Excerpt: To the editor: The authors of the article on chronic prostatitis effectively summarize the practical dilemmas that arise when managing this complex disease.

Still House is a poetry manuscript that explores the relationship between traditional gender roles and traditional poetic forms. The poems in this collections seek to revise the role of the homemaker and interrogate whether it is okay to take comfort and pleasure in tasks that are often labeled as feminine (i.e. cooking, baking, decorating, organizing, shopping, choosing outfits) while rejecting other parts of the homemaker archetype, such as subservience to and dependence upon men. Limited gender roles, patriarchy, sexist comments, capitalism, toxic masculinity, the cis-hetero-white-male gaze, trauma, physical pain, illness—these all can make it feel like we are not fully in control and ownership of our bodies, like something is encroaching. The poems in Still House are invested in using the poetics of embodiment (a poetics centered around telling stories about the body through immersive sensory details) to reclaim the body from trauma, patriarchy, and chronic pain and illness.

In agreement with previous work, adult rats given selective lesions to dopamine (DA)-containing neurons as neonates exhibited a greater behavioral sensitization to repeated phencyclidine (PCP) treatment in comparison to sham-lesioned controls. Acute administration of olanzapine (1-5 mg/kg ip) or clozapine (15 mg/kg ip) decreased sensitized PCP-induced activity in both lesioned and control animals. Acute haloperidol (0.5 mg/kg ip) had no impact on PCP responsiveness in lesioned animals, but significantly antagonized PCP effects in sham-lesioned controls. Ketanserin, a selective 5-HT 2A/5-HT2C-receptor antagonist, significantly reduced PCP activation in both lesioned and control rats, suggesting that the efficacy of atypical antipsychotics against PCP-induced sensitized responses may be mediated by one of the 5-HT2-receptor subtypes. A 6-week chronic regimen of orally administered olanzapine, clozapine, or haloperidol failed to block the sensitization induced by repeated PCP exposure. However, a 10-month oral olanzapine treatment significantly blunted the behavioral sensitization to repeated PCP exposure in lesioned animals, even after withdrawal from chronic olanzapine for more than 3 weeks. A 10-month oral haloperidol treatment had no effect on the sensitization induced by repeated PCP dosing. The persistent effect of chronic olanzapine administration on PCP sensitization may be relevant to the chronic therapeutic efficacy of atypical antipsychotics treating schizophrenia - a clinical syndrome linked to enhanced sensitivity to N-methyl-D-aspartate (NMDA)-receptor antagonists.

Theory and evidence suggests that person-centred models may be especially relevant for elucidating the role of perfectionism in health and well-being in those with chronic health conditions. This may be particularly true for conditions, such as chronic fatigue syndrome (CFS), in which perfectionism is known to play a prominent role in health outcomes. Yet to date no research has taken a person-centred approach to examine how within-person combinations of perfectionistic strivings and perfectionistic concerns are linked to vulnerability for poor health in CFS. The current study compared matched samples of people with CFS and healthy controls (N = 163 each) on measures of stress, depression, and health problems. Consistent with the Stress and Coping Cyclical Amplification Model of Perfectionism in Illness and the tripartite model of perfectionism, within-person combinations of high perfectionistic concerns and strivings had the poorest health profile compared to other within-person combinations, but only among those with CFS. In addition, the perfectionism was indirectly associated with health through stress in those with CFS only. Findings add to a growing evidence base on the utility of person-centred models for understanding the health risks of perfectionism in the context of chronic illness.

Thesis (M. Pharm. (Pharmacology)) -- University of Limpopo, 2021 / Introduction: Zebediela Hospital in Limpopo Province is running an outreach programme as part of its chronic care initiative. In the programme, pharmacy personnel visit the feeder clinics attached to the hospital to dispense chronic medicines to patients. This study aimed at evaluating how this pharmacy chronic care outreach programme is performing, by looking at pharmacy personnel, nursing personnel and patients’ perceptions. Method: A cross-sectional descriptive study was conducted at the six feeder clinics attached to Zebediela Hospital in the Lepelle-Nkumpi municipality of the Capricorn district in Limpopo Province using a quantitative research method. This quantitative research was administered in the form of a survey. Questionnaires were used to collect data from patients, nursing personnel and pharmacy personnel. A total of 399 participants (n=399) took part in the study. The participants included 337 patients from six different clinics, 18 pharmacy personnel and 44 nursing personnel. Data was analysed using the SPSS version 25.0. Results: The pharmacy personnel showed that an allocation of more than three personnel per duty roster sufficed. Regarding transport used by pharmacy personnel when embarking on the Pharmacy Chronic Care Outreach Programme, 71.4% of pharmacy personnel indicated that they always used hospital transport in 83.3% of the cases. The study findings showed that, 71% of patients agreed they were satisfied with the pharmacy times for collecting medicines apart from the fact that 65.6% of patients travelled for more than two hours from their respective homes to their nearest clinic. Sixty eight percent of pharmacy personnel perceived the PCCOP model to be reducing patient waiting time at the clinics. Both the patients and nursing personnel were however not satisfied with the pharmacy personnel’s arrival time at the clinic. The other negative aspect reported was the space problem at the clinics where, 77.8% of pharmacy personnel and 54.5% of nursing personnel reported this as not user-friendly. The patients’ satisfaction levels regarding the PCCOP model for “very satisfied” stood at 64.2% and 0.6% for “very dissatisfied”. Both pharmacy and nursing personnel recommended that the PCCOP model be continued with recommendations towards improving human resources and infrastructure. Conclusion: In conclusion, both pharmacy personnel and nursing personnel showed that the outreach programme was a good initiative in the health system and it benefitted patients. However, the concerns mentioned by patients included long waiting times at the clinic and medicine stock outs. As the results show, the pharmacy chronic care outreach programme should be continued, as long as patients’ complaints can be attended to. Key words: Evaluation, Pharmacy Chronic care Outreach Programme, Zebediela

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京都大学 / 新制・課程博士 / 博士(社会健康医学) / 甲第24536号 / 社医博第128号 / 新制||社医||12(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 近藤 尚己, 教授 西浦 博, 教授 柳田 素子 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

Context: Chronic ankle instability (CAI) individuals experience residual symptoms including pain, swelling, ankle instability, etc. A small majority of CAI individuals report ankle pain during daily or physical activity. Despite the known negative effects of chronic pain on neuromuscular control, there is a paucity of research exploring the specific impact of chronic pain mechanisms on altered neuromuscular control in CAI individuals. Purpose: The purpose of this study was to identify the effects of pain levels on static and dynamic postural control and visual reliance in CAI individuals. Methods: A total of 60 participants were recruited, consisting of 20 CAI individuals with high pain, 20 CAI individuals with low pain, and 20 healthy controls. Participants performed static postural control with eyes open and closed, the star excursion balance test (SEBT), and single-leg hop stabilization. One-way ANOVA assessed differences in Romberg ratios, SEBT, dynamic postural stability index, and self-reported outcomes. Two-way ANOVA (3x2) was used to assess differences in static postural control across the three groups. Results: The high pain group showed decreased mediolateral (ML) direction of static postural stability in eyes closed and a higher Romberg ratio in ML direction compared to the low pain group. The high pain group showed decreased reach distance and increased dynamic postural control in vertical and dynamic postural stability index compared to the healthy control group and low pain group, respectively. Conclusions: The levels of chronic pain can have a significant impact on both static and dynamic postural control and visual reliance in CAI individuals. Therefore, fluctuating chronic pain levels may result in alterations in motor outcomes.