"Pain is Subjective": A Mixed-Methods Study of Provider Attitudes and Practices Regarding Pain Management in Sickle Cell Disease Across Three Countries.

CONTEXT: Sickle cell disease (SCD), an autosomal recessive blood disorder, affects millions of people worldwide. Approximately 80% of all cases are located in Africa. OBJECTIVES: This cross-national, interdisciplinary, collaborative study investigated provider attitudes about, and practices for, managing (assessing and treating) SCD pain. METHODS: We conducted 111 quantitative surveys and 52 semistructured interviews with health-care providers caring for adults and/or children with SCD in Cameroon, Jamaica, and the U.S. RESULTS: Applying Haywood's scale for assessing SCD provider attitudes, the Jamaica site scored lower on "Negative Attitudes" than the Cameroonian and U.S. sites (P = 0.03 and <0.001, respectively). Providers at the U.S. site scored lower on "Positive Attitudes" than other sites (P < 0.001). "Red Flag" scores at the Cameroon sites were lower than at other sites (P < 0.001). Qualitative results across all three sites describe the current practices for SCD pain management, as well as the challenges surrounding management for health providers, including pain subjectivity, patient-provider and parent-provider relationships, resource availability, perceptions of drug-seeking behavior, and adherence. Providers also spontaneously offered solutions to reported challenges. CONCLUSION: Overall, findings reveal that SCD provider attitudes toward their patients differed across sites, yet at all three sites, treating SCD pain is multidimensional.

Psychopathy and neurodynamic brain functioning: A review of EEG research.

Studies related to psychopathy and EEG have increased over the past decade making it a good time to examine where the field is on this topic as well as to determine future directions. The current study reviewed 68 research reports that focused on psychopathy and various components of EEG. We examined early, mid, and late level ERP processing as well as spectra analyses. The results indicate that psychopathic individuals exhibit generally unencumbered performance categorizing cognitive stimuli and demonstrate the typical facilitation of physical responses commensurate with an intact orienting response. Moreover, the results suggest that individuals with elevated psychopathic traits are especially adept at screening out distracting threat-related and other irrelevant information allowing them to allocate attention to stimuli that are goal-relevant. Those with elevated psychopathic traits also do not appear to have significant impairments in associative learning or error processing. Where psychopathic individuals diverge most from those with low levels of these traits is in relation to processing affect-laden content. In some contexts, psychopathic individuals appear to quickly terminate the processing of emotional information and in other contexts (e.g., seeing others in pain) they elaborately process emotional information both of which may help explain their prototypical lack of conscience. Much of the aberrant functioning of those with elevated psychopathic traits depends on the psychopathy factor being examined with F1 traits showing less cognitive impairment than F2 traits. Recommendations for future research are provided.

Psychopathy: Relations with three conceptions of intelligence.

Psychopathy is often associated with heightened intelligence in the eyes of clinicians and laypersons despite mixed research support for this possibility. We adopted a fine-grained approach to studying the relations among psychopathy and multiple indices of intelligence, including both cognitively based intelligence (CBI) and emotional intelligence (EI), in a large sample of undergraduates (N = 1,257, 70% female, 82% Caucasian). We found no clear support for marked associations between psychopathy and CB I measures, with the magnitudes of these relations being small. With the exception of the dimensions of Fearless Dominance (FD) and Coldheartedness (C), psychopathy dimensions were negatively associated with (EI). In contrast, we found some support for the hypothesis that intelligence served as a protective factor against antisocial behavior among individuals with high levels of psychopathy. On balance, our findings show weak relations between psychopathy and intelligence, suggesting that the link between them may be less robust than theoretical models portray, at least among undergraduates. (PsycINFO Database Record

Prevalence of ectoparasites in a population of feral cats from north central Florida during the summer.

Ectoparasites are a common and important cause of skin disorders in cats. Ectoparasites are capable of disease transmission and can cause life-threatening anemia in young or debilitated animals. The objective of this study was to determine the potential feline ectoparasites in domestic cats by using a cohort of feral cats from north central Florida that have not received veterinary care and have no known exposure to insecticide application. A total of 200 feral cats were randomly selected for this study. Four monthly sessions were scheduled for feral cat ectoparasite examination and sample collection. Five minutes flea combing revealed that 185/200 (92.5%) of the cats were infested with fleas. The cat flea, Ctenocephalides felis was the most common flea infesting 92.5% feral cats (mean = 13.6; standard deviation +/- 16.4 fleas per cat). Pulex simulans was identified on 9/200 (4.5%) (mean = 1 +/- 0.50 fleas per cat). Echidnophaga gallinacea was found on 11/200 (5.5%) of cats (mean = 14.8 +/- 9.63 fleas per cat). There was a significant difference (P = 0.0005) in the average number of C. felis counted per cat between months. Mean counts in June (18.3 +/- 2.4) and July (16.6 +/- 2.1) were significantly (P < 0.01) higher than in August (8.4 +/- 2.5) and September (7.7 +/- 2.0). Only 15/200 cats had skin disease. Flea infestation may potentially be the underlying cause in 10/15. Otoscopic examination of both ears revealed mite movement and black ceruminous exudate typically indicative of the presence of Otodectes cynotis in 45/200 (22.5%) cats. Examination of a swab specimen from both ear canals of all cats revealed O. cynotis in 74/200 (37%) cats. Of 74 cats positive on ear swab, 8 (10.8%) showed a normal ear canal appearance (no or mild ceruminous exudate) in both ears upon otoscopic examination. A total of nine ticks were recovered from five cats. The number and species of ticks recovered were: one adult female Rhipicephalus sanguineus; one adult female Amblyomma americanum; one adult male A. americanum; five adult female Dermacentor variabilis; and one adult female Ixodes scapularis. All superficial skin scrapes were negative. Hair clippings from the abdomen of all cats revealed 2/200 (1%) of the cats were infested with Felicola subrostratus.