Assessing the Effects of Childhood Multitype Maltreatment on Adult Spirituality.

Continued research regarding the effects of experiencing multiple types of childhood maltreatment is necessary in gauging the impact of such experiences on survivors. In an effort to contribute to this area of study, the authors investigated the relationship between multitype childhood maltreatment and adult spirituality and compared three established methods of assessing the these effects to investigate the degree to which a researcher's choice of method might affect their findings. Surveys were completed by 254 university students that included data on childhood maltreatment and current spirituality. Findings suggest the presence of a dose response between multitype childhood maltreatment and adult spirituality and that the researcher's assessment method choice can affect findings of the research. In addition, the authors report their findings on the unique effects of five types of childhood maltreatment on adult spirituality. Emotional neglect and emotional abuse were found to be associated with lower levels of spirituality; no significant relationships were found between sexual abuse, physical abuse, and physical neglect and spirituality. The findings suggest the need for further study regarding the effects of experiencing multiple types of childhood maltreatment, the most accurate methods of assessing those effects on survivors, and the relationship between multitype maltreatment and spirituality.

Repetitive transcranial magnetic stimulation over primary motor vs non-motor cortical targets; effects on experimental hyperalgesia in healthy subjects.

BACKGROUND: High frequency repetitive transcranial magnetic stimulation (rTMS) targetted to different cortical regions (primary motor/sensory, prefrontal) are known to alter somatosensory responses. The mechanism(s) for these effects are unclear. We compared the analgesic effects of rTMS at different cortical sites on hyperalgesia induced using topical capsaicin cream. METHODS: Fourteen healthy subjects had capsaicin cream applied to a 16 cm2 area of the medial aspect of the right wrist (60 min) on 4 separate occasions over 6 weeks. rTMS (10Hz for 10s/min = 2000 stimuli @ 90% resting motor threshold of first dorsal interosseus muscle) was applied to the optimum site for right hand (M1), left dorsolateral prefrontal (DLFPC) and occipital midline (OCC) in a pseudo-randomised order. Thermal and mechanical perception and pain thresholds were determined using standardised quantitative sensory testing (QST) methods at the capsaicin site. Subjective responses to thermal stimuli (pain score on a numerical rating scale) from -2.5°C to +2.5°C of the individualised heat pain threshold (HPT) resulted in a hyperalgesia curve. Sensory testing took place prior to capsaicin application (PRE-CAP), after 30 min of capsaicin (POST-CAP) and following rTMS (30 min = POST-TMS). RESULTS: Capsaicin application resulted in substantial changes in thermal (but not mechanical) sensitivity to both heat and cold (eg. HPT PRE-CAP = 43.6°C to POST-CAP = 36.7°C (p < 0.001)) with no differences between groups pre-rTMS. POST-TMS HPT showed no changes for any of the treatment groups, however the pain scores for the hyperalgesia curve were significantly lower for M1 vs OCC (-24.7%, p < 0.001) and for M1 vs DLFPC (-18.3%, p < 0.02). CONCLUSION: rTMS over the primary motor cortex results in a significant analgesic effect compared to other cortical areas.

The efficacy of a senior outreach program in the reduction of hospital readmissions and emergency department visits among chronically ill seniors.

This study reports on the effectiveness of a community-based senior outreach program in decreasing rehospitalizations and emergency department visits among chronically ill seniors. Participants had been repeatedly hospitalized with chronic illnesses and were subsequently served in an in-home program designed to address their psychosocial and medical needs. Participation in the program was found to be related to lower hospital readmission rates and emergency department usage. Clients also reported decreased financial concerns and depression and anxiety and increased social support. The study adds to the growing body of work supporting community-based programs as effective strategies for decreasing health care usage and improving quality of life for chronically ill seniors.

Dancing with "death": p-methoxyamphetamine overdose and its acute management.

Para-methoxyamphetamine (PMA) is a substituted synthetic amphetamine used in the recreational drug scene. It is unusual because of the high incidence of significant morbidity and mortality in overdose. We report a case of PMA overdose in South Australia, and review our experience with the drug. We review the literature on PMA overdose and offer suggestions on the management of overdose with this dangerous drug.