Managing chronic bone, joint pain

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Musculoskeletal pain of the bone, joint and muscles is one of the most common reasons for primary care visits in the United States. According to a literature review appearing in a recent issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), chronic pain, or pain that persists beyond an expected period of healing, is estimated to affect 100 million Americans.The majority of chronic pain complaints concern the musculoskeletal system, but they also include headaches and abdominal pain. “As orthopaedic surgeons, we are experts in the management of acute injuries to the extremities and spine. As a specialty, however, we are admittedly less adept in the management of chronic musculoskeletal pain,” says lead study author Richard L. Uhl, MD, an orthopaedic surgeon at Albany Medical Center in Albany, N.Y. “Given its prevalence, and the profound economic implications of chronic pain on both healthcare costs and lost productivity, we have a duty to be proficient in its diagnosis and care.”The Bare FactsLow back pain affects up to 80 percent of Americans at some point in life, and consistently ranks among the top five most common reasons for all healthcare visits in the U.S. Chronic knee, hip, and shoulder pain from degenerative processes also is common, as are chronic neuropathic pains from advanced diabetes. Orthopaedic surgeons and primary care physicians encounter patients who suffer from chronic pain almost daily.A Surprising Study Finding Non-steroidal anti-inflammatory drugs (NSAIDs) — easily the most commonly recommended or prescribed medication by orthopaedic surgeons — are not especially effective in many chronic pain scenarios. “While far from the everyday ‘arsenal’ of orthopaedic surgeons, antidepressants and anticonvulsants (medications to prevent seizures) can have remarkable effects on many forms of chronic bone and joint pain. There are many readily-accessible, economic, safe and effective treatments for chronic pain,” says Dr. …


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Optimizing donor kidney distribution in the United States

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Northwestern University’s Sanjay Mehrotra has developed an innovative model that could help ease kidney distribution inequities among regions in the U.S. and ultimately help save hundreds of lives. His mathematical model, which takes into account a number of different factors, simulates and optimizes donor kidney distribution.Mehrotra will discuss his research in a presentation titled “Addressing Allocation Inefficiencies and Geographic Disparities” at the American Association for the Advancement of Science (AAAS) annual meeting in Chicago. His presentation is part of a symposium titled “Transplant Organ Shortage: Informing National Policies Using Management Sciences” to be held from 10 to 11:30 a.m. CST Friday, Feb. 14, in Columbus IJ of the Hyatt Regency Chicago.Mehrotra also will participate in a press briefing to be held at 1 p.m. CST the same day in Vevey Room 3 of the Swisstel Chicago.In addition to Mehrotra, two other Northwestern professors will discuss issues related to organ shortage during both the symposium and press briefing.Michael Abecassis, M.D., chief of the division of organ transplantation and founding director of the Comprehensive Transplant Center at Northwestern University Feinberg School of Medicine, will offer a brief overview of the current issues facing organ allocation.John Friedewald, M.D., associate professor in medicine and surgery at Feinberg and director of clinical research at Northwestern University Feinberg School of Medicine Comprehensive Transplant Center and transplant nephrologist at Northwestern Memorial Hospital, will speak about policy changes in kidney allocation that were developed during his recent term as chair of the United Network for Organ Sharing Kidney Transplantation Committee.Nearly 100,000 people in the United States are waiting for kidney transplants, but only 17,000 kidneys are available annually from both living and deceased donors. There are major regional inequalities in access to organs because of supply and demand disparities among different areas of the country. A person in one state might get a kidney within a year, while someone in another state might wait up to four years. As a consequence, nearly 5,000 people die each year waiting for a kidney transplant.Logistically, organ allocation is a difficult problem. …


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#Alzheimer, #Chief, #Comprehensive, #Engineering, #Health-Insurance, #Management, #Mehrotra, #National, #Network, #Organ, #Professor, #Science

Rice seed treatments effective, worth investment: Study

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When every extra expense makes a difference in profitability, farmers often wonder which management decisions are worth the extra cost.One recent example is the development of seeds treated with insecticides to discourage early damage by crop pests. Researchers at Mississippi State University have been evaluating the effectiveness of rice seed treatments to find out what producers can expect from the extra investment. Their research saves farmers time and money while helping them make informed decisions about managing their fields.After testing scores of samples taken from rice fields across the state, MSU scientists found that seed treatments are effective in managing the crop’s most troublesome insect pests.”In Mississippi, we’ve been evaluating seed treatments for about five years,” said Jeff Gore, entomologist with the Mississippi Agricultural and Forestry Experiment Station and MSU Extension Service. “Our research has shown that rice grown with a seed treatment typically yields from 8 to 12 bushels more per acre than untreated rice. The main reason for that yield increase is rice water weevil control.” Gore said seed treatments are effective in both conventional rice varieties and hybrids.”Although they do not provide 100 percent control of rice water weevil, seed treatments do provide significant benefits in rice,” he said. “Because control is not absolute, a foliar insecticide application may be necessary to maximize control in some situations.”Insect managementGore works at the Delta Research and Extension Center in Stoneville. He said researchers take core samples about 4 inches in diameter and 8 inches deep from farms across the Delta, wash them and count the rice water weevil larvae.”An infestation of one larva per core will result in about a 1 percent yield loss,” Gore said. “Typical infestations in the Delta range from 10 to 25 weevils per core in untreated fields, resulting in a 10 to 25 percent yield loss.”Gore said that seed treatments provide other benefits to rice producers, too.”Seed treatments provide good control against a whole complex of other rice pests,” he said. “Seed treatments help manage chinch bugs, grape colapsis, thrips and soil insects, such as wire worms and white grubs, and get the plants off to a good, healthy start.”Performance under floodSeed treatments for row crops, such as corn, cotton or soybean, target early-season pests that are in the soil when the seed is planted. But rice seed treatments are different.”We’re targeting primarily rice water weevils, and they only move into the field when producers establish the permanent flood about three to six weeks after planting,” Gore said. …


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#Agriculture, #Alzheimer, #Cruiser, #Decisions, #Development, #Farmers, #Flushing, #Management, #Profitability, #Result, #Science

The 4 Cardinal Rules of Smart Money Management

The 4 Cardinal Rules of Smart Money Management



Americans are getting better at making ends meet, according to the 2013 National Financial Capability Study, but they are lacking in savings and debt management skills. Less than half of Americans surveyed had emergency savings of three months’ i...

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Marriage"s "haves" and "have nots": Changing expectations and rising inequality improve best marriages, but undermine average marriages

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Today Americans are looking to their marriages to fulfill different goals than in the past — and although the fulfillment of these goals requires especially large investments of time and energy in the marital relationship, on average Americans are actually making smaller investments in their marital relationship than in the past, according to new research from Northwestern University.Those conflicting realities don’t bode well for the majority of marriages, according to Eli Finkel, professor of psychology in the Weinberg College of Arts and sciences and professor of management and organizations at the Kellogg School of Management at Northwestern and the lead author of the study. But today’s best marriages — those in which the spouses invest enough time and energy in bolstering the marital relationship to help each other achieve what they seek from the marriage — are flourishing even more than the best marriages of yesteryear.What accounts for these divergent trends?Many scholars and social commentators have argued that contemporary Americans are, to their peril, expecting more of their marriage than in the past. But Finkel, who wrote the article in collaboration with Northwestern graduate students Ming Hui, Kathleen Carswell and Grace Larson, disagrees.”The issue isn’t that Americans are expecting more versus less from their marriage, but rather that the nature of what they are expecting has changed,” Finkel said. “They’re asking less of their marriage regarding basic physiological and safety needs, but they’re asking more of their marriage regarding higher psychological needs like the need for personal growth.”According to Finkel, these changes over time in what Americans are seeking from their marriage are linked to broader changes in the nation’s economic and cultural circumstances.In the decades after America’s Declaration of Independence in 1776, the nation primarily consisted of small farming villages in which the household was the unit of economic production and wage labor outside the home was rare. During that era, the primary functions of marriage revolved around meeting basic needs like food production, shelter and physical safety.”In 1800, the idea of marrying for love was ludicrous,” Finkel said. “That isn’t to say that people didn’t want love from their marriage; it just wasn’t the point of marriage.”Starting around 1850, the nation began a sharp and sustained transition toward urbanization, and the husband-breadwinner/wife-homemaker model of marriage became increasingly entrenched. With these changes, and as the nation became wealthier, the primary functions of marriage revolved less around basic needs and more around needs pertaining to love and companionship.”To be sure,” Finkel observed, “marriage remained an economic institution, but the fundamental reason for getting married and for achieving happiness within the marriage increasingly revolved around love and companionship.”Starting with the various countercultural revolutions of the 1960s, a third model of marriage emerged. This third model continued to value love and companionship, but many of the primary functions of marriage now involved helping the spouses engage in a voyage of self-discovery and personal growth.”In contemporary marriages, “Finkel notes, “Americans look to their marriage to help them ‘find themselves’ and to pursue careers and other activities that facilitate the expression of their core self.”Finkel is generally enthusiastic about these historical changes, as having a marriage meet one’s needs for self-discovery and personal growth can yield extremely high-quality marriages. Yet, he has doubts about whether the majority of American marriages can, at present, meet spouses’ new psychological expectations of their marriage.According to Finkel, when the primary functions of marriage revolved around shelter and food production, there wasn’t much need for spouses to achieve deep insight into each other’s core psychological essence. As the primary functions shifted to love and then to self-expression, however, it became increasingly essential for spouses to develop such insight.”However, developing such insight requires a heavy investment of time and psychological resources in the marriage, not to mention strong relationship skills and interpersonal compatibility,” Finkel said.Those marriages that are successful in meeting the two spouses’ love and self-expression goals are extremely happy — happier than the best marriages in earlier eras. …


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#Alternative-Medicine, #America, #Article, #Finkel, #Health, #Management, #Northwestern, #Pregnancy, #Professor, #Study