Psychosocial distress in patients treated for cancer pain: a prospective observational study.

Introduction: Untreated emotional distress negatively impacts the management of cancer pain.

Objectives: The authors evaluated 64 patients with cancer pain who completed baseline and follow-up measures to identify if (1) measures of psychosocial wellbeing, pain intensity, and pain management were associated with survival time; (2) higher opioid doses were associated with less psychosocial distress; and (3) intrasubject correlations across time altered the relationship between pain, depression, social support, spirituality, and increased desire for hastened death (DHD).

Methods: The main outcome measures included the Brief Pain Inventory (BPI), Daily Morphine Equivalent Dose (DMED), Beck Depression Inventory-II (BDI-II), DHD scale, Bottomley Social Support Scale, FACIT Spiritual Well-Being Scale (FACIT-Sp), Karnofsky Performance Rating Scale (KPRS), and State-Trait Anxiety Inventory (STAI).

Comparison of outpatient health care utilization among returning women and men veterans from Afghanistan and Iraq.

Background: The number of women serving in the United States military increased during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), leading to a subsequent surge in new women Veterans seeking health care services from the Veterans Administration (VA). The objective of this study was to examine gender differences among OEF/OIF Veterans in utilization of VA outpatient health care services.

Methods: Our retrospective cohort consisted of 1,620 OEF/OIF Veterans (240 women and 1380 men) who enrolled for outpatient healthcare at a single VA facility.

Time to depression treatment in primary care among HIV-infected and uninfected veterans.

Background: Multiple factors, including patient characteristics, competing demands, and clinic type, impact delivery of depression treatment in primary care.

Objective: Assess whether depression severity and HIV serostatus have a differential effect on time to depression treatment among depressed patients receiving primary care at Infectious Disease or General Medicine clinics.

Design: Multicenter prospective cohort, (Veterans Aging Cohort Study), comparing HIV-infected to uninfected patients.

Patterns of drug use and abuse among aging adults with and without HIV: a latent class analysis of a US Veteran cohort.

This study characterized the extent and patterns of self-reported drug use among aging adults with and without HIV, assessed differences in patterns by HIV status, and examined pattern correlates. Data derived from 6351 HIV-infected and uninfected adults enrolled in an eight-site matched cohort, the Veterans Aging Cohort Study (VACS). Using clinical variables from electronic medical records and socio-demographics, drug use consequences, and frequency of drug use from baseline surveys, we performed latent class analyses (LCA) stratified by HIV status and adjusted for clinical and socio-demographic covariates.

Recommendations from the International Consensus Workshop: convergence on an orofacial pain taxonomy.

This 2·5-day workshop was organized by the International RDC/TMD Consortium Network of the International Association for Dental Research and the Orofacial Pain Special Interest Group of the International Association for the Study of Pain. Workshop participation was by invitation based on representation within the field, which included the Consortium Network, the Orofacial Pain Special Interest Group, the National Institute for Dental and Craniofacial Research, American Academy of Orofacial Pain, the European Academy of Craniomandibular Disorders, and the International Headache Society; other disciplines included radiology, psychology, ontology, and patient advocacy. The workshop members were divided into workgroups that reviewed core literature describing the properties of the RDC/TMD, provided recommendations for revision, and suggested relevant research directions.

Social-economic status and rates of hospital admission for chronic disease in urban Canada.

Socio-economic status (SES) is recognized as an important factor that influences the utilization of health-care services. We set out to explore this association in the context of hospital admissions for the treatment of ambulatory care sensitive conditions (ACSCs)--chronic conditions normally managed on an outpatient basis. We examined rates of hospital admission for the treatment of ACSCs overall and for three specific conditions: chronic obstructive pulmonary disease (COPD), diabetes and asthma in children.

Systematic cultural adaptation of cognitive-behavioral therapy to reduce alcohol use among HIV-infected outpatients in western Kenya.

Two-thirds of those with HIV worldwide live in sub-Saharan Africa. Alcohol use is associated with the HIV epidemic through risky sex and suboptimal ARV adherence. In western Kenya, hazardous drinking was reported by HIV (53%) and general medicine (68%) outpatients.

Erectile dysfunction drug receipt, risky sexual behavior and sexually transmitted diseases in HIV-infected and HIV-uninfected men.

Background: Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior.

Objectives: To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups.

Design: Cross-sectional study.

Pain among Veterans of Operations Enduring Freedom and Iraqi Freedom: do women and men differ?

Objective: To evaluate sex differences in the prevalence of overall pain, moderate-severe pain, and persistent pain among Veterans of Operations Enduring Freedom and Iraqi Freedom seen at VA outpatient clinics, and to evaluate sex differences in pain assessment.

Design: The observational cohort consisted of Veterans discharged from the U.S.

Wake tracking and the detection of vortex rings by the canal lateral line of fish.

Research on the lateral line of fish has mainly focused on the detection of oscillating objects. Yet many fish are able to track vortex wakes that arise from other fish. It is not yet known what the sensory input from a wake looks like and how fish can extract relevant information from it.

The effect of combined antiretroviral therapy on the overall mortality of HIV-infected individuals.

Objective: To estimate the effect of combined antiretroviral therapy (cART) on mortality among HIV-infected individuals after appropriate adjustment for time-varying confounding by indication.

Design: A collaboration of 12 prospective cohort studies from Europe and the United States (the HIV-CAUSAL Collaboration) that includes 62 760 HIV-infected, therapy-naive individuals followed for an average of 3.3 years.

Disubstituted pyrimidines as Lck inhibitors.

We have developed a family of 4-benzimidazolyl-N-piperazinethyl-pyrimidin-2-amines that are subnanomolar inhibitors of Lck. A subset of these Lck inhibitors, with heterocyclic substituents at the benzimidazole C5, are also low-nanomolar inhibitors of cellular IL2 release.

Impact of cigarette smoking on mortality in HIV-positive and HIV-negative veterans.

It is unknown whether smoking confers similar mortality risk in HIV-positive as in HIV-negative patients. We compared overall mortality stratified by HIV and smoking of 1,034 HIV-positive block-matched to 739 HIV-negative veterans, enrolled 2001-2002 in the Veterans Aging Cohort 5 Site Study. Adjusted incidence rate ratios (IRR) for mortality were calculated using Poisson regression.

The association between the receipt of lipid lowering therapy and HIV status among veterans who met NCEP/ATP III criteria for the receipt of lipid lowering medication.

Objective: To examine the association between HIV infection status and the receipt of lipid lowering therapy based on National Cholesterol Education Program/Adult Treatment Panel (NCEP/ATP III) guidelines and to assess whether HIV viral load and hepatitis C (HCV) status alters that association.

Participants And Design: A cross-sectional analysis of survey, laboratory, and pharmacy data from 1,577 male participants (59% HIV infected) of the Veterans Aging Cohort Five-Site Study, a prospective observational cohort of U.S.

Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud's phenomenon to systemic sclerosis: a twenty-year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis.

Objective: To identify in patients with Raynaud's phenomenon (RP) independent markers that predict progression to definite systemic sclerosis (SSc) and to determine in patients with progression to SSc the type and sequence of microvascular damage and its relationship to SSc-specific autoantibodies.

Methods: Consecutive patients referred for evaluation of RP who had no definite connective tissue disease were evaluated for microvascular damage by nailfold capillary microscopy (NCM) and for anticentromere (anti-CENP-B), anti-Th/To, anti-topoisomerase I, and anti-RNA polymerase III (anti-RNAP III) autoantibodies by specific assays. Patients were studied prospectively.

Administration of Pediococcus acidilactici or Saccharomyces cerevisiae boulardii modulates development of porcine mucosal immunity and reduces intestinal bacterial translocation after Escherichia coli challenge.

In this study, the influence of the probiotics, Pediococcus acidilactici (PA) and Saccharomyces cerevisiae boulardii (SCB), on intestinal immune traits and resistance to enterotoxigenic Escherichia coli (ETEC) infection was evaluated in pigs. Two weeks before farrowing, 30 sows and their future litters were allocated to the following treatments: 1) control group without antibiotic or probiotic treatment (CTRL), 2) control with antibiotic (tiamulin) added to weanling feed (ABT), or litters treated with 3) PA, 4) SCB, or 5) PA+SCB from 24 h after birth. During lactation, PA, SCB, or PA+SCB were given to piglets 3 times a week by gavage.

Estimating alcohol content of traditional brew in Western Kenya using culturally relevant methods: the case for cost over volume.

Traditional homemade brew is believed to represent the highest proportion of alcohol use in sub-Saharan Africa. In Eldoret, Kenya, two types of brew are common: chang'aa, spirits, and busaa, maize beer. Local residents refer to the amount of brew consumed by the amount of money spent, suggesting a culturally relevant estimation method.

Drug toxicity, HIV progression, or comorbidity of aging: does tipranavir use increase the risk of intracranial hemorrhage?

The US Food and Drug Administration has issued a warning that tipranavir may be associated with increased risk of intracranial hemorrhage. We studied 2 large cohorts to estimate the background rate of intracranial hemorrhage and compared it with rates reported among persons who had been exposed to tipranavir.

Temporal relationship between change in cognition and change in functioning in schizophrenia.

Most research establishing the relationship between cognition and functioning in schizophrenia has been conducted cross-sectionally, leaving unanswered the question of whether there is a predictive relationship between temporal change in cognition and temporal change in functioning. In the present study, we used longitudinal mixed models to examine the relationship between change in cognition and change in Quality of Life (QLS), as measured over three time-points spanning a 12-month period, for 151 schizophrenia outpatients participating in work therapy with or without cognitive remediation. Memory and executive function changes were significant predictors of improved QLS total.

Depression symptoms and treatment among HIV infected and uninfected veterans.

Depression is one of the most common comorbid conditions affecting persons with HIV. We compared depressive symptoms and depression treatment using data from the Veterans Aging Cohort Study (VACS), a prospective cohort of HIV-infected and uninfected subjects. We identified subjects with a Patient Health Questionnaire score of 10 or greater.

Impact of pneumococcal vaccination on the incidence of pneumonia by HIV infection status among patients enrolled in the Veterans Aging Cohort 5-Site Study.

Background: Human immunodeficiency virus (HIV)-infected persons have a high incidence of pneumonia and pneumococcal disease. Benefits of vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPV) among these patients continue to be debated.

Methods: The impact of PPV vaccination on the incidence of pneumonia events (i.

Curriculum structure: principles and strategy.

This report provides general guidelines for the structure of a curriculum, followed by specific advice on the principles of learning and teaching, the process of restructuring and change leadership and management. It provides examples of several educational philosophies, including vertical and horizontal integration. It discusses the use of competence, learning outcomes, level of degree and assessment and provides a number of recommendations.

Relationship between eating behaviours and food and drink consumption in healthy postmenopausal women in a real-life context.

Associations between eating behaviours and dietary variables have not been thoroughly investigated in healthy postmenopausal women in a real life uncontrolled context. To investigate how eating behaviours (cognitive dietary restraint, disinhibition and susceptibility to hunger) were associated with food and drink consumption, energy density and meal pattern in 112 healthy postmenopausal women (age 56.8 (SD 4.

Determinants of hormone therapy discontinuation among female veterans nationally.

Purpose: The growing presence of female veterans within the Department of Veterans Affairs (VA) health care system highlights the need to assess the quality of and access to gender-specific care for menopause. We assessed the use of hormone therapy (HT) among female veterans before and after the release of the Women's Health Initiative clinical trial results and evaluated whether the structure of women's health care services within the VA system affects the use of HT.

Methods: We identified all female veterans using HT in 2001 by using the VA pharmacy benefits management database and administrative data.

Quantifying the decrement in utility from perceived side effects of combination antiretroviral therapies in patients with HIV.

Background: The decrement in utility attributable to side effects from combination antiretroviral therapy (CART) is unknown and likely to influence clinical decisions regarding CART initiation and cost-effectiveness.

Objective: To quantify the decrement in utility attributable to side effects from CART.

Methods: We estimated SF-6D utilities (quality-of-life weights on a scale from 0.