Allopregnanolone Levels Are Inversely Associated with Self-Reported Pain Symptoms in U.S. Iraq and Afghanistan-Era Veterans: Implications for Biomarkers and Therapeutics.

BACKGROUND AND OBJECTIVES: Pain symptoms are common among Iraq/Afghanistan-era veterans, many of whom continue to experience persistent pain symptoms despite multiple pharmacological interventions. Preclinical data suggest that neurosteroids such as allopregnanolone demonstrate pronounced analgesic properties, and thus represent logical biomarker candidates and therapeutic targets for pain. Allopregnanolone is also a positive GABAA receptor modulator with anxiolytic, anticonvulsant, and neuroprotective actions in rodent models. We previously reported inverse associations between serum allopregnanolone levels and self-reported pain symptom severity in a pilot study of 82 male veterans. METHODS: The current study investigates allopregnanolone levels in a larger cohort of 485 male Iraq/Afghanistan-era veterans to attempt to replicate these initial findings. Pain symptoms were assessed by items from the Symptom Checklist-90-R (SCL-90-R) querying headache, chest pain, muscle soreness, and low back pain over the past 7 days. Allopregnanolone levels were quantified by gas chromatography/mass spectrometry. RESULTS: Associations between pain ratings and allopregnanolone levels were examined with Poisson regression analyses, controlling for age and smoking. Bivariate nonparametric Mann–Whitney analyses examining allopregnanolone levels across high and low levels of pain were also conducted. Allopregnanolone levels were inversely associated with muscle soreness [P = 0.0028], chest pain [P = 0.032], and aggregate total pain (sum of all four pain items) [P = 0.0001]. In the bivariate analyses, allopregnanolone levels were lower in the group reporting high levels of muscle soreness [P = 0.001]. CONCLUSIONS: These findings are generally consistent with our prior pilot study and suggest that allopregnanolone may function as an endogenous analgesic. Thus, exogenous supplementation with allopregnanolone could have therapeutic potential. The characterization of neurosteroid profiles may also have biomarker utility.

Capturing teachers' experience of learning design through case studies

This article distinguishes three dimensions to learning design: a technological infrastructure, a conceptual framework for practice that focuses on the creation of structured sequences of learning activities, and a way to represent and share practice through the use of mediating artefacts. Focusing initially on the second of these dimensions, the article reports the key findings from an exploratory study, eLIDA CAMEL. This project examined a hitherto under-researched aspect of learning design: what teachers who are new to the domain perceive to be its value as a framework for practice in the design of both flexible and classroom-based learning. Data collection comprised 13 case studies constructed from participants' self-reports. These suggest that providing students with a structured sequence of learning activities was the major value to teachers. The article additionally discusses the potential of such case studies to function as mediating artefacts for practitioners who are considering experimenting with learning design.

A case study of the effectiveness of the electronic survey as a research tool for measuring students' experience of e-learning

This paper uses a case study approach to consider the effectiveness of the electronic survey as a research tool to measure the learner voice about experiences of e-learning in a particular institutional case. Two large scale electronic surveys were carried out for the Student Experience of e-Learning (SEEL) project at the University of Greenwich in 2007 and 2008, funded by the UK Higher Education Academy (HEA). The paper considers this case to argue that, although the electronic web-based survey is a convenient method of quantitative and qualitative data collection, enabling higher education institutions swiftly to capture multiple views of large numbers of students regarding experiences of e-learning, for more robust analysis, electronic survey research is best combined with other methods of in-depth qualitative data collection. The advantages and disadvantages of the electronic survey as a research method to capture student experiences of e-learning are the focus of analysis in this short paper, which reports an overview of large-scale data collection (1,000+ responses) from two electronic surveys administered to students using surveymonkey as a web-based survey tool as part of the SEEL research project. Advantages of web-based electronic survey design include flexibility, ease of design, high degree of designer control, convenience, low costs, data security, ease of access and guarantee of confidentiality combined with researcher ability to identify users through email addresses. Disadvantages of electronic survey design include the self-selecting nature of web-enabled respondent participation, which tends to skew data collection towards students who respond effectively to email invitations. The relative inadequacy of electronic surveys to capture in-depth qualitative views of students is discussed with regard to prior recommendations from the JISC-funded Learners' Experiences of e-Learning (LEX) project, in consideration of the results from SEEL in-depth interviews with students. The paper considers the literature on web-based and email electronic survey design, summing up the relative advantages and disadvantages of electronic surveys as a tool for student experience of e-learning research. The paper concludes with a range of recommendations for designing future electronic surveys to capture the learner voice on e-learning, contributing to evidence-based learning technology research development in higher education.

Adult personality inconsistency and problems with parents: uncovering the roots of the false self

Research has established that individuals who tend to vary their personality depending on who they are with, show a variety of signs of psychological maladjustment in comparison to those who do not; they show more negative affect (Baird, Le and Lucas, 2006), lower life satisfaction (Suh, 2002), lower self-esteem (Sheldon et al., 1997), lower role-satisfaction (Donahue et al., 1993), higher rates of depression (Lutz and Ross, 2003), more anxiety (Diehl, Hastings and Stanton, 2001) and poorer physical health (Cross, Gore and Morris, 2003). It has also been shown that personality variability is positively related to the experience of inauthenticity and falsity (Sheldon et al., 1997). Donahue, Roberts, Robins and John (1993) found that personality inconsistency of this type is related to tension within the family. Psychoanalytic theory has also linked the operation of an adult false self to experiences with parents, particularly in early life (Winnicott, 1960). It was hypothesized that personality variability and the adult experience of falsity in social situations would be related to an emotionally unstable relationship with parents. The method to test this comprised a questionnaire-based survey given to a non-clinical population. The final sample comprised 305, with 193 women and 112 men, aged from 19 to 55. The first questionnaire asked participants to rate personality traits, including emotional stability, in three social contexts - with parents, with friends and with work colleagues. The second part involved 3 questions; participants were asked to select in which of the aforementioned three social contexts they felt “most themselves”; in which they were “most authentic” and in which they “put on a front”. It was found, consistent with predictions, that an index of overall personality variability calculated from the personality questionnaire correlated strongly with emotional instability around parents (r = 0.46, p<0.001), while not correlating with emotional instability in either of the other two contexts measured. This suggests a specific link between a person’s relationship with their parents and their overall personality integration. Furthermore, it was found that participants who cited one of the three social contexts (parents, friends, work colleagues) as being one in which they were “more themselves” or “more authentic” had significantly higher ratings of emotional instability with parents than those participants who found that they were equally authentic across settings (F = 9.8, p<0.005). The results suggest a clear link between a person’s relationships with their parents and their adult personality integration. An explanation is that individuals who experience an anxious or ambiguous attachment with their parents in childhood may fear rejection or abandonment in later life, and so habitually adapt their personality to fit in to social contexts as adults, in order to be accepted by others and to minimize the possibility of social rejection. These individuals meanwhile retain an emotionally unstable relationship with their parents in adulthood. This interpretation is speculative but is open to empirical testing. Clinicians should be aware that attachment problems with parents may underlie poor personality integration in adulthood.

Sexual behaviour of young people in Northern Ireland: First sexual experience

Two National Surveys of Sexual Attitudes and Lifestyles in Britain (Natsal) were conducted, one in 1990 and one in 2000. Northern Ireland was excluded from both studies. Now, for the first time, comparable data about sexual attitudes and lifestyles of young people (14- to 25-year-olds) in Northern Ireland are available. Data were collected through self-administered questionnaires, one-to-one interviews and focus-group discussions. As in Natsal 1990 and 2000, young people were asked about their sexual attitudes towards sex, experiences of sex education, knowledge of sexually transmitted infections (STIs) and, if sexually active, about the circumstances in which sexual intercourse occurred. A total of 1013 young people in the target age group completed the self-administered questionnaire. Young people in Northern Ireland do not differ significantly from their counterparts in Britain in terms of sexual lifestyles and attitudes. Some 53.3% of all respondents reported that they had had sexual intercourse. Condom use at first sex was reported by 64% of sexually active respondents; 27.4% said they used no contraception; 26.7% of all respondents said they had sex before age 16. Respondents who first had sex when they were 15 or 16 years were more likely than other respondents to say that 'being drunk' was the main reason why intercourse occurred. Peer pressure to engage in sex was more prevalent among males than females. Young people in Northern Ireland regard friends as their most important source of sex education. School is the second most important source but most respondents wanted more sex education in school. It is important that it is needs focused and includes potentially sensitive and contentious information.

Self-Management of Chronic Pain: Interventions, Strategies, Barriers, and Facilitators

Background & Purpose: Chronic pain is a prevalent chronic condition for which the best management options rarely provide complete relief. Individuals with chronic pain with neuropathic characteristics (NC) report more severe pain and experience less relief from interventions. Little is known about current self-management practices. The purpose of this dissertation was to inform self-management of chronic pain with and without NC at the individual, health system, and policy levels using the Innovative Care for Chronic Conditions Framework. Methods: The study included a systematic search and review and cross-sectional survey. The review evaluated the evidence for chronic pain self-management interventions and explored the role of health care providers in supporting self-management. The survey was mailed to 8,000 randomly selected Canadians in November 2011, and non-respondents were followed-up in May 2012. Screening questions were included for both chronic pain and NC. The questionnaire captured pain descriptions, self-management strategies, and self-management barriers, and facilitators. Results: Findings of the review suggested that self-management interventions are effective in improving pain and health outcomes. Health care professionals provided self-management advice and referred individuals to self-management interventions. The questionnaire was completed by 1,520 Canadians. Those with chronic pain (n=710) identified primary care physicians as the most helpful pain management professional. Overall, use of non-pharmaceutical medical self-management strategies was low. While use positive emotional self-management strategies was high, individuals with NC were more likely to use negative emotional self-management strategies compared to those without NC. Multiple self-management barriers and facilitators were identified, however those with NC were more likely than those without NC to experience low self-efficacy, depression and severe pain which may impair the ability to self-management. Conclusions: Health care professionals have the opportunity to improve chronic pain outcomes by providing self-management advice, referring to self-management interventions, and addressing self-management barriers and facilitators. Individuals with NC may require additional health services to address their greater self-management challenges, and further research is needed to identify non-pharmaceutical interventions effective in relieving chronic pain with NC. Public policy is needed to facilitate health systems in providing long-term self-management support for individuals with chronic pain.

Computer usage and the validity of self-assessed computer competence among first-year business students

Abstract This study evaluates the reliability of self-assessment as a measure of computer competence. This evaluation is carried out in response to recent research which has employed self-reported ratings as the sole indicator of students’ computer competence. To evaluate the reliability of self-assessed computer competence, the scores achieved by students in self-assessed computer competence tests are compared with scores achieved in objective tests. The results reveal a statistically significantly over-estimation of computer competence among the students surveyed. Furthermore, reported pre-university computer experience in terms of home and school use and formal IT education does not affect this result. The findings call into question the validity of using self-assessment as a measure of computer competence. More generally, the study also provides an up-to-date picture of self-reported computer usage and IT experience among pre-university students from New Zealand and South-east Asia and contrasts these findings with those from previous research.

Continuous assessment activities - correlation with final exam grades and effect on final grades. A business studies experience

In this paper we analyze the partial grades – of continuous assessment activities including the final exam – and the final grades – computed as a weighted average of partial grades – for nine subjects taught in the third year of Business Administration Degree. On one hand, results show that there is a significant positive correlation between the grades of continuous assessment activities (excluded the final exam) and final exam in seven subjects. On the other hand, overall we find that students’ grades in continuous assessment activities (excluded the final exam) help in the improvement of their final grades (i.e., students’ final grades exceed the grades that they would obtain by only taking into account their final exam grades). The results are consistent when the analysis is carried out over each subject area as well as over the grades of the students who registered for the nine subjects.

The influence of experience on the research competencies of university professors

Implementation of EHEA, among others, motivates a transforming process in universities and promotes changes in the professor’s tasks. This events, promote changes to which the university professor has to adapt, meaning this to acquire and to develop new competencies to respond correctly to new professional tasks that are demanded. To design training plans in accordance to the new training needs, and to establish referents in accreditation, selection and promotion protocols appear to be necessary to define the new competences profile professors have to face in order to develop their teaching, research and management tasks suitably, and according to their professional settings and professional development stage. A qualitative research was developed to define the emerging competence profile. Quantitative and qualitative methods were mixed as well as different tools (questionnaires, interviews and focus groups) and sources (faculty, experts and students). This article only shows the results obtained from professors (expert and novice) in the 4 research competencies analyzed (design, development and assessment of projects; organization and management of scientific events; development of scientific material; communication and dissemination of scientific knowledges) and the most significant dates of the 30 competency units that compose them. Results show significant differences of self-perception of current competency domain level between novice faculty and expert faculty. These results help us to establish the priority training areas to the faculty according to their professional development stage.

Co-evaluation as a strategy to improve working group dynamics: an experience in Sport Sciences

The aim of this study was to analyze if the perceptions of students before and after carrying out the work, that is, their perception of different aspects of the functioning of the group, the working skills acquired as well as those they think that need to be improved, varied depending on whether the contribution of the different members of the group was being co-evaluated or not. 144 students of Physical Activity and Sport Sciences participated in this study. In order to analyze the students' perception of group work the adapted questionnaire by Bourne et al. (2001) was used. Results showed that groups which implemented co-evaluation assessed more negatively the experience in general than those which did not. However, co-evaluation groups perceived their competence to work as a team had improved to a greater extent than the groups without co-evaluation, evaluating more positively both the performance and the result of work and increasing their knowledge of the other team members. Using a co-evaluation system seems to generate both a better assessment of the running of the team and the result of its work.

Adjusting to Life After Esophagectomy: The Experience of Survivors and Carers

Following surgery for esophageal cancer, patients can experience complex physical, social, and emotional changes. Investigation of these challenges, particularly from the perspective of the patient and his or her carer, has been limited. The current study explored the emotional and cognitive experiences of esophageal cancer survivors and those of their carers, using focus groups conducted with members of a patient support group. Analysis of the patients’ data yielded three themes: coping with a death sentence, adjusting to and accepting an altered self, and the unique benefits of peer support. Analysis of the carers’ data also yielded three themes: the carer as buffer, representations of recovery and recurrence, and normalizing experiences through peer support. Esophageal cancer patients and their carers require holistic support in their efforts to adjust to the social, emotional, and physical consequences of esophagectomy. Peers could be an effective channel for the support of patients and carers.

Adolescent males experience of the counselling process

This study examines 11 adolescent males' self-reports of their experiences of 23 counselling sessions to identify what they found helpful and unhelpful during key moments in the therapeutic process. The findings suggest that the experiences of the adolescent males in this study are similar in many ways to the to the reported experiences of adults in counselling. In particular, the experience of emotional support and relief appears to be highly significant for adolescent males, who give significantly lesser importance to cognitive task factors.

Conceptions of Teacher Identity: Creating Self-Boxes as Arts-Based Self-Study

This paper presents a palimpsest of ways in which self-study draws upon arts-based methods not just as processes towards teacher development, but also as means to problematize and inquire into conceptualizations of the self. It focuses on the creation of individual self-boxes that mediate teachers’ dynamic narratives of identity. Concepts of the unitary self, the decentred self and the relationship between inner and outer experience are challenged and illustrated through two interlapping stories made manifest through the creation of self-boxes. From time immemorial man has known that he is the subject most deserving of his own study, but he has also fought shy of treating this subject as a whole, that is, in accordance with its total character. (Buber, 1947, p. 140)

Does chronic illness place constraints on positive constructions of identity? Temporal comparisons and self-evaluations in people with schizophrenia

It is often suggested that people in potentially threatening situations might engage in self-enhancing temporal comparisons that allow them to view themselves and their experience in a more positive light. Data from semistructured interviews with 12 individuals in the UK diagnosed as having schizophrenia were content analyzed to explore patterns of temporal comparison. The study found that the onset of schizophrenic symptoms created a new baseline in participants' representations of their past, with different types of temporal comparisons occurring before and after this point. Although comparisons with past selves after onset supported the suggestion that people may select and construct their past in such a manner that permits them to see their present circumstances more positively and envisage a better future, comparisons with past selves before onset were more negative. The findings suggest that the Theory of Temporal Self-Appraisals (Ross I Wilson, 2000) needs to be elaborated to include people who have experienced major life changes. (c) 2004 Elsevier Ltd. All rights reserved.