Interference In Daily Life Research Articles

O conceito de autonomia sob a perspectiva de sujeitos acometidos por Acidente Vascular Cerebral

Este estudo tem como objetivo compreender o conceito de autonomia sobre a perspectiva de sujeitos acometido por Acidente Vascular Cerebral – AVC, familiares/cuidadores e dos terapeutas ocupacionais. Trata-se um estudo qualitativo. Participaram deste estudo pessoas acometidas por AVC que mantinham acompanhamento em um Ambulatório de Terapia Ocupacional de uma Universidade Federal da região central do Rio Grande do Sul, seus cuidadores e terapeutas ocupacionais. A coleta de dados ocorreu no período de março a julho de 2014, e para esta utilizou-se uma entrevista semiestruturada. Os dados foram analisados através da Análise de Conteúdo. A partir desta sugiram quatro categorias relevantes para a compreensão da temática: Autonomia nas escolhas; Interferência no cotidiano; Busca por objetivos a médio e longo prazo; Autonomia nas atividades. O estudo traz contribuições para a compreensão da concepção sobre a autonomia nas diferentes percepções. Através dos resultados se fez notar a necessidade de maior número de estudos com aprofundamento sobre os aspectos centrais do tema, devido à importância sobre a influência da autonomia nos papéis sociais e na qualidade de vida dos sujeitos acometidos por AVC.

Bladder training for urinary tract symptoms in Parkinson disease: A randomized controlled trial.

ObjectiveTo assess the feasibility and efficacy of bladder training for troublesome lower urinary tract symptoms (LUTS) in Parkinson disease (PD).MethodsIn this single-center, single-blinded, randomized controlled trial, participants with a history of PD and LUTS were randomized to a 12-week bladder training program (BT) or conservative advice (CA). Outcome measures included a 3-day volume frequency diary, International Consultation on Incontinence Questionnaire (ICIQ)–Overactive Bladder Module, and ICIQ—Quality of Life Module. Co–primary endpoints were (1) patient perception of change and (2) change in number of urgency episodes at 12 weeks. Secondary endpoints included change in ICIQ scores, number of micturitions, and volume voided.ResultsThirty-eight participants were randomized (18 to CA, 20 to BT). Both CA and BT were associated with significant improvements in volume voided, number of micturitions, symptom severity scores, and measures of quality of life (all p < 0.05). At 12 weeks, compared to CA, BT was associated with significant superiority on patient perception of improvement (p = 0.001), significantly greater reductions in number of voids in 24 hours (mean decrease 2.3 ± 0.8 voids vs 0.3 ± 0.5 [p < 0.05]), and greater reductions in interference with daily life (2.1 ± 0.8 point improvement vs 0.3 ± 0.7 point deterioration [p < 0.05]). BT was not associated with change in urgency episodes (mean change 2.4 ± 1.5 urgency episodes vs 3.5 ± 1.5 [p NS]). At 20 weeks, BT remained associated with greater improvement in interference in daily life. Loss of significance in other measures may reflect loss of power from loss to follow-up.ConclusionThis controlled trial demonstrated the potential benefits of BT for LUTS in PD.Classification of evidenceThis study provides Class III evidence that for patients with PD and LUTS, BT significantly increased patient perception of improvement but did not significantly reduce urgency episodes.

Are Processes in Acceptance & Commitment Therapy (ACT) Related to Chronic Pain Outcomes Within Individuals Over Time? An Exploratory Study Using n-of-1 Designs.

IntroductionAcceptance & Commitment Therapy (ACT) explicitly postulates experiential avoidance (EA) and values-based living (VBL) as essential treatment processes. As outcomes from between-subject studies cannot readily be generalized to within-subject processes in individuals, we explored the unfolding of, and relationship between, EA and VBL and levels of pain interference in daily life and emotional well-being within individuals experiencing chronic pain.MethodsUsing n-of-1 designs, three participants following a multidisciplinary treatment program filled out a 12-item daily questionnaire (87–110 days). After multiple imputation of missing data, McKnight Time-series analysis procedures were performed for each participant separately. The interrelationships of EA, VBL and pain intensity, and the relationship of EA and VBL beyond pain intensity with both chronic pain outcomes were assessed both concurrently (same day) and prospectively (consecutive days).ResultsBoth EA and VBL were associated with at least one of five outcome variables (four domains of pain interference and emotional well-being) beyond pain intensity in two participants, but not in the third participant. These associations primarily existed for concurrent, but not consecutive, days. In contrast to VBL, EA was not associated with emotional well-being for any of the three participants.ConclusionsAlthough the finding that ACT-processes were associated with pain outcomes on concurrent days is consistent with ACT theory, the absence of such associations on consecutive days means that alternative explanations cannot be rule out. One possibility is that pain interference fluctuates within days at a higher variability rate than was currently assessed. Future research should consider using a higher measurement frequency to be able to grasp time-lagged effects.

Comparison of Neuropathic Pain in Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis

Background and PurposeTo compare the characteristics of neuropathic pain in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS).MethodsFrom 2016 to 2018, 500 patients with NMOSD and MS from 6 referral hospitals in Korea underwent pain investigation. After the patients with current pain were matched for sex ratio and disease duration as confounding factors, PainDETECT questionnaires were assessed in 99 NMOSD and 58 MS patients to investigate neuropathic pain. The short form of the Brief Pain Inventory from 74 patients with neuropathic pain component was also analysed.ResultsAccording to the PainDETECT questionnaire, mechanical allodynia (p=0.014) and thermal hyperalgesia (p=0.011) were more severe in NMOSD patients than in MS patients. Strong involvements (score >3) of the pain in domains of tingling/prickling sensation (p=0.024), mechanical allodynia (p=0.027), sudden pain attacks (p=0.018), and thermal hyperalgesia (p=0.002) were significantly more frequent in NMOSD compared to MS patients. Among the patients experiencing pain with a neuropathic component, total pain-related interference (p=0.045) scores were significantly higher in NMOSD patients than in MS patients. In daily life, pain interfered with normal work (p=0.045) and relationships with other people (p=0.039) more often in NMOSD patients than in MS patients. Although pain medication was prescribed more frequently in NMOSD patients, the percentage of patients experiencing medication-related pain relief was lower in those patients.ConclusionsThe severity of neuropathic pain and the pain-related interference in daily life were greater in NMOSD patients than in MS patients. Individualized analgesic management should be considered based on a comprehensive understanding of neuropathic pain in these patients.

QOLP-10. PATIENT-REPORTED OUTCOMES DURING TREATMENT FOR GLIOBLASTOMA: SYMPTOM BURDEN AND ASSOCIATED IMPACT ON DAILY LIFE

Abstract INTRODUCTION Glioblastoma is the most common primary malignant brain tumor, with an annual incidence of 3–4 new cases per 100,000 people. Despite advances in chemotherapy, radiotherapy, and surgical interventions, prognosis remains poor. Aims of treatment for life-limiting diagnoses should extend beyond increasing survival time to include palliation of symptoms and promotion of quality of life. Here we describe patient-reported symptoms both early and late in the glioblastoma treatment trajectory, as well as their associated interference with daily life. METHODS Fifty patients with newly diagnosed glioblastoma were recruited between September 2015-March 2018. Demographic and clinical information was collected from medical records. Patients also completed the brain tumor-specific MD Anderson Symptom Inventory (MDASI-BT) approximately every 8 weeks from completion of chemoradiation through cessation of active disease treatment. Both individual and categories of related symptoms reported in the initial two (early treatment) and final two (late treatment) MDASI-BT assessments were examined for symptom frequency, severity, and relationships between symptom severity and interference with daily life. Patients still receiving treatment or who completed &lt; 4 total MDASI-BT assessments were excluded from the analysis. RESULTS The most commonly reported symptoms were often, but not always, consistent with the symptoms rated as most severe. This was true for individual symptoms as well as categories of symptoms. The most common/severe symptoms also changed from early to late treatment. Overall symptom burden was positively correlated with symptom interference in daily life (r=0.67, p&lt; 0.0001). Regression analysis identified different symptoms as predictors of interference in early as opposed to late treatment, and these predictors did not necessarily align with the most common/severe symptoms. CONCLUSION Symptom experience for patients with glioblastoma is complex and dynamic. Attention to symptom trajectories for patients with glioblastoma may direct approaches to assessment, early identification, and symptom management, thus promoting better quality of life.

Reasons why osteoarthritis predicts mortality: path analysis within a Cox proportional hazards model

ObjectivesTo identify potentially modifiable factors that mediate the association between symptomatic osteoarthritis (OA) and premature mortality.MethodsA population-based prospective cohort study; primary care medical record data were linked to self-report information...

Additional effects of a cognitive task on dual-task training to reduce dual-task interference

ObjectiveWhen we perform dual-tasks in daily life, task performance is generally reduced. As these reductions in performance (i.e., dual-task interference) are responsible for various accidents such as falls, the repeated practice of dual-task (i.e., dual-task training) is often implemented to reduce dual-task interference. However, the risk of various accidents increases with longer dual-task training, as dual-task interference cannot be avoided. Therefore, it is important to achieve training goals more rapidly during dual-task training. This study sought to determine whether a combination of dual-task training and cognitive tasks would accelerate training effects. DesignThe experimental design included four groups: 1) cognitive task training group, 2) dual-task training group, 3) cognitive task and dual-task training group, and 4) non training group. MethodWe assessed single- and dual-task performance before and after the 2-week training sessions. We adopted a dual-task involving knee extension and an auditory reaction, and used N-back task as a cognitive task. On the other hand, dual-task training was the same method to assess dual-task performance. ResultDual-task interference was reduced in all groups in both the tasks. However, the number of participants in the cognitive task and dual-task training group who achieved a reduction in dual-task cost was significantly higher than those in other groups. ConclusionThese findings could contribute to the development of an effective method for reducing dual-task interference and resolving issues caused by dual-task interference in daily life.

Development and validation of the comprehensive assessment scale for chemotherapy\u2013induced peripheral neuropathy in survivors of cancer

BackgroundAppropriate assessment is essential for the management of chemotherapy-induced peripheral neuropathy (CIPN), an intractable symptom that cannot yet be palliated, which is high on the list of causes of distress for cancer patients. However, objective assessment by medical staff makes it easy to underestimate the symptoms and effects of CIPN in cancer survivors. As a result, divergence from subjective evaluation of cancer survivors is a significant problem. Therefore, there is an urgent need to develop a subjective scale with high accuracy and applicability that reflects the experiences of cancer patients. We developed a comprehensive assessment scale for CIPN in cancer survivors, named the Comprehensive Assessment Scale for Chemotherapy-Induced Peripheral Neuropathy in Survivors of Cancer (CAS-CIPN), and demonstrated its reliability and validity.MethodsWe developed a questionnaire based on qualitative studies of peripheral neuropathy in Japanese cancer patients and literature review. Twelve cancer experts confirmed the content validity of the questionnaire. A draft version comprising 40 items was finalized by a pilot test on 100 subjects. The participants in the present study were 327 Japanese cancer survivors. Construct validity was determined by factor analysis, and internal validity by confirmation factor analysis and Cronbach’s α.ResultsFactor analysis showed that the structure consisted of 15 items in four dimensions: “Threatened interference in daily life by negative feelings”, “Impaired hand fine motor skills”, “Confidence in choice of treatment/management,” and “Dysesthesia of the palms and soles.” The CAS-CIPN internal consistency reliability was 0.826, and the reliability coefficient calculated using the Spearman-Brown formula [q = 2r/(1 + r)] was 0.713, confirming high internal consistency and stability. Scores on this scale were strongly correlated with Gynecologic Oncology Group-Neurotoxicity scores (r = 0.714, p < 0.01), confirming its criterion-related validity.ConclusionsThe CAS-CIPN is an assessment tool with high reliability and validity for the comprehensive evaluation of CIPN in cancer survivors. The CAS-CIPN is simple to use, and can be used by medical professionals for appropriate situational assessment and intervention.

A perda urinária é frequente em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC) atendidos ambulatorialmente

INTRODUÇÃO: A incontinência urinária (IU) é definida como qualquer perda involuntária de urina, sendo a tosse um fator de risco. A tosse é um sintoma frequente da Doença Pulmonar Obstrutiva Crônica (DPOC) podendo associar-se com a IU. OBJETIVO: Avaliar a frequência de perda urinária e o impacto da IU na qualidade de vida das pessoas com DPOC e caracterizar a presença de tosse. MATERIAL E MÉTODOS: Tratou-se de um estudo descritivo, realizado em pessoas com DPOC. A coleta dos dados foi realizada no Departamento de Ciências da Vida II/UNEB. Aplicou-se o International Consultation Incontinence Short-Form (ICIQ-SF) para avaliar a frequência de perda urinária e o King’s Health Questionnaire (KHQ) para o impacto na qualidade de vida. Os dados foram analisados no software SPSS (v.22.0), descritos em medida de tendência central, dispersão e proporções. Um p &lt; 0,05 foi considerado estatisticamente significante. RESULTADOS: Das 30 pessoas avaliadas, a média da idade foi 66,7± 8,6 anos; desses 11 (36,7%) apresentaram queixa de IU, sendo sete (63,3%) mulheres. Entre esses a média de pontuação do ICIQ-SF foi de 5,9± 4,4. Vinte e oito participantes (93,3%) tinham tosse crônica. Analisando o KHQ, o domínio de maior impacto foi “percepção geral de saúde’’. CONCLUSÃO: A frequência de IU em pessoas com DPOC foi de 35,7% e a de tosse foi de 93,3%. Entre as pessoas com perda urinária, 36,7% referiram alguma interferência na vida diária. É importante incluir a avaliação da IU para ampliar o manejo clínico da condição de saúde dessas pessoas.

Utilization of medicinal cannabis for pain by individuals with spinal cord injury.

Study designA cross-sectional multi-center study using an on-line survey addressing utilization, knowledge, and perceptions of medicinal cannabis (MC) by people with spinal cord injury (SCI).ObjectiveTo characterize differences between current (CU), past (PU), and never users (NU) of MC with SCI; to determine why people with SCI use MC; to examine reports of MCs’ efficacy and tolerability by individuals with SCI.SettingThree academic medical centers in the United States.MethodsComparison of demographic and attitudinal differences between CU, PU, and NU and differences in the groups’ reports of pain, health, and quality of life (QOL). Evaluation of utilization patterns and perceived efficacy of MC among CU and PU and reports of side effects of MC versus prescription medications. Data were analyzed using either Chi Square, distribution-free exact statistics, or t-tests for continuous data.ResultsAmong a nationwide sample (n = 353) of individuals with SCI, NU were less likely than CU and PU to believe that cannabis ought to be legalized and more likely to endorse risks of use. Current users and PU reported greater pain interference in daily life than did NU, but there were no between group differences in QOL or physical or emotional health. Current users and PU took MC to address pain (65.30%), spasms (63.30%), sleeplessness (32.70%), and anxiety (24.00%), and 63.30% reported it offered “great relief” from symptoms. Participants reported that MC is more effective and carries fewer side effects than prescription medications.ConclusionsMedicinal cannabis is an effective and well-tolerated treatment for a number of SCI-related symptoms.

Risk factors associated with pain among community adults in Northwest China.

Objectives: We aimed to investigate the prevalence of and risk factors associated with pain and to compare the correlation between depression and sleep quality and pain among adults in Northwest China, where health care resources are limited.Methods: In total, 7,602 subjects (age ≥40 years) participated in this survey. Using the Brief Pain Inventory-Chinese version, we evaluated the overall pain among respondents, including pain sites, pain intensity, and its interference in daily life. In addition, depression symptoms were measured using the Center for Epidemiologic Studies Depression Scale Chinese edition. Furthermore, the subjective sleep quality among participants was assessed using the Pittsburgh Sleep Quality Index.Results: Approximately 25.2% of the participants experienced pain, and 41.7% of those perceived the worst pain they had experienced as severe pain. Chronic disease exhibited the most robust correlation with severe pain, followed by poor sleep quality. Furthermore, the correlation between depression and pain was found only in the population with severe pain.Conclusion: The study reveals that pain affects a large proportion of Chinese adults, especially females, living in rural areas, having lower incomes, unemployed, and suffering from poor health status or mental illness. Furthermore, this study suggests we should have a screen and intervention for depression and poor sleep quality among pain suffers, which will be helpful for pain management in Northwest China.

Moderate and Stable Pain Reductions as a Result of Interdisciplinary Pain Rehabilitation-A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP).

Few studies have investigated the real-life outcomes of interdisciplinary multimodal pain rehabilitation programs (IMMRP) for chronic pain. This study has four aims: investigate effect sizes (ES); analyse correlation patterns of outcome changes; define a multivariate outcome measure; and investigate whether the clinical self-reported presentation pre-IMMRP predicts the multivariate outcome. To this end, this study analysed chronic pain patients in specialist care included in the Swedish Quality Registry for Pain Rehabilitation for 22 outcomes (pain, psychological distress, participation, and health) on three occasions: pre-IMMRP, post-IMMRP, and 12-month follow-up. Moderate stable ES were demonstrated for pain intensity, interference in daily life, vitality, and health; most other outcomes showed small ES. Using a Multivariate Improvement Score (MIS), we identified three clusters. Cluster 1 had marked positive MIS and was associated with the overall worst situation pre-IMMRP. However, the pre-IMMRP situation could only predict 8% of the variation in MIS. Specialist care IMPRPs showed moderate ES for pain, interference, vitality, and health. Outcomes were best for patients with the worst clinical presentation pre-IMMRP. It was not possible to predict who would clinically benefit most from IMMRP.

Observational Prospective Study to Determine the Evolution of the Symptomatic Profile of Metastatic Non-Small Cell Lung Cancer (NSCLC) Patients and Its Relation to the Control of the Disease.

To evaluate the evolution of disease-related symptoms and its relationship with the control of the disease in first-line treatment in patients with metastatic non-small cell lung cancer (NSCLC). This was an observational, prospective, national and multicentre study with two visits in which the following were collected: (1) baseline visit: sociodemographic and clinical variables (2) visit after completing the 4-6 chemotherapy cycles: criteria for ending treatment, control of the disease and clinical variables. Ad hoc questionnaires were collected to assess the frequency of symptoms (evaluated by the patient), and quality-of-life questionnaires to assess the intensity of symptoms (using the Lung Cancer Symptom Scale, LCSS), and interference in the patient's daily life, assessed by the patient and by the investigator. A total of 155 patients were included. Patients predominantly described tiredness (24.1%) and pain (23.9%) as the symptoms that appeared "frequently or continuously". A statistically significant decrease in scores for symptoms of cough (15.4 points), dyspnoea (8.5 points), pain (9.5 points) and discomfort related to their illness (9points) was observed between visits. Patients who achieved a complete or partial response showed a statistically significant reductionin the cough, dyspnoea, pain and disconfort frequency.Regardingthe intensity, cough was the only symptomthat showed a statistically significant decrease for both the patient and the investigator. Tiredness/asthenia and pain were the symptoms with the greatest interference in daily life at baseline according to the patient; however, according to the investigator, they were mood and quality/quantity of sleep, although none of them were significant. But changes in the score of the interference questionnaire between visits were not statistically significantly related to the control of the disease.However, average score according to both investigator and patients showed a significant correlation with ECOG status. The first-line treatment of NSCLC is correlated with an improvement in the symptomatic evolution of advanced NSCLC patients. Roche.

Patients' Global Impression of Change in the management of peripheral neuropathic pain: Clinical relevance and correlations in daily practice.

Patient-Reported Outcome (PRO) instruments have been developed to evaluate pain management in daily practice; the Patients' Global Impression of Change (PGIC) is particularly recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials. The prospective non-interventional multicenter PRO-QURE study aimed at assessing correlations between PGIC and pain measurements and treatment effects in patients followed in French pain centres. Respectively, 495 and 379 patients with peripheral neuropathic pain initiating treatment with capsaicin 8% cutaneous patch(es) (female, 62.6%; mean age, 54.0±14.8years; post-surgical or traumatic pain, 52.7%; mean pain duration, 42.2±54.1months; DN4 score >4, 92.9%) completed the PGIC and several other PRO instruments before (baseline) and 3months (M3) after treatment application. At M3, improvement ("much improved" or "very much improved") was observed in 23.0% of patients, associated with decreases of -3.0±2.2, -2.5±2.4, and -23.1±19.7 in BPI pain intensity, BPI pain interference and NPSI total scores, respectively. The highest Spearman's rank correlation coefficients with PGIC were found for pain intensity (BPI: r=-0.479, p<0.001), satisfaction with current state (Patient Acceptable Symptomatic State: r=0.455, p<0.001), and treatment effectiveness (TSQM: r=0.431, p<0.001); correlation coefficients were lower for all NPSI scores, BPI pain interference score, HAD scores and EQ-5D-3L index. In daily clinical practice, significant improvement in peripheral neuropathic pain, as assessed by PGIC scores, significantly correlated with changes in well-established measures of pain intensity, pain interference with activities of daily living, mood and quality of life, confirming its clinical interest as PRO measure in real-world conditions. Clinically important improvement in peripheral neuropathic pain, as assessed by PGIC scores, significantly correlated with well-established measures of pain intensity, pain interference in daily life and treatment efficacy. This result, associated with the ease of administration and scoring, encourages the widespread use of the PGIC in daily practice.

Efficacy of Botulinum Toxin A for Treating Cramps in Diabetic Neuropathy.

Muscle cramps occur in >50% of diabetic patients and reduce the quality of life. No effective treatment is available. We evaluated the clinical effectiveness of botulinum toxin A (BTX-A) injections for treating cramps in diabetic patients with neuropathy. This single-center, double-blind, placebo-controlled perspective study investigated the efficacy and safety of BTX-A intramuscular injection for treating calf or foot cramps refractory to common pharmacological drugs. Fifty diabetic patients with peripheral neuropathy and cramps were randomly assigned to 2 matched groups. BTX-A (100 or 30 units) or saline was injected on each side into the gastrocnemius or the small flexor foot muscles. Changes in pain intensity (primary outcome) and cramp frequency were evaluated over the course of 20 weeks after BTX-A administration. Cramp interference in daily life and the electrophysiological cramp threshold frequency were also measured. The treatment was repeated 5 months after first injection in 19 responders. All outcome measures improved significantly after BTX-A compared with placebo. The changes with respect to baseline were already significant after 1 week and persisted up to week 14. Only 5 of 25 (20%) patients were nonresponders (<50% decrease of the primary outcome). The responses to a second BTX-A injection provided results similar to the first administration. Mild pain at the injection site (4/25 cases) was the only adverse event, and it disappeared within 2 to 3 days. Local BTX-A infiltration is an efficacious and safe procedure for obtaining a sustained amelioration of muscle cramps associated with diabetic neuropathy. Ann Neurol 2018;84:682-690.

Differences between Transdermal Fentanyl and Buprenorphine in the Elderly Hospice Patients.

Introduction Opioids are the most important drugs in treating pain in palliative care patients. Transdermal formulations are especially useful due to their noninvasive nature and minimal interference in daily life. However, studies have shown a controversial relationship of opioids to survival and a rise in deaths associated with the use of transdermal opioids. Although applying precise doses is paramount, we have no clear recommendations for the exact equianalgesic ratio for buprenorphine patch and no recommendation for the type of transdermal opioid to use in hospice. Methods We analyzed the differences between the transdermal fentanyl and buprenorphine group by analyzing patient characteristics and evaluating the differences in survival in hospice patients over the age of 65, from 2013 to 2017. Results A total of 292 patients (75.8%) used fentanyl patch and 93 (24.1%) were on buprenorphine patch. Patients had virtually the same characteristics in both groups. However, when using a 1:100 buprenorphine equianalgesic ratio, there were significant differences in initial and final doses, and it seems that a 1:80 conversion rate is more accurate for elderly hospice patients. Finally, there was no difference in survival between the two groups using transdermal opioids, with or without adjuvant analgesics. Discussion There were no differences in survival between the group using transdermal fentanyl and the group using buprenorphine in the elderly hospice population. Although adjuvant NSAIDs could be useful in the treatment of pain in terminal cancer, they do not affect survival or reduce the opioid doses, while a 1:80 equianalgesic ratio of buprenorphine might be the most appropriate in this population.

Cervical myofascial pain syndrome - Is the ultrasound-guided needling approach a therapeutic option?

Myofascial pain syndrome (MPS) is a frequent entity in clinical practice and is characterized by the presence of trigger points, limitation of joint mobility and neurological symptoms. The main purpose of this work was to evaluate the results obtained by perform an ultrasound-guided needling of the trapezius and levator scapulae muscles with simultaneous injection of steroids and local anesthetics, in the pain intensity and interference in daily life and the subjective benefits in patients with cervical MPS. Prospective longitudinal study, including patients with clinical diagnosis of unilateral or bilateral cervical MPS refractory to the conventional rehabilitation program, submitted to treatment during the year 2017. The technique included to pepper the trigger point with a fanlike manner under ultrasound guidance, using a 22G needle with simultaneous injection of 2% lidocaine and methylprednisolone acetate 40 mg/mL. A sociodemographic questionnaire, the pain numerical rating scale (NRS) and the brief pain inventory (BPI) were applied prior and 1 month after the procedure. In this last evaluation, a Likert scale was also applied to evaluate the subjective benefits. Eighteen patients were included, 82% female, with a mean of 54 years (SD = 8.2). No adverse effects were recorded. There was a statistically significant and clinically relevant reduction in the score obtained in the NRS (2.9, P < 0.001) and in all components of the BPI, including intensity (2.6, P < 0.001), pain interference in general activity (1.9, P < 0.001) and in the affective subdimension (1.7, P < 0.001). Fifty-four percent of the patients reported a very significant improvement with the procedure, but only 33% presented a ≤ 4 value in the NRS at 1 month reassessment. The results presented in this study show the importance of ultrasound-guided needling procedures in the treatment of myofascial pain and, at least, it short-term efficacy on reliefing pain, particularly in refractory cervical MPS.

The correspondence between transdermal alcohol monitoring and daily self-reported alcohol consumption

Alcohol consumption is typically assessed via self-report methods, though there are concerns over the accuracy of this information. Transdermal alcohol monitoring can passively and continuously measure alcohol consumption with minimal interference in daily life. The current study examines the correspondence between daily self-reported alcohol consumption and transdermal alcohol monitors. Thirty-two healthy men (n = 16) and women (n = 16) wore a transdermal alcohol monitor for 28 days. Participants were instructed to drink as they usually do and prompted daily with a survey link to report yesterday's drinking. Data analyses focused on the following comparisons: (1) the overall correspondence between self-reported drinking and TAC readings; (2) the sensitivity of various TAC criteria thresholds to detect self-reported drinking (TAC thresholds of none, low, moderate, and heavy); and (3) the risks of false positive TAC findings using self-reported drinking as the Gold Standard. Participants self-reported drinking a total of 324 days, of which, TAC events were detected on 212 days (65.4%). When participants self-reported not drinking (399 days), zero TAC was also found on 366 days (92%). The correspondence between self-reported drinking and transdermal concentrations tended to be good: overall, when self-reported drinking was reported, TAC also detected drinking 65.4% of the time.

Enablers to seeking professional help for psychological distress–a study on Chinese primary care attenders

This study investigated enablers to seeking professional help for psychological distress among Chinese primary care attenders in Hong Kong. Nine focus groups and six individual interviews were conducted among adult patients with/without known distress, significant others of the distressed, and the general public. The identified potential enablers were further investigated in a questionnaire survey with data from 1626 patients. Survey respondents who had sought professional help for distress (n = 231) and those without this experience (n = 1395) showed similar attitudes to the enabler items. However, the first group had more “strongly agree” responses and their top five enablers were: crisis caused by distress, distress affecting daily life, wanting to treat associated physical symptoms, having trust in doctor, and encouragement by family/friends to seek help. Qualitative interviews found that the patients often somatised distress and they felt comfortable to consult for somatic symptoms. There was strong family involvement in help-seeking whereas the doctors were the authoritative figures to convince the patients for treatment. The findings, in line with Western literature, indicate that crisis and interference in daily life due to distress are the top enablers to seeking professional help. The other three key enablers are likely to be influenced by Chinese culture.

Progress on microwave absorption materials with core-shell structure

Microwave absorber is a kind of functional material, which can absorb electromagnetic (EM) wave effectively and then convert EM energy into thermal energy or make EM wave dissipate by interference. The researches of microwave absorbers are important to satisfy the need of electromagnetic interference in daily life and industrial production, also meet the application requirements of stealth technology in military. Nowadays, the rapid increase in the use of telecommunications equipment, digital systems, and fast processors result in the increasing demand for the development of novel high-efficient microwave absorbers with light weight, thin thickness, wide absorption frequency, and strong absorption characteristics. The structures of microwave absorber are found closely related to the absorption properties. In recent years, many research institutions including our research group, found that the core-shell structure has good absorption performance. The core-shell structured nanocomposites, which combined functionalities of cores and shells, show great potential for significant effect on broadening the absorption spectrum and increasing the absorption intensity because of the complex impedance material matching, interface polarization and multi structure interface scattering. For example, the combination of magnetic materials (e.g., Fe3O4, Co, Ni) and dielectric materials (e.g., TiO2, SnO2, carbon nanotubes) in one entity may take advantages of both the magnetic and dielectric materials, which then can be used as high-performance microwave absorbers. It is well known that Fe3O4, which have been widely used as microwave absorbers because of low cost and strong absorption characteristics usually suffer from ease of oxidation at high-tempera- ture and relatively narrow absorption frequency bandwidth at applied frequency range. While, the magnetic nanoparticles encapsulated within carbon-nanotube composites and Fe3O4/TiO2 core/shell nanotubes were found with lower reflection loss and wider absorption frequency range than single-component absorbers. Meanwhile, remarkable progress has been made in the study of the absorbing mechanism of core-shell structure absorbing materials, which is a great contribution to the design of new structures to meet the new demands of absorbing materials. For example, the particle shapes and grain sizes of magnetic absorbents are of importance for high performance microwave absorbing materials, which are well known. However, research into the relationships among microstructure, electromagnetic property, and microwave absorption performance is rarely reported, especially from the influence of microcosmic magnetism distribution on microwave absorption performance is still lacking previously. While, based on the micro-magnetic investigation via electron holography and Lorentz microscopy, the micromagnetic analysis of the absorber provides a series of direct evidences regarding the effect of grain size on the microcosmic magnetic property, which was important for the further comprehension of the microwave absorption mechanism and new insight into the microstructure design strategy. Other researches, which focus on the influence of cores or shells to absorption performance, are also meaningful to absorption mechanism explanation. The development of science and technology has never stopped the demand for high performance microwave absorbing materials. It is still a difficult but meaningful task for absorbers practical applications to design microwave absorption materials with minimal coating thickness, even light weight, ultra-wide bandwidth, stronger absorption and higher heat-resistance characteristics