Pain-Coping Traits of Nontraditional Women Athletes: Relevance to Optimal Treatment and Rehabilitation.

CONTEXT: The primary goal of traditional treatment and rehabilitation programs is to safely return athletes to full functional capacity. Nontraditional activities such as rock climbing or rodeo are typically less training structured and coach structured; individualism, self-determination, and autonomy are more prevalent than observed in athletes in National Collegiate Athletic Association (NCAA)-sponsored sports. The limited research available on nontraditional athletes has provided the athletic trainer little insight into the coping skills and adaptations to stressors that these athletes may bring into the clinical setting, especially among the growing number of women participating in these types of activities. A better understanding of the pain-coping traits of nontraditional competitors would enhance insight and triage procedures while heading off potential athlete-related risk factors in the clinical setting. OBJECTIVE: To quantify and compare pain-coping traits among individual-sport women athletes participating in nontraditional versus traditional NCAA-structured competition, with relevance to optimal treatment and rehabilitation. DESIGN: Cross-sectional study. SETTING: Data collected during each participant's respective group meeting before seasonal activity. Participants or Other Participants : A total of 298 athletes involved in either nontraditional, non-NCAA individual sports (n = 152; mean age = 20.2 ± 1.3 years; downhill skiing, martial arts, rock climbing, rodeo, skydiving, telemark skiing) or traditional NCAA sports (n = 146; mean age = 20.3 ± 1.4 years; equestrian, golf, swimming/diving, tennis, track). MAIN OUTCOME MEASURE(S): All participants completed the Sports Inventory for Pain, a sport-specific, self-report instrument that measures pain-coping traits relevant to competition, treatment, and rehabilitation. Trait measures were direct coping, cognitive, catastrophizing, avoidance, body awareness, and total coping response. Data were grouped for analyses by type of athlete (nontraditional, traditional). RESULTS: We found a significant main effect for type of athlete (Wilks' λ F6,291 = 12.922; P = .0001). Nontraditional sport athletes scored lower on direct coping (P = .0001), cognitive (P = .0001), catastrophizing (P = .0001), and total coping response (P = .0001) than traditional athletes. CONCLUSIONS: Women participating in nontraditional individual-sport activity revealed less pronounced pain-coping traits than women participating in more coach-structured, traditional NCAA sports. Sport and medical personnel should consider the type of athlete when prescribing training, treatment, and rehabilitation for optimal performance and return to play.

Potential of milk fatty acid composition to predict diet composition and authenticate feeding systems and altitude origin of European bulk milk.

The aims of this work were to elucidate the potential of using milk fatty acid (FA) concentration to predict cow diet composition and altitude of bulk milk collected in 10 different European countries and to authenticate cow-feeding systems and altitude of the production area using a data set of 1,248 bulk cow milk samples and associated farm records. The predictions based on FA for cow diet composition were excellent for the proportions of fresh herbage [coefficient of determination (R2)=0.81], good for hay, total herbage-derived forages, and total preserved forages (R2>0.73), intermediate for corn silage and grass silage (R2>0.62), and poor for concentrates (R2<0.51) in the cow diet. Milk samples were assigned to groups according to feeding system, level of concentrate supplementation, and altitude origin. Milk FA composition successfully authenticated cow-feeding systems dominated by a main forage (>93% of samples correctly classified), but the presence of mixed diets reduced the discrimination. Altitude prediction reliability was intermediate (R2<0.62). Milk FA composition was not able to authenticate concentrate supplementation level in the diet (<58% of samples correctly classified). Similarly, the altitude origin was not successfully authenticated by milk FA composition (<76% of samples correctly classified). The potential of milk FA composition to authenticate cow feeding was confirmed using a data set representative of the diversity of European production conditions.

Post-pollination barriers and their role in asymmetric hybridization in Rhinanthus (Orobanchaceae).

PREMISE OF THE STUDY: Several barriers against hybrid formation exist, and their combined action can affect the evolutionary outcomes of hybridization. To explain the asymmetrical introgression observed between two bumblebee-pollinated plant species (Rhinanthus angustifolius and R. minor), we focused on post-pollination barriers and ethological isolation of hybrids. METHODS: We studied pollen competition in conspecific and heterospecific crosses on both species and analyzed germination rates of hybrid and pure seeds. We also measured bumblebee visitation rates to hybrids relative to their parents using potted Rhinanthus placed in populations of each parental species. KEY RESULTS: In mixed pollinations, there was a conspecific siring advantage in both species, but no difference in pollen tube growth rates in either cross type. F(1) seeds with a R. angustifolius maternal plant germinated poorly, while those with R. minor as the maternal parent germinated better than pure seeds. Interestingly, bumblebees treated hybrids almost as equal to the background species and more often rejected the nonresident Rhinanthus. In a R. angustifolius background, bumblebees preferred R. angustifolius, but visited hybrids more often than R. minor. In contrast, visitation rates were similar on a R. minor background. CONCLUSIONS: Our results suggest that hybridization rates in Rhinanthus remain low because of several leaky barriers that make R. minor the maternal parent of most F(1) offspring. Preference for R. angustifolius and the equal treatment of F(1) and background species by bumblebees induce a visitation pattern that directs gene flow toward R. angustifolius when this species predominates.

Shared pollinators and pollen transfer dynamics in two hybridizing species, Rhinanthus minor and R. angustifolius.

Gene flow between hybridizing plant species depends strongly on pollinator behaviour, which affects pollen transfer among floral types and reproductive isolation. We examined bumblebee behaviour and pollen transfer between two hybridizing Rhinanthus species that are very similar in ecology and floral traits. The two species, Rhinanthus minor and R. angustifolius, shared similar pollinator guilds and assemblages, but pollinator recruitment and flower visitation rates were higher in R. angustifolius sites, probably because of its higher reward levels and better visibility. When presented with Rhinanthus flowers, bumblebees that previously foraged on R. angustifolius were less prone to visit R. minor inflorescences, while R. minor foragers accepted both species in similar proportions. Although Rhinanthus has been cited as a case of mechanical isolation resulting from interactions between bee behaviour and differences in stigma and anther placement, we found no support for efficient mechanical reproductive isolation. Bumblebees that foraged on R. minor flowers carried more pollen, but pollen placement on their bodies was similar to that of bees that visited R. angustifolius, and cross-specific stigmatic pollen deposition was similar in both directions. However, the asymmetry in pollinator handling time between the two species, due to dissimilar pollen rewards, may have lowered relative heterospecific pollen receipt on R. angustifolius, suggesting that net gene flow resulting from pollen transfer dynamics is more likely towards R. minor, although this effect remains weak and will be most likely counterbalanced by context-based labile pollinator preference.

Correlates of intake of folic acid-containing supplements among pregnant women.

OBJECTIVE: This study describes the timing and correlates of folic acid supplement intake among pregnant women. STUDY DESIGN: Data from 2518 women with estimated delivery dates from 1997 to 2000, collected for the National Birth Defects Prevention Study, a population-based case-control study, were analyzed. Multinomial logistic regression was used to identify correlates of supplement intake. RESULTS: Fifty-three percent of women began taking folic acid supplement during the periconceptional period, 35% during early pregnancy, and 8% during late pregnancy (ie, 3 months before through 1 month after conception, 2-3 months after conception, or more than 3 months after conception, respectively). Women who did not take folic acid supplement periconceptionally tended to be nonwhite, speak Spanish, have low education, be younger than 25 years old, be nulliparous, smoke, have no previous miscarriage and no fertility treatments, begin prenatal care and become aware of their pregnancy after the first trimester, have nonplanned pregnancies, and eat less breakfast cereal. CONCLUSION: This study identifies correlates of folic acid supplement intake, which may contribute to the design of interventions to improve intake during early pregnancy.

Multifactorial interactions involved in linear self-transport distance estimate: a place for time.

As the vestibular system is the only sensory organ whose primary function is self-motion detection, we examined the conditions under which the otoliths, which detect the linear acceleration of the head, could be used to estimate traveled distance. In order to isolate the contribution of the otoliths (with the somatosensory system) from contributions of the visual and motor systems subjects were transported in darkness. We initially hypothesized that self-transport with continuously varying linear velocity should facilitate distance computation by continuously stimulating the otoliths, and that active control of self-motion should also help subjects estimate the distance traveled. However, it was found that the distance covered during self-motion is actually better estimated when transport velocity is quasi-constant. Nevertheless, such estimates strongly depend upon velocity magnitude; subjects show an idiosyncratic preferred self-motion velocity for which distance measurements are most accurate. Furthermore, the active control of self-transport improves estimates of self-motion mainly because the subjects can then adopt a constant velocity, and more precisely their preferred one. It was finally found that subjects mentally count in order to assess their displacement length, and that time perception is indeed disturbed by varying self-motion velocity.

A culture-bound syndrome 'amafufunyana' and a culture-specific event 'ukuthwasa': differentiated by a family history of schizophrenia and other psychiatric disorders.

BACKGROUND: 'Amafufunyana' and 'ukuthwasa' are two culture-specific descriptive terms used by Xhosa traditional healers to explain aberrant behavioral and psychological phenomena. Some overlap between these conditions and schizophrenia (DSM-IV) is apparent. The aim of this study was to determine the extent to which amafufunyana and ukuthwasa were used as cultural explanatory models by traditional healers for DSM-IV-defined schizophrenia and whether there were significant phenomenological differences in schizophrenia symptoms in patients with the diagnosis of amafufunyana rather than ukuthwasa. SAMPLING AND METHODS: Xhosa patients with schizophrenia underwent a structured clinical diagnostic interview (Diagnostic Interview for Genetic Studies). The use of traditional diagnostic and treatment methods was assessed by structured open-ended interviewer-rated questions. The sample was then stratified for the presence/absence of a past/current diagnosis of amafufunyana and/or ukuthwasa. The clinical parameters were compared across groups by means of the chi2 or Student t tests. RESULTS: 247 adult subjects participated in the study. 106 (53%) patients reported a previous diagnosis of amafufunyana, and 9 (4.5%) reported a diagnosis of ukuthwasa. A family history of schizophrenia (p = 0.004) or any psychiatric disorder (p = 0.008) was more common in the ukuthwasa group. Subjects with a primary diagnosis other than amafufunyana or ukuthwasa were more likely to be married (p = 0.004), to have a history of stressor(s) prior to illness onset (p = 0.026), to be from a rural environment (p = 0.007) or to have a history of cannabis abuse/dependency (p = 0.015). CONCLUSION: The culture-bound syndrome amafufunyana and the culture-specific phenomenon of ukuthwasa are both used to explain symptoms in patients with schizophrenia (DSM-IV). Identification of cases as amafufunyana and ukuthwasa may correlate with a distinction between familial and sporadic cases of schizophrenia. Whether the positive connotations associated with ukuthwasa, as opposed to the more negative connotations associated with amafufunyana, hold any implications for the treatment or prognosis of schizophrenia remains to be clarified.

[Acupuncture worth trying in severe tinnitus]. / Akupunktur värt att pröva vid svår tinnitus.

The article consists in a report of a study of 22 patients with disabling tinnitus, performed to elucidate the effects of a 3-month course of acupuncture (15 treatments) on the severity of tinnitus and on quality of life (QOL), as compared with those of individualised physiotherapy. The study was designed as a prospective, randomised, cross-over study with a follow-up period of one year after the final treatment. Treatment effects were evaluated in terms of the patients' VAS (visual analogue scale) ratings and answers to questionnaires, including the NHP (Nottingham Health Profile), regarding the impact of tinnitus on different aspects of QOL. Baseline NHP scores showed tinnitus patients to manifest pronounced depressive characteristics. Acupuncture was found to yield immediate relief, both in terms of loudness and disturbance of the tinnitus, and significant improvement in QOL (NHP) for three months after the conclusion of treatment. Although many patients in the subgroup with concurrent muscle tension reported beneficial effects of individualised physiotherapy, such treatment yielded no significant reduction of tinnitus loudness or disturbance due to tinnitus, and no improvement in NHP scores. In both treatment groups, however, both annoyance due to tinnitus and QOL scores had returned to pretreatment levels at one-year follow-up. Thus, the results suggest tinnitus patients to manifest depressive characteristics, and that acupuncture may yield temporary improvement in terms of tinnitus relief and QOL.

[Anorectal reconstruction by coloperineal anastomosis and dynamic double graciloplasty after abdomino-perineal resection]. / Reconstruction anorectale par anastomose colo-périnéale et double graciloplastie dynamique après amputation abdomino-périnéale.

UNLABELLED: The aim of this study was to assess the technical and functional results of total anorectal reconstruction with double dynamic graciloplasty after abdominoperineal resection (APR). PATIENTS AND METHODS: From May 1995 to December 1996. 10 patients (6 males and 4 females), with a mean age of 54 years (range 39-74), underwent anorectal reconstruction for low rectal adenocarcinoma. All patients had preoperative radiotherapy and six had postoperative chemotherapy. The surgical procedure was performed in three stages: 1) APR, coloperineal anastomosis, double graciloplasty and ileostomy; 2) three months later, implantation of stimulator and leads; 3) after a two-months training period, the stoma was closed. RESULTS: There was no postoperative mortality. Early and late morbidity occurred in 5 patients: 2 colonic fistulas, 1 necrosis of colon, 1 ileostomy prolapse, 1 neosphincter stenosis, 1 sepsis of stimulator. No patient had recurrence of the disease (mean follow-up 16 months), but two patients died at 3 and 8 months, respectively from anorexia and pulmonary embolism. Seven patients were available for evaluation (2 fistula, 1 death). Before training, the resting pressure and the squeeze pressure were 30 and 175 cm H2O respectively. At the time of evaluation, the electrical stimulated pressure was 95 cm H2O. Six of these 7 patients were continent (5 with spontaneous defecation, 1 with enemas) and 1 was incontinent. CONCLUSIONS: Anorectal reconstruction with dynamic graciloplasty can be an alternative to permanent colostomy for selected patients after APR. However, there is a high morbidity and the quality of life of the patients must be evaluated.