The development and validation of the daily electronic Endometriosis Pain and Bleeding Diary

Background  

The objective of this study was to develop and validate a daily electronic Endometriosis Pain and Bleeding Diary (EPBD) for assessing treatment-related changes in endometriosis symptoms from the patient's perspective in a clinical trial setting.     

Impact of jerry can disinfection in a camp environment - experiences in an IDP camp in Northern Uganda

In July 2007, a study by the Centre for Environmental Health Engineering, at the University of Surrey, assessed a modified method of jerry can cleaning in an internally displaced persons (IDP) camp in Kitgum, N. Uganda. The poor condition of drinking water vessels used in the camp was confirmed as a potential source for microbiological contamination both visually and by microbiological testing. Jerry cans were disinfected using high strength sodium hypochlorite (NaOCl) generated using an experimental AquaChlor Solar unit. The study suggested that regular jerry can cleaning, using a high strength chlorine based disinfectant, offers an effective method of alleviating the adverse effects of contamination in water collection and storage vessels. Results indicated that the method is capable of significantly reducing thermo-tolerant coliform numbers to below 5 cfu/100 ml in most cases. Chlorine strength depletion after repetitive cleaning confirms the impact of process. The method does not substitute for good hygiene practices, which are essential for maintaining water quality in the household. It is suggested that the process can play an important role during outbreaks of water-borne diseases, such as cholera, particularly if combined with regular water disinfection.     

Perceptions of factors influencing healthful food consumption behavior in the Lower Mississippi Delta: focus group findings

OBJECTIVE: To identify perceptions of Lower Mississippi Delta (LMD) residents regarding factors that influence a change in healthful food consumption behavior to assist in planning sustainable nutrition interventions in the LMD. DESIGN: Nine focus groups were conducted with LMD residents in 9 counties in Arkansas, Louisiana, and Mississippi. One focus group was held in each county on the topical area of behavioral change. SETTING: Nine counties in Arkansas, Louisiana, and Mississippi. PARTICIPANTS: The study population included 91 persons, 85 females and 6 males (18-60+ years of age), of whom 71 were African Americans, 17 were Caucasians, and 3 were Hispanics, who participated in the focus group discussions. ANALYSIS: Data analyses were completed by general and specific content coding. Data were reviewed for emerging themes for each topic. The Social Cognitive Theory served as the framework for understanding the determinants of a change in healthful food consumption behavior. RESULTS: The study showed considerable variability in perceptions that are influenced by both personal and external factors. These factors include health concerns, family influence, and need for and availability of nutrition information. Participants were interested in learning about healthful eating, food preparation skills, and portion control. CONCLUSIONS: Focus groups in the LMD identified many important themes relevant to the development of nutrition interventions in these communities. These data will be used to guide the community-based participatory interventions that will be developed and implemented in the LMD. The findings could be applicable to other researchers designing interventions for similar populations.     

The prevalence, distribution and severity of detectable pathological lesions in badgers naturally infected with Mycobacterium bovis

The Randomized Badger Culling Trial (RBCT) began in 1998 to determine the impact of badger culling in controlling bovine tuberculosis in cattle. A total of 1166 badgers (14% of total) proactively culled during the RBCT were found to be tuberculous, offering a unique opportunity to study the pathology caused by Mycobacterium bovis in a large sample of badgers. Of these, 39% of adults (approximately 6% of all adults culled) had visible lesions (detectable at necropsy) of bovine tuberculosis; cubs had a lower prevalence of infection (9%) but a higher percentage of tuberculous cubs (55.5%) had visible lesions. Only approximately 1% of adult badgers had extensive, severe pathology. Tuberculous badgers with recorded bite wounds (approximately 5%) had a higher prevalence of visible lesions and a different distribution of lesions, suggesting transmission via bite wounds. However, the predominance of lesions in the respiratory tract indicates that most transmission occurs by the respiratory route.     

Total pancreatectomy with islet cell transplantation vs intrathecal narcotic pump infusion for pain control in chronic pancreatitis

AIM: To evaluate pain control in chronic pancreatitis patients who underwent total pancreatectomy with islet cell transplantation or intrathecal narcotic pump infusion.METHODS: We recognized 13 patients who underwent intrathecal narcotic pump (ITNP) infusion and 57 patients who underwent total pancreatectomy with autologous islet cell transplantation (TP + ICT) for chronic pancreatitis (CP) pain control between 1998 and 2008 at Indiana University Hospital. All patients had already failed multiple other modalities for pain control and the decision to proceed with either intervention was made at the discretion of the patients and their treating physicians. All patients were evaluated retrospectively using a questionnaire inquiring about their pain control (using a 0-10 pain scale), daily narcotic dose usage, and hospital admission days for pain control before each intervention and during their last follow-up.RESULTS: All 13 ITNP patients and 30 available TP + ICT patients were evaluated. The mean age was approximately 40 years in both groups. The median duration of pain before intervention was 6 years and 7 years in the ITNP and TP + ICT groups, respectively. The median pain score dropped from 8 to 2.5 (on a scale of 0-10) in both groups on their last follow up. The median daily dose of narcotics also decreased from 393 mg equivalent of morphine sulfate to 8 mg in the ITNP group and from 300 mg to 40 mg in the TP + ICT group. No patient had diabetes mellitus (DM) before either procedure whereas 85% of those who underwent pancreatectomy were insulin dependent on their last evaluation despite ICT.CONCLUSION: ITNP and TP + ICT are comparable for pain control in patients with CP however with high incidence of DM among those who underwent TP + ICT. Prospective comparative studies and longer follow up are needed to better define treatment outcomes.     

The role of glucocorticoids in the uncontrollable stress-induced potentiation of nucleus accumbens shell dopamine and conditioned place preference responses to morphine

Exposure to stressors can impact on the responsiveness to drugs of abuse, and glucocorticoid hormones (CORT) may interact with dopamine (DA) within the nucleus accumbens shell (NAcs) to mediate these responses. We have previously shown that the CORT response to morphine, but not to a previous uncontrollable stressor, is necessary for the stress-induced potentiation of morphine's rewarding effects. Here, we test (1) the necessity of CORT during inescapable stress (IS) and/or morphine for IS potentiation of morphine-induced NAcs DA and (2) the sufficiency of enhanced CORT, in the absence of prior IS, to potentiate morphine-induced NAcs DA as well as morphine conditioned place preference (CPP) in male Sprague-Dawley rats. In the first experiment, we administered the CORT synthesis inhibitors metyrapone and aminoglutethimide (100mg/kg each, sc) to suppress the CORT response to either IS (100 1 mA tailshocks) or subsequent morphine (3 mg/kg, sc) treatment. Twenty-four hour after IS, microdialysis was performed and morphine was administered. In the next experiments, CORT (1 mg/kg, sc) was injected 20 or 30 min before morphine during either microdialysis or CPP testing, respectively, in non-stressed rats. We found that IS potentiated subsequent morphine-induced NAcs DA and this was completely blocked by CORT suppression before morphine, but not before IS. However, elevated levels of CORT concurrent with morphine, but in the absence of a stressor, failed to potentiate NAcs DA or CPP. These results suggest that the CORT response to morphine is necessary, but not sufficient in the absence of prior IS, for sensitized NAcs DA and CPP responding to morphine, and provide further evidence that CORT is involved in the expression, but not the induction, of this sensitization.