Showing papers by "University of Rochester published in 2003"

The Benefits of Being Present: Mindfulness and Its Role in Psychological Well-Being

Abstract: Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced selfawareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress. Many philosophical, spiritual, and psychological traditions emphasize the importance of the quality of consciousness for the maintenance and enhancement of well-being (Wilber, 2000). Despite this, it is easy to overlook the importance of consciousness in human well-being because almost everyone exercises its primary capacities, that is, attention and awareness. Indeed, the relation between qualities of consciousness and well-being has received little empirical attention. One attribute of consciousness that has been much-discussed in relation to well-being is mindfulness. The concept of mindfulness has roots in Buddhist and other contemplative traditions where conscious attention and awareness are actively cultivated. It is most commonly defined as the state of being attentive to and aware of what is taking place in the present. For example, Nyanaponika Thera (1972) called mindfulness “the clear and single-minded awareness of what actually happens to us and in us at the successive moments of perception” (p. 5). Hanh (1976) similarly defined mindfulness as “keeping one’s consciousness alive to the present reality” (p. 11). Recent research has shown that the enhancement of mindfulness through training facilitates a variety of well-being outcomes (e.g., Kabat-Zinn, 1990). To date, however, there has been little work examining this attribute as a naturally occurring characteristic. Recognizing that most everyone has the capacity to attend and to be aware, we nonetheless assume (a) that individuals differ in their propensity or willingness to be aware and to sustain attention to what is occurring in the present and (b) that this mindful capacity varies within persons, because it can be sharpened or dulled by a variety of factors. The intent of the present research is to reliably identify these inter- and intrapersonal variations in mindfulness, establish their relations to other relevant psychological constructs, and demonstrate their importance to a variety of forms of psychological well-being.

Core outcome domains for chronic pain clinical trials: IMMPACT recommendations.

Abstract: Objective. To provide recommendations for the core outcome domains that should be considered by investigators conducting clinical trials of the efficacy and effectiveness of treatments for chronic pain. Development of a core set of outcome domains would facilitate comparison and pooling of d

Osteoblastic cells regulate the haematopoietic stem cell niche

Abstract: Stem cell fate is influenced by specialized microenvironments that remain poorly defined in mammals. To explore the possibility that haematopoietic stem cells derive regulatory information from bone, accounting for the localization of haematopoiesis in bone marrow, we assessed mice that were genetically altered to produce osteoblast-specific, activated PTH/PTHrP receptors (PPRs). Here we show that PPR-stimulated osteoblastic cells that are increased in number produce high levels of the Notch ligand jagged 1 and support an increase in the number of haematopoietic stem cells with evidence of Notch1 activation in vivo. Furthermore, ligand-dependent activation of PPR with parathyroid hormone (PTH) increased the number of osteoblasts in stromal cultures, and augmented ex vivo primitive haematopoietic cell growth that was abrogated by gamma-secretase inhibition of Notch activation. An increase in the number of stem cells was observed in wild-type animals after PTH injection, and survival after bone marrow transplantation was markedly improved. Therefore, osteoblastic cells are a regulatory component of the haematopoietic stem cell niche in vivo that influences stem cell function through Notch activation. Niche constituent cells or signalling pathways provide pharmacological targets with therapeutic potential for stem-cell-based therapies.

Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994.

Abstract: Background In adults the metabolic syndrome imposes a substantial risk for type 2 diabetes mellitus and premature coronary heart disease. Even so, no national estimate is currently available of the prevalence of this syndrome in adolescents. Objective To estimate the prevalence and distribution of a metabolic syndrome among adolescents in the United States. Design and Setting Analyses of cross-sectional data obtained from the Third National Health and Nutrition Examination Survey (1988-1994), which was administered to a representative sample of the noninstitutionalized civilian population of the United States. Participants Male and female respondents aged 12 to 19 years (n = 2430). Main Outcome Measures The prevalence and distribution of a metabolic syndrome among US adolescents, using the National Cholesterol Education Program (Adult Treatment Panel III) definition modified for age. Results The overall prevalence of the metabolic syndrome among adolescents aged 12 to 19 years was 4.2%; 6.1% of males and 2.1% of females were affected ( P = .01). The syndrome was present in 28.7% of overweight adolescents (body mass index [BMI], ≥95th percentile) compared with 6.8% of at-risk adolescents (BMI, 85th to P Conclusions Perhaps 4% of adolescents and nearly 30% of overweight adolescents in the United States meet these criteria for a metabolic syndrome, a constellation of metabolic derangements associated with obesity. These findings may have significant implications for both public health and clinical interventions directed at this high-risk group of mostly overweight young people.

Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis.

Abstract: Providing care for a frail older adult has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. In this meta-analysis, the authors integrated findings from 84 articles on differences between caregivers and noncaregivers in perceived stress, depression, general subjective well-being, physical health, and self-efficacy. The largest differences were found with regard to depression (g = .58), stress (g = .55), self-efficacy (g = .54), and general subjective well-being (g = -.40). Differences in the levels of physical health in favor of noncaregivers were statistically significant, but small (g = .18). However, larger differences were found between dementia caregivers and noncaregivers than between heterogeneous samples of caregivers and noncaregivers. Differences were also influenced by the quality of the study, relationship of caregiver to the care recipient, gender, and mean age of caregivers.

Action video game modifies visual selective attention

Abstract: As video-game playing has become a ubiquitous activity in today's society, it is worth considering its potential consequences on perceptual and motor skills. It is well known that exposing an organism to an altered visual environment often results in modification of the visual system of the organism. The field of perceptual learning provides many examples of training-induced increases in performance. But perceptual learning, when it occurs, tends to be specific to the trained task; that is, generalization to new tasks is rarely found. Here we show, by contrast, that action-video-game playing is capable of altering a range of visual skills. Four experiments establish changes in different aspects of visual attention in habitual video-game players as compared with non-video-game players. In a fifth experiment, non-players trained on an action video game show marked improvement from their pre-training abilities, thereby establishing the role of playing in this effect.

Searching for the structure of coping: a review and critique of category systems for classifying ways of coping.

Abstract: From analyzing 100 assessments of coping, the authors critiqued strategies and identified best practices for constructing category systems. From current systems, a list of 400 ways of coping was compiled. For constructing lower order categories, the authors concluded that confirmatory factor analysis should replace the 2 most common strategies (exploratory factor analysis and rational sorting). For higher order categories, they recommend that the 3 most common distinctions (problem- vs. emotion-focused, approach vs. avoidance, and cognitive vs. behavioral) no longer be used. Instead, the authors recommend hierarchical systems of action types (e.g., proximity seeking, accommodation). From analysis of 6 such systems, 13 potential core families of coping were identified. Future steps involve deciding how to organize these families, using their functional homogeneity and distinctiveness, and especially their links to adaptive processes.

Decline in Invasive Pneumococcal Disease after the Introduction of Protein–Polysaccharide Conjugate Vaccine

Abstract: Background In early 2000, a protein–polysaccharide conjugate vaccine targeting seven pneumococcal serotypes was licensed in the United States for use in young children. Methods We examined population-based data from the Active Bacterial Core Surveillance of the Centers for Disease Control and Prevention to evaluate changes in the burden of invasive disease, defined by isolation of Streptococcus pneumoniae from a normally sterile site. Serotyping and susceptibility testing of isolates were performed. We assessed trends using data from seven geographic areas with continuous participation from 1998 through 2001 (population, 16 million). Results The rate of invasive disease dropped from an average of 24.3 cases per 100,000 persons in 1998 and 1999 to 17.3 per 100,000 in 2001. The largest decline was in children under two years of age. In this group, the rate of disease was 69 percent lower in 2001 than the base-line rate (59.0 cases per 100,000 vs. 188.0 per 100,000, P<0.001); the rate of disease caused by va...

Intellectual Impairment in Children with Blood Lead Concentrations below 10 μg per Deciliter

Abstract: background Despite dramatic declines in children’s blood lead concentrations and a lowering of the Centers for Disease Control and Prevention’s level of concern to 10 µg per deciliter (0.483 µmol per liter), little is known about children’s neurobehavioral functioning at lead concentrations below this level. methods We measured blood lead concentrations in 172 children at 6, 12, 18, 24, 36, 48, and 60 months of age and administered the Stanford–Binet Intelligence Scale at the ages of 3 and 5 years. The relation between IQ and blood lead concentration was estimated with the use of linear and nonlinear mixed models, with adjustment for maternal IQ, quality of the home environment, and other potential confounders. results The blood lead concentration was inversely and significantly associated with IQ. In the linear model, each increase of 10 µg per deciliter in the lifetime average blood lead concentration was associated with a 4.6-point decrease in IQ (P=0.004), whereas for the subsample of 101 children whose maximal lead concentrations remained below 10 µg per deciliter, the change in IQ associated with a given change in lead concentration was greater. When estimated in a nonlinear model with the full sample, IQ declined by 7.4 points as lifetime average blood lead concentrations increased from 1 to 10 µg per deciliter. conclusions Blood lead concentrations, even those below 10 µg per deciliter, are inversely associated with children’s IQ scores at three and five years of age, and associated declines in IQ are greater at these concentrations than at higher concentrations. These findings suggest that more U.S. children may be adversely affected by environmental lead than previously estimated.

Conservatism in Accounting Part I: Explanations and Implications

Abstract: This paper is the first in a two‐part series on conservatism in accounting. Part I examines alternative explanations for conservatism in accounting and their implications for accounting regulators....

The toxicology of mercury--current exposures and clinical manifestations.

Abstract: ercury has been used commercially and medically for centuries. In the past it was a common constituent of many medications. It is still used in hospitals in thermometers and blood-pressure cuffs and commercially in batteries, switches, and fluorescent light bulbs. Large quantities of metallic mercury are employed as electrodes in the electrolytic production of chlorine and sodium hydroxide from saline. These uses still give rise to accidental and occupational exposures. 1 Today, however, exposure of the general population comes from three major sources: fish consumption, dental amalgams, and vaccines. Each has its own characteristic form of mercury and distinctive toxicologic profile and clinical symptoms. Dental amalgams emit mercury vapor that is inhaled and absorbed into the bloodstream. Dentists and anyone with an amalgam filling are exposed to this form of mercury. Liquid metallic mercury (quicksilver) still finds its way into homes, causing a risk of poisoning from the vapor and creating major cleanup costs. Humans are also exposed to two distinct but related organic forms, methyl mercury (CH 3 Hg + ) and ethyl mercury (CH 3 CH 2 Hg + ). Fish are the main if not the only source of methyl mercury, since it is no longer used as a fungicide. In many countries, babies are exposed to ethyl mercury through vaccination, since this form is the active ingredient of the preservative thimerosal used in vaccines. Whereas removal of certain forms of mercury, such as that in blood-pressure cuffs, will not cause increased health risks, removal of each of the three major sources described in this article entails health risks and thus poses a dilemma to the health professional. Exposure to mercury from dental amalgams and fish consumption has been a concern for decades, but the possible risk associated with thimerosal is a much newer concern. These fears have been heightened by a recent recommendation by the Environmental Protection Agency (EPA) that the allowable or safe daily intake of methyl mercury be reduced from 0.5 µg of mercury per kilogram of body weight per day, the threshold established by the World Health Organization in 1978, 2 to 0.1 µg of mercury per kilogram per day. 3 Table 1 summarizes the clinical toxicologic features of mercury vapor and methyl and ethyl mercury. It also includes data on inorganic divalent mercury, since this is believed to be the toxic species produced in tissues after inhalation of the vapor. 5 It is also responsible for kidney damage after exposure to ethyl mercury, since ethyl mercury is rapidly converted to the inorganic form. 13 Inorganic mercury as both mercuric and mercurous salts was also the chief cause of acrodynia, a childhood disease that is now mainly of historical interest. 14 The clinical symptoms of acrodynia consist of painful, red, swollen fingers and toes in association with photophobia, irritability, asthenia, and hypertension. It is believed to be a hypersensitivity reaction. m

Biology of wolbachia

Abstract: ▪ Abstract Wolbachia are a common and widespread group of bacteria found in reproductive tissues of arthropods. These bacteria are transmitted through the cytoplasm of eggs and have evolved various mechanisms for manipulating reproduction of their hosts, including induction of reproductive incompatibility, pathenogenesis, and feminization. Wolbachia are also transmitted horizontally between arthropod species. Significant recent advances have been made in the study of these interesting microorganisms. In this paper, Wolbachia biology is reviewed, including their phylogeny and distribution, mechanisms of action, population biology and evolution, and biological control implications. Potential directions for future research are also discussed.

Regulation of signaling protein function and trafficking by the hsp90/hsp70-based chaperone machinery.

Abstract: Nearly 100 proteins are known to be regulated by hsp90. Most of these substrates or "client proteins" are involved in signal transduction, and they are brought into complex with hsp90 by a multiprotein hsp90/hsp70-based chaperone machinery. In addition to binding substrate proteins at the chaperone site(s), hsp90 binds cofactors at other sites that are part of the heterocomplex assembly machinery as well as immunophilins that connect assembled substrate*hsp90 complexes to protein-trafficking systems. In the 5 years since we last reviewed this subject, much has been learned about hsp90 structure, nucleotide-binding, and cochaperone interactions; the most important concept is that ATP hydrolysis by an intrinsic ATPase activity results in a conformational change in hsp90 that is required to induce conformational change in a substrate protein. The conformational change induced in steroid receptors is an opening of the steroid-binding cleft so that it can be accessed by steroid. We have now developed a minimal system of five purified proteins-hsp90, hsp70, Hop, hsp40, and p23- that assembles stable receptor*hsp90 heterocomplexes. An hsp90*Hop*hsp70*hsp40 complex opens the cleft in an ATP-dependent process to produce a receptor*hsp90 heterocomplex with hsp90 in its ATP-bound conformation, and p23 then interacts with the hsp90 to stabilize the complex. Stepwise assembly experiments have shown that hsp70 and hsp40 first interact with the receptor in an ATP-dependent reaction to produce a receptor*hsp70*hsp40 complex that is "primed" to be activated to the steroid-binding state in a second ATP-dependent step with hsp90, Hop, and p23. Successful use of the five-protein system with other substrates indicates that it can assemble signal protein*hsp90 heterocomplexes whether the substrate is a receptor, a protein kinase, or a transcription factor. This purified system should facilitate understanding of how eukaryotic hsp70 and hsp90 work together as essential components of a process that alters the conformations of substrate proteins to states that respond in signal transduction.

Cumulative Advantage/Disadvantage and the Life Course: Cross-Fertilizing Age and Social Science Theory

Abstract: Age and cumulative advantage/disadvantage theory have obvious logical, theoretical, and empirical connections, because both are inherently and irreducibly related to the passage of time. Over the past 15 years, these connections have resulted in the elaboration and application of the cumulative advantage-disadvantage perspective in social gerontology, especially in relation to issues of heterogeneity and inequality. However, its theoretical origins, connections, and implications are not widely understood. This article reviews the genesis of the cumulative advantage/disadvantage perspective in studies of science, its initial articulation with structural-functionalism, and its expanding importance for gerontology. It discusses its intellectual relevance for several other established theoretical paradigms in sociology, psychology, and economics. On the basis of issues deriving from these perspectives and from the accumulating body of work on cumulative advantage and disadvantage, I identify several promising directions for further research in gerontology.

Advances in Neuropathic Pain: Diagnosis, Mechanisms, and Treatment Recommendations

Abstract: Chronic neuropathic pain, caused by lesions in the peripheral or central nervous system, comes in many forms. We describe current approaches to the diagnosis and assessment of neuropathic pain and discuss the results of recent research on its pathophysiologic mechanisms. Randomized controlled clinical trials of gabapentin, the 5% lidocaine patch, opioid analgesics, tramadol hydrochloride, and tricyclic antidepressants provide an evidence-based approach to the treatment of neuropathic pain, and specific recommendations are presented for use of these medications. Continued progress in basic and clinical research on the pathophysiologic mechanisms of neuropathic pain may make it possible to predict effective treatments for individual patients by application of a pain mechanism–based approach.

Differentiating autonomy from individualism and independence: A self-determination theory perspective on internalization of cultural orientations and well-being.

Abstract: On the basis of self-determination theory (R. M. Ryan & E. L. Deci, 2000) and cultural descriptions drawn from H. C. Triandis (1995), the authors hypothesized that (a) individuals from different cultures internalize different cultural practices; (b) despite these differences, the relative autonomy of individuals' motivation for those practices predicts well-being in all 4 cultures examined; and (c) horizontal practices are more readily internalized than vertical practices across all samples. Five hundred fifty-nine persons from South Korea, Russia, Turkey and the United States participated. Results supported the hypothesized relations between autonomy and well-being across cultures and gender. Results also suggested greater internalization of horizontal relative to vertical practices. Discussion focuses on the distinction between autonomy and individualism and the relative fit of cultural forms with basic psychological needs.

Software transactional memory for dynamic-sized data structures

Abstract: We propose a new form of software transactional memory (STM) designed to support dynamic-sized data structures, and we describe a novel non-blocking implementation. The non-blocking property we consider is obstruction-freedom. Obstruction-freedom is weaker than lock-freedom; as a result, it admits substantially simpler and more efficient implementations. A novel feature of our obstruction-free STM implementation is its use of modular contention managers to ensure progress in practice. We illustrate the utility of our dynamic STM with a straightforward implementation of an obstruction-free red-black tree, thereby demonstrating a sophisticated non-blocking dynamic data structure that would be difficult to implement by other means. We also present the results of simple preliminary performance experiments that demonstrate that an "early release" feature of our STM is useful for reducing contention, and that our STM lends itself to the effective use of modular contention managers.

Measures of abstinence in clinical trials: issues and recommendations.

Abstract: A workgroup formed by the Society for Research on Nicotine and Tobacco reviewed the literature on abstinence measures used in trials of smoking cessation interventions. We recommend that trials report multiple measures of abstinence. However, at a minimum we recommend that trial: (a) report prolonged abstinence (i.e., sustained abstinence after an initial period in which smoking is not counted as a failure) as the preferred measure, plus point prevalence as a secondary measure; (b) use 7 consecutive days of smoking or smoking on > or = 1 day of 2 consecutive weeks to define treatment failure; (c) include non-cigarette tobacco use, but not nicotine medications in definitions of failure; and (d) report results from survival analysis to describe outcomes more fully. Trials of smokers willing to set a quit date should tie all follow-ups to the quit date and report 6- and/or 12-month abstinence rates. For these trials, we recommend an initial 2-week grace period for prolonged abstinence definitions; however, the period may vary, depending on the presumed mechanism of the treatment. Trials of smokers who may not be currently trying to quit should tie follow-up to the initiation of the intervention and should report a prolonged abstinence measure of > or = 6-month duration and point prevalence rates at 6- and 12-month follow-ups. The grace period for these trials will depend on the time necessary for treatment dissemination, which will vary depending on the treatment, setting, and population. Trials that use short-term follow-ups ( or = 4 weeks. We again recommend a 2-week grace period; however, that period can vary.

Molecular Diagnosis of Primary Mediastinal B Cell Lymphoma Identifies a Clinically Favorable Subgroup of Diffuse Large B Cell Lymphoma Related to Hodgkin Lymphoma

Abstract: Using current diagnostic criteria, primary mediastinal B cell lymphoma (PMBL) cannot be distinguished from other types of diffuse large B cell lymphoma (DLBCL) reliably. We used gene expression profiling to develop a more precise molecular diagnosis of PMBL. PMBL patients were considerably younger than other DLBCL patients, and their lymphomas frequently involved other thoracic structures but not extrathoracic sites typical of other DLBCLs. PMBL patients had a relatively favorable clinical outcome, with a 5-yr survival rate of 64% compared with 46% for other DLBCL patients. Gene expression profiling strongly supported a relationship between PMBL and Hodgkin lymphoma: over one third of the genes that were more highly expressed in PMBL than in other DLBCLs were also characteristically expressed in Hodgkin lymphoma cells. PDL2, which encodes a regulator of T cell activation, was the gene that best discriminated PMBL from other DLBCLs and was also highly expressed in Hodgkin lymphoma cells. The genomic loci for PDL2 and several neighboring genes were amplified in over half of the PMBLs and in Hodgkin lymphoma cell lines. The molecular diagnosis of PMBL should significantly aid in the development of therapies tailored to this clinically and pathogenetically distinctive subgroup of DLBCL.

Associations of Stressors and Uplifts of Caregiving With Caregiver Burden and Depressive Mood: A Meta-Analysis

Abstract: In the present meta-analysis, we integrated findings from 228 studies on the association of six caregiving-related stressors and caregiving uplifts with burden and depressed mood. Care recipients' behavior problems showed stronger associations with caregiver outcomes than other stressors did. The size of the relationships varied by sample characteristics: Amount of care provided and care receivers' physical impairments were less strongly related to burden and depression for dementia caregivers than for caregivers of nondemented older adults. For spouse caregivers, physical impairments and care recipients' behavior problems had a stronger relationship to burden than for adult children. Furthermore, we found evidence that the association of caregiver burden with the number of caregiving tasks, perceived uplifts of caregiving, and the level of physical impairment of the care receiver were stronger in probability samples than in convenience samples.

Automatic soccer video analysis and summarization

Abstract: We propose a fully automatic and computationally efficient framework for analysis and summarization of soccer videos using cinematic and object-based features. The proposed framework includes some novel low-level processing algorithms, such as dominant color region detection, robust shot boundary detection, and shot classification, as well as some higher-level algorithms for goal detection, referee detection, and penalty-box detection. The system can output three types of summaries: i) all slow-motion segments in a game; ii) all goals in a game; iii) slow-motion segments classified according to object-based features. The first two types of summaries are based on cinematic features only for speedy processing, while the summaries of the last type contain higher-level semantics. The proposed framework is efficient, effective, and robust. It is efficient in the sense that there is no need to compute object-based features when cinematic features are sufficient for the detection of certain events, e.g., goals in soccer. It is effective in the sense that the framework can also employ object-based features when needed to increase accuracy (at the expense of more computation). The efficiency, effectiveness, and robustness of the proposed framework are demonstrated over a large data set, consisting of more than 13 hours of soccer video, captured in different countries and under different conditions.

Microarray analysis of Pseudomonas aeruginosa quorum-sensing regulons: Effects of growth phase and environment

Abstract: Bacterial communication via quorum sensing (QS) has been reported to be important in the production of virulence factors, antibiotic sensitivity, and biofilm development. Two QS systems, known as the las and rhl systems, have been identified previously in the opportunistic pathogen Pseudomonas aeruginosa. High-density oligonucleotide microarrays for the P. aeruginosa PAO1 genome were used to investigate global gene expression patterns modulated by QS regulons. In the initial experiments we focused on identifying las and/or rhl QS-regulated genes using a QS signal generation-deficient mutant (PAO-JP2) that was cultured with and without added exogenous autoinducers [N-(3-oxododecanoyl) homoserine lactone and N-butyryl homoserine lactone]. Conservatively, 616 genes showed statistically significant differential expression (P ≤ 0.05) in response to the exogenous autoinducers and were classified as QS regulated. A total of 244 genes were identified as being QS regulated at the mid-logarithmic phase, and 450 genes were identified as being QS regulated at the early stationary phase. Most of the previously reported QS-promoted genes were confirmed, and a large number of additional QS-promoted genes were identified. Importantly, 222 genes were identified as being QS repressed. Environmental factors, such as medium composition and oxygen availability, eliminated detection of transcripts of many genes that were identified as being QS regulated.

Autonomy support and need satisfaction in the motivation and well-being of gymnasts.

Abstract: This study examined the effects of young athletes’ perceptions of support from coaches and parents on their need satisfaction, motivation, and well-being. Using the framework of selfdetermination theory (Ryan & Deci, 2000b), a 4-week diary study of 33 female gymnasts from the northeastern U.S. was conducted that examined (a) the relations of perceived parent and coach supports to the athlete’s enduring and daily motivation and need satisfaction and (b) how daily motivation and psychological need satisfaction during practice affects athletes’ well-being. Results obtained using hierarchical linear modeling (HLM) revealed that, as predicted, daily motivation predicted pre-practice well-being, and that changes in well-being from pre- to post-practice varied systematically with the need satisfaction experienced during practice. Discussion highlights the importance of adult supports for adolescent sport participants to ensure need satisfaction, and the advantages of diary methodologies in sport research.

Pregabalin for the treatment of postherpetic neuralgia A randomized, placebo-controlled trial

Abstract: Objective: To evaluate the efficacy and safety of pregabalin in the treatment of postherpetic neuralgia (PHN). Methods: The authors conducted a multicenter, parallel-group, double-blind, placebo-controlled, 8-week, randomized clinical trial in PHN, defined as pain for 3 or more months following herpes zoster rash healing. Patients (n = 173) were randomized to treatment with pregabalin or placebo. Patients randomized to pregabalin received either 600 mg/day (creatinine clearance > 60 mL/min) or 300 mg/day (creatinine clearance 30 to 60 mL/min). The primary efficacy measure was the mean of the last seven daily pain ratings. Secondary endpoints included additional pain ratings, sleep interference, quality of life, mood, and patient and clinician ratings of global improvement. Results: Pregabalin-treated patients had greater decreases in pain than patients treated with placebo (endpoint mean scores 3.60 vs 5.29, p = 0.0001). Pain was significantly reduced in the pregabalin-treated patients after the first full day of treatment and throughout the study, and significant improvement on the McGill Pain Questionnaire total, sensory, and affective pain scores was also found. The proportions of patients with ≥30% and ≥50% decreases in mean pain scores were greater in the pregabalin than in the placebo group (63% vs 25% and 50% vs 20%, p = 0.001). Sleep also improved in patients treated with pregabalin compared to placebo ( p = 0.0001). Both patients and clinicians were more likely to report global improvement with pregabalin than placebo ( p = 0.001). Given the maximal dosage studied, pregabalin had acceptable tolerability compared to placebo despite a greater incidence of side effects, which were generally mild to moderate in intensity. Conclusions: Treatment of PHN with pregabalin is safe, efficacious in relieving pain and sleep interference, and associated with greater global improvement than treatment with placebo.