Successful treatment of infertility in a female Sumatran orangutan Pongo abelii.

In 2011, a female Sumatran orangutan housed at Durrell Wildlife Conservation Trust became infertile following a massive antepartum hemorrhage in labor and the delivery of a stillborn infant. The placenta was infected with Pantoea sp. Hysterosalpingography (HSG) revealed blocked fallopian tubes, and pressurized fallopian tube perfusion was used to reverse the tubal occlusion. She subsequently conceived and following an intensive training program, we were able to measure umbilical artery waveform analysis for fetal well-being and placental localization to exclude placenta previa, which could complicate pregnancy and lead to catastrophic hemorrhage. The female went on to deliver a healthy offspring. We suggest that these techniques should be considered for other infertile females in the global captive population.

Paediatric anaesthetists' perceptions of neonatal and infant pain.

A questionnaire was sent to all members of the Association of Paediatric Anaesthetists in the U.K. and Eire, enquiring into their attitudes towards the perception of pain, its assessment and the use of opioids and regional anaesthesia in neonates and infants under 1 year of age. Sixty members returned completed forms out of a total of 66. The results showed that although most anaesthetists in the survey believe that even neonates feel pain, they are reluctant to prescribe analgesia. It was found that the objective signs considered to be most indicative of pain were potentially misleading.

Beliefs about back pain: results of a population survey of working age adults.

BACKGROUND: Beliefs about low back pain (LBP) have been widely studied. Research supports the importance of attitudes and beliefs in the development of disability. However, public opinions about LBP have been the subject of few studies to date and more research into public attitudes has been advocated to inform future public health initiatives. OBJECTIVES: To investigate public attitudes and beliefs about LBP, and the association of these with demographic variables. In addition, to determine whether certain group differences in demographic characteristics were useful in predicting individuals with negative attitudes about LBP. METHODS: A stratified sample of 3400 households were invited to participate in the Jersey Annual Social Survey. One thousand five hundred and seventy-four (46.3%) responded and 1132 (71.9%) were identified as being of working age. Complete responses to the Back Beliefs Questionnaire were provided by 1023 (65.0%). RESULTS: Respondents were grouped according to pain report: no current pain, current pain not LBP, and current LBP. Significant differences existed between subgroups for most demographic characteristics. Moreover, beliefs about LBP differed significantly between the 3 groups [F (2,1019)=17.72, P<0.001]. Further analyses were carried out for the subgroups separately. For the Current LBP group, beliefs differed significantly by educational level [F(2,186)=14.65, P<0.001], perceived general health [F (2,187)=4.42, P<0.05], acceptability of work absence [F (2,189)=10.69, P<0.001], LBP impact on activity [F (2,186)=6.38, P<0.01], and previous LBP absence [t (185)=4.84, P<0.001]. Multiple regression using these characteristics produced an adjusted R of 0.25 [F (4,181)=16.33, P<0.001] for the prediction of back beliefs. DISCUSSION: Implications for public health initiatives and future research are discussed.

Test-retest reliability of the pain attitudes and beliefs scale and sensitivity to change in a general practitioner population.

BACKGROUND: Costs of compensated work loss for low back pain have risen dramatically. Current healthcare management of this condition may contribute to this trend. Researchers are currently investigating the degree to which healthcare practitioners' attitudes and beliefs may influence their patient management. Measures used to assess healthcare practitioners' attitudes and beliefs have often been adapted from patient tools. The degree to which they have been assessed for use with different populations varies. OBJECTIVES: To measure test-retest reliability of the Pain Attitudes and Beliefs Scale and sensitivity to detect change after a minimal intervention strategy (MIS) in general practitioners (GPs). METHODS: GPs completed up to 3 presentations of the 2-factor measure (initial, reliability, and after MIS). RESULTS: There were significant intraclass correlations between initial and reliability scores: biomedical factor (0.806) and biopsychosocial factor (0.653). Analyses revealed no systematic change for either factor between initial and reliability presentations. Ninety-four percent of biomedical and 93% of biopsychosocial scores fell between Bland and Altman 95% Limits of Agreement. Paired samples t tests suggested statistically significant differences in scores after MIS (biomedical P<0.0005 and biopsychosocial P<0.0005). Ninety-five percent smallest real difference bandwidths revealed only scores on the biomedical factor changed significantly after MIS. When analyzed separately, a subset that scored lowest on the biopsychosocial factor (< or =15) before training, did shift significantly after training. DISCUSSION: Statistical methods used suggest that the measure demonstrates good reliability with a GP population. The influence of training on attitudes and beliefs of GPs is discussed.

General practitioner sickness absence certification for low back pain is not directly associated with beliefs about back pain.

Recent research has demonstrated a relationship between healthcare practitioner beliefs about low back pain and recommendations about activity, work restrictions and work absence. None of the research to date has looked at the relationship between practitioner beliefs and actual behaviour. This study investigated the internal consistency of the pain attitudes and beliefs scale (PABS) and if general practitioner (GP) beliefs about back pain were more predictive of sickness certification for non-specific low back pain (NSLBP) than a general predisposition to sick certify patients with other non-specific conditions (common mental illness and non-specific upper respiratory disorders). Ninty-four eligible general practitioners were invited to participate in the study and data from 83 (88.3%) were included in the full analysis. Evaluation of the internal consistency of the PABS found the biomedical subscale was good (alpha=0.781) but the psychosocial subscale was poor (alpha=0.396) after item elimination both subscales improved; biomedical alpha=0.790, psychosocial alpha=0.602. GP sickness certification behaviour for 1 year was gathered from the Department of Employment and Social Security database. Multiple regression analysis demonstrated that neither the biomedical nor the psychosocial subscale of the PABS predicted the number of sickness certificates issued even after controlling for the time employed as a GP, number of hours worked per week and the number of NSLBP patients seen. Certification for other conditions was predictive of NSLBP certificates issued. These results demonstrate that sickness absences certification for NSLBP is predicted by sickness certification behaviour in general and not by scores on the PABS.