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rally offer tangible safety benefits for a wide range of wheelchair-seated drivers in frontal crashes.Background People with substance use disorders (SUD) and co-occurring chronic pain report the use of myriad substances, which is concerning due to the heightened risk of overdose associated with polysubstance use. Identifying malleable factors associated with polysubstance use in this population can inform interventions. In this study, we examined whether two pain processes - pain interference and pain catastrophizing - were associated with polysubstance use. Objectives We examined the cross-sectional associations among self-reported pain interference and catastrophizing and polysubstance use. We also determined if sex and primary SUD moderated these associations. Methods Participants were 236 (36% female) adults receiving inpatient treatment for SUD (58% alcohol use disorder, 42% opioid use disorder) who met criteria for chronic pain. We utilized negative binomial regression to examine associations between pain interference and catastrophizing (focal independent variables) and the number of substances used in the month before treatment (i.e., polysubstance use; outcome). Results Participants used three substances, on average, in the month prior to treatment. Neither pain interference (IRR = 1.05, p = .06) nor pain catastrophizing (IRR = 1.00, p = .37) were associated with polysubstance use. The association between pain interference and polysubstance use was moderated by sex and primary SUD (ps less then 0.01), such that these variables were positively related in men and those with alcohol use disorder. Conclusion Pain interference and catastrophizing were not uniformly associated with polysubstance use, underscoring the need to examine other factors associated with polysubstance use in this population. However, men and those with alcohol use disorder might benefit from interventions targeting pain interference to reduce polysubstance use.Background Neovascularization in the retina and hyperglycaemia-induced oxidative stress are implicated in the pathogenesis of diabetic retinopathy (DR). In this study, we hypothesized that the plasma angiogenic and oxidative stress markers associated with these derangements could aid in the screening of diabetic patients who are at an increased risk of developing retinopathy.Methods This study included normal (n = 148), type2 diabetes without retinopathy (DNR; n = 148), proliferative DR (PDR; n = 74) and non-PDR (NPDR; n = 148) subjects. Plasma concentrations of vascular endothelial growth factor-A (VEGF-A), hypoxia-inducible factor-1α (HIF-1α), matrix metalloproteinase-9 (MMP-9), pigment epithelium-derived factor (PEDF), nitric oxide (NO), soluble receptors for advanced glycation end products (sRAGE), malondialdehyde (MDA) and protein thiols were estimated.Results A statistically significant increase was observed in the plasma concentrations of pro-angiogenic factors and markers of oxidative stress in both retinopathy groups. By contrast, the concentrations of anti-angiogenic factors and antioxidants were decreased significantly in these groups. Receiver operating characteristic analysis indicated that the plasma thresholds of HIF-1α and PEDF can be suitable markers in case of NPDR. However, in PDR, HIF-1α, NO, MMP-9 and PEDF showed high sensitivity and specificity.Conclusions The factors associated with hypoxia, matrix degradation and angiogenic inhibition play a crucial role in predicting DR.Problem Prior studies have reported significant negative attitudes amongst both faculty and residents toward direct observation and feedback. Selleck GW4064 Numerous contributing factors have been identified, including insufficient time for direct observation and feedback, poorly understood purpose, inadequate training, disbelief in the formative intent, inauthentic resident-patient clinical interactions, undermining of resident autonomy, lack of trust between the faculty-resident dyad, and low-quality feedback information that lacks credibility. Strategies are urgently needed to overcome these challenges and more effectively engage faculty and residents in direct observation and feedback. Otherwise, the primary goals of supporting both formative and summative assessment will not be realized and the viability of competency-based medical education will be threatened. Intervention Toward this end, recent studies have recommended numerous strategies to overcome these barriers protected time for direct observation and feedback;, would ask a clarifying question, but then internally discounted the feedback. Lessons Learned Direct observation and structured feedback programs that bundle recent recommendations may overcome many of the challenges identified by previous research. Yet, residents discounted disagreeable feedback, illustrating a significant limitation and the need for other strategies that help residents reconcile conflict between external data and one's self-appraisal.Opioid overdose deaths are a major health issue in Australia and around the world. Programmes to provide opioid consumers with 'take-home' naloxone to reverse overdose exist internationally, but uptake by mainstream health services and consumers remains inconsistent. Researchers have identified a range of important educational, training and logistical impediments to take-home naloxone uptake and distribution, yet they have focused less on the social dynamics that can enhance or limit access, such as stigma. In this article, we also explore impediments to uptake, drawing on qualitative interview data gathered for an Australian research project on take-home naloxone. Mobilising a performative approach to stigma, we argue that overdose and prevention are shaped by the social dynamics of stigma and, as such, responsibility for dealing with overdose, as with take-home naloxone, should also be considered social (i.e. shared among peers, the public, communities and governments). Our interview data illuminate the varcriminalisation, and other ambitious attempts to reduce overdose.This qualitative study aimed to identify common stress beliefs. Undergraduate psychology students (N = 35) completed semi-structured interviews discussing the sensations, causes, purpose, valence, consequences, control, and timeline of stress. Interviews were analysed via double-coded thematic analysis employing a latent, inductive, and realist framework. Five themes (cognition, emotion, physical health, interpersonal relations, and behaviour) and 17 subthemes were identified. Themes and subthemes were validated in a Delphi study of experts in stress research (N = 14). Many of these identified beliefs have not been incorporated into current measures of stress beliefs, suggesting the need for new approaches to measuring this construct.
Homepage: https://www.selleckchem.com/products/gw-4064.html
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