A macroscopic assessment of porosity and new bone formation on the inferior pars basilaris: Normal growth or an indicator of scurvy?

OBJECTIVES: This research aims to determine the aetiology of porosity and subperiosteal new bone formation on the inferior surface of the pars basilaris. MATERIALS: A total of 199 non-adult individuals aged 36 weeks gestation to 3.5 years, from a total of 12 archaeological sites throughout the UK, including Iron Age (n=43), Roman (n=12), and post-medieval (n=145) sites, with a preserved pars basilaris. METHODS: The pars basilaris was divided into six segments, with porosity (micro and macro) and subperiosteal new bone formation recorded on the inferior surface in scorbutic and non-scorbutic individuals. Scurvy was diagnosed using criteria from the palaeopathological literature that was developed using a biological approach. RESULTS: There was no statistically significant difference in microporosity between scorbutic and non-scorbutic individuals in four out of the six segments analysed. There was a significant negative correlation between age and microporosity in non-scorbutic and scorbutic individuals. A significant difference in subperiosteal new bone formation was observed between scorbutic and non-scorbutic individuals. CONCLUSIONS: Microporosity on the inferior pars basilaris should not be considered among the suite of lesions included in the macroscopic assessment of scurvy in non-adult skeletal remains (less than 3.5 years). SIGNIFICANCE: This study highlights the risk of over diagnosing scurvy in past populations. LIMITATIONS: It is difficult to distinguish between physiological (normal) and pathological (abnormal) bone changes in the skeleton of individuals less than one year of age. SUGGESTIONS FOR FURTHER RESEARCH: Future research should focus on the analysis of individuals over 3.5 years of age.

Mast cell stabilizer ketotifen fumarate reverses inflammatory but not neuropathic-induced mechanical pain in mice.

INTRODUCTION: Mast cell (MC) activation could establish a positive feedback loop that perpetuates inflammation and maintains pain. Stabilizing MCs with ketotifen fumarate (KF) may disrupt this loop and relieve pain. OBJECTIVE: We aimed to test the effect of treatment with KF in pain assays in mice and in a case series of patients with chronic widespread pain. METHODS: The analgesic effect of KF was tested in CD-1 mice injected with formalin, complete Freund's adjuvant, or subjected to spared nerve injury. In addition, wild-type (C57BL/6) and MC-deficient (C57BL/6-Kit W-sh/W-sh) mice were injected with formalin or complete Freund's adjuvant and treated with KF. Patients with chronic widespread pain (n = 5; age: 13-16 years) who failed to respond to standard of care participated in a 16-week treatment trial with KF (6 mg/d). Ketotifen fumarate's therapeutic effect was evaluated using the patient global impression of change. RESULTS: In the mouse experiments, KF produced dose- and MC-dependent analgesic effects against mechanical allodynia in the acute and chronic inflammatory pain but not neuropathic pain assays. In the patient case series, 4 patients reported that activity limitations, symptoms, emotions, and overall quality of life related to their pain condition were "better" or "a great deal better" since beginning treatment with KF. This was accompanied by improvements in pain comorbid symptoms. CONCLUSION: Treatment with KF is capable of reducing established inflammatory-induced mechanical nociception in an MC-dependent manner in mice, and it may be beneficial for the treatment of chronic pain conditions.

Chronic non-cancer pain in children: we have a problem, but also solutions.

Chronic non-cancer pain in children and adolescents has been described as "a modern public health disaster" that has generated significant medical and economic burdens within society. Seen as a disease in its own right, chronic pain has short and long-term consequences that impact not only the patient's health but also that of friends and families, due to significant parenting stress and disruptions in family life and structure. The evidence supporting pharmacological treatments and interventional procedures is limited, and no single strategy has been shown to be completely effective in children with chronic non-cancer pain. Therefore, considering the multifactorial nature of chronic pain, these patients should be treated with a multidisciplinary, balanced approach that seeks a primary outcome of improved functioning rather than of pain reduction. Using a bio-psycho-social approach, a multidisciplinary team, including a physiotherapist, nurse, social worker, psychologist, and physician, has been effective in achieving this outcome of improved functioning in children and adolescents with chronic pain. In this review, we discuss the impact, associated conditions, and evolution of chronic pain, along with the crucial role of every member of a multidisciplinary chronic pain clinic involved in the care of the children and adolescents with chronic non-cancer pain.

Low-income working immigrant families in Quebec: Exploring their challenges to well-being.

OBJECTIVES: To identify low-income working families' health challenges and understand their barriers and facilitators to navigating those challenges. METHODS: We conducted a focused ethnographic study in a food bank in Montreal, Quebec. Using purposeful sampling, we recruited participants who had at least one employed family member and one live-in child. Sensitizing concepts included social determinants of health (SDH) and family strengths. Participant observation, focus groups and in-depth interviews constituted the primary means of data collection. Thematic and contextual analyses were conducted iteratively. RESULTS: We recruited 25 participants, 22 clients (15 women and 7 men with up to 5 children per family) and 3 members of staff. All clients were immigrants, having been in Canada for a range of 2 months to 23 years, thus reflecting the ethnic demography of the site. Families described health as physical, mental and socio-cultural well-being. Challenges to well-being included insufficient finances, non-standard work, hurdles in professional equivalency, isolation, children's acculturation, inadequate access to health care and the Canadian winter. Personal and structural barriers and facilitators to navigating challenges centred on parents' sense of the challenges being finite, control over discrete dimensions of life and hope of children's future success. Families who incorporated these perceptions into their narratives seemed to describe the challenges as navigable. Importantly, the SDH model did not anticipate the degree to which challenges would be defined by immigration factors. CONCLUSION: In order to help low-income working immigrant families face diverse challenges to well-being, community workers and policy-makers must consider the specific challenges of immigration and the importance of individual families' outlooks as they navigate them.

Understanding of visual attention by adult humans (Homo sapiens): a partial replication of Povinelli, Bierschwale, and Cech (1999).

Povinelli, Bierschwale, and Cech (1999) reported that when tested on a visual attention task, the behavior of juvenile chimpanzees did not support a high-level understanding of visual attention. This study replicates their research using adult humans and aims to investigate the validity of their experimental design. Participants were trained to respond to pointing cues given by an experimenter, and then tested on their ability to locate hidden objects from visual cues. Povinelli et al.'s assertion that the generalization of pointing to gaze is indicative of a high-level framework was not supported by our findings: Training improved performance only on initial probe trials when the experimenter's gaze was not directed at the baited cup. Furthermore, participants performed above chance on such trials, the same result exhibited by chimpanzees and used as evidence by Povinelli et al. to support a low-level framework. These findings, together with the high performance of participants in an incongruent condition, in which the experimenter pointed to or gazed at an unbaited container, challenge the validity of their experimental design.