Painful bladder syndrome/interstitial cystitis and vulvodynia: a clinical correlation

Vulvodynia affects 25% of women with painful bladder syndrome/interstitial cystitis (PBS/IC). The objective of our study was to clinically evaluate the association of PBS/IC and vulvodynia and possible contributing factors. To our knowledge, this has not been reported. Seventy women with PBS/IC were evaluated from December 2005 to December 2006 with a comprehensive history and exam. Two groups were formed—those with vulvodynia and those without vulvodynia for comparison. Of the women, 51.4% had vulvodynia and 48.6% did not have vulvodynia using our operative definition. Average levator pain levels were significantly greater in those with vulvodynia. There was no significant difference in the total number of lifetime pelvic surgeries, history of sexually transmitted infections (STIs), vaginitis, or abuse history between groups. The correlation of vulvodynia and PBS/IC may have been underestimated. Research needs to explore the link between precipitating factors, symptoms, and effective treatment options for PBS/IC and vulvodynia.     

Emotional intervention strategies for dementia-related behavior: a theory synthesis.

Behavioral disturbances of elders with dementia are prevalent. Yet the science guiding development and testing of effective intervention strategies is limited by rudimentary and often-conflicting theories. Using a theory-synthesis approach conducted within the perspective of the need-driven dementia-compromised behavior model, this article presents the locomoting responses to environment in elders with dementia (LRE-EWD) model. This new model, based on empirical and theoretical evidence, integrates the role of emotion with that of cognition in explicating a person-environment dynamic supporting wandering and other dementia-related disturbances. Included is evidence of the theory's testability and elaboration of its implications. The LRE-EWD model resolves conflicting views and evidence from current research on environmental interventions for behavior disturbances and opens new avenues to advance this field of study and practice.     

Revised Pediatric Reference Data for the Lateral Distal Femur Measured by Hologic Discovery/Delphi Dual-Energy X-Ray Absorptiometry

Lateral distal femur (LDF) scans by dual-energy X-ray absorptiometry (DXA) are often feasible in children for whom other sites are not measurable. Pediatric reference data for LDF are not available for more recent DXA technology. The objective of this study was to assess older pediatric LDF reference data, construct new reference curves for LDF bone mineral density (BMD), and demonstrate the comparability of LDF BMD to other measures of BMD and strength assessed by DXA and by peripheral quantitative computed tomography (pQCT). LDF, spine and whole body scans of 821 healthy children, 5–18 yr of age, recruited at a single center were obtained using a Hologic Discovery/Delphi system (Hologic, Inc., Bedford, MA). Tibia trabecular and total BMD (3% site), cortical geometry (38% site) (cortical thickness, section modulus, and strain-strength index) were assessed by pQCT. Sex- and race-specific reference curves were generated using LMS Chartmaker (LMS Chartmaker Pro, version 2.3. Tim Cole and Huiqi Pan. Copyright 1997-2006, Medical Research Council, UK) and Z-scores calculated and compared by correlation analysis. Z-scores for LDF BMD based on published findings demonstrated overestimation or underestimation of the prevalence of low BMD-for-age depending on the region of interest considered. Revised LDF reference curves were generated. The new LDF Z-scores were strongly and significantly associated with weight, body mass index, spine and whole body BMD Z-scores, and all pQCT Z-scores. These findings demonstrate the comparability of LDF measurements to other clinical and research bone density assessment modes, and enable assessment of BMD in children with disabilities, who are particularly prone to low trauma fractures of long bones, and for whom traditional DXA measurement sites are not feasible.     

BEREAVEMENT PRACTICES AMONG CALIFORNIA HOSPICES: RESULTS OF A STATEWIDE SURVEY

During 1999-2000, the California Hospice and Palliative Care Association (CHAPCA) surveyed its 160 member hospices regarding bereavement support services. Over 80% of hospices participated, providing information about program content, staff training, and costs incurred by participants. Results revealed that a greater percentage of larger hospices and non-profit hospices offer support groups and workshops than do smaller hospices and for-profit hospices. Volunteers account for almost one quarter of bereavement staff. The professional background of paid staff is varied, with social workers and clergy being most common overall but nurses more common in small hospices. Almost 90% of hospices provide all bereavement support at no charge to the bereaved. Services most likely to be associated with a fee include special support groups, children's programs, and professional counseling to individuals and families.     

Fear appeals and binge drinking: A terror management theory perspective

Objectives The aim of the current research was to test the terror management theory‐derived hypotheses that exposure to information about the mortality‐related risks of binge drinking would make mortality salient (Study 1) and, hence, exacerbate willingness to binge drink amongst those who perceive this behaviour to benefit self‐esteem (Study 2). Study 1 Participants (N=97) were allocated to one of five experimental conditions. Results confirmed that exposure to information about the mortality‐related risks of binge drinking made mortality salient. Study 2 Participants (N=296) were allocated to one of three experimental conditions. Exposure to mortality‐related information about the risks of binge drinking was found to result in greater willingness to binge drink among (i) binge drinkers and (ii) non‐binge drinkers who perceived this behaviour to benefit self‐esteem. There was no evidence, however, that exposure to such information influenced binge drinking over the following week. Conclusions Research findings suggest that mortality‐related health promotion campaigns might inadvertently make mortality salient, and hence precipitate the very behaviours which they aim to deter among some recipients.