It was nice to wake up from that one : an exploratory qualitative content analysis of vivid dreams and nightmares reported by people living with HIV/AIDS as side effects of Efavirenz

This is an exploratory, qualitative content analysis of 50 vivid dream and nightmare narratives posted to an online forum by people living with HIV/AIDS and taking the anti-HIV drug Efavirenz. It examines thematic connections among the dreams with consideration of how these themes might be linked to and reflective of complex subjective experiences of living with HIV/AIDS. This thesis demonstrates that the phenomenon of vivid dreams and nightmares as purported side effects of Efavirenz is of substantial interest to people living with HIV/AIDS. Furthermore, it argues that vivid dreams and nightmares experienced by people living with HIV/AIDS and taking Efavirenz are not simply medication side effects, but are meaningful experiences that are potentially useful in clinical social work with this population

Metabolic balance studies and dietary protein requirements in patients undergoing continuous ambulatory peritoneal dialysis

Metabolic balance studies and dietary protein requirements in patients undergoing continuous ambulatory peritoneal dialysis. Balance studies for nitrogen, potassium, magnesium, phosphorus, and calcium were carried out in eight men undergoing continuous ambulatory peritoneal dialysis (CAPD) to determine dietary protein requirements and mineral balances. Patients were fed high energy diets for 14 to 33 days which provided either 0.98 (seven studies) or 1.44g (six studies) of primarily high biological value protein/kg body wt/day. Mean nitrogen balance was neutral with the lower protein diet (+0.35 ± 0.83SEMg/day) and strongly positive with the higher protein diet (+2.94 ± 0.54g/day). With the higher protein diet the balances for potassium, magnesium, and phosphorus were strikingly positive, there was an increase in body weight in all patients, and a rise in mid-arm muscle circumference in five of the six patients. The relation between protein intake and nitrogen balance suggests that the daily protein requirement for clinically stable CAPD patients should be at least 1.1g/kg/day; to account for variability among subjects 1.2 to 1.3g protein/kg/day is probably preferable. Potassium balance correlated directly with nitrogen balance (r = 0.81). High fecal potassium losses (19 ± 1.2 mEq/day) in all patients probably helped maintain normal serum potassium concentrations. Mean serum magnesium was increased (3.1 ± 0.1 mg/dl), and magnesium balances were positive suggesting that the dialysate magnesium of 1.85 mg/dl is excessive. The netgain of calcium from dialysate was 84 ± 18 mg/day; this correlated inversely with serum calcium levels (r = -0.90).Bilans métaboliques et besoins protéiques alimentaires de malades en dialyse péritonéale continue ambulatoire. Des études de bilan de l'azote, du potassium, du magnésium, du phosphore et du calcium, étaient fait en sept hommes en dialyse péritonéale continue ambulatoire (CAPD), pour déterminer leurs besoins protéiques alimentaires et leur bilan minéral. Les malades ont reçu pendant 14 à 33 jours des régimes hautement énergétiques, apportant soit 0,98 (sept études), soit 1,44g (six études) de protéines de haute valeur biologique par kg de poids et par jour. Le bilan azoté moyen etait nul avec le régime comportant la plus faibie teneur protéique (+ 0,35 ± 0,88g/jSEM) et était fortement positive avec le régime à plus forte teneur protéique (+2,94 ± 0,54g/j). Avec le régime à haute teneur en protéine, les bilans potassique, magnésien et phosphoré étaient fortement positifs; le poids corporel s'est élevé chez tous les malades; la circonférence musculaire mesurée du milieu du bras a augmenté chez cinq sur six malades. La relation existant entre l'apport protéique et le bilan azoté suggère que les besoins journaliers en protéines pour des malades cliniquement stables en CAPD devraient être au moins de 1,1g/kg/j; 1,2 à 1,3g de protéines/kg/j sont sans doute préférables pour tenir compte de la variabilité entre les sujets. Le bilan potassique était directement corrélé avec la balance azotée (r = 0,81). De fortes pertes potassiques fécales (19 ± 1,2 mEq/j) chez tous les malades ont probablement contribué à maintenir normales les concentrations sériques du potassium. La magnésémie moyenne était élevée (3,1 ± 0,1 mg/dl), et les bilans magnésiens aient positifs suggérant que le magnésium du dialysat (1,85 18 mg/dl) était trop élevé. Le gain net en calcium à partir du dialysat était de 84 ± 18 mg/j; ce gain était inversement corrélé avec la calcémie (r = 0,90)

Glucose absorption during continuous ambulatory peritoneal dialysis

Glucose absorption during continuous ambulatory peritoneal dialysis. Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) are exposed to a continuous infusion of glucose via their peritoneal cavity. We performed studies to quantitate the amount of energy derived from dialysate glucose. Net glucose absorption averaged 182 ± (SD) 61 g/day in 19 studies with a dialysate dextrose concentration of 1.5 or 4.25 g/dl. The amount of glucose absorbed per liter of dialysate (y) varied with the concentration of glucose in dialysate (x), (y = 11.3x - 10.9, r = 0.96), The amount of glucose absorbed per day during a given dialysis regimen was constant. Energy intake from dialysate glucose was 8.4 ± 2.8 kcal/kg of body wt per day, or 12 to 34% of total energy intake. This additional energy may contribute to the anabolic effect reported during CAPD. The ability to vary glucose absorption by altering the dialysate glucose concentration may prove a useful tool to modify energy intake.Absorption de glucose au cours de la dialyse péritonéale continue ambulatoire. Les malades soumis à la dialyse péritonéale continue ambulatoire (CAPD) sont exposés à une administration continue de glucose via leur cavité péritonéale. La quantité d'énergie qui dérive du glucose du dialysat a été quantifiée. L'absorption nette de glucose est en moyenne de 182 ± (SD) 61 g/jour au cours de 19 études avec un dialysat contenant du dextrose, 1,5 ou 4,25 g/dl. La quantité de glucose absorbée par litre de dialysat (y) varie avec la concentration de glucose dans le dialysat (x), (y = 11,3x - 10,9, r = 0,96). La quantité de glucose absorbée par jour pour un type donné de dialyse a été constante. L'entrée d'énergie à partir du glucose du dialysat était de 8,4 ± 2,8 kcal/kg de poids par jour, soit 12 à 34% de l'entrée totale d'énergie. Cette énergie supplémentaire peut contribuer à l'effet anabolique rapporté au cours de CAPD. La possibilité de faire varier l'absorption de glucose en modifiant la concentration de glucose dans le dialysat peut être un moyen utile pour influencer l'entrée d'énergie

Gender Comparisons of Mechanomyographic Amplitude and Mean Power Frequency Versus Isometric Torque Relationships

This is the publisher's version, also found at http://ehis.ebscohost.com/ehost/detail?sid=e7a03093-e666-4634-b895-d6b4313857c2%40sessionmgr13&vid=1&hid=17&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=s3h&AN=15943883This study compared the patterns of mechanomyographic (MMG) amplitude and mean power frequency vs. torque relationships in men and women during isometric muscle actions of the biceps brachii. Seven men (mean age 23.9 ± 3.5 yrs) and 8 women (mean 21.0 ± 1.3 yrs) performed submaximal to maximal isometric muscle actions of the dominant forearm flexors. Following determination of the isometric maximum voluntary contraction (MVC), they randomly performed submaximal step muscle actions in 10% increments from 10% to 90% MVC. Polynomial regression analyses indicated that the MMG amplitude vs. isometric torque relationship for the men was best fit with a cubic model (R2 = 0.983), where MMG amplitude increased slightly from 10% to 20% MVC, increased rapidly from 20% to 80% MVC, and plateaued from 80% to 100% MVC. For the women, MMG amplitude increased linearly (r2 = 0.949) from 10% to 100% MVC. Linear models also provided the best fit for the MMG mean power frequency vs. isometric torque relationship in both the men (r2 = 0.813) and women (r2 = 0.578). The results demonstrated gender differences in the MMG amplitude vs. isometric torque relationship, but similar torque-related patterns for MMG mean power frequency. These findings suggested that the plateau in MMG amplitude at high levels of isometric torque production for the biceps brachii in the men, but not the women, may have been due to greater isometric torque, muscle stiffness, and/or intramuscular fluid pressure in the men, rather than to differences in moto

Medial open transversus abdominis plane (MOTAP) catheters for analgesia following open liver resection: study protocol for a randomized controlled trial

Background: The current standard for pain control following liver surgery is intravenous, patient-controlled analgesia (IV PCA) or epidural analgesia. We have developed a modification of a regional technique called medial open transversus abdominis plane (MOTAP) catheter analgesia. The MOTAP technique involves surgically placed catheters through the open surgical site into a plane between the internal oblique muscle and the transverse abdominis muscle superiorly. The objective of this trial is to assess the efficacy of this technique. Methods/design: This protocol describes a multicentre, prospective, blinded, randomized controlled trial. One hundred and twenty patients scheduled for open liver resection through a subcostal incision will be enrolled. All patients will have two MOTAP catheters placed at the conclusion of surgery. Patients will be randomized to one of two parallel groups: experimental (local anaesthetic through MOTAP catheters) or placebo (normal saline through MOTAP catheters). Both groups will also receive IV PCA. The primary endpoint is mean cumulative postoperative opioid consumption over the first 2 postoperative days (48 hours). Secondary outcomes include pain intensity, patient functional outcomes, and the incidence of complications. Discussion: This trial has been approved by the ethics boards at participating centres and is currently enrolling patients. Data collection will be completed by the end of 2014 with analysis mid-2015 and publication by the end of 2015. Trial registration: The study is registered with http://clinicaltrials.gov (NCT01960049; 23 September 2013)This research is supported by the Innovation Fund of the Alternative Funding Plan from the Academic Health Sciences Centres of Ontario

Data Curation Services, Together!

November 2018 RDAP Webinar presentation.“Launching the Data curation Network: A cross-institutional staffing model for curating research data” funded 2018-2021 by the Alfred P. Sloan Foundation grant G-2018-10072

Analysis of the effectiveness of interventions used during the 2009 A/H1N1 influenza pandemic

<p>Abstract</p> <p>Background</p> <p>Following the emergence of the A/H1N1 2009 influenza pandemic, public health interventions were activated to lessen its potential impact. Computer modelling and simulation can be used to determine the potential effectiveness of the social distancing and antiviral drug therapy interventions that were used at the early stages of the pandemic, providing guidance to public health policy makers as to intervention strategies in future pandemics involving a highly pathogenic influenza strain.</p> <p>Methods</p> <p>An individual-based model of a real community with a population of approximately 30,000 was used to determine the impact of alternative interventions strategies, including those used in the initial stages of the 2009 pandemic. Different interventions, namely school closure and antiviral strategies, were simulated in isolation and in combination to form different plausible scenarios. We simulated epidemics with reproduction numbers R₀of 1.5, which aligns with estimates in the range 1.4-1.6 determined from the initial outbreak in Mexico.</p> <p>Results</p> <p>School closure of 1 week was determined to have minimal effect on reducing overall illness attack rate. Antiviral drug treatment of 50% of symptomatic cases reduced the attack rate by 6.5%, from an unmitigated rate of 32.5% to 26%. Treatment of diagnosed individuals combined with additional household prophylaxis reduced the final attack rate to 19%. Further extension of prophylaxis to close contacts (in schools and workplaces) further reduced the overall attack rate to 13% and reduced the peak daily illness rate from 120 to 22 per 10,000 individuals. We determined the size of antiviral stockpile required; the ratio of the required number of antiviral courses to population was 13% for the treatment-only strategy, 25% for treatment and household prophylaxis and 40% for treatment, household and extended prophylaxis. Additional simulations suggest that coupling school closure with the antiviral strategies further reduces epidemic impact.</p> <p>Conclusions</p> <p>These results suggest that the aggressive use of antiviral drugs together with extended school closure may substantially slow the rate of influenza epidemic development. These strategies are more rigorous than those actually used during the early stages of the relatively mild 2009 pandemic, and are appropriate for future pandemics that have high morbidity and mortality rates.</p