Annals of the New York Academy of Sciences
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Ann. N. Y. Acad. Sci. · May 2014
ReviewWhen and for how long should glucocorticoids be used in rheumatoid arthritis? International guidelines and recommendations.
Glucocorticoids are widely used in rheumatoid arthritis (RA); however, their effectiveness and safety is still a subject of debate. In particular, when to introduce glucocorticoids, but also when and how to taper them, are important questions for clinicians. ⋯ The recommendations cover the introduction of glucocorticoids (and for whom they are recommended), doses and duration of treatment, and tapering strategies. Items still on the research agenda include more data on safety, particularly for long-term use, and small doses of glucocorticoids.
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Since the first demonstrations that mindfulness-based therapies could have a positive influence on chronic pain patients, numerous studies have been conducted with healthy individuals in an attempt to understand meditative analgesia. This review focuses explicitly on experimental pain studies of meditation and attempts to draw preliminary conclusions based on the work completed in this new field over the past 6 years. Dividing meditative practices into the broad categories of focused attention (FA) and open monitoring (OM) techniques allowed several patterns to emerge. ⋯ The neural pattern underlying pain modulation during OM suggests meditators actively focus on the noxious stimulation while inhibiting other mental processes, consistent with descriptions of mindfulness. A preliminary model is presented for explaining the influence of mindfulness practice on pain. Finally, the potential analgesic effect of the currently unexplored technique of compassion meditation is discussed.
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Ann. N. Y. Acad. Sci. · Jan 2014
ReviewLeveraging paraprofessionals and family strengths to improve coverage and penetration of nutrition and early child development services.
Children need to be protected in intergenerational networks, with parents who have positive mood, resources to feed their children, and skills to promote early childhood development (ECD). Globally, more than 200 million children are raised annually without these resources. This article reviews the potential contributions of increasing coverage and penetration of services for these children, challenges to achieving penetration of services in high-risk families, opportunities created by bundling multiple services within one provider, potential leveraging of paraprofessionals to deliver care, and mobilizing communities to support children in households at high risk for negative outcomes. We end with a number of suggestions for how to ensure the equitable scale-up of integrated ECD and nutrition services that take into account current global priorities, as well as coverage and penetration of services.
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This paper presents commentaries on reflux-induced injury of human esophageal epithelium; inflammation in human reflux esophagitis; motor consequences of reflux-induced inflammation in esophageal epithelium; the microscopic morphology of esophageal squamous epithelium; intraluminal impedance in the evaluation of the esophageal mucosa; endoscopic tissue morphology of esophageal squamous epithelium; and the developmental biology of esophageal squamous epithelium.
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Ann. N. Y. Acad. Sci. · Sep 2013
ReviewSacred values in the Israeli-Palestinian conflict: resistance to social influence, temporal discounting, and exit strategies.
Conflicts over sacred values may be particularly difficult to resolve. Because sacred values are nonfungible with material values, standard attempts to negotiate, such as offering material incentives to compromise, often backfire, increasing moral outrage and support for violent action. ⋯ We show that devoted actors (1) were less amenable to social influence, (2) perceived conflict-related events in the past as well as expected events in the future to be temporally closer, and (3) were blind to individual opportunities to escape the conflict. These results suggest that sacred values may affect decision making in a number of ways, which, when combined, contribute to common defense and continuation of conflict.