Multicenter assessment of quantitative sensory testing (QST) for the detection of neuropathic-like pain responses using the topical capsaicin model

Background: The use of quantitative sensory testing (QST) in multicenter studies has been quite limited, due in part to lack of standardized procedures among centers. Aim: The aim of this study was to assess the application of the capsaicin pain model as a surrogate experimental human model of neuropathic pain in different centers and verify the variation in reports of QST measures across centers. Methods: A multicenter study conducted by the Quebec Pain Research Network in six laboratories allowed the evaluation of nine QST parameters in 60 healthy subjects treated with topical capsaicin to model unilateral pain and allodynia. The same measurements (without capsaicin) were taken in 20 patients with chronic neuropathic pain recruited from an independent pain clinic. Results: Results revealed that six parameters detected a significant difference between the capsaicin-treated and the control skin areas: (1) cold detection threshold (CDT) and (2) cold pain threshold (CPT) are lower on the capsaicin-treated side, indicating a decreased in cold sensitivity; (3) heat pain threshold (HPT) was lower on the capsaicin-treated side in healthy subjects, suggesting an increased heat pain sensitivity; (4) dynamic mechanical allodynia (DMA); (5) mechanical pain after two stimulations (MPS2); and (6) mechanical pain summation after ten stimulations (MPS10), are increased on the capsaicin-treated side, suggesting an increased in mechanical pain (P < 0.002). CDT, CPT and HPT showed comparable effects across all six centers, with CPT and HPT demonstrating the best sensitivity. Data from the patients showed significant difference between affected and unaffected body side but only with CDT. Conclusion: These results provide further support for the application of QST in multicenter studies examining normal and pathological pain responses

Adult Graduate Students\u27 Perceptions of Gender & Race: Implications for Program Development in Rural Communities

The purpose of this study was to assess the existing levels of awareness toward issues of race and gender in graduate students. Implications for curriculum planning are that faculty members should encourage sensitivity to diversity in all of their classes through small group discussions, case studies, presentations concerning racial and gender issues, and readings that encourage multiple views of issues

The Differential Association between Alexithymia and Primary versus Secondary Psychopathy

Using a sample of 104 college students, this study tested the hypothesis that alexithymia is positively related to secondary (also known as “neurotic psychopathy”), but not primary psychopathy (i.e., inability to form emotional bonds with others and a fear insensitivity). Participants completed the TAS-20 (alexithymia), the LSRP (primary and secondary psychopathy), the PPI-R (psychopathy), and the trait version of the STAI (trait anxiety). The interaction between the latter two measures was used as a second index of primary and secondary psychopathy. Support was found for the study hypothesis with both methods of assessing psychopathy (i.e., the LSRP subscales or the combination of the PPI-R and the STAI). These results further our understanding of both alexithymia and psychopathy. Highlights: * We hypothesized that alexithymia would be related to secondary psychopathy. * We hypothesized that alexithymia would not be related to primary psychopathy. * Support for these hypotheses was used with two different ways of operationalizing psychopathy. * Primary psychopathy was correlated with “externally oriented thinking

Methods to improve recruitment to randomised controlled trials : Cochrane systematic review and meta-analysis

Peer reviewedPublisher PD

Homing of stem cells to sites of inflammatory brain injury after intracerebral and intravenous administration: a longitudinal imaging study

Introduction This study aimed to determine the homing potential and fate of epidermal neural crest stem cells (eNCSCs) derived from hair follicles, and bone marrow-derived stem cells (BMSCs) of mesenchymal origin, in a lipopolysaccharide (LPS)-induced inflammatory lesion model in the rat brain. Both eNCSCs and BMSCs are easily accessible from adult tissues by using minimally invasive procedures and can differentiate into a variety of neuroglial lineages. Thus, these cells have the potential to be used in autologous cell-replacement therapies, minimizing immune rejection, and engineered to secrete a variety of molecules. Methods Both eNCSCs and BMSCs were prelabeled with iron-oxide nanoparticles (IO-TAT-FITC) and implanted either onto the corpus callosum in healthy or LPS-lesioned animals or intravenously into lesioned animals. Both cell types were tracked longitudinally in vivo by using magnetic resonance imaging (MRI) for up to 30 days and confirmed by postmortem immunohistochemistry. Results Transplanted cells in nonlesioned animals remained localized along the corpus callosum. Cells implanted distally from an LPS lesion (either intracerebrally or intravenously) migrated only toward the lesion, as seen by the localized MRI signal void. Fluorescence microscopy of the FITC tag on the nanoparticles confirmed the in vivo MRI data, Conclusions This study demonstrated that both cell types can be tracked in vivo by using noninvasive MRI and have pathotropic properties toward an inflammatory lesion in the brain. As these cells differentiate into the glial phenotype and are derived from adult tissues, they offer a viable alternative autologous stem cell source and gene-targeting potential for neurodegenerative and demyelinating pathologies. </br

Assessment of Client Satisfaction in Six Urban WIC Clinics

Customer service is a measure of support and courtesy provided to individuals who patronize an organization, and is a factor vital to the success of any business. Programs that strive to meet critical needs of at risk populations, such as the Special Supplementation Nutrition Program for Women, Infants, and Children (WIC), may also benefit from assessment of client satisfaction. The purpose of the study was to examine factors related to customer satisfaction in Duval County Florida WIC clinics and identify potential barriers to participation through a two-year project initiated by the health department and the state university. The study examined appointment wait time, duration of appointment, the preferred time of day and day of the week for appointment scheduling, and customer service practices in WIC clinics from the perspective of WIC participants. Results suggest that most WIC participants served by the Duval County Health Department were satisfied; however, three areas exist for improvement. The most salient issue reported by clients was duration of appointment wait time, continued improved customer service, and to a lesser extent improvement in the physical environment. Clients provided suggestions for improvement related to each of these areas

Moving beyond the ‘language problem': developing an understanding of the intersections of health, language and immigration status in interpreter-mediated health encounters

Health systems internationally are dealing with greater diversity in patient populations. However the focus on ‘the language problem’ has meant little attention is paid to diversity within and between migrant populations; and how interpreted consultations are influenced by intersecting migratory, ethnicity and sociodemographic variables. Our analysis of the experiences of patients, health care providers and interpreters in Scotland evidences the need to move beyond language, addressing multiple hidden inequalities in health care access and provision that operate in both clinic and, especially, home-based settings. We call for a practice-evidenced research agenda promoting cultural communication across health care and home settings, acknowledging immigration status as a social determinant of health. Sur le plan international, des systèmes de santé font face à une diversité croissante dans ses populations de patients. Cependant, l’accent sur ‘le problème de langue’ se traduit dans une manque d’attention à la diversité a l’intérieur même et entre des populations des migrants; et la façon par laquelle des variables migratoire, ethnique et sociodémographique influencent elles-mêmes des consultations interprétées. Notre analyse des expériences des patients, des professionnels fournissant de soins de santé et des interprètes offre des preuves du besoin de dépasser le problème de langue. Et en faisant cela, nous adressons des multiples inégalités, souvent cachées dans des contextes de soins de santé, dans les milieux clinique et domicile. Nous proposons un programme de recherche basé sur la pratique, qui favorise la communication culturelle dans des milieux clinique et domicile, et qui reconnait le statut d’immigration comme un déterminant social de la santé

Sources of Airborne Endotoxins in Ambient Air and Exposure of Nearby Communities—A Review

Endotoxin is a bioaerosol component that is known to cause respiratory effects in exposed populations. To date, most research focused on occupational exposure, whilst much less is known about the impact of emissions from industrial operations on downwind endotoxin concentrations. A review of the literature was undertaken, identifying studies that reported endotoxin concentrations in both ambient environments and around sources with high endotoxin emissions. Ambient endotoxin concentrations in both rural and urban areas are generally below 10 endotoxin units (EU) m−3; however, around significant sources such as compost facilities, farms, and wastewater treatment plants, endotoxin concentrations regularly exceeded 100 EU m−3. However, this is affected by a range of factors including sampling approach, equipment, and duration. Reported downwind measurements of endotoxin demonstrate that endotoxin concentrations can remain above upwind concentrations. The evaluation of reported data is complicated due to a wide range of different parameters including sampling approaches, temperature, and site activity, demonstrating the need for a standardised methodology and improved guidance. Thorough characterisation of ambient endotoxin levels and modelling of endotoxin from pollution sources is needed to help inform future policy and support a robust health-based risk assessment process

Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of the SPORTSMART pilot randomised controlled trial

Background: The objective of this study was to compare the costs and outcomes of two sexually transmitted infection (STI) screening interventions targeted at men in football club settings in England, including screening promoted by team captains. Methods: A comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms: (1) captain-led and poster STI screening promotion; (2) sexual health advisor-led and poster STI screening promotion and (3) poster-only STI screening promotion (control/comparator). For all study arms, resource use and cost data were collected prospectively. Results: There was considerable variation in uptake rates between clubs, but results were broadly comparable across study arms with 50% of men accepting the screening offer in the captain-led arm, 67% in the sexual health advisor-led arm and 61% in the poster-only control arm. The overall costs associated with the intervention arms were similar. The average cost per player tested was comparable, with the average cost per player tested for the captain-led promotion estimated to be £88.99 compared with £88.33 for the sexual health advisor-led promotion and £81.87 for the poster-only (control) arm. Conclusions: Costs and outcomes were similar across intervention arms. The target sample size was not achieved, and we found a greater than anticipated variability between clubs in the acceptability of screening, which limited our ability to estimate acceptability for intervention arms. Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated

A Pilot Study: Attention Deficit Hyperactivity Disorder, Sensation Seeking, and Pubertal Changes

This study was designed to examine the relationship of pubertal changes and sensation seeking (SS) in adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Patients with current or past histories of uncomplicated stimulant medication use for ADHD between the ages of 11 and 15 (13 ± 1.5) were recruited from a Child Psychiatry and a General Pediatric Clinic. SS was measured using the SS Scale for Children. Pubertal development was measured using Tanner staging, free testosterone, and DHEAS. Subjects and their parent were interviewed with the Diagnostic Interview Schedule for Children (DISC). SS total score was correlated with Tanner stage, free testosterone, and DHEAS (p ≤ 0.01). The combined parent and child reports of symptoms of Oppositional Defiant Disorder from the DISC were inversely related to age (p ≤ 0.05). Understanding SS in ADHD adolescents as they move through puberty will aid clinicians in monitoring ADHD adolescents and their trajectory into high-risk behaviors