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Purpose: This article presents an in-depth, idiographic study examining the lived experience of chronic pain following spinal cord injury (SCI). Neuropathic pain (NP) occurs in a large majority of the SCI population and is particularly intractable to treatment. It can be both psychologically and physically debilitating. This study examines how the experience of NP is mediated by its meaning to the sufferer.Methods: Semi-structured interviews were conducted with eight people with SCI and chronic NP, attending outpatient clinics at a specialist SCI Centre in the UK. Verbatim transcripts were subjected to interpretative phenomenological analysis to further understand the experience.Results: Analysis suggested that NP has powerful consequences upon the sufferer’s physical, psychological and social well-being, in line with a biopsychosocial understanding of pain. Three super-ordinate themes were identified: a perceived gap between treatments received and participants’ views of what they wanted and needed; a fight for life control and acceptance; and feeling understood by others with SCI, but isolated from the non-understanding able-bodied.Conclusions: The results are discussed in terms of the possible application of acceptance-based therapy to NP and the potential for the alleviation of the debilitating consequences of NP.Implications for RehabilitationChronic NP after SCI is often described as worse than the injury itself, often impacting upon the sufferers physical and psychological health.The experiences of persons with SCI-specific NP highlight the impact of pain on their physical, psychological and social health. This indicates that healthcare professionals should incorporate a biopsychosocial approach for managing pain post-SCI.Routine clinical follow-up of SCI patients with chronic NP, as well as comprehensive pain management treatment programmes, could address the three themes evidenced in the current study, by moving routine intervention with NP away from pain relief, towards pain management.Continued education for patients, friends, family members and healthcare professionals may be beneficial in promoting understanding and awareness of NP and its consequences following SCI. [ABSTRACT FROM PUBLISHER]

Primary objective: To examine the predictive associations of family satisfaction, functional impairment, pain, and depression on health-related quality-of-life (HRQoL) among persons with traumatic brain injury (TBI) through structural equation modelling (SEM). Research design: Participants were part of a larger longitudinal study of adjustment following TBI. Direct and indirect effects of predictor variables on HRQoL were analyzed through SEM. Methods and procedures: The sample included 131 participants with TBI (89 men, 42 women) who had been discharged from an acute care hospital. The Sickness Impact Profile was administered to measure HRQoL at or beyond 24 months post-discharge. Predictor variable measures included the Functional Independence Measure, Family Satisfaction Scale and single items assessing the presence of pain and depression. Main outcomes and results: SEM revealed direct effects of functional impairment ( p < 0.001), family satisfaction ( p < 0.01), depression ( p < 0.05) and pain ( p < 0.01) on HRQoL. Indirect effects from functional impairment ( p < 0.05) and pain ( p < 0.05) to HRQoL through depression were also present. Conclusions: The presence of pain and depression, greater functional impairment and lower family satisfaction were predictively associated with lower HRQoL. Depression further mediated the effects of pain and functional impairment on HRQoL. The present study advances understanding of the ways in which pain, depression and functional impairment predict HRQoL. [ABSTRACT FROM AUTHOR]

Purpose The aim was to determine the extent of daily disposable contact lens prescribing worldwide and to characterise the associated demographics and fitting patterns. Methods Up to 1,000 survey forms were sent to contact lens fitters in up to 40 countries between January and March every year for five consecutive years (2007 to 2011). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey form. Survey data collected since 1996 were also analysed for seven nations to assess daily disposable lens fitting trends since that time. Results Data were collected in relation to 97,289 soft lens fits, of which 23,445 (24.1 per cent) were with daily disposable lenses and 73,170 (75.9 per cent) were with reusable lenses. Daily disposable lens prescribing ranged from 0.6 per cent of all soft lenses in Nepal to 66.2 per cent in Qatar. Compared with reusable lens fittings, daily disposable lens fittings can be characterised as follows: older age (30.0 ± 12.5 versus 29.3 ± 12.3 years for reusable lenses); males are over-represented; a greater proportion of new fits versus refits; 85.9 per cent hydrogel; lower proportion of toric and presbyopia designs and a higher proportion of part-time wear. There has been a continuous increase in daily disposable lens prescribing between 1996 and 2011. The proportion of daily disposable lens fits (as a function of all soft lens fits) is positively related to the gross domestic product at purchasing power parity per capita (r2 = 0.55, F = 46.8, p < 0.0001). Conclusions The greater convenience and other benefits of daily disposable lenses have resulted in this modality capturing significant market share. The contact lens field appears to be heading toward a true single-use-only, disposable lens market. [ABSTRACT FROM AUTHOR]

This study provides an intercomparison of the performance of a newly developed water-based condensation particle counter (WCPC) and a more widely used butanol-based CPC (TSI 3022A). Four test aerosols (ammonium nitrate, ammonium sulfate, adipic acid, and glutaric acid) were generated and tested in the laboratory before the instruments were deployed at four field locations (USC/downtown LA, I-710 Freeway, Pacific coast, and Los Angeles International Airport). Both instruments sampled the same incoming aerosol. Selected experiments utilized a differential mobility analyzer to select a particle size upstream of the CPCs. Evaluation of performance was based on the response of the instruments to varying particle composition, concentrations, and size. The results indicated good correlation between the two CPCs, with R2 values ranging from 0.74-0.99. Good agreement was found between the two instruments for particle concentrations between 0 and 40,000 particles/cm3, with W-CPC/TSI 3022A ratios between 0.8 and 1.2. Due to differences in the photometric mode calibration of these instruments, the ratio drops to 0.6-0.8 between 40,000-100,000 particles/cm3. However, the ratio rises again for lab aerosols above 100,000 particles/cm3 to 1.0-1.1. Results of this evaluation show that the W-CPC is a reliable particle-counting technology for particle concentrations encountered downstream of a DMA as well as in some ambient environments (<40,000 particles/cm3). [ABSTRACT FROM AUTHOR]

Particle size distribution measurements of twelve USEPA priority pollutant polycyclic aromatic hydrocarbons (PAHs)—collected in Riverside, California, down to 10 nm aerodynamic diameter (Dp)—observed on integrated nocturnal samples (7:00 p.m.-6:30 a.m.) revealed that between 46 and 100% of the mass of particles in the Aitken size range was found in the 10-18 nm size bin. Particles in this size range have high alveolar deposition efficiency. [ABSTRACT FROM AUTHOR]

Volatility properties of ultrafine particles were analyzed next to State Route 110 (Pasadena freeway CA), a light-duty vehicle freeway where heavy-duty traffic is prohibited. In addition, mass concentration and chemical composition of particulate matter (PM) were measured in coarse, accumulation, and ultrafine modes. On weekdays from 17 May to 4 June 2004, measurements were performed in two locations, one very close to the freeway (within 2.5 m from the curb) and one at a distance of about 50 m from the freeway. For measurement of mass and chemical composition, the study employed in each location a micro-orifice uniform deposit impactor (MOUDI) and a modified high-volume sampler. Both instruments sampled with the same size cutpoints: a coarse mode from 2.5 to 10 µm, an accumulation mode from 0.18 to 2.5 µm, and an ultrafine mode of particles less than 0.18 µm in aerodynamic diameter. Alternately, a tandem differential mobility analyzer (TDMA) was used at the two sites. A heater between the two DMAs evaporated volatile material from the monodisperse aerosol, size selected by the first DMA. The second DMA analyzed the losses of volatile components. The ultrafine number concentrations next to the freeway were 46,000 cm -3 on average during the sampling period. The MOUDI ultrafine mass concentration, nitrate, and EC were higher next to the freeway than at the background site farther from the freeway. The other components analyzed in the ultrafine mode had similar concentrations next to the freeway and at the background site. Volatility ranged from about 65% volume losses of 120 nm particles heated to 110°C to 95% of 20 nm particles. The 20 nm aerosol was only internally mixed, whereas increasing nonvolatile fractions were found for 40 nm (6% next to the freeway), 80 nm (20%), and 120 nm (28%) aerosols. [ABSTRACT FROM AUTHOR]

Primary objective : To investigate the internal consistency, long-term stability and validity of the Life Satisfaction Index-A (LSI-A) in a sample of survivors of traumatic brain injury (TBI). Research design : Cohort study. Methods and procedures : LSI-A was administered to survivors of TBI at 12, 24, 48 and 60 months post-injury during telephone interviews. Participants rated their quality of life, independence and participation in activities as well as health status at 24 months. Internal consistency was evaluated with Coefficient α. Pearson's r was used to investigate score stability. Test validity was explored with Pearson's r and Analysis of Covariance with age and sex as covariates. Experimental interventions : None. Main outcomes and results : Coefficient α s ranged from 0.85-0.92. Test-re-test coefficients ranged from 0.42-0.77. The LSI-A was positively correlated with self-reported quality of life, independence, activity level and health status. Conclusions : The LSI-A is a reliable and valid measure of the construct of life satisfaction among survivors of TBI. [ABSTRACT FROM AUTHOR]

Primary objective : Determine (1) the sensitivity of world-wide-web searches for deaths among persons with traumatic brain injuries and (2) factors associated with the likelihood of identifying deceased persons with traumatic brain injuries. Research design : Stratified case series. Methods and procedures : Sequential submission of 371 deceased persons with traumatic brain injuries to a world-wide-web site to determine inclusion in the Social Security Death Index (SSDI). Main outcomes and results : Almost 87% of deceased persons ages 50+ were found, 69.8% of persons ages 30-49 and 34.6% of persons younger than age 30. Other factors influencing the likelihood of finding deceased persons in the SSDI were male gender, white race, being married, knowing the Social Security number and survival of 1+ years post-injury. Conclusions : The SSDI provides useful information for mortality studies among persons with traumatic brain injuries, but does a poor job of identifying deaths among younger persons. Sole reliance on the SSDI may result in under-ascertainment of mortality. [ABSTRACT FROM AUTHOR]

Recent studies that have found increased health effects of atmospheric ultrafine particulate matter (PM) have refocused attention on particle number rather than particle mass concentrations as a relevant measurement of PM pollution. As part of the Southern California Supersite program, ambient particle characteristics were measured over 13 months at three different sites in the eastern portion of the Los Angeles Basin: Riverside, Rubidoux, and Claremont, CA. The sites represent receptor locations that are influenced by local particle sources as well as advection from the more intense particle sources upwind closer to Downtown Los Angeles. An SMPS/APS tandem system was employed to collect continuous particle size distributions, from which particle number and mass concentrations were calculated. An aethalometer provided continuous particulate elemental carbon (EC) concentrations. Results show no meaningful correlation between particle number and mass, indicating that fine particle standards may not be effective in controlling ultrafine concentrations. Diurnal patterns show a morning traffic peak indicated by increases in particle mass, number, and EC. Afternoon periods in the warmer months are characterized by high number counts while mass and EC remain low, suggesting the formation of new particles by photochemistry. Particle mode diameters range from 30 nm up to above 100 nm, a result not seen in most other studies of particle size distributions in other urban or rural areas where mode diameters are generally less than 50 nm. Evidence is presented that the observed ultrafine particle concentrations and size distributions are influenced by long-range advection and photochemical processes as well as vehicular emissions, which have been previously assumed to dominate day-to-day ultrafine particle levels. [ABSTRACT FROM AUTHOR]

This article presents the development and evaluation of a very compact facility for exposing humans to concentrated ambient ultrafine particles (da < 0.15 µm). The human ultrafine particle concentrator (UFPC) operates at an intake flow rate of 1200 liters per minute (LPM). The concentrator is preceded by an ultrafine impactor which separates the accumulation mode from ultrafine mode particles under a very low pressure drop (1.5 kPa), a feature that is essential in enabling human inhalation studies of ultrafine concentrated ambient particulates (CAP). A key feature of the UFPC is a new cooling system, consisting of a programmable refrigerated circulator, which produces the supersaturation that is necessary to grow ultrafine PM to supermicrometer sizes so that they can be concentrated by means of conventional virtual impaction. The new cooling system allows for entirely automated operation of the UFPC. The UFPC was characterized in field experiments, in which the concentration enrichment of ultrafine particles was determined based on their number and mass concentration as well as on chemical composition including elemental carbon (EC), inorganic ions (sulfate and nitrate), and polycyclic aromatic hydrocarbons (PAH). Tests were conducted at minor-to-total flow ratios varying from 2.5-5% (hence at minor flow rates between 30-60 LPM). Measurements with the scanning mobility particle sizer (SMPS) showed a near-ideal increase in number concentrations (corresponding to the ratio of total-to-minor flow rate) of ultrafine particles after enrichment. The concentration enrichment was uniform across the entire particle diameter range of 15-660 nm. Similar results were obtained for EC and PAH concentrations (measured by an Aethalometer). Time-integrated filter-based tests, conducted to characterize the system for ultrafine PM mass and inorganic ion concentrations showed that the average enrichment factor was very close to the ideal values, indicating near perfect collection efficiency with minimal particle losses. [ABSTRACT FROM AUTHOR]

Assesses the relationship between depression and life satisfaction among survivors of traumatic brain injury (TBI) over a 3-year period after injury. Hypothesis that survivors of TBI with depression would have decreased life satisfaction; Interview of TBI survivors.

Reports on the use of continuous monitor, a fine particle nitrate monitor from Berkeley, California-based Aerosol Dynamics Inc. for measuring size-fractioned PM2.5 nitrate. Techniques for separating particles from ambient gases; Description of the size-segregated integrated collection and vaporization cell for nitrate measurement; Field comparison with time-integrated filter and impactor measurements.

Paper/pencil psychological tests such as the Minnesota Multiphasic Personality Inventory (MMPI) are difficult to complete independently by patients with limited hand function. This paper describes a voice recognition system developed to allow patients with no hand function to take the MMPI independently. Profiles generated by this system are not statistically different from those generated by standard MMPI booklet format. Limitations and possible extensions of the system as it currently exists are discussed. [ABSTRACT FROM AUTHOR]

Particle size distribution measurements of twelve USEPA priority pollutant polycyclic aromatic hydrocarbons (PAHs)—collected in Riverside, California, down to 10 nm aerodynamic diameter (Dp)—observed on integrated nocturnal samples (7:00 p.m.-6:30 a.m.) revealed that between 46 and 100% of the mass of particles in the Aitken size range was found in the 10-18 nm size bin. Particles in this size range have high alveolar deposition efficiency. [ABSTRACT FROM AUTHOR]