Simultaneous direct measurement of the electrocaloric and dielectric dynamics of ferroelectrics with microsecond temporal resolution.

A contactless technique for direct time-resolved measurements of the full dynamics of the adiabatic temperature change in electrocaloric materials is introduced. The infrared radiation emitted by the electrocaloric sample is sensitively detected with µs time resolution and mK temperature resolution. We present time-resolved measurements of the electrocaloric effect up to kHz frequencies of the driving electric field and down to small field strengths. The simultaneous recording of transients for applied electric field and induced polarization gives a comprehensive view of the correlation of electrocaloric and ferroelectric properties. The technique can further be applied to the continuous measurement of fatigue for >106 electric field cycles.

The EORTC clinical research coordinators group. European Organisation for Research and Treatment of Cancer.

The Clinical Research Coordinators Group (CRCG) is an umbrella organisation, compiled from four existing groups, namely the Oncology Nurses Group, the Data Management Group, the Radiation Technologists Group and the Early Clinical Studies Group Research Nurses. From the existing steering committees, a new board was formed and consists of two members per group. The CRCG will function as an independent group within the EORTC. The CRCG will create conditions and standards for implementing and conducting clinical protocols according to Good Clinical Practice.

From bite to mind: TMD--a personal and literature review.

PURPOSE: The purpose of this study was to present a personal view of the development of prevailing opinions about temporomandibular disorders (TMD) during the last half century from a mechanistic to a psychosomatic concept. It also presents some hypotheses concerning: (1) the role of stress in the etiology of human oral parafunctions and its relationship to oral stereotypies in domestic animals; and (2) the pathogenetic mechanisms of masticatory muscle pain. MATERIALS AND METHODS: The basis for this article was a review of personal experiences derived from clinical and research work with TMD patients. Studies of both older and more recent literature on TMD and related disorders--especially in the fields of stress research, psychosocial medicine, occupational medicine, and etiology--were also used. RESULTS: A clear line is found in the development of the ideas on etiology, pathogenesis, and therapy of TMD, from the mechanistic attitude of Costen syndrome through the introduction of psychologic and psychophysical theories by the Columbia and Chicago schools to the now increasingly accepted biopsychosocial concept and the view of refractory TMD as a chronic pain condition. CONCLUSION: The formerly dominant bite-centered therapies--including intraoral appliances, the effects of which still are unexplained--appear to be increasingly banished to the domain of placebo Hence, to an ever-increasing extent occlusal treatments are replaced by physiotherapy and cognitive behavior therapy. The presented hypotheses may have implications for the understanding of the origin of oral parafunction and masticatory muscle pain.

Expanding the role of the nurse in clinical trials: the nursing summaries.

In order to improve the overall quality of clinical trials, the role of the nurse should be expanded. The minimum requirement to facilitate nurses' participation and the optimal implementation of a clinical research protocol is to provide access to the clinical protocol document itself. However, given the high workload in an oncology unit, there is often little time for the staff to read the entire document. In addition, clinical protocols do not often provide detailed practical instructions for delivering treatment, observing patients, managing toxicities, and treating complications. A nursing summary of the medical protocol is a document that provides a short and easy-to-read selection of protocol-relevant information. It enables nurses to safely and more easily implement the research protocol and improve the care of patients in clinical trials. Master nursing summaries can be prepared centrally by the group responsible for the research protocol, while the unit/wards involved in the research can customize or adapt it to local needs. The potential benefit of implementing nursing summaries is overall improvement of the quality of the study by (a) increasing the reliability of nursing care regarding patients' safety, (b) standardizing monitoring and care of patients, (c) standardizing preventive measures, (d) proposing similar management of complications related to experimental treatments. Moreover, discussing nursing summaries may help evaluate workload related to research, allowing for better planning and allocation of resources.

Clinical trials and quality of life assessment: the nurses' viewpoint.

The rationale for quality of life assessment has been largely developed in the literature. Quality of life is an important concept in the oncology environment because the physical, psychological and social wellbeing of patients are affected both by the disease and the related treatments. The relevance of quality of life assessment to nursing clinical practice has been discussed by several authors. There is a need to use more valid and reliable instruments to plan appropriate nursing care, to evaluate and document the effect of nursing interventions. In clinical trials, quality of life assessment is being used increasingly to predict patients' outcomes and to evaluate medical and nursing interventions. Nurses' viewpoints of potential benefits and pitfalls related to quality of life assessment are discussed. Among the benefits, it is usually considered that therapeutic interventions might be improved. These could be adjusted and individualised and the need for supportive care interventions might be evaluated more accurately. As for the pitfalls, the quality of life evaluation causes an extra burden if its implementation is not properly co-ordinated and if poor or incomplete guidelines are provided to patients and staff. Proposals for implementing effective quality of life assessment in clinical trials are discussed. Basic requirements, such as preliminary instructions, guidelines for administration of the questionnaire and proposals for reducing missing evaluations, are presented.

The environmental somatization syndrome.

Patients with environmental somatization syndrome (ESS) believe that their symptoms are caused by exposure to tangible components of the external environment or by ergonomic stress at work. ESS is distinguishable by mental contagiousness and by the patients' focus on the external environment as cause of the illness. The presentation is often polysymptomatic, and epidemic outbreaks may appear. The patients usually refuse alternative explanations of their symptoms and discredit and reject any suggestion of a psychogenic etiology. It is important to distinguish between hygienic problems and ESS problems, particularly when poor and inadequate hygienic factors are present simultaneously with an ESS epidemic.

The involvement of nurses in clinical trials. Results of the EORTC Oncology Nurses Study Group survey.

The Oncology Nurses Study Group (ONSG) of the European Organization for Research and Treatment of Cancer (EORTC) initiated a survey to document the involvement of nurses in clinical trials. An English-language questionnaire was sent to 312 nurses in > 15 European countries. Results indicate that nurses lack training in oncology and in research methods. Nurses' tasks and activities are mainly oriented toward patient care. Nurses are rarely involved in activities related to protocol preparation and review. The circulation of information about clinical studies varies according to the center and the investigator responsible. Proposals to optimize nurse participation in clinical trials that were rated highly included (a) the availability of nursing protocol summaries translated into the local language, (b) contact with colleagues involved in the same trials, and (c) additional training in aspects of clinical trials related to nursing.

[Environmental somatization syndrome. How to deal with the external milieu syndrome?]. / Environmental somatization syndrome. Hur hanteras det yttre miljösyndromet?

Somatization is a tendency to experience and communicate psychogenic distress in the form of somatic symptoms and to seek medical help for them. Patients suffering from environmental somatization syndrome (ESS) consider their symptoms to be caused by exposure to chemical or physical components of the external environment or by ergonomic stress at work. ESS is distinguished by mental contagiousness and a tendency to cluster. Sometimes it explodes in wide-spread epidemics that may be escalated by mass-media campaigns. Extensive ESS epidemics have been connected to, i.a., arsenic, carbon monoxide ("generator gas poisoning"), mercury ("oral galvanism"), carbon-free copy papers, electromagnetic fields ("electric allergy") and repetitive movements ("repetition strain injury", RSI). The typical patient directs the interest on the external environment, refuses alternative explanations of his symptoms and abhors any suggestion of a psychogenic etiology. The community is often placed in difficult positions by lobby groups calling for drastic measures to eliminate alleged disease-inducing exposures. When hygienic evils occur simultaneously with an ESS epidemic, it is essential to strictly differ the hygienic problems from the ESS problems. If mismanaged, measures aimed at reducing hygienic inconveniences may aggravate the complex of ESS problems.

Amalgam--fact and fiction.

A brief history of amalgam is given, stressing the role of G. V. Black. The background and the progress of the two Amalgam Wars are sketched. Aspects are presented of the drawbacks of amalgam with respect to toxic effects of, especially, mercury vapor and corrosion products. An account is given of some frequent fallacies concerning the health hazards of dental amalgam fillings and the role of psychosocial factors in the development of illness attributed to amalgam is emphasized.

Portal vein thrombosis in Crohn's disease.

Thromboembolic complications of inflammatory bowel disease are a well-recognized occurrence. Portal vein thrombosis has been reported in patients with ulcerative colitis but to date has not been reported in patients with Crohn's disease. We present the first case of portal vein thrombosis in a patient with Crohn's disease.

Oral galvanism in Sweden.

Although a questionnaire response showed that many Swedes are concerned about oral galvanism, it seems that the symptoms changed as each theory was challenged. The symptoms changed with additional knowledge of the patient and the environment.