Sumatriptan mediated growth hormone responses do not alter throughout the menstrual cycle

The objective of this study was to determine the effects of oral sumatriptan on growth hormone (GH) release throughout the menstrual cycle in healthy female volunteers. A placebo-controlled cross-over design was employed. Subjects were tested a total of six times over two consecutive menstrual cycles; twice in the early follicular phase, twice in midcycle and twice in the late luteal phase. Oral sumatriptan (100 mg) and placebo were administered on alternate visits. Twelve healthy female volunteers aged between 18-40 years with regular menses and not taking oral contraceptives were recruited. Baseline blood samples at 0 min were taken for GH, oestrogen and progesterone estimation. GH was measured at +60, +90, +120 and +180 min following administration of oral sumatriptan 100 mg or matched placebo. GH, progesterone and oestrogen were measured by radioimmunoassay. At each phase of the menstrual cycle serum GH levels peaked at 60-90 min following administration of oral sumatriptan compared to placebo which showed no response. Analysing GH response to sumatriptan and placebo over time for the three phases of the menstrual cycle (three-way ANOVA) demonstrates that the GH response to sumatriptan did not alter.     

Community psychologists as consultants: A survey of tax preparers regarding Michigan's income tax checkoff

The Michigan Children's Trust Fund (MCTF) funds child abuse and neglect prevention programs and consults with community and clinical psychologists to oversee its research efforts. This paper highlights the role of community psychologists in this capacity and documents the effectiveness of this relationship through an example of the work they are asked to perform. The primary source of funding for MCTF is a voluntary donation line on Michigan's state income tax form. Because even modest changes in the percentage donating have bearing on funding, MCTF sought a greater understanding of forces affecting donations. Given that one half of all tax forms in Michigan are prepared professionally, an exploratory survey of preparers was undertaken. Results found preparers approved of raising money via the checkoff and were aware of MCTF, although they confused it with other social programs. Differences were found in knowledge and practices toward MCTF based on degree of approval of use of the tax checkoff, and the age, parental status, and gender of the preparer. These findings were important to MCTF in directing efforts to educate a segment of the population that has influence over the major source of their funding, and may be relevant to other organizations that depend on tax checkoffs for their income.     

Eating behavior in binge eating disorder

In order to examine the eating behavior of individuals with the newly proposed diagnosis, binge eating disorder (BED), standardized meals were served to 20 obese women, 10 with BED and 10 without BED. When asked to binge eat from a multiple-item array of foods, obese subjects with BED consumed significantly more calories than did obese subjects without BED. Significant differences between the two groups were also found on several of the self-report measures. © 1993 by John Wiley & Sons, Inc.     

Body shape concerns in bulimia nervosa

Overconcern with shape and weight is considered a primary feature of the psychopathology of bulimia nervosa and was included as a diagnostic criterion in DSM- III-R. In order to test the significance of shape and weight concern in bulimia nervosa, we administered the Body Shape Questionnaire (BSQ) to 78 outpatients with bulimia nervosa and three comparison groups: 14 women with seasonal affective disorder (SAD), 10 acquaintances of patients, and 32 normal controls. Women with bulimia nervosa had significantly higher mean BSQ scores than did other subject groups. Other self-report measures of body shape concern, eating attitudes, and depression were correlated with BSQ score. Furthermore, all patients had BSQ scores greater than the average score of the normal control group. These data support the continued inclusion of body shape and weight overconcern as a diagnostic criterion for bulimia nervosa but suggest that “overconcern” should be interpreted as “above average” rather than “outside the normal range”.     

IFNγ signaling integrity in colorectal cancer immunity and immunotherapy

The majority of colorectal cancer patients are not responsive to immune checkpoint blockade (ICB). The interferon gamma (IFNγ) signaling pathway drives spontaneous and ICB-induced antitumor immunity. In this review, we summarize recent advances in the epigenetic, genetic, and functional integrity of the IFNγ signaling pathway in the colorectal cancer microenvironment and its immunological relevance in the therapeutic efficacy of and resistance to ICB. Moreover, we discuss how to target IFNγ signaling to inform novel clinical trials to treat patients with colorectal cancer.     

The relationship between headache-attributed disability and lost productivity: 2. Empirical evidence from population-based studies in nine disparate countries

BackgroundHeadache disorders are disabling, with major consequences for productivity, yet the literature is silent on the relationship between headache-attributed disability and lost productivity, often erroneously regarding the two as synonymous. We evaluated the relationship empirically, having earlier found that investment in structured headache services would be cost saving, not merely cost-effective, if reductions in headache-attributed disability led to > 20% pro rata recovery of lost productivity.MethodsWe used individual participant data from Global Campaign population-based studies conducted in China, Ethiopia, India, Nepal, Pakistan and Russia, and from Eurolight in Lithuania, Luxembourg and Spain. We assessed relationships in migraine and probable medication-overuse headache (pMOH), the most disabling common headache disorders. Available symptom data included headache frequency, usual duration and usual intensity. We used frequency and duration to estimate proportion of time in ictal state (pTIS). Disability, in the sense used by the Global Burden of Disease study, was measured as the product of pTIS and disability weight for the ictal state. Impairment was measured as pTIS * intensity. Lost productivity was measured as lost days (absence or < 50% productivity) from paid work and corresponding losses from household work over the preceding 3 months. We used Spearman correlation and linear regression analyses.ResultsFor migraine, in a linear model, we found positive associations with lost paid worktime, significant (p < 0.05) in many countries and highly significant (p < 0.001) in some despite low values of R² (0–0.16) due to high variance. With lost household worktime and total lost productivity (paid + household), associations were highly significant in almost all countries, although still with low R² (0.04–0.22). Applying the regression equations for each country to the population mean migraine-attributed disability, we found pro rata recoveries of lost productivity in the range 16–56% (> 20% in all countries but Pakistan). Analysing impairment rather than disability increased variability. For pMOH, with smaller numbers, associations were generally weaker, occasionally negative and mostly not significant.ConclusionRelief of disability through effective treatment of migraine is expected, in most countries, to recover > 20% pro rata of lost productivity, above the threshold for investment in structured headache services to be cost saving.     

Examining the Dimensionality of Trust in the Inpatient Setting: Exploratory and Confirmatory Factor Analysis

BackgroundTrust in healthcare providers is associated with important outcomes, but has primarily been assessed in the outpatient setting. It is largely unknown how hospitalized patients conceptualize trust in their providers.ObjectiveTo examine the dimensionality of a measure of trust in the inpatient setting.DesignExploratory factor analysis (EFA) and confirmatory factor analysis (CFA).ParticipantsHospitalized patients (N = 1756; 76% response rate) across six hospitals in the midwestern USA. The sample was randomly split such that approximately one half was used in the EFA, and the other half in the CFA.Main MeasuresThe Trust in Physician Scale, adapted for inpatient care.Key ResultsBased on the Kaiser-Guttman criterion and parallel analysis, EFAs were inconclusive, indicating that trust may be comprised of either one or two factors in this sample. In follow-up CFAs, a 2-factor model fit best based on a chi-squared difference test (Δχ² = 151.48(1), p < .001) and a Comparative Fit Index (CFI) difference test (CFI difference = .03). The overall fit for the 2-factor CFA model was good (χ² = 293.56, df = 43, p < .01; CFI = .95; RMSEA = .081 [90% confidence interval = .072–.090]; TLI = .93; SRMR = .04). Items loaded onto two factors related to cognitive (i.e., whether patients view providers as competent) and affective (i.e., whether patients view that providers care for them) dimensions of trust.ConclusionsWhile measures of trust in the outpatient setting have been validated as unidimensional, in the inpatient setting, trust appears to be composed of two factors: cognitive and affective trust. This provides initial evidence that inpatient providers may need to work to ensure patients see them as both competent and caring in order to gain their trust.KEY WORDS: trust, trust in physician scale, psychometrics