Parkinson patients as partners in care.

Increasing physical activity, as part of an active lifestyle, is an important health goal for individuals with Parkinson's disease (PD). Exercise can positively impact health related quality of life. Given this, how can we promote physically active lifestyles among PD patients (most of whom are sedentary)? Here we suggest that health care professionals could significantly expand their impact by collaborating with PD patients and their spouses (or caregivers) as partners-in-care. We outline reasons why partners-in-care approaches are important in PD, including the need to increase social capital, which deals with issues of trust and the value of social networks in linking members of a community. We then present results of a qualitative study involving partners-in-care exercise beliefs among 19 PD patients and spouses, and conclude with our perspective on future benefits of this approach.

Persistent postmastectomy pain in breast cancer survivors: analysis of clinical, demographic, and psychosocial factors.

UNLABELLED: Persistent postmastectomy pain (PPMP) is increasingly recognized as a major individual and public health problem. Although previous studies have investigated surgical, medical, and demographic risk factors, in this study we aimed to more clearly elucidate the relationship of psychosocial factors to PPMP. Postmastectomy patients (611) were queried about pain location, severity, and burden 38.3 ± 35.4 months postoperatively. Validated questionnaires for depressive symptoms, anxiety, sleep, perceived stress, emotional stability, somatization, and catastrophizing were administered. Detailed surgical, medical, and treatment information was abstracted from patients' medical records. One third (32.5%) of patients reported PPMP, defined as ≥3/10 pain severity in the breast, axilla, side, or arm, which did not vary according to time since surgery. Multiple regression analysis revealed significant and independent associations between PPMP and psychosocial factors, including catastrophizing, somatization, anxiety, and sleep disturbance. Conversely, treatment-related factors including surgical type, axillary node dissection, surgical complication, recurrence, tumor size, radiation, and chemotherapy were not significantly associated with PPMP. These data confirm previous studies suggesting that PPMP is relatively common and provide new evidence of significant associations between psychosocial characteristics such as catastrophizing with PPMP, regardless of the surgical and medical treatment that patients receive, which may lead to novel strategies in PPMP prevention and treatment. PERSPECTIVE: This cross-sectional cohort study of 611 postmastectomy patients investigated severity, location, and frequency of pain a mean of 3.2 years after surgery. Significant associations between pain severity and individual psychosocial attributes such as catastrophizing were found, whereas demographic, surgical, medical, and treatment-related factors were not associated with persistent pain.

Lipophilicity screening of novel drug-like compounds and comparison to clog P.

We determined the distribution coefficients of solutes between a polymer film phase (polyvinyl chloride (PVC) with 67% (w/w) dioctyl sebacate (DOS)) and an aqueous phase in a 96-well format. The parallel measurement approach is efficient and uses very little material. Polymer-water distribution coefficients (D(pw)) at different pH values yield the pKa and polymer-water partition coefficient values (P(pw)) of the solutes. log P(pw) of a prominent drug-like compound, 2H-1,2,6-thiadiazine, 3-methyl-5-phenyl-,1,1-dioxide, is in good agreement with clog P, while the pK(a) value is substantially different from calculated values. This method has been also successfully applied to a library of novel drug-like compounds. log D(pw) values (at pH 4.0, 7.0, 10.0) of 24 novel drug-like compounds have been determined with good reproducibility with the 96-well plate approach. Differences between experimental values and a variety of available calculated values are significant. This emphasizes the need for laboratory separations-based measurements of log D.

Promoting exercise in Parkinson's disease through community-based participatory research.

Parkinson's disease (PD) is a chronic, progressive, as-of-yet incurable, neurodegenerative condition affecting the nigro-striatal dopaminergic system. Emerging evidence suggests the importance of exercise in improving the trajectory of PD. Yet few people with PD are physically active. One challenge that healthcare professionals face in the 21st century is how to deliver physical activity programs to the population of individuals living with PD. A novel approach to delivering physical activity to people with PD is introduced - termed community-based participatory research (CBPR) - which engages people with PD and patient advocates as co-researchers in the development and implementation of community-based exercise programs. The authors describe the CBPR approach and provide several recent examples of community exercise programs that are steps in the direction of developing the CBPR model. This is followed by a discussion of what a more fully realized CBPR model might look like. Finally, the authors describe some obstacles to conducting CBPR and suggest strategies for overcoming them. It is argued that people with PD are an integral component of delivering the exercise intervention.