytokines. Furthermore, overexpression of CDK9 in THP-1 cells can promote a pro-inflammatory phenotype in these cells, suggesting that CDK9 plays an important role in the inflammatory phenotype of macrophages. Overall, this study demonstrates that pharmacological and genetic targeting of CDK9 inhibits an inflammatory phenotype in human MDMs. As such these data indicate that CDK9 may be key to therapeutically targeting pro-inflammatory macrophage functions during chronic inflammation