Changes resembling complex regional pain syndrome following surgery and immobilization.

UNLABELLED: The study of complex regional pain syndrome (CRPS) in humans is complicated by inhomogeneities in available study cohorts. We hoped to characterize early CRPS-like features in patients undergoing hand surgery. Forty-three patients were recruited from a hand surgery clinic that had elective surgeries followed by cast immobilization. On the day of cast removal, patients were assessed for vasomotor, sudomotor, and trophic changes, and edema and pain sensitization using quantitative sensory testing. Pain intensity was assessed at the time of cast removal and after 1 additional month, as was the nature of the pain using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). Skin biopsies were harvested for the analysis of expression of inflammatory mediators. We identified vascular and trophic changes in the surgical hands of most patients. Increased sensitivity to punctate, pressure, and cold stimuli were observed commonly as well. Moreover, levels of IL-6, TNF-alpha, and the mast cell marker tryptase were elevated in the skin of hands ipsilateral to surgery. Moderate-to-severe pain persisted in the surgical hands for up to 1 month after cast removal. Exploratory analyses suggested interrelationships between the physical, quantitative sensory testing, and gene expression changes and pain-related outcomes. PERSPECTIVE: This study has identified CPRS-like features in the limbs of patients undergoing surgery followed by immobilization. Further studies using this population may be useful in refining our understanding of CRPS mechanisms and treatments for this condition.

Development of a safety awareness group intervention for women with diverse disabilities: a pilot study.

OBJECTIVE: Describe the development and preliminary evaluation of a safety awareness program for women with disabilities. DESIGN: Baseline and postintervention questionnaires administered to a sample of women who completed a safety awareness program. PARTICIPANTS: Seven women with diverse disabilities. INTERVENTION: Eight interactive sessions designed to increase protective factors. SETTING: Community site for persons with disabilities. MAIN OUTCOMES: Safety self-efficacy, safety skills, social support/isolation, and safety promoting behaviors. RESULTS: Significant increases from baseline to postintervention were found on measures of self-efficacy and safety skills. Although not statistically significant, improvements were also found in safety promoting behavior. CONCLUSION: Despite the small sample, findings suggest that participation in a safety awareness program may improve protective factors.

Nutritional intervention improves menu adequacy in group homes for adults with intellectual or developmental disabilities.

BACKGROUND: Research documents that adults with intellectual or developmental disabilities (IDD) living in the community experience nutritional deficits, inadequate diets, and poor nutritional status. OBJECTIVE: We developed a nutrition intervention that was targeted at improving the food systems in group homes for adults with intellectual or developmental disabilities, called MENU-AIDDs (Materials Supporting Education and Nutrition for Adults with Intellectual or Developmental Disabilities). METHODS: MENU-AIDDs was implemented for 8 and 16 weeks in four community-based group homes for adults with IDD. Improved nutritional adequacy of planned menus was tested as a marker of improved dietary intake in the residents of the homes. RESULTS: Results showed significant statistical and clinical improvements in the planned menus whereby there were significant increases in the appearance on menus of whole grains, vegetables overall and green/yellow/orange vegetables in particular, and low-fat proteins, and significant decreases in the higher-fat proteins, potatoes, and "junk foods." The positive practice of specifying portion sizes on the menus increased significantly. CONCLUSIONS: MENU-AIDDs is a community-based health promotion intervention that can improve menu planning and dietary adequacy while being responsive to the needs of group home residents, direct care staff, and administrators.

Acculturation's influence on antifat attitudes, body image and eating behaviors.

Antifat attitudes (AFA) refer to the belief that overweight and obese individuals are responsible for their weight. Using 264 Latina and European American females, a regression showed that AFA positively correlated with body dissatisfaction and eating concerns. An ANOVA revealed that European American females reported significantly greater AFA than Latinas. Furthermore, European American females and high acculturated Latinas reported significantly greater AFA than both bicultural and low acculturated Latinas. No differences existed between European Americans and high acculturated Latinas. Language-use significantly interacted with body dissatisfaction to predict AFA. The role of AFA, acculturation, and suggestions for future research are discussed.