Can induced moods trigger drug-related responses in opiate abuse patients?

This study investigated the ability of four hypnotically induced mood states (euphoria, depression, anxiety, and anger) to trigger craving and other drug-related conditioned responses in detoxified opiate abuse patients. Hypnotically induced depression produced significant increases in drug craving for opiates. Depression also tended to increase global self-ratings of opiate withdrawal. Other trends included increases in self-rated craving by induced anxiety and increases in withdrawal symptoms by induced anger. These results suggest that negative mood states, perhaps in the context of repeated attempts at self-medication, may become conditioned stimuli capable of triggering craving and other drug-related conditioned responses. The ability of depression to produce reliable effects in this particular patient group may reflect the high lifetime prevalence of depression diagnoses for this sample. The implications of these findings for therapeutic strategies are discussed.

Breast cancer survival: a phenomenological inquiry

This inquiry describes the experience of 45 female breast cancer survivors using Schutz's interpretation of phenomenology as the theoretical framework. The research design is a multicase, comparative situational analysis. Breast cancer survival is explored from the points of view of all study participants. A dialectic is formed that juxtaposes etic and emic views of survival to enhance understanding of the meaning of breast cancer survival. Hermeneutic analysis yielded commonalities in meanings, situations, and life experiences. Analysis was further divided into thematic analysis, depiction of exemplars, and paradigm cases to provide clarity and vividness to the multifaceted phenomenon of breast cancer survival.

Accessing primary care Big Data: the development of a software algorithm to explore the rich content of consultation records

OBJECTIVE

To develop a natural language processing software inference algorithm to classify the content of primary care consultations using electronic health record Big Data and subsequently test the algorithm's ability to estimate the prevalence and burden of childhood respiratory illness in primary care.

DESIGN

Algorithm development and validation study. To classify consultations, the algorithm is designed to interrogate clinical narrative entered as free text, diagnostic (Read) codes created and medications prescribed on the day of the consultation.

SETTING

Thirty-six consenting primary care practices from a mixed urban and semirural region of New Zealand. Three independent sets of 1200 child consultation records were randomly extracted from a data set of all general practitioner consultations in participating practices between 1 January 2008-31 December 2013 for children under 18 years of age (n=754,242). Each consultation record within these sets was independently classified by two expert clinicians as respiratory or non-respiratory, and subclassified according to respiratory diagnostic categories to create three 'gold standard' sets of classified records. These three gold standard record sets were used to train, test and validate the algorithm.

OUTCOME MEASURES

Sensitivity, specificity, positive predictive value and F-measure were calculated to illustrate the algorithm's ability to replicate judgements of expert clinicians within the 1200 record gold standard validation set.

RESULTS

The algorithm was able to identify respiratory consultations in the 1200 record validation set with a sensitivity of 0.72 (95% CI 0.67 to 0.78) and a specificity of 0.95 (95% CI 0.93 to 0.98). The positive predictive value of algorithm respiratory classification was 0.93 (95% CI 0.89 to 0.97). The positive predictive value of the algorithm classifying consultations as being related to specific respiratory diagnostic categories ranged from 0.68 (95% CI 0.40 to 1.00; other respiratory conditions) to 0.91 (95% CI 0.79 to 1.00; throat infections).

CONCLUSIONS

A software inference algorithm that uses primary care Big Data can accurately classify the content of clinical consultations. This algorithm will enable accurate estimation of the prevalence of childhood respiratory illness in primary care and resultant service utilisation. The methodology can also be applied to other areas of clinical care.

Multimodal Recruitment to Study Ovulation and Menstruation Health: Internet-Based Survey Pilot Study

BACKGROUND

Multimodal recruitment strategies are a novel way to increase diversity in research populations. However, these methods have not been previously applied to understanding the prevalence of menstrual disorders such as polycystic ovary syndrome.

OBJECTIVE

The purpose of this study was to test the feasibility of recruiting a diverse cohort to complete a web-based survey on ovulation and menstruation health.

METHODS

We conducted the Ovulation and Menstruation Health Pilot Study using a REDCap web-based survey platform. We recruited 200 women from a clinical population, a community fair, and the internet.

RESULTS

We recruited 438 women over 29 weeks between September 2017 and March 2018. After consent and eligibility determination, 345 enrolled, 278 started (clinic: n=43; community fair: n=61; internet: n=174), and 247 completed (clinic: n=28; community fair: n=60; internet: n=159) the survey. Among all participants, the median age was 25.0 (SD 6.0) years, mean BMI was 26.1 kg/m² (SD 6.6), 79.7% (216/271) had a college degree or higher, and 14.6% (37/254) reported a physician diagnosis of polycystic ovary syndrome. Race and ethnicity distributions were 64.7% (176/272) White, 11.8% (32/272) Black/African American, 7.7% (21/272) Latina/Hispanic, and 5.9% (16/272) Asian individuals; 9.9% (27/272) reported more than one race or ethnicity. The highest enrollment of Black/African American individuals was in clinic (17/42, 40.5%) compared to 1.6% (1/61) in the community fair and 8.3% (14/169) using the internet. Survey completion rates were highest among those who were recruited from the internet (159/174, 91.4%) and community fairs (60/61, 98.4%) compared to those recruited in clinic (28/43, 65.1%).

CONCLUSIONS

Multimodal recruitment achieved target recruitment in a short time period and established a racially diverse cohort to study ovulation and menstruation health. There were greater enrollment and completion rates among those recruited via the internet and community fair.

Detection of viruses by electron microscopy: an efficient approach

Wetting of grids is the most important aspect of the detection of viruses by electron microscopy. Carbon or plastic/carbon coated grids used in most electron microscopy laboratories are negatively charged and hydrophobic (Sogo, Portman, Kaufman and Koller, 1975. J. Microsc. 104, 187-198.). Most viruses are negatively charged at pH 6.0-7.0 which does not allow them to adhere effectively to the support film. Viruses are then washed away or form clumps on the grid making detection more difficult. A suitable wetting agent, 0.1% poly-L-lysine hydrobromide (MW 35000) has been used for the detection of plant viruses (Roberts, personal communication). This chemical was used for processing faecal samples from patients with gastroenteritis for electron microscopy. The result showed a significant increase in terms of virus concentration on the grids and an increase in the general detection rate of positive samples. A study was then undertaken comparing the treatment method of grids using faecal samples. The grids were treated and not treated with poly-L-lysine hydrobromide.

Tonsillectomy. A comparative study of dissection/snare vs suction-cautery

In an optimal situation, a surgical procedure would be one that generates minimal post-operative pain, incurs little or no bleeding, and allows the patient to return to their normal daily activities in the shortest time period. A tonsillectomy is one of the most common operations performed in the world. Various surgical procedures for tonsillectomy are performed with a wide array of opinions to support the pros and cons of each technique.

OBJECTIVES/GOALS

To determine if there is a significant difference between two methods of tonsillectomy.

METHODS AND MATERIALS

A prospective single blinded randomized control study using (i) A dissection/snare technique, and (ii) A suction-cautery method. Measured outcomes such as blood loss, surgical time, post-op pain, post-op hydration, pyrexia, and the length of time to resume normal daily activities will be assessed.

RESULTS

In total, 50 patients were studied, 23 in the dissection/snare technique, and 27 in the suction cautery technique. Inclusion criteria was, the patient must be at least 2 years of age and not older than 16 years of age. Data was collected intra-operatively, at 2 and 4 hour post-op intervals, as well as a 2 week follow-up questionnaire completed by the parents.

CONCLUSIONS

The suction cautery group had statistically significant differences in blood loss, surgical time and pain in the immediate post-operative period.