This study evaluated a theoretically and empirically based model of the progression of acute neck and back pain to chronic pain and disability, developed from the literature in chronic pain, ...cognition, and stress and trauma. Clinical information and standardized psychosocial measures of cumulative traumatic events exposure (TLEQ), depressed mood (CES-D), pain (DDS), physical disability (PDI), and pain beliefs (PBPI) were collected at baseline from 84 acute back pain patients followed at an Acute Back Clinic over 3 months. Path analysis was used for the longitudinal prediction of perceived pain and disability. The predictive model accounted for 26% of the variance in persistent pain intensity and 58% of the variance in perceived physical disability at 3 months. Greater exposure to past traumatic life events and depressed mood were most predictive of chronic pain; depressed mood and negative pain beliefs were most predictive of chronic disability. More cumulative traumatic life events, higher levels of depression in the early stages of a new pain episode, and early beliefs that pain may be permanent significantly contribute to increased severity of subsequent pain and disability. Replication in a larger sample is desirable to confirm these paths. Early detection of elevated depressive symptoms and high trauma exposure may identify individuals at greater risk for developing chronic pain syndromes who may benefit from early multidisciplinary intervention.
Hyperarousal, defined as increased levels of cortical activity and cognitive-emotional reactivity induced by stress, is suggested to be a key factor in insomnia. In particularly, pre-sleep arousal ...constitutes one of the major features of insomnia. The Pre-Sleep Arousal Scale is the best-known measure used to evaluate pre-sleep arousal. However, a well-validated Japanese version of the scale (PSAS-J) has not yet been established. The aim of this research was to develop and validate such a scale. A cross-sectional questionnaire-based study was conducted via the internet. In total, 237 of 300 participants (mean age 43.28 ± 11.19 years) completely responded to the questionnaires as followed: the PSAS-J, the Insomnia Severity Index, Ford Insomnia Response to Stress Test, and Dysfunctional Beliefs and Attitudes about Sleep Scale. In addition, the participants were divided into two groups: insomniacs and normal sleepers. As a result, the PSAS-J had a two-factor structure similar to that of the original version, i.e., somatic and cognitive arousal subscales. The internal consistency (α = 0.85 to 0.90) and test-retest reliability (r = 0.67 to 0.78) were high. Correlations between the PSAS-J and the above-mentioned scales ranged from 0.35 to 0.53. Discriminant validity showed that the PSAS-J was distinct from the Ford Insomnia Response to Stress Test and Dysfunctional Beliefs and Attitudes about Sleep Scale. The PSAS-J scores were significantly higher in insomniacs than in normal sleepers. Our results suggest that the PSAS-J has high reliability and validity and that this scale is adequate for assessing pre-sleep arousal.
Heat Shock Proteins are chaperones primary involved in the repair of cellular damages induced by temperature. The harmful effect of temperature on the male gonad is well known, on the contrary ...knowledge on the effects of the environment on semen quality are still insufficient. The aim of this paper was to learn more about the role of HSPs and the environment in modulating the physiology of equine male gonads. We showed a detailed analysis of equine semen characteristic and the expression level of three HSPs (60-70-90) over a one-year period analyzing the effects of temperature and humidity and the correlation among the different variables. We showed also that the interpretation of results depends strongly on the way in which data are assembled and analyzed, therefore we compared results obtained from three different ways of grouping: according to single months, to weather seasons and to mare reproductive periods. Results showed that the expression of the three HSPs is correlated to the environment through temperature and humidity and that it reaches the highest level in the breeding season and in summer. We found also that HSPs expression is correlated to some variables describing the quality of equine semen (concentration) and the kinetic of spermatozoa (total motility-MOT, %, average path velocity -VAP, μm/s- and lateral head displacement -ALH, μm). No correlation was found between HSPs expression and the mitochondrial membrane potential; while viability and HSP90 expression resulted positively correlated. The month-by-month analysis evidenced that in February equine semen has the highest kinetic characteristics (increased linearity –LIN, %-, straightness –STR, % -and average path velocity -VAP, μm/s) with the highest number of motile, progressive motile and rapid cells.
These results may have a great impact in the comprehension of functional aspects of the physiology of equine semen and may have potential implications for breeders who want to understand the period (and/or month) of the year in which equine semen reaches the best characteristics with increased chances for better results in reproductive practice.
•The level of HSP60, 70,90 expressed on equine spermatozoa changes during the year.•In equine spermatozoa, HSPs expression is correlated to environmental temperature.•During the year, HSP60,70,90 expression is correlated to equine semen quality.•In summer and in the breeding season HSPs reach the highest level of expression.
Meta-analyses support the effectiveness of behavioral interventions for the treatment of insomnia, although few have systematically evaluated the relative efficacy of different treatment modalities ...or the relation of old age to sleep outcomes. In this meta-analysis of randomized controlled trials (
k =
23), moderate to large effects of behavioral treatments on subjective sleep outcomes were found. Evaluation of the moderating effects of behavioral intervention type (i.e., cognitive-behavioral treatment, relaxation, behavioral only) revealed similar effects for the 3 treatment modalities. Both middle-aged adults and persons older than 55 years of age showed similar robust improvements in sleep quality, sleep latency, and wakening after sleep onset. A research agenda is recommended to examine the mechanisms of action of behavioral treatments on sleep with increased attention to the high prevalence of insomnia in older individuals.
Objective
Helplessness is a relevant construct in systemic lupus erythematosus (SLE), an
unpredictable chronic illness with no known cure characterized by relapsing and
remitting features. However, ...no measure of helplessness has been validated in this
population. The present study examined the structural validity, reliability, and
convergent validity of the Arthritis Helplessness Index, a measure initially developed
for rheumatoid arthritis populations, in a sample of patients with SLE.
Methods
Patients with SLE (N = 136) receiving medical care at a private
hospital completed the Arthritis Helplessness Index and other self-report measures. The
structural validity of the Arthritis Helplessness Index was examined using confirmatory
factor analysis. Internal consistency reliability was evaluated with Cronbach’s
coefficient alpha. Pearson product–moment correlations were used to examine convergent
validity with measures of depression, anxiety and mastery.
Results
The five-item Arthritis Helplessness Index–Helplessness measure demonstrated a tenable
factor structure (comparative fit index 0.98, root mean square error of approximation
0.06, standardized root mean residual 0.04). Internal consistency reliability was fair
(α = 0.69). Convergent validity was evidenced by significant correlations with measures
of depression, anxiety and mastery.
Conclusion
The five-item Arthritis Helplessness Index–Helplessness scale can confidently be used
as a measure of helplessness in SLE.
Objectives
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that leads to a variety of negative health outcomes resulting from inflammation in various organ systems. Although ...treatment continues to advance, fatigue remains one of the most salient, poorly understood and addressed patient complaints. Understanding the mechanisms of fatigue can help guide the development of interventions to improve health outcomes. The aim of this research was to evaluate the contribution of six variables (disease activity, insomnia, depression, stress, pain and physical health) to fatigue in SLE without concomitant fibromyalgia (FM).
Methods
A total of 116 ethnically diverse, primarily female participants (91%) with SLE, receiving care at university medical centers, completed assessments of disease activity and quality of life outcomes (FACIT-FT, Insomnia Severity Index, Perceived Stress Scale (PSS-4), Pain Inventory, Depression-PHQ-9, and LupusPRO-physical function). All patients met the American College of Rheumatology classification criteria for SLE and did not have a known diagnosis of FM. Multivariate linear and stepwise regression analyses were conducted with fatigue (FACIT-FT) as the dependent variable, and the above six variables as independent variables.
Results
Mean (SD) age was 39.80 (13.87) years; 50% were African American, 21% Caucasian, 13% Hispanic, 9% Asian and 8% other. Mean (SD) FACIT-FT was 20.09 (12.76). Collectively, these six variables explained 57% of the variance in fatigue. In the multivariate model, depression, stress and pain were significantly and independently associated with fatigue, but not disease activity, sleep or physical health. Stress had the largest effect on fatigue (β 0.77, 95% CI 0.17–1.38, p = 0.01), followed by depression (β 0.66, 95% CI 0.21–1.10, p = 0.005). On stepwise regression analysis, only stress, depression and pain were retained in the model, and collectively explained 56% of the variance in fatigue. All three remained independent correlates of fatigue, with the largest contribution being stress (β 0.84, 95% CI 0.27–1.42, p = 0.005), followed by depression (β 0.79, 95% CI 0.44–1.14, p < 0.001) with fatigue.
Conclusion
Stress, depression and pain are the largest independent contributors to fatigue among patients with SLE, without concurrent FM. Disease activity, sleep and physical health were not associated with fatigue. The evaluation of stress, depression and pain needs to be incorporated during assessments and clinical trials of individuals with SLE, especially within fatigue. This stress-depression-fatigue model requires further validation in longitudinal studies and clinical trials.
Significance and innovation:
• Disease activity, sleep, pain, stress, depression, and physical health have been reported individually to be associated with fatigue in lupus. This analysis evaluated the role of each and all of these six variables collectively in fatigue among patients with SLE without a known diagnosis of FM.
• Disease activity, sleep and physical health were not significantly related to fatigue, but depression, stress and pain were.
• The results emphasize the need to evaluate and treat fatigue in individuals with SLE utilizing a biopsychosocial approach, particularly in the realm of clinical trials. Behavioral medicine interventions are shown to be most effective for the treatment of depression, stress and pain.
It is well known that insemination of cryopreserved semen always results in lower fertility when compared with fresh semen, but there is an increased interest and demand for frozen equine semen by ...the major breeder associations because of the utility arising from semen already “on hand” at breeding time. In this article, we report that equine sperm cells express L-type voltage-gated calcium channels; their localization is restricted to sperm neck and to the principal piece of the tail in both fresh and frozen-thawed spermatozoa. We also studied the causes of cryoinjury at the membrane level focusing on the function of L-type calcium channels. We report that in cryopreserved spermatozoa the mean basal value of Ca2+i is higher than that of spermatozoa from fresh semen (447.130 vs. 288.3 nM; P < 0.001) and L-type channels function differently in response to their agonist and antagonist in relation to semen condition (fresh or frozen-thawed). We found that on addition of agonist to the culture medium, the increase in intracellular calcium concentrations (Ca2+i) was greater in frozen semen than in fresh semen (ΔCa2+i = 124.59 vs. 16.04 nM; P < 0.001), whereas after the addition of antagonist the decrease in Ca2+i was lower in frozen semen than in fresh semen (ΔCa2+i = 32.5 vs. 82.5 nM; P < 0.001). In this article, we also discuss the impact of cryopreservation on sperm physiology.
Disturbances of sleep are hypothesized to contribute to pain. However, experimental data are limited to healthy pain-free individuals. This study evaluated the effect of sleep loss during part of the ...night on daytime mood symptoms and pain perceptions in patients with rheumatoid arthritis in comparison with control subjects.
A between-groups laboratory study with assessment of mood symptoms and pain perception before and after partial night sleep deprivation (PSD; awake 23:00 hr to 03:00 hr).
General clinical research center.
Patients with rheumatoid arthritis (n = 27) and volunteer comparison control subjects (n = 27).
Subjective reports of sleep, mood symptoms and pain, polysomnographic assessment of sleep continuity, and subjective and objective assessment of rheumatoid arthritis-specific joint pain.
PSD induced differential increases in self-reported fatigue (P < 0.09), depression (P < 0.04), anxiety (P < 0.04), and pain (P < 0.01) in patients with rheumatoid arthritis compared with responses in control subjects, in whom differential increases of self-reported pain were independent of changes in mood symptoms, subjective sleep quality, and objective measures of sleep fragmentation. In the patients with rheumatoid arthritis, PSD also induced increases in disease-specific activity as indexed by self-reported pain severity (P < 0.01) and number of painful joints (P < 0.02) as well as clinician-rated joint counts (P < 0.03).
This study provides the first evidence of an exaggerated increase in symptoms of mood and pain in patients with rheumatoid arthritis after sleep loss, along with an activation of rheumatoid arthritis-related joint pain. Given the reciprocal relationship between sleep disturbances and pain, clinical management of pain in patients with rheumatoid arthritis should include an increased focus on the prevention and treatment of sleep disturbance in this clinical population.
The neutral beam power into JET can be increased by increasing the neutraliser gas flow (and gas pressure), hence ensuring a higher neutralisation efficiency. This has the potential to increase the ...loading on the ion source backplate due to backstreaming electrons. Measurements of the total backplate power loading due to backstreaming electrons and also the arc discharge are presented for the JET EP2 neutral beam injectors as the neutraliser gas flow rate is varied. The measurements are carried out for normal gas delivery operation and for the gas delivery method (grid gas delivery) that is required for the production of tritium beams at JET. Modelling of the backstreaming electron power load and the power distribution is also carried out and the former is compared to the experimental measurements. The backplate loading is more sensitive to the gas flow rate in the case of grid gas delivery. The measurements and calculations can be used to understand the thermo-mechanical performance of the system to balance the benefit of increased neutral beam power against potential increased fatigue and reduced lifetime of the backplate.
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