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Background: Palliative care (PC) helps maintain quality of life for seriously ill patients, yet, many Americans lack knowledge of PC. Aim: To explore the relationships between knowledge of PC of individuals living in north-central Florida and throughout the United States. Design: This cross-sectional survey with three sampling approaches, one was a community-engaged sample and two were panel respondent samples. Respondents and setting: Respondents of the Florida sample (n1 = 329) and the community-engaged sample (n2 = 100), were representative of the 23 Florida county general population. Respondents of the national sample (n = 1800) were adult members of a panel owned by a cloud-based survey platform. Results: Young adults compared with adults (OR 1.62, 95% CI 1.14-2.28, P.007), middle-adults (OR 2.47, 95% CI 1.58-3.92, P <.001) and older-adults (OR 3.75, 95% CI 2.50-5.67, P <.001) were less likely to agree that the goal of PC is to help friends and family cope with a patient's illness, and that the goal of PC is to manage pain and other physical symptoms compared with adults (OR 1.67, 95% CI 1.20-2.30, P.002) middle-adults (OR 2.58, 95% CI 1.71-3.95, P <.001) and older-adults (OR 7.19, 95% CI 4.68-11.2, P <.001). Participants with greater rural identity (OR 1.39, 95% CI 1.31-1.48, P <.001) were more likely to agree that accepting PC means giving up. Conclusions: Increased knowledge of PC might be influenced through targeting educational interventions and educating the general population through social media use. [ABSTRACT FROM AUTHOR]

Abstract Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder with a range of symptoms that significantly affect quality of life for patients. The difficulty of differential diagnosis and its [...]

Little is known about the effects of self-managed relaxation interventions on pain, stress, and autonomic responses in patients with sickle cell disease (SCD). This pre-post randomized controlled pilot study was conducted to determine the feasibility of using computer tablets for relaxation intervention delivery; acceptability of study procedures; and intervention effects on pain, stress, and indicators of relaxation. The 30 research participants ranged in age from 22 years to 59 years. All were African American; 53% were male. They were randomized to an experimental group that watched a relaxation video or a control group that discussed their disease. All participants completed the study, indicating feasibility. Acceptability rates were also high. Data were obtained for the intervention's immediate effect on pain, stress, respiration, pulse, finger skin temperature, and self-reported relaxation. These preliminary findings will guide future, higher-powered studies to determine the intervention's efficacy and mechanism in SCD. The ClinicalTrials.gov Identifier: NCT02729363 [ABSTRACT FROM AUTHOR]

Background: Cancer cachexia (CC) is a significant contributor to mortality and morbidity in patients with gastrointestinal (GI) cancer. Treatment options to prevent or halt the progression of CC are limited. Targeted acupuncture (TA) was used in GI patients with CC to evaluate for a potential gender effect. Patients and methods: Participants (n = 30) were recruited from two outpatient clinics in the northern central part of Florida. All participants were diagnosed with CC and GI cancers. A randomized, single-blind, placebo-controlled clinical trial was used to compare TA to non-targeted acupuncture (NTA) over the course of 8 weeks. Primary endpoints were weight and body composition changes measured by bioelectrical impedance analysis (BIA) and biomarker analysis (tumor necrosis factor (TNF)-α and leptin). Herein, gender differences across and within TA and NTA groups were examined as a secondary analysis. Results: A significant (p = 0.026) interaction between weight and gender was noted, which manifested in a non-significant increase in the male intervention (MI) group, while TNF-α levels significantly increased by gender (p = 0.028) and group (p = 0.006) over the course of the study. All other groups either lost or did not change weight. The extracellular-to-intracellular water (ECW/ICW) ratio was significantly elevated for the TA group (p = 0.02) and for males (p = 0.009) at completion of the study. TNF-α and leptin levels were positively correlated within the MI group at the end of the study. Conclusion: A decrease in leptin in the MI group corresponded to higher appetite and weight gain. The elevated ECW/ICW ratio indicates an inflammatory response in the MI group. This gender-specific response may be based on hormone-specific regulation of food intake. Further studies with larger sample sizes are required to support the results. [ABSTRACT FROM AUTHOR]

Background: We sought to refine a screening measure for discriminating a sensitized or normal sensation pain phenotype among African American adults with sickle cell disease (SCD). Objective: To develop scoring schemes based on sensory pain quality descriptors; evaluate their performance on classifying patients with SCD who had sensitization or normal sensation, and compare with scores on the Self‐report Leeds Assessment of Neuropathic Symptoms and Signs (S‐LANSS) and the Neuropathic Pain Symptom Inventory (NPSI). Methods: Participants completed PAINReportIt, quantitative sensory testing (QST), S‐LANSS, and NPSI. Conventional binary logistic regression and least absolute shrinkage and selection operator (lasso) regression were used to obtain 2 sets of weights resulting in 2 scores: the PR‐Logistic (PAINReportIt score weighted by conventional binary logistic regression coefficients) and PR‐Lasso (PAINReportIt score weighted by lasso regression coefficients). Performance of the proposed scores and the existing scores were evaluated. Results: Lasso regression resulted in a parsimonious model with non‐zero weights assigned to 2 neuropathic descriptors, cold and spreading. We found positive correlations between the PR‐Lasso and other scores: S‐LANSS (r = 0.22, P < 0.01), NPSI (r = 0.22, P < 0.01), and PR‐Logistic (r = 0.35, P < 0.01). The NPSI and PR‐Lasso performed similarly at different levels of required specificity and outperformed the S‐LANSS and PR‐Logistic at the various specificity points. Conclusion: The PR‐Lasso offers a way to discriminate a SCD pain phenotype. [ABSTRACT FROM AUTHOR]

The use of complementary and alternative medicine (CAM) is widespread among adults in the United States to self-treat a range of disorders, including gastrointestinal (GI) disorders. This study determined the self-reported use of CAM, including dietary supplements, in managing GI symptoms among Internet users and investigated perceived effects of supplement use on GI symptoms. We used a cross-sectional, descriptive, correlational design. A Qualtrics online survey was utilized to collect data through various websites. Focused areas include demographics, health evaluation, health issue(s), supplement and CAM use, and GI symptoms. Of the participants included in the study, a majority (88%) were women and half (50.1%) were between the ages of 26 and 45. Most participants (84.5%) reported use of herbal supplements, and 84.8% of the participants used herbal supplements for a specific health problem. The most common reported health condition was gastroesophageal reflux (44.4%). The attrition rate was low at 22%. The novelty of using an anonymous online survey to collect data on supplement use in GI disorders indicated a high prevalence of dietary and herbal supplement use among persons with GI disorders comparable to previous reports. Health-care providers should ask patients about supplement use in addition to prescribed medications and communicate effectively if conventional pharmacotherapy is not sufficient to manage symptoms or patients are inclined to use supplements. [ABSTRACT FROM AUTHOR]