Open-label pilot study of ranolazine for cramps in amyotrophic lateral sclerosis.

INTRODUCTION/AIMS: Neuronal hyperexcitability (manifested by cramps) plays a pathological role in amyotrophic lateral sclerosis (ALS), and drugs affecting it may help symptomatic management and slow disease progression. We aimed to determine safety and tolerability of two doses of ranolazine in patients with ALS and evaluate for preliminary evidence of drug-target engagement by assessing muscle cramp characteristics. METHODS: We performed an open-label dose-ascending study of ranolazine in 14 individuals with ALS in two sequential cohorts: 500 mg (cohort 1) and 1000 mg (cohort 2) orally twice daily. Each had a 2-week run-in period, 4-week drug administration, and 6-week safety follow-up. Primary outcome was safety and tolerability. Exploratory measures included cramp frequency and severity, fasciculation frequency, cramp potential duration, ALS Functional Rating Scale---Revised score, and forced vital capacity. RESULTS: Six and eight participants were enrolled in cohorts 1 and 2, respectively. There were no serious adverse events. Two subjects in cohort 2 discontinued the drug due to constipation. The most frequent drug-related adverse event was gastrointestinal (40%). Cramp frequency decreased by 54.8% (95% confidence interval [CI], 39%-70.8%) and severity decreased by 46.3% (95% CI, 29.5-63.3%), which appeared to be dose-dependent, with decreased awakening due to cramps. Other outcomes showed no change. DISCUSSION: Ranolazine was well tolerated in ALS up to 2000 mg/day, with gastrointestinal side effects being the most frequent. Ranolazine reduced cramp frequency and severity, supporting its investigation for muscle cramps in a future placebo-controlled trial.

The View From Anne's Shoulders: Preserving and Honoring the Legacy of Our Leaders.

In 2016, students and faculty at the University of Illinois at Chicago recreated and celebrated the life of nursing leader, Anne Larson Zimmerman (1914-2003). Students conducted archival research and oral histories. Faculty transformed their findings into a script recreating Zimmerman's life. Following months of rehearsals, 22 nursing students, directed by 2 theater students, offered 3 performances of While I am Here: The Life and Legacy of Anne Zimmerman. Audiences included Zimmerman's family, the general public, students, and nurses. Through their engagement in the project, students discovered in Zimmerman a role model for social justice leadership and deepened appreciation of nursing history's relevancy.

Cultural and linguistic adaptation of a multimedia colorectal cancer screening decision aid for Spanish-speaking Latinos.

As the United States becomes more linguistically and culturally diverse, there is a need for effective health communication interventions that target diverse, vulnerable populations, including Latinos. To address such disparities, health communication interventionists often face the challenge to adapt existing interventions from English into Spanish in a way that retains essential elements of the original intervention while also addressing the linguistic needs and cultural perspectives of the target population. The authors describe the conceptual framework, context, rationale, methods, and findings of a formative research process used in creating a Spanish-language version of an evidence-based (English language) multimedia colorectal cancer screening decision aid. The multistep process included identification of essential elements of the existing intervention, literature review, assessment of the regional context and engagement of key stakeholders, and solicitation of direct input from target population. The authors integrated these findings in the creation of the new adapted intervention. They describe how they used this process to identify and integrate sociocultural themes such as personalism (personalismo), familism (familismo), fear (miedo), embarrassment (verguenza), power distance (respeto), machismo, and trust (confianza) into the Spanish-language decision aid.

Measurement of posttraumatic growth in young people: a review.

The potential of the positive psychology perspective to change the focus of clinical research and practice has become increasingly recognized. A variety of new psychometric instruments informed by positive psychology are now available to mental health clinicians, providing them with tools to assess change across the spectrum of human functioning. One area of research and practice in which this is evident is in posttrauma work, where it is becoming more common to assess posttraumatic growth alongside posttraumatic stress. The majority of work on posttraumatic growth has been with adults, but the last few years have also seen a new body of research with children and adolescents. The aim is to review literature relating to the measurement of growth. It is concluded that several measures with acceptable psychometric properties now exist for the assessment of posttraumatic growth in children and adolescents.