Distal radius fracture is a common injury. The majority of people recover well but a proportion have ongoing pain, stiffness, deformity and functional limitation. Associations between these outcomes, injury characteristics and treatment methods are inconsistent, for example a deformed wrist is not always painful, stiff and functionally limiting. The psychological response to fracture and the role that psychological factors play in recovery are complex and poorly understood. Identification and treatment of those psychological factors that might influence disability and symptom intensity could improve outcomes in this large group of patients. The aim of this thesis is to explore the influence of psychological factors on outcome following fracture of the distal radius. To investigate these relationships further a literature review was carried out looking at the association between psychological factors and outcomes in distal radius fracture patients. Prospective studies were then performed in order to identify associations between demographic factors, injury severity, treatment and psychosocial factors and symptom intensity and disability after fracture and to identify predictors of psychological response to injury. A prospective randomised controlled trail (RCT) was then carried out to compare the impact of an additional psychological workbook intervention versus an information workbook in the otherwise routine management of distal radius fracture. The literature review identified evidence to support the association between psychological factors and outcome after acute injury in general but limited evidence specifically pertaining to distal radius fracture. The first prospective study of 216 patients found psychosocial factors to be more strongly associated with disability (Disability of Arm Shoulder and Hand score, DASH) and pain intensity after distal radius fracture than any injury or treatment factor. The second prospective study of 153 patients found that psychological traits are relatively stable in this cohort and that no demographic, injury or treatment factors were associated with the small changes in psychological scores up to 10 weeks following injury. The RCT demonstrated that use of a psychological workbook did not significantly improve disability six weeks after injury compared to an information workbook in a cohort of patients with distal radius fracture (DASH 38 vs 35, p = 0.949). The importance of psychosocial factors in recovery from distal radius fracture has been demonstrated. Following this injury, psychological factors remain stable over time or fluctuate to a small degree with distinct trends. In cohorts with stable psychological responses to fracture, the individual psychological response cannot be reliably predicted by demographic, injury or treatment factors. Use of a psychological workbook intervention does not improve outcomes in patients with a good initial psychological response to injury. Future work should investigate less psychologically stable and well adapted cohorts, establish how best to identify patients at risk of poor outcome and whether, indeed, these specific groups are amenable to treatment and if so what form this intervention should take. It should address limitations identified in this work, primarily, reduce questionnaire fatigue with more focused psychological questionnaires. Ultimately, it should work towards creating a structure where patients can be screened with a recognised psychological scoring system at initial presentation to fracture clinic and allow a sub-group of psychologically mal-adpted patients to be referred on to a dedicated psychology service, that would work to optimise the psychological conditions for recovery.

<p>Illamående och kräkning är förekommande biverkningar hos patienter med cancer som behandlas med cytostatika och är därmed tillstånd som sjuksköterskan kommer i kontakt med. Om patientens illamående och kräkning inte förebyggs kan det leda till konsekvenser som att patienten blir dehydrerad, tappar aptiten, blir undernärd och försvårar skadad vävnad att återhämta sig från cytostatikabehandling. Trots att de flesta patienter får antiemetika lyckas inte deras illamående och kräkning förebyggas. Syftet var att belysa komplementära behandlingsmetoder vid cytostatikarelaterat illamående och kräkning. Studien är utförd som en litteraturstudie och baserad på 14 vetenskapliga studier. Resultatet visar att komplementära behandlingsmetoder har ett visst vetenskapligt stöd och är ett bra komplement till antiemetika. Akupressur är den behandlingsmetod som är effektivast för att förebygga cytostatikarelaterat illamående och kräkning. Även akustimulation, elektroakupunktur och avslappning minskar patienternas illamående och kräkning. Mer forskning behövs för att ge mer styrka åt de olika komplementära behandlingsmetoder, eftersom sjuksköterskans arbete måste utföras utifrån vetenskap och beprövad erfarenhet. Genom att sjuksköterskan får ökad kunskap om hur cytostatikarelaterat illamående och kräkning förebyggs kan patientens lidande minska.</p>

Illamående och kräkning är förekommande biverkningar hos patienter med cancer som behandlas med cytostatika och är därmed tillstånd som sjuksköterskan kommer i kontakt med. Om patientens illamående och kräkning inte förebyggs kan det leda till konsekvenser som att patienten blir dehydrerad, tappar aptiten, blir undernärd och försvårar skadad vävnad att återhämta sig från cytostatikabehandling. Trots att de flesta patienter får antiemetika lyckas inte deras illamående och kräkning förebyggas. Syftet var att belysa komplementära behandlingsmetoder vid cytostatikarelaterat illamående och kräkning. Studien är utförd som en litteraturstudie och baserad på 14 vetenskapliga studier. Resultatet visar att komplementära behandlingsmetoder har ett visst vetenskapligt stöd och är ett bra komplement till antiemetika. Akupressur är den behandlingsmetod som är effektivast för att förebygga cytostatikarelaterat illamående och kräkning. Även akustimulation, elektroakupunktur och avslappning minskar patienternas illamående och kräkning. Mer forskning behövs för att ge mer styrka åt de olika komplementära behandlingsmetoder, eftersom sjuksköterskans arbete måste utföras utifrån vetenskap och beprövad erfarenhet. Genom att sjuksköterskan får ökad kunskap om hur cytostatikarelaterat illamående och kräkning förebyggs kan patientens lidande minska.

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 105-124). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 105-124). Also available on the Internet.

Background: Chronic pain is a major public health concern in Canada, with an estimated annual cost of $6 billion in direct health care expenses. At the same time, Canadians are participating in an increased use of complementary and alternative medicine (CAM) therapies. Purpose: The purpose of this quantitative research study was to examine the relationship between the use of CAM and HRQOL for individuals living with chronic pain. Method: This study was a secondary data analysis of the nationally representative Canadian Community Health Survey (CCHS) Cycle 3.1 Subsample 1 collected by Statistics Canada in 2005 (n=32,133). Results: The prevalence of CAM use for the Canadian population was 20.9% whereas for the chronic pain subset, it was 30.8%. CAM users had 1.48 times increased odds of reporting a high HRQOL than non-CAM users (CI=1.16-1.88). Conclusion: These results demonstrate that a modest but significant positive association exists between CAM use and a high HRQOL.

Thesis (M.S.)--West Virginia University, 2000. / Title from document title page. Document formatted into pages; contains x, 73 p. Includes abstract. Includes bibliographical references (p. 61-63).

Thesis--University of Oklahoma. / Bibliography: leaves 48-51.

Indiana University-Purdue University Indianapolis (IUPUI) / We have previously demonstrated that disabling the transcription factor Nuclear Matrix Protein 4 (NMP4) improved parathyroid hormone (PTH)-induced trabecular bone gain in ovariectomized (OVX) and healthy mice. Here we evaluated whether loss of Nmp4 enhanced bone restoration in OVX mice under concurrent PTH combination therapies and anti-catabolic mono-therapies. Wild type (WT) and Nmp4-/- mice were OVX at 12wks of age followed by therapy regimens, administered from 16wks-24wks, and included individually or combined PTH, alendronate (ALN), zoledronate (ZOL), and raloxifene (RAL). Generally the PTH+RAL and PTH+ZOL therapies were more effective in restoring bone than the PTH mono-therapy. Loss of Nmp4 further improved the restoration of femoral trabecular bone under these treatments. RAL and ZOL mono-therapies moderately increased bone volume but unexpectedly the Nmp4-/- mice showed an enhanced RAL-induced increase in femoral trabecular bone. Immunohistochemical and flow cytometry analyses of the bone marrow and serum profiling for markers of bone formation and resorption indicated that the heightened osteoanabolism of the Nmp4-/- mice under these diverse osteoporosis treatments was partially attributed to an expansion of the osteoprogenitor pool. To address whether the enhanced bone formation observed in Nmp4-/- mice produced structurally sound tissue, mechanical testing was conducted on the femurs of healthy mice treated with intermittent PTH, RAL mono-therapy, or PTH+RAL. Nmp4-/- femurs showed modestly improved mechanical and material properties. At the cellular level, loss of Nmp4 accelerated mineralization in differentiating mesenchymal stem/progenitor cells (MSPCs). Transcriptomic and biochemical analyses indicated that loss of Nmp4 elevated ribosome biogenesis and expanded the capacity of the endoplasmic reticulum for processing protein. Preliminary data showed that disabling Nmp4 increased both aerobic glycolysis and oxidative phosphorylation in osteoprogenitors, which is an emerging hallmark of anabolic osteogenic cells. Transcriptomic analysis also suggested NMP4 targeted pathways driving bone formation. These included but not limited to BMP, IGF1, TGFβ and Wnt signaling pathways. Finally, transcriptomic profiling revealed that Nmp4-/- MSPCs showed a significant perturbation in numerous immunomodulatory pathways, particularly in the interleukin system. The heightened osteoanabolism of the Nmp4-/- skeleton enhances the effectiveness of diverse osteoporosis treatments, providing a promising target pathway for identifying barriers to pharmacologically-induced bone formation.

With all the improvements in cancer treatments, multidrug resistance is still the major challenge in treating cancer. Cells can develop multidrug resistance (MDR) during or after treatment, which will render the cancer cells resistant not only to the chemotherapy drug being used but also to many other structurally- and mechanically-different chemotherapeutics. In the first project, the main focus was on development of drug resistant cell lines by selection with taxol. Gene changes in the L1T2 cell line after treatment with Taxol was studied. Treatment of L1T2 cells with taxol leads to changes in the expression of ABC transporter proteins, whereas the combination of Taxol with protease inhibitors leads to increased efficacy via inhibition of P-glycoprotein (P-gp). In the second project, we showed that our innovatively-designed Au-loaded poly(lactide-co-glycolic acid) nanoparticles (GPLGA NPs) are able to cross biological barriers and deliver inside the cells without being recognized by the ABC protein transporter. (We focus specifically on P-gp-mediated drug efflux in a model of HEK cell lines.) The concentration of gold was measured using inductively-coupled plasma/mass spectrometry (ICP-MS) after 6- and 24-hour treatment of GPLGA NPs, which did not show significant increase of gold inside the cells in presence of the P-gp inhibitor valspodar. Cancer cells were treated with the GPLGA NPs for 24 hours and then irradiated 5 minutes at 1Wcm-2 using laser settings at 680 or 808 nm. Heat generation in cancer cells, after internalizing GPLGA NPs and laser irradiation, was significant irrespective of laser wavelength. The plasmomic heating response in this in vitro model can be a step closer to overcome MDR. Finally, for the third and last project represented in this dissertation, the focus was on the design and synthesis of innovative, biodegradable PLGA NPs, encapsulated with the platinum(II)-based non-organometallic/non-cyclometalated phosphorescent complex PTA = [Pt(ptp)2], a brightly phosphorescent complex (ptp = square-planar bis[3,5-bis(2-pyridyl)-1,2,4-triazolato]). Size-tunable, emission-polarized phosphorescent PTA-loaded PLGA NPs were synthesized using a single-emulsion, solvent evaporation technique. Photoluminescence characterization shows that PTA-loaded PLGA NPs exhibit strong and stable orange emission with peak maximum ~ 580 nm. The photoluminescence quantum yield (QY) of the synthesized PTA-PLGA NPs was evaluated at ~55%, which allows recording of images with a much better contrast than that with PTA in organic solvents without the PLGA (QY ~0.5% and ~0 emission polarization) or even that with typical fluorescent organic dyes like rhodamines.