Pain coping skills training for African Americans with osteoarthritis: Results of a randomized controlled trial

African Americans bear a disproportionate burden of osteoarthritis (OA), but they have been underrepresented in trials of behavioral interventions for pain. This trial examined a culturally tailored pain coping skills training (CST) program, compared to a wait list control group, among 248 African Americans with knee or hip OA. The pain CST program involved 11 telephone-based sessions over 3 months. Outcomes were assessed at baseline, 3 months (primary), and 9 months, and included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (primary outcome), WOMAC total score and function subscale, PROMIS Pain Interference, Short-Form 12 Mental and Physical Composite Subscales, Coping Strategies Questionnaire - Total Coping Attempts, Pain Catastrophizing Scale, Patient Health Questionnaire-8, Arthritis Self-Efficacy Scale, and Patient Global Impression of Arthritis Symptom Change. Linear mixed models were fit for all outcomes. There were no significant between-group differences in WOMAC pain score at 3 months (-0.63 [95% confidence interval -1.45, 0.18]; P = 0.128) or 9 months (-0.84 [95% confidence interval -1.73, 0.06]; P = 0.068). Among secondary outcomes, at 3 months, there were significant differences, in favor of the CST group, for Coping Strategies Questionnaire Total Coping Attempts, Pain Catastrophizing Scale, Arthritis Self-Efficacy, and Patient Global Impression of Arthritis Symptom Change (P < 0.01). Coping Strategies Questionnaire Total Coping Attempts, Arthritis Self-Efficacy, and Patient Global Assessment Change were also significantly improved at 9 months in the CST group, compared with wait list (P < 0.01). The culturally tailored pain CST program did not significantly reduce pain severity but did improve key measures of pain coping and perceived ability to manage pain among African Americans with OA

Acceptability of telephone-based pain coping skills training among African Americans with osteoarthritis enrolled in a randomized controlled trial: A mixed methods analysis

Background: Osteoarthritis (OA) disproportionately impacts African Americans compared to Caucasians, including greater pain severity. The Pain Coping Skills Training for African Americans with Osteoarthritis (STAART) study examined a culturally enhanced Pain Coping Skills Training (CST) program among African Americans with OA. This mixed methods study evaluated the acceptability of the Pain CST program among STAART participants. Methods: STAART was a randomized controlled trial evaluating the effectiveness of an 11-session, telephone-based pain CST program, compared to a usual care control group. Participants were from the University of North Carolina and Durham Veterans Affairs Healthcare Systems. The present analyses included 93 participants in the CST group who completed a questionnaire about experiences with the program. Descriptive statistics of the questionnaire responses were calculated using SAS software. Thematic analysis was applied to open-response data using Dedoose software. Results: Participants' mean rating of overall helpfulness of the pain CST program for managing arthritis symptoms was 8.0 (SD = 2.2) on a scale of 0-10. A majority of participants reported the program made a positive difference in their experience with arthritis (83.1%). Mean ratings of helpfulness of the specific skills ranged from 7.7 to 8.8 (all scales 0-10). Qualitative analysis of the open-response data identified four prominent themes: Improved Pain Coping, Mood and Emotional Benefits, Improved Physical Functioning, and experiences related to Intervention Delivery. Conclusions: The high ratings of helpfulness demonstrate acceptability of this culturally enhanced pain CST program by African Americans with OA. Increasing access to cognitive-behavioral therapy-based programs may be a promising strategy to address racial disparities in OA-related pain and associated outcomes. Trial registration: NCT02560922, registered September 25, 2015

Pain coping skills training for African Americans with osteoarthritis study: Baseline participant characteristics and comparison to prior studies 11 Medical and Health Sciences 1103 Clinical Sciences 11 Medical and Health Sciences 1117 Public Health and Health Services

Background: The Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) trial is examining the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with osteoarthritis (OA). This disparities-focused trial aimed to reach a population with greater symptom severity and risk factors for poor pain-related outcomes than previous studies. This paper compares characteristics of STAART participants with prior studies of CST or cognitive behavioral therapy (CBT)-informed training in pain coping strategies for OA. Methods: A literature search identified 10 prior trials of pain CST or CBT-informed pain coping training among individuals with OA. We descriptively compared characteristics of STAART participants with other studies, in 3 domains of the National Institutes of Minority Health and Health Disparities' Research Framework: Sociocultural Environment (e.g., age, education, marital status), Biological Vulnerability and Mechanisms (e.g, pain and function, body mass index), and Health Behaviors and Coping (e.g., pain catastrophizing). Means and standard deviations (SDs) or proportions were calculated for STAART participants and extracted from published manuscripts for comparator studies. Results: The mean age of STAART participants, 59 years (SD = 10.3), was lower than 9 of 10 comparator studies; the proportion of individuals with some education beyond high school, 75%, was comparable to comparator studies (61-86%); and the proportion of individuals who are married or living with a partner, 42%, was lower than comparator studies (62-66%). Comparator studies had less than about 1/3 African American participants. Mean scores on the Western Ontario and McMaster Universities Osteoarthritis Index pain and function scales were higher (worse) for STAART participants than for other studies, and mean body mass index of STAART participants, 35.2 kg/m2 (SD = 8.2), was higher than all other studies (30-34 kg/m2). STAART participants' mean score on the Pain Catastrophizing scale, 19.8 (SD = 12.3), was higher (worse) than other studies reporting this measure (7-17). Conclusions: Compared with prior studies with predominantly white samples, STAART participants have worse pain and function and more risk factors for negative pain-related outcomes across several domains. Given STAART participants' high mean pain catastrophizing scores, this sample may particularly benefit from the CST intervention approach. Trial registration: NCT02560922

Magnetic thin films formed in a glow discharge. Final report

Since this project is a continuation of a cooperative effort between UMR and General Motor Research Laboratories (GMR), it seemed fitting to provide some background information which was instrumental in the evolution of this program. A family of filled epoxies that can be cast-to-size into sheet metal stamping dies has been developed by GMR. Advantages of this material over commercial plastic tooling materials are a fast curing rate, high strength, and negligible volume shrinkage after curing. Superior Tooling And Molding Plastic (STAMP) tooling dies are considerably cheaper and faster to make than steel tooling dies; therefore, they are currently used for prototype applications throughout General Motors. With improvement of wear resistance, STAMP dies can be used for limited production applications involving 10,000 or 20,000 parts. GMR proposed to provide a thin (< 25 {micro}m) wear surface for the cast-to-size STAMP die to extend its wear performance. The objective of the University of Missouri-Rolla (UMR) research effort is to technically evaluate methodologies to coat STAMP material to appreciably improve wear resistance. This does not necessarily mean that various types of coatings will be developed and evaluated. Rather, the primary responsibility is to characterize the nature of the STAMP material and design engineered films which will lead to an optimized system. An example of this was the finding that a thin polymer layer existed on the surface of an as-cast STAMP die necessitating removal if satisfactory adherence and toughness were to be attained. The next important finding involved the influence of particle size on wear. The theme of the research approach was maintained throughout the course of the project, with improvements being made as the causes of failure were determined and appropriate corrections or improvements were made

Engineering study of a 10 MeV heavy ion linear accelerator

LBL's Heavy Ion Fusion Accelerator Research group has completed the engineering study of the Induction Linac Systems Experiment (ILSE). ILSE will address nearly all accelerator physics issues of a scaled heavy ion induction linac inertial fusion pellet driver. Designed as a series of subsystem experiments, ILSE will accelerate 16 parallel carbon ion beams from a 2 MeV injector presently under development to 10 MeV at one ..mu..sec. This overview paper will present the physics and engineering requirements and describe conceptual design approaches for building ILSE. Major ILSE subsystems consist of electrostatic focusing quadrupole matching and accelerating sections, a 16 to 4 beam transverse combining section, a 4 beam magnetic focusing quadrupole accelerating section, a single beam 180 degree bend section, a drift compression section and a final focus and target chamber. These subsystems are the subject of accompanying papers. Also discussed are vacuum and alignment, diagnostics/data acquisition and controls, key conclusions and plans for further development. 10 refs., 4 figs., 1 tab

Transverse Beam Dynamics Studies of a Heavy Ion Induction Linac

The multiple beam induction linac experiment (MBE-4) was built to study the accelerator physics of the low energy, electrostatically focussed end of a driver for heavy ion inertial confinement fusion. In this machine four beams of Cs{sup +} ions are accelerated through 24 common induction gaps while being focussed in separate AG focussing channels. Each channel consists of a syncopated FODO lattice of 30 periods. We report results of the most recent studies of the transverse beam dynamics of a single drifting (180 keV) beam in this machine. The dependence of the emittance on the zero-current phase advance shows systematic variations which may be understood in the light of previous theoretical work on this topic. This result, unique to the beam parameters of a linac for heavy ion fusion, will be discussed in the context of its implications for a driver design. In addition we will discuss recent measurements of the motion of the beam centroid through the linac. These measurements, coupled with simulations, have proven to be a powerful tool in determining the presence of misalignment errors in the lattice of the accelerator. 6 refs., 3 figs

Multiple Beam Induction Linac Research at LBL

We present results of progress on the LBL multiple beam induction linac experiment (MBE-4). This machine models the accelerator physics of the electric-focused portion of a driver for heavy ion inertial confinement fusion. Four beams of cesium ions are accelerated in common through twenty four induction gaps while being separately focused in individual electrostatic AG focusing channels. Early experiments have demonstrated current amplification in the linac, from 10 mA to 90 mA per beam. This is achieved both by acceleration (from 200 keV to 1 MeV) and by carefully controlled bunch compression. Recent experiments have concentrated on studies of beams extracted from an ion source which produces 5 mA cesium beams at emittances near 0.03 {pi} mm-mrad (normalized). Experiments and theory show a growth of emittance (by about a factor of 2) as these beams are accelerated through the linac. Results of recent measurements of the transverse emittance behavior of these strongly space-charge-dominated ion beams are reviewed and compared with theory. 9 refs., 3 figs