Effects of Storage Duration and Structures on Sesame Seed Germination, Mold Growth, and Mycotoxin Accumulation.

Sesame is an important oil crop for the Ethiopian economy. However, the lack of adequate storage facilities results in significant losses of sesame seeds. This study was designed to compare the effects of storage conditions and the subsequent impact on sesame seed germination, mold growth, and mycotoxin accumulation over the storage period. The efficacy of two hermetic bags (1. Purdue Improved Crop Storage (PICS) bags and 2. Super GrainPro (SGP) bags) was directly compared to sesame storage in polypropylene (PP bags) and Jute bags. Storage conditions (oxygen, carbon dioxide, temperature, moisture content and relative humidity) of samples were analyzed in the laboratory in three replicates. Results showed that the oxygen concentrations dropped to 6.9% (±0.02) in PICS bags and 8.7% (±0.06) in SGP bags at the end of 6 months of storage. In non-hermetic bags Jute and PP), oxygen levels were close to atmospheric levels at 2-, 4-, and 6-month storage periods. In non-hermetic bags throughout storage, the amount of seed infection by mold constantly increased, and seed germination decreased. Sesame seeds stored in hermetic bags had 89.7% (±0.58) to 88.3% (±2.89) germination rates versus 61.67% (±2.08) for non-hermetic storage bags over the 6-month seed storage period. All mycotoxin levels increased over the same storage period, whereas comparative levels were much lower in hermetic bags after six months. Sesame seeds stored in both hermetic bags had the lowest level of tested mycotoxins, and levels among the SGP and PICS bags were not significantly different from one another. This study provides strong evidence indicating that hermetic storage structures such as PICS and SGP significantly affect temperature, humidity, moisture content, CO2 and oxygen levels resulting in the lowering of fungal growth and mycotoxin accumulation and effectively preserving stored sesame without relying on synthetic pesticides in Ethiopia.

The Influence of Weather on the Occurrence of Aflatoxin B1 in Harvested Maize from Kenya and Tanzania.

A study was conducted using maize samples collected from different agroecological zones of Kenya (n = 471) and Tanzania (n = 100) during the 2013 maize harvest season to estimate a relationship between aflatoxin B1 concentration and occurrence with weather conditions during the growing season. The toxins were analysed by the ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method. Aflatoxin B1 incidence ranged between 0-100% of samples in different regions with an average value of 29.4% and aflatoxin concentrations of up to 6075 µg/kg recorded in one sample. Several regression techniques were explored. Random forests achieved the highest overall accuracy of 80%, while the accuracy of a logistic regression model was 65%. Low rainfall occurring during the early stage of the maize plant maturing combined with high temperatures leading up to full maturity provide warning signs of aflatoxin contamination. Risk maps for the two countries for the 2013 season were generated using both random forests and logistic regression models.

Predictors of short and long term outcome in patellofemoral pain syndrome: a prospective longitudinal study.

BACKGROUND: Patellofemoral pain syndrome (PFP) is a common musculoskeletal condition that has a tendency to become chronic and problematic in a proportion of affected individuals. The objective of this study was to identify prognostic factors that may have clinical utility in predicting poor outcome on measures of pain and function in individuals with PFP. METHODS: A prospective follow-up study was conducted of 179 participants in a randomised clinical trial. Nine baseline factors (age, gender, body mass index, arch height, duration of knee pain, worst pain visual analogue scale, Kujala Patellofemoral Score (KPS), functional index questionnaire (FIQ), step down repetitions) were investigated for their prognostic ability on outcome assessed at six, 12 and 52 weeks (worst pain, KPS and FIQ). Factors with significant univariate associations were entered into multivariate linear regression models to identify a group of factors independently associated with poor outcome. RESULTS: Long symptom duration was the most consistent predictor of poor outcome over 52 weeks rated on the KPS and the FIQ (beta-0.07, 95% confidence interval -0.1 to -0.03, p < 0.000; and -0.02, -0.03 to -0.01, p < 0.000, respectively). Worse KPS at baseline was predictive of outcome at six, 12 and 52 weeks. Gender, body mass index and arch height were generally not associated with outcome (univariate analysis), while age, worst pain, FIQ and step downs were excluded during multivariate analyses. CONCLUSIONS: Patients presenting with PFP of long duration who score worse on the KPS have a poorer prognosis, irrespective of age, gender and morphometry. These results suggest that strategies aimed at preventing chronicity of more severe PFP may optimise prognosis.

Daily mapping of Australian Plague Locust abundance.

Locust population outbreaks have been a longstanding problem for Australian agriculture. Since its inception in the mid-1970s, The Australian Plague Locust Commission (APLC) is responsible for monitoring, forecasting and controlling populations of several locust pest species across inland eastern Australia (ca. two million km2). Ground surveys are typically targeted according to prevailing environmental conditions. However, due to the sheer size of the region and limited resources, such surveys remain sparse. Here we develop daily time-step statistical models of populations of Chortoicetes terminifera (Australian plague locust) that can used to predict abundances when observations are lacking, plus uncertainties. We firstly identified key environmental covariates of locust abundance, then examined their relationship with C. terminifera populations by interpreting the responses of Generalized Additive Models (GAM). We also illustrate how estimates of C. terminifera abundance plus uncertainties can be visualized across the region. Our results support earlier studies, specifically, populations peak in grasslands with high productivity, and decline rapidly under very hot and dry conditions. We also identified new relationships, specifically, a strong positive effect of vapour pressure and sunlight, and a negative effect of soil sand content on C. terminifera abundance. Our modelling tool may assist future APLC management and surveillance effort.

Improving climate suitability for Bemisia tabaci in East Africa is correlated with increased prevalence of whiteflies and cassava diseases.

Projected climate changes are thought to promote emerging infectious diseases, though to date, evidence linking climate changes and such diseases in plants has not been available. Cassava is perhaps the most important crop in Africa for smallholder farmers. Since the late 1990's there have been reports from East and Central Africa of pandemics of begomoviruses in cassava linked to high abundances of whitefly species within the Bemisia tabaci complex. We used CLIMEX, a process-oriented climatic niche model, to explore if this pandemic was linked to recent historical climatic changes. The climatic niche model was corroborated with independent observed field abundance of B. tabaci in Uganda over a 13-year time-series, and with the probability of occurrence of B. tabaci over 2 years across the African study area. Throughout a 39-year climate time-series spanning the period during which the pandemics emerged, the modelled climatic conditions for B. tabaci improved significantly in the areas where the pandemics had been reported and were constant or decreased elsewhere. This is the first reported case where observed historical climate changes have been attributed to the increase in abundance of an insect pest, contributing to a crop disease pandemic.

Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial.

OBJECTIVE: To compare the clinical efficacy of foot orthoses in the management of patellofemoral pain syndrome with flat inserts or physiotherapy, and to investigate the effectiveness of foot orthoses plus physiotherapy. DESIGN: Prospective, single blind, randomised clinical trial. SETTING: Single centre trial within a community setting in Brisbane, Australia. PARTICIPANTS: 179 participants (100 women) aged 18 to 40 years, with a clinical diagnosis of patellofemoral pain syndrome of greater than six weeks' duration, who had no previous treatment with foot orthoses or physiotherapy in the preceding 12 months. INTERVENTIONS: Six weeks of physiotherapist intervention with off the shelf foot orthoses, flat inserts, multimodal physiotherapy (patellofemoral joint mobilisation, patellar taping, quadriceps muscle retraining, and education), or foot orthoses plus physiotherapy. MAIN OUTCOME MEASURES: Global improvement, severity of usual and worst pain over the preceding week, anterior knee pain scale, and functional index questionnaire measured at 6, 12, and 52 weeks. RESULTS: Foot orthoses produced improvement beyond that of flat inserts in the short term, notably at six weeks(relative risk reduction 0.66,99%confidence interval 0.05 to 1.17; NNT 4 (99% confidence interval 2 to 51). No significant differences were found between foot orthoses and physiotherapy, or between physiotherapy and physiotherapy plus orthoses. All groups showed clinically meaningful improvements in primary outcomes over 52 weeks. CONCLUSION: While foot orthoses are superior to flat inserts according to participants' overall perception, they are similar to physiotherapy and do not improve outcomes when added to physiotherapy in the short term management of patellofemoral pain. Given the long term improvement observed in all treatment groups, general practitioners may seek to hasten recovery by prescribing prefabricated orthoses.

Black Sigatoka in bananas: Ecoclimatic suitability and disease pressure assessments.

Black leaf streak disease, or black Sigatoka, is caused by the fungus Pseudocercospora fijiensis, and has been identified as a major constraint to global production of banana and plantain. We fitted a climatic niche model (CLIMEX) for P. fijiensis to gain an understanding of the patterns of climate suitability, and hence hazard from this disease. We then calibrated the climate suitability patterns against the results of an expert elicitation of disease pressure patterns. We found a moderately strong non-linear relationship between modelled climate suitability for P.°fijiensis and the expert ratings for disease pressure. The strength of the relationship provides a cross-validation between the CLIMEX model and the expert elicitation process. The bulk of global banana production experiences high potential threat from P. fijiensis, and the higher yielding areas for banana and plantain production are at greatest threat. By explicitly considering the role of irrigation we have been able to identify how strategic irrigation could be used to support banana production in areas that are at low risk from P. fijiensis.

Effects of ambient acoustic noise on the auditory steady-state response thresholds in normally hearing adults.

The effect of noise on auditory steady-state response (ASSR) has not been systematically studied, despite the fact that ASSR thresholds are sometimes measured in noisy environments. This study examined the effects of noise (speech babble) on the ASSR thresholds obtained from 31 normal hearing adults aged from 17 to 36 years (mean = 25 years). The ASSR thresholds at 0.5, 1, 2 and 4 kHz were measured in the right ear only using the Biologic MASTER system twice in quiet and in the presence of 55 dB A and 75 dB A of speech babble. The results showed no change in mean ASSR thresholds across the test-retest conditions in quiet. The mean ASSR thresholds obtained in the quiet conditions were 23.8, 22.5, 18.2 and 20.4 dB HL at 0.5, 1, 2 and 4 kHz, respectively. No significant shift in ASSR thresholds across all test frequencies was found when 55 dB A of speech babble was presented. However, when 75 dB A of noise was applied, the mean ASSR thresholds were significantly shifted by 9.5, 3.8, 4.2 and 5.8 dB at 0.5, 1, 2 and 4 kHz, respectively.

Comparison of sensorimotor disturbance between subjects with persistent whiplash-associated disorder and subjects with vestibular pathology associated with acoustic neuroma.

OBJECTIVE: To determine if differences exist in reported symptoms and in outcomes of sensorimotor tests (cervical joint position error [JPE], neck-influenced eye movement control, postural stability) between subjects with persistent whiplash and subjects with unilateral vestibular pathology associated with acoustic neuroma. DESIGN: Repeated measures, case controlled. SETTING: Tertiary institution and metropolitan hospital. PARTICIPANTS: Twenty subjects with persistent whiplash, 20 subjects with acoustic neuroma, and 20 control subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Symptom descriptors, Dizziness Handicap Inventory (short form), measures of cervical JPE, the smooth pursuit neck torsion (SPNT) test, and forceplate measures of postural stability in comfortable and narrow stances. RESULTS: The results showed differences in SPNT (P=.00), selected measures of postural stability (P<.04), and reported symptoms between the whiplash and vestibular groups. There was no between-group difference in cervical JPE (P>.27) or dizziness handicap (P>.69). CONCLUSIONS: This study showed differences in sensorimotor disturbances between subjects with discreet whiplash and those with vestibular pathology associated with acoustic neuroma. The results support the SPNT test as a test of cervical afferent dysfunction. Further research into cervical JPE as a discreet test of cervical afferentation is warranted.

The explicit learning of new names for known objects is improved by dexamphetamine.

A randomised, double-blind, placebo-controlled, between subjects study design (N=37) was used to investigate the effects of dexamphetamine on explicit new name learning. Participants ingested 10mg of dexamphetamine or placebo daily over 5 consecutive mornings before learning new names for 50 familiar objects plus fillers. The dexamphetamine group recognised and recalled the new names more accurately than the placebo group over the 5 days and 1 month later. Word learning success was not associated with baseline neuropsychological performance, mood, cardiovascular arousal, or sustained attention. These results may have implications for the pharmacological treatment of acquired naming difficulties.

Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: a randomised clinical trial.

BACKGROUND: Patellofemoral pain syndrome is a highly prevalent musculoskeletal overuse condition that has a significant impact on participation in daily and physical activities. A recent systematic review highlighted the lack of high quality evidence from randomised controlled trials for the conservative management of patellofemoral pain syndrome. Although foot orthoses are a commonly used intervention for patellofemoral pain syndrome, only two pilot studies with short term follow up have been conducted into their clinical efficacy. METHODS/DESIGN: A randomised single-blinded clinical trial will be conducted to investigate the clinical efficacy and cost effectiveness of foot orthoses in the management of patellofemoral pain syndrome. One hundred and seventy-six participants aged 18-40 with anterior or retropatellar knee pain of non-traumatic origin and at least six weeks duration will be recruited from the greater Brisbane area in Queensland, Australia through print, radio and television advertising. Suitable participants will be randomly allocated to receive either foot orthoses, flat insoles, physiotherapy or a combined intervention of foot orthoses and physiotherapy, and will attend six visits with a physiotherapist over a 6 week period. Outcome will be measured at 6, 12 and 52 weeks using primary outcome measures of usual and worst pain visual analogue scale, patient perceived treatment effect, perceived global effect, the Functional Index Questionnaire, and the Anterior Knee Pain Scale. Secondary outcome measures will include the Lower Extremity Functional Scale, McGill Pain Questionnaire, 36-Item Short-Form Health Survey, Hospital Anxiety and Depression Scale, Patient-Specific Functional Scale, Physical Activity Level in the Previous Week, pressure pain threshold and physical measures of step and squat tests. Cost-effectiveness analysis will be based on treatment effectiveness against resource usage recorded in treatment logs and self-reported diaries. DISCUSSION: The randomised clinical trial will utilise high-quality methodologies in accordance with CONSORT guidelines, in order to contribute to the limited knowledge base regarding the clinical efficacy of foot orthoses in the management of patellofemoral pain syndrome, and provide practitioners with high-quality evidence upon which to base clinical decisions. TRIAL REGISTRATION: Australian Clinical Trials Registry ACTRN012605000463673ClinicalTrials.gov NCT00118521.

Metabolites Identified during Varied Doses of Aspergillus Species in Zea mays Grains, and Their Correlation with Aflatoxin Levels.

Aflatoxin contamination is associated with the development of aflatoxigenic fungi such as Aspergillus flavus and A. parasiticus on food grains. This study was aimed at investigating metabolites produced during fungal development on maize and their correlation with aflatoxin levels. Maize cobs were harvested at R3 (milk), R4 (dough), and R5 (dent) stages of maturity. Individual kernels were inoculated in petri dishes with four doses of fungal spores. Fungal colonisation, metabolite profile, and aflatoxin levels were examined. Grain colonisation decreased with kernel maturity: milk-, dough-, and dent-stage kernels by approximately 100%, 60%, and 30% respectively. Aflatoxin levels increased with dose at dough and dent stages. Polar metabolites including alanine, proline, serine, valine, inositol, iso-leucine, sucrose, fructose, trehalose, turanose, mannitol, glycerol, arabitol, inositol, myo-inositol, and some intermediates of the tricarboxylic acid cycle (TCA—also known as citric acid or Krebs cycle) were important for dose classification. Important non-polar metabolites included arachidic, palmitic, stearic, 3,4-xylylic, and margaric acids. Aflatoxin levels correlated with levels of several polar metabolites. The strongest positive and negative correlations were with arabitol (R = 0.48) and turanose and (R = −0.53), respectively. Several metabolites were interconnected with the TCA; interconnections of the metabolites with the TCA cycle varied depending upon the grain maturity.

Criterion validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST).

This paper reports on the criterion validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST) including concurrent criterion validity and its sensitivity and specificity. The performance of 208 people following stroke on the OT-APST and a reference tool (either the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) or the LOTCA--Geriatric version (LOTCA-G)) was compared. The OT-APST subscale scores and performance outcome (intact or impaired) on related subscales of the reference tool was analyzed to evaluate the concurrent criterion validity of the OT-APST and its sensitivity and specificity at selected cut-off scores. Significant correlations were found between participants' performance (intact or impaired) on the reference tool and scores on the OT-APST. The sensitivity and specificity of the OT-APST were analyzed at selected cut-off scores to explore the validity of decisions based on OT-APST performance when compared with the reference tool. This study shows that the OT-APST is a tool with demonstrated concurrent criterion validity for the assessment of visual perception.

Construct and ecological validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST).

This paper reports on the construct validity (scale design and convergent validity) and ecological validity of the Occupational Therapy Adult Perceptual Screening Test (OT-APST). The performance of 208 participants following stroke on the OT-APST and a reference tool (either the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) or the LOTCA-Geriatric version (LOTCA-G)) was compared. The OT-APST performance of the stroke sample was compared with a healthy normative sample (n = 356). The relationship between the OT-APST performance and the Functional Independence Measure (FIM) score of the participants following stroke was also examined. Factor analysis and internal consistency results supported the scale design of the OT-APST. Significant correlations between the performance of the participants following stroke on the OT-APST and the reference tool supported the convergent validity of the OT-APST. The ability of the OT-APST to separate the two participant groups provided further evidence of its construct validity. Significant correlations between OT-APST and FIM scores supported the ecological validity of this tool. This study shows that the OT-APST is an ecologically valid tool with demonstrated construct validity in the assessment of visual perception.

Physical and psychological factors predict outcome following whiplash injury.

Predictors of outcome following whiplash injury are limited to socio-demographic and symptomatic factors, which are not readily amenable to secondary and tertiary intervention. This prospective study investigated the predictive capacity of early measures of physical and psychological impairment on pain and disability 6 months following whiplash injury. Motor function (ROM; kinaesthetic sense; activity of the superficial neck flexors (EMG) during cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds, brachial plexus provocation test), sympathetic vasoconstrictor responses and psychological distress (GHQ-28, TSK, IES) were measured in 76 acute whiplash participants. The outcome measure was Neck Disability Index scores at 6 months. Stepwise regression analysis was used to predict the final NDI score. Logistic regression analyses predicted membership to one of the three groups based on final NDI scores (<8 recovered, 10-28 mild pain and disability, >30 moderate/severe pain and disability). Higher initial NDI score (1.007-1.12), older age (1.03-1.23), cold hyperalgesia (1.05-1.58), and acute post-traumatic stress (1.03-1.2) predicted membership to the moderate/severe group. Additional variables associated with higher NDI scores at 6 months on stepwise regression analysis were: ROM loss and diminished sympathetic reactivity. Higher initial NDI score (1.03-1.28), greater psychological distress (GHQ-28) (1.04-1.28) and decreased ROM (1.03-1.25) predicted subjects with persistent milder symptoms from those who fully recovered. These results demonstrate that both physical and psychological factors play a role in recovery or non-recovery from whiplash injury. This may assist in the development of more relevant treatment methods for acute whiplash.

Timing of rotator cuff activation during shoulder external rotation in throwers with and without symptoms of pain.

STUDY DESIGN: Fine-wire EMG rotator cuff onset time analysis in 2 matched groups of throwers with and without pain. OBJECTIVE: To identify if there is a difference in the activation patterns of the rotator cuff muscles during a rapid shoulder external rotation task between throwers with and without pain. BACKGROUND: The coordinated action of the rotator cuff is recognized as essential for glenohumeral joint control in the throwing athlete. Identification of abnormalities occurring in muscle activation patterns for injured athletes is relevant when prescribing rehabilitative exercises. METHODS AND MEASURES: Twelve throwers with shoulder pain were compared to a matched group of 11 asymptomatic throwers. Participants were matched for age, height, body mass, and habitual activity. Fine-wire EMG electrodes were inserted into the subscapularis, supraspinatus, and infraspinatus. EMG activity was measured during a reaction time task of rapid shoulder external rotation in a seated position. The timing of onset of EMG activity was analyzed in relation to visualization of a light (reaction time) and to the onset of infraspinatus activity (relative latency). RESULTS: In the group with shoulder pain, the onset of subscapularis activity was found to be significantly delayed (reaction time, P = .0018; relative latency, P = .0005) from the onset of infraspinatus activity when compared to the control group. CONCLUSIONS: The presence of shoulder pain in these athletes was associated with a difference in the onset of subscapularis EMG activity during a rapid shoulder external rotation movement. This was an initial step in the understanding of the joint protection mechanisms of the glenohumeral joint and the problems that occur in throwers. This information may assist in providing future guidelines for more effective rehabilitation and prevention strategies for this condition.

Attenuation of species abundance distributions by sampling.

Quantifying biodiversity aspects such as species presence/ absence, richness and abundance is an important challenge to answer scientific and resource management questions. In practice, biodiversity can only be assessed from biological material taken by surveys, a difficult task given limited time and resources. A type of random sampling, or often called sub-sampling, is a commonly used technique to reduce the amount of time and effort for investigating large quantities of biological samples. However, it is not immediately clear how (sub-)sampling affects the estimate of biodiversity aspects from a quantitative perspective. This paper specifies the effect of (sub-)sampling as attenuation of the species abundance distribution (SAD), and articulates how the sampling bias is induced to the SAD by random sampling. The framework presented also reveals some confusion in previous theoretical studies.

Development of motor system dysfunction following whiplash injury.

Dysfunction in the motor system is a feature of persistent whiplash associated disorders. Little is known about motor dysfunction in the early stages following injury and of its progress in those persons who recover and those who develop persistent symptoms. This study measured prospectively, motor system function (cervical range of movement (ROM), joint position error (JPE) and activity of the superficial neck flexors (EMG) during a test of cranio-cervical flexion) as well as a measure of fear of re-injury (TAMPA) in 66 whiplash subjects within 1 month of injury and then 2 and 3 months post injury. Subjects were classified at 3 months post injury using scores on the neck disability index: recovered (<8), mild pain and disability (10-28) or moderate/severe pain and disability (>30). Motor system function was also measured in 20 control subjects. All whiplash groups demonstrated decreased ROM and increased EMG (compared to controls) at 1 month post injury. This deficit persisted in the group with moderate/severe symptoms but returned to within normal limits in those who had recovered or reported persistent mild pain at 3 months. Increased EMG persisted for 3 months in all whiplash groups. Only the moderate/severe group showed greater JPE, within 1 month of injury, which remained unchanged at 3 months. TAMPA scores of the moderate/severe group were higher than those of the other two groups. The differences in TAMPA did not impact on ROM, EMG or JPE. This study identifies, for the first time, deficits in the motor system, as early as 1 month post whiplash injury, that persisted not only in those reporting moderate/severe symptoms at 3 months but also in subjects who recovered and those with persistent mild symptoms.

Does participation in a pain course based on the International Association for the Study of Pain's curricula guidelines change student knowledge about pain?

BACKGROUND: The People in Pain course was set up as a joint initiative of the Departments of Occupational Therapy and Physiotherapy within the School of Health and Rehabilitation Sciences at The University of Queensland. It was instigated in response to the publication of Pain Curricula for Occupational Therapy and Physiotherapy by the International Association for the Study of Pain (IASP) in 1994 (1). The first year it was offered, the "People in Pain" course comprised 14 h of lecture content. It was then expanded to encompass 28 h of lectures and seminar involvement. OBJECTIVES: To evaluate the impact of participation in a university pain course that meets the IASP pain curricula guidelines to increase health professional students' knowledge about pain. METHODS: Students who participated in the People in Pain course over the first three years were invited to complete the Revised Pain Knowledge and Attitudes Questionnaire (R-PKAQ) pre- and postcourse. Data obtained from 22 students in the short course formed a pilot project, and data from 22 students in the longer version of the course were used in the present study. RESULTS: Examination of the correlation matrix indicated substantial correlations between all R-PKAQ subscales except physiological basis of pain and pharmacological management of pain. In both the pilot project during the first year of the course and the expanded course in the following two years, significant improvement was found in the students' knowledge on five of the six subscales of the R-PKAQ: physiological basis of pain, psychological factors of pain perception, assessment and measurement of pain, cognitive-behavioural methods of pain relief, and pharmacological management of pain. Improvements in the developmental aspects of pain perception subscale failed to reach significance. CONCLUSIONS: An integrated pain course developed according to the pain curriculum guidelines developed by the IASP resulted in increased student knowledge regardless of the length of the program attended.