Effects of Repeat Test Exposure on Gait Parameters in Naïve Lewis Rats.

Rodent gait analysis has emerged as a powerful, quantitative behavioral assay to characterize the pain and disability associated with movement-related disorders. In other behavioral assays, the importance of acclimation and the effect of repeated testing have been evaluated. However, for rodent gait analysis, the effects of repeated gait testing and other environmental factors have not been thoroughly characterized. In this study, fifty-two naïve male Lewis rats ages 8 to 42 weeks completed gait testing at semi-random intervals for 31 weeks. Gait videos and force plate data were collected and processed using a custom MATLAB suite to calculate velocity, stride length, step width, percentage stance time (duty factor), and peak vertical force data. Exposure was quantified as the number of gait testing sessions. Linear mixed effects models were used to evaluate the effects of velocity, exposure, age, and weight on animal gait patterns. Relative to age and weight, repeated exposure was the dominant parameter affecting gait variables with significant effects on walking velocity, stride length, fore and hind limb step width, fore limb duty factor, and peak vertical force. From exposure 1 to 7, average velocity increased by approximately 15 cm/s. Together, these data indicate arena exposure had large effects on gait parameters and should be considered in acclimation protocols, experimental design, and subsequent data analysis of rodent gait data.

African Spiny Mice (Acomys) Exhibit Mild Osteoarthritis Following Meniscal Injury.

OBJECTIVE: Hyaline cartilage has limited innate healing abilities and hyaline cartilage loss is a hallmark of osteoarthritis (OA). Animal models can provide important insights into cartilage regeneration potential. One such animal model, the African spiny mouse (Acomys), is capable of regenerating skin, skeletal muscle, and elastic cartilage. This study aims to evaluate whether these regenerative abilities protect Acomys with meniscal injury from OA-related joint damage and behaviors indicative of joint pain and dysfunction. DESIGN: Acomys received destabilization of the medial meniscus (DMM) surgery (n = 11) or a skin incision (n = 10). Gait testing occurred at 4, 6, 8, 10, and 12 weeks after surgery. At endpoint, joints were processed for histology to assess cartilage damage. RESULTS: Following joint injury, Acomys with DMM surgery altered their walking patterns by increasing the percent stance time on the contralateral limb relative to the operated limb, thereby reducing the amount of time the injured limb must bear weight on its own throughout the gait cycle. Histological grading indicated evidence of OA-related joint damage in Acomys with DMM surgery; these changes were primarily driven by loss of structural integrity in the hyaline cartilage. CONCLUSIONS: Acomys developed gait compensations, and the hyaline cartilage in Acomys is not fully protected from OA-related joint damage following meniscal injury, although this damage was less severe than that historically found in C57BL/6 mice with an identical injury. Thus, Acomys do not appear to be completely protected from OA-related changes, despite the ability to regenerate other wounded tissues.

Evaluation of a Randomized Clinical Trial Comparing the Effectiveness of a Culturally Targeted and Nontargeted Smoking Cessation Intervention for Lesbian, Gay, Bisexual, and Transgender Smokers.

PURPOSE: To examine the benefits of a culturally targeted compared with a nontargeted smoking cessation intervention on smoking cessation outcomes among lesbian, gay, bisexual, and transgender (LGBT) smokers. METHODS: A prospective randomized design was used to evaluate the added benefits of an LGBT culturally targeted Courage to Quit (CTQ-CT) smoking cessation treatment (N = 172) compared with the standard intervention (CTQ; N = 173). The smoking cessation program consisted of six treatment sessions combined with 8 weeks of nicotine replacement therapy. The primary smoking cessation outcome was 7-day point prevalence quit rates. Secondary outcomes examined included changes in nicotine dependence, nicotine withdrawal, cigarettes per day, smoking urges, self-efficacy, and readiness to quit. RESULTS: Overall quit rates were 31.9% at 1 month, 21.1% at 3 months, 25.8% at 6 months, and 22.3% at 12 months. Quit rates did not differ between treatment groups [1 month OR = 0.81 (0.32, 2.09), 3 months OR = 0.65 (0.23, 1.78), 6 months OR = 0.45 (0.17, 1.21), 12 months OR = 0.70 (0.26, 1.91)]. Compared with baseline levels, all secondary smoking cessation outcomes measured were improved at 1 month and were maintained at 12-month follow-up. Compared with the CTQ, the CTQ-CT intervention was more highly rated on program effectiveness (d = 0.2, p = .011), intervention techniques (d = 0.2, p = .014), the treatment manual (d = 0.3, p < .001), and being targeted to the needs of LGBT smokers (d = 0.5, p < .0001). CONCLUSIONS: LGBT smokers receiving the CTQ intervention achieved smoking cessation outcomes in the range reported for other demographic groups. Cultural targeting improved the acceptability of the intervention but did not confer any additional benefit for smoking cessation outcomes. IMPLICATIONS: Study results have implications for understanding the benefits of culturally targeted compared with nontargeted smoking cessation interventions for improving smoking cessation outcomes among LGBT smokers. Shorter and longer term 7-day point prevalence quit rates associated with the targeted and nontargeted interventions were modest but comparable with other group-based interventions delivered in a community setting. Although cultural targeting improved the overall acceptability of the intervention, no added benefits were observed for the culturally targeted intervention on either the primary or secondary outcomes.

Validation of three pain scales among adult postoperative patients in Ghana.

BACKGROUND: Pain assessment is an important component of pain management and health professionals require valid tools to assess pain to guide their pain management decisions. The study sought to select, develop, and validate context-appropriate unidimensional pain scales for pain assessment among adult post-operative patients. METHODS: A mixed methods design was adopted. The study was conducted at two hospitals in Accra, Ghana. The qualitative phase involved 17 patients and 25 nurses, and the quantitative phase involved 150 post-operative patients. Qualitative data was collected iteratively through individual interviews and focus groups. RESULTS: Two existing pain scales (0-10 Numeric Rating Scale [NRS] and Wong-Baker FACES [FPS] scales) and one new pain scale (Colour-Circle Pain Scale-[CCPS]) were validated. The psychometric properties of the three scales were assessed when patients had fully recovered from anesthesia. The CCPS had higher scale preference than NRS and FPS. Convergent validity was very good and significant (0.70-0.75). Inter-rater reliability was high (0.923-0.928) and all the scales were sensitive to change in the intensity or level of pain experienced before and after analgesia such as paracetamol and diclofenac suppositories, injectable pethidine, and oral tramadol had been administered. CONCLUSION: Using a valid tool for pain assessment gives the clinician an objective criterion for pain management. Due to the subjective nature of pain, consideration of socio-cultural factors for the particular context ensures that the appropriate tool is used.

Dysmenorrhea Management and Coping among Students in Ghana: A Qualitative Exploration.

STUDY OBJECTIVE: The study sought to gain an in-depth understanding of primary dysmenorrhea management and coping strategies for dysmenorrhea among adolescents and young adults who were in school. DESIGN: The study adopted a qualitative exploratory approach using a descriptive phenomenology to explore the phenomenon of interest. SETTING: The study was conducted in two educational institutions in Accra, Ghana: a Senior High School (SHS) and a University. PARTICIPANTS AND DATA COLLECTION: Sixteen participants were purposively recruited (8 SHS and 8 University students) through snowball sampling. Individual interviews were conducted in English, audio-taped, transcribed and analysed using content analysis procedures. Informed consent was obtained from all participants and rigor was ensured through prolonged engagement and member checking. RESULTS: Participants employed both pharmacologic (orthodox and herbal) and nonpharmacologic approaches such as warm compress, exercise, and water and diet therapy for their dysmenorrhea. Students' dysmenorrhea was managed at the school clinic and the hospital. Health professionals demonstrated negative attitudes towards dysmenorrhea management. Students coped with dysmenorrhea by planning activities before the onset of pain, receiving social and spiritual support, and developing a mind-set to bear pain. CONCLUSIONS: Individualized approaches should be employed to enhance dysmenorrhea management. Health professionals should be educated on dysmenorrhea to improve their attitude and skills for dysmenorrhea management.

Breast cancer diagnosis and factors influencing treatment decisions in Ghana.

Researchers in this study explored the reactions of women with breast cancer and identified factors influencing treatment decisions. A qualitative exploratory approach was employed. Participants were recruited from a tertiary hospital and a breast cancer support group. Purposive sampling recruited 12 women. It was found that women identified breast lesions accidentally or intentionally and that diagnosis was delayed. Emotional reactions to diagnosis included shock and sadness. Factors that influenced treatment were the influence of other people, alternative sources of treatment, faith and support, knowledge, "tuning the mind," and effects on intimacy. Health professionals should develop effective communication and counseling skills for clients.

Sleep quality, BDNF genotype and gene expression in individuals with chronic abdominal pain.

BACKGROUND: Sleep quality and genetics may contribute to the etiology of gastrointestinal (GI) symptoms. Individuals with impaired sleep often have a number of associated symptoms including chronic abdominal pain (CAP). The current study examined the interactions of brain-derived neurotrophic factor (BDNF) genotype with sleep quality in persons with CAP and healthy controls. In addition, associations among sleep quality, BDNF genotype, and gene expression were explored in the participants. METHODS: Data were collected on 59 participants (46% male, 61% White, 26.9 ± 6.6 years; CAP (n=19) and healthy controls (n=40)). Participants with CAP reported poorer sleep quality compared to healthy controls. BDNF genotype, categorized as Val/Val homozygotes versus the Met carriers. RESULTS: Microarray analysis found twenty-four differentially expressed genes by a two-fold magnitude in participants with poor sleep quality compared to good sleep quality, and seven differentially expressed genes comparing CAP to healthy control. Three specific genes in the pain group overlap with sleep quality, including insulin-like growth factor 1 (IGF1), spermatogenesis associated serine-rich 2-like (SPATS2L), and immunoglobulin heavy constant gamma 1 or mu (IGHG1/// IGHM). BDNF was shown to have an interaction effect with GI and sleep symptoms. CONCLUSIONS: Participants with CAP reported poor sleep quality compared to healthy controls. The role of the BDNF Met allele on differential gene expression was not distinct as main factor, but impacted interactions with sleep quality and CAP. Down-regulation of IGF1, SPATS2L, and IGHG1 expression may be related to the etiology of poor sleep quality and CAP. TRIAL REGISTRATION: Clinicaltrial.gov # NCT00824941.

The experience of dysmenorrhoea among Ghanaian senior high and university students: pain characteristics and effects.

BACKGROUND: Dysmenorrhoea is a common problem of women at the reproductive age and may have negative effect on the education of females at various stages on the educational ladder. CONTEXT AND PURPOSE: This study sought to gain an in-depth understanding of the experience of dysmenorrhoea and its effect on female students in a secondary and a tertiary institution in Accra, Ghana. METHODS: The study employed a descriptive phenomenology design and was conducted at a University and a Senior High School (SHS) in Accra. Purposive and snowball sampling techniques were used to recruit participants and data was saturated with 16 participants. Concurrent analysis was done by applying the processes of content analysis and the NVivo software was used to manage the data. RESULTS: It was realized that dysmenorrhoea is associated with symptoms such as diarrhoea, headache and vomiting. Pain may start one week to the day of menstruation and the severity differed across the days of menstruation. The effect of dysmenorrhoea included activity intolerance, altered emotion and interaction, altered sleep pattern, absenteeism and inattentiveness, wishes and regrets, and misconceptions. CONCLUSIONS: It was concluded that severe dysmenorrhoea has a debilitating effect on female students and is associated with misconceptions that could result in drastic action with fatal consequences. Thus, there is the need to enhance education on dysmenorrhoea, and an aggressive step should be taken to effectively manage dysmenorrhoea.

Immunoexpression of constitutive and inducible cyclo-oxygenase isoforms in the rat foetal and maternal digestive tract.

Cyclo-oxygenase (COX), which catalyses the conversion of arachidonic acid to prostaglandin endoperoxide and prostanoids, is widely expressed in mammalian organs. The aim of the study was to evaluate the immunoexpression of the constitutive and inducible cyclo-oxygenase isoforms (COX-1 and COX-2 respectively) in the oesophagus, stomach and the small and large bowels of untreated rat dams and foetuses on gestational day 21. The localisation of the COX isoforms was similar in the maternal and foetal organs, although the intensity of the reaction for COX-2 was stronger in the foetuses. Cytoplasmic COX-1 immunostaining was found in myocytes of the muscularis propria, muscularis mucosae and the blood vessels. It was also positive in the endothelial cells, scattered stromal cells of the lamina propria and the ganglion cells of the nerve plexus in the bowels. Apart from the keratinised layer, a strong reaction was revealed in the stratified squamous epithelium of the oesophagus and forestomach. Negative or weakly positive staining was found in the mucus-secreting cells covering the surface, gastric pits and pyloric glands, as well as in the parietal cells and the chief cells. Weakly positive COX-1 immunostaining was observed in epithelial cells of the small intestine crypts, but in some cases enterocytes and goblet cells covering villi were also positive. In the colonic mucosa weak COX-1 staining was typical of the absorptive, and goblet cells. The COX-2 immunostaining was nuclear and/or cytoplasmic. An inconsistent positive reaction was seen in the muscle of the muscularis mucosae, muscularis propria and the blood vessels. Positive staining was also found in scattered stromal cells of the lamina propria and adventitia and the ganglion cells. Weak nuclear staining was found in the stratified squamous epithelium of the oesophagus and forestomach. Unlike the strong foetal reactivity in the epithelial cells of the glandular stomach, a negative or weakly positive reaction was seen in the maternal parietal and/or mucous-secreting surface stomach cells. Some epithelial cells of the crypts both in the small and large bowel were also COX-2 positive. In conclusion, constitutive and inducible COX isoforms were detected in the digestive tract of pregnant female and in foetuses. COX-1 was the predominant isoform in both the adult and foetal organs.