A survey of physical therapists' clinical practice patterns and adherence to clinical guidelines in the management of patients with whiplash associated disorders (WAD).

OBJECTIVES: To explore the clinical practice of physical therapists and examine adherence to clinical guidelines for treating patients with whiplash associated disorders (WAD). METHODS: A cross-sectional electronic survey was sent to 1484 licensed physical therapists from the Orthopedic Section of the American Physical Therapy Association and the American Academy of Orthopedic Manual Physical Therapists. The survey included demographic data and two clinical vignettes describing patients with acute and chronic WAD. The chi-square test was used to analyze responses. RESULTS: There were 291(19.6%) responses to the survey. Of those, 237 (81.4%) provided data for vignette 1 and 204 (70.1%) for vignette 2. One hundred and eighty (76.6%) respondents reported familiarity with evidence-based or clinical practice guidelines for treating patients with WAD. Of those, 71.5% (n = 128) indicated that they followed them more than 50% of the time. Therapists with an advanced certification were more likely to be familiar with clinical guidelines than those who were not certified (P<0.01). Responses indicated overall adherence to guidelines; however, there was a low utilization of quantitative sensory assessment, screening for psychological distress and some outcome measures. Significant differences in clinical practice (P<0.01) were found between therapists who were and were not familiar with guidelines and those with and without an advanced certification. DISCUSSION: Advanced certification and knowledge of guidelines appeared to play a role in the clinical practice of physical therapists treating patients with WAD. Further research is needed to explore factors affecting knowledge translation from research to clinical practice and to evaluate the outcomes of patients with WAD when clinical guidelines are applied in practice.

Using Mindfulness for the Treatment of Insomnia.

PURPOSE OF REVIEW: The goal of this review is to provide an update on the use of mindfulness meditation for the treatment of insomnia, including conceptual models and empirical evidence from randomized controlled trials. RECENT FINDINGS: A metacognitive model of insomnia has been proposed as a conceptual model to explain the application of mindfulness principles for reducing insomnia-related arousal. Furthermore, the evidence base for mindfulness-based therapies has grown with the results of several randomized controlled trials published in the past three years. Treatment effects appear to be strongest on self-report measures compared to objective measures of sleep. SUMMARY: Treatment programs featuring mindfulness meditation appear to be viable treatment options for people with insomnia. Further research is needed to determine who is likely to benefit from mindfulness-based therapies and how these interventions work. Additionally, further work is needed to resolve issues related to the delivery and implementation of mindfulness-based therapies.

Black racial identity as a mediator of cardiovascular reactivity to racism in African-American college students.

OBJECTIVES: The purpose of the present study was to examine the ability of Black racial identity to mediate cardiovascular reactivity to racism. The Multidimensional Model of Racial Identity (MMRI), which consists of four dimensions, salience, centrality, regard, and ideology was used to define Black racial identity. The subdimensions of ideology are oppressed minority, nationalist, humanist, and assimilationist racial identities. DESIGN AND METHODS: Heart rate, cardiac output, stroke volume, and blood pressure were measured in 72 African-American men as they viewed a videotaped scene depicting racial profiling and a neutral scene. We hypothesized that individuals with high levels of Black-oriented identities (centrality, public regard, private regard, oppressed minority, and nationalist) would be less stressed by the racial profiling scenes than those low in these identities. In addition, we predicted that individuals with high levels of non-Black-oriented identities (assimilationist, humanist) would be more stressed by the racial profiling scenes than those with low levels of these identities. RESULTS: Private regard, humanist, and assimilationist racial identities were significantly associated with increased cardiovascular reactivity to the scenes. Specifically, private regard significantly predicted cardiac output and stroke volume responses to the scenes. In addition, assimilationist and humanist racial identities were associated with greater blood output and faster heart rates in response to the scenes. CONCLUSIONS: Although private regard (Black oriented) and assimilationist and humanist (non- Black oriented) racial identities showed elevated cardiovascular reactivity to the scenes, the underlying mechanisms of these associations may differ.

Preparative and analytical chromatography of pegylated myelopoietin using monolithic media.

Monolithic media were compared with Q- and SP-Sepharose high performance chromatography for preparative purification and with Q- and SP-5PW chromatography for analysis of a pegylated form of myelopoietin (MPO), an engineered hematopoietic growth factor. The use of either monolithic or Sepharose based supports for preparative chromatography produced highly purified pegylated MPO with the monolithic media demonstrating peak resolution and repeatability at flow rates of 1 and 5 ml/min resulting in run times as much as five-fold shorter compared to Sepharose separations. The monolithic disks also resulted in 10-fold shorter run times for the analytical chromatography, however, their chromatographic profiles and peak symmetry were not as sharp compared to their Q-5PW and SP-5PW counterparts.

Human monoclonal antibodies to the insulin-like growth factor 1 receptor inhibit receptor activation and tumor growth in preclinical studies.

INTRODUCTION: The insulin-like growth factor type 1 (IGF-1) receptor contributes importantly to transformation and survival of tumor cells both in vitro and in vivo, and selective antagonists of the IGF-1 receptor (IGF-1R) activity represent an attractive experimental approach for human cancer therapy. METHODS: Using a phage display library, we identified several high-affinity fully human monoclonal antibodies with inhibitory activity against both human and rodent IGF.1Rs. RESULTS: These candidate therapeutic antibodies recognized several distinct epitopes and effectively blocked ligand-mediated receptor signal transduction and cellular proliferation in vitro. They also induced IGF-1R downregulation and catabolism following antibody-mediated endocytosis. These antibodies exhibited activity against human, primate, and rodent IGF-1Rs, and dose-dependently inhibited the growth of established human tumors in nude mice. CONCLUSION: These fully human antibodies therefore have the potential to provide an effective anti-tumor biological therapy in the human clinical setting.