Identification of unique genomic signatures in patients with fibromyalgia and chronic pain

Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread pain. The pathophysiology of fibromyalgia is not clearly understood and there are no specific biomarkers available for accurate diagnosis. Here we define genomic signatures using high throughput RNA sequencing on 96 fibromyalgia and 93 control cases. Our findings revealed three major fibromyalgia-associated expression signatures. The first group included 43 patients with a signature enriched for gene expression associated with extracellular matrix and downregulation of RhoGDI signaling pathway. The second group included 30 patients and showed a profound reduction in the expression of inflammatory mediators with an increased expression of genes involved in the CLEAR signaling pathway. These results suggest defective tissue homeostasis associated with the extra-cellular matrix and cellular program that regulates lysosomal biogenesis and participates in macromolecule clearance in fibromyalgia. The third group of 17 FM patients showed overexpression of pathways that control acute inflammation and dysfunction of the global transcriptional process. The result of this study indicates that FM is a heterogeneous and complex disease. Further elucidation of these pathways will lead to the development of accurate diagnostic markers, and effective therapeutic options for fibromyalgia.

Marketing syringe/needle exchange programs

In an effort to bring the AIDS epidemic under control among the highest risk population of injecting drug users, Syringe/Needle Exchange Programs are being considered, developed and implemented. This paper looks at some of the programs in the United States in various stages of development. Also discussed will be the medical, social and political issues surrounding Needle Exchange Programs.

Food management for the aging population

The older population is becoming more important to our society everyday. These individuals are being studied for their past, present, and potential impact on markets and marketing. Evaluated as a user of products or services in the marketplace or an employee or volunteer within the marketing system, this segment is gaining a visibility and importance. An interview was conducted with five Nutrition Project Directors to obtain an overview of Federally Funded Nutrition Programs for the Elderly. The areas which were highlighted were service delivery, site activities, management styles, barriers to service, clientele composition, food planning and preparation, staffing, USDA funding, coordination, marketing, transportation, and volunteerism. The Second Quarter Service Provider Output Reports for 1991, which are compiled by the Nutrition Projects and submitted to the Area Agency on Aging, were utilized to obtain client profile information (Reports, 1991). The analysis sought to compare the programs offered in the five counties on a number of factors which could be quantified. It was hoped that by looking at the numerical ratios, and depicting them graphically, any trends or unique characteristics of the programs could be identified. In that the percentage of Florida's present elder population (17%) far exceeds the national average (12%) these findings could be utilized by nutrition programs outside of Florida to plan for future funds. Analysis of quantitative information on the five programs yielded information on cost comparisons and on services.

Marketing nutrition services for the elderly

The Older Americans Act of 1965 was implemented to provide assistance in the development of new or improved programs to help older persons through grants for the States. Community planning, and services for training, were established within the Department of Health, Education, and Welfare under an agency designated as the Administration on Aging (Older Americans Act of 1965, p. 1). There has been an evolution of Community Nutrition services for the elderly. The original purpose was the establishment of community based congregate dining sites where seniors would come together for food and fellowship. The homebound seniors were recognized and home-delivered meal service was developed. This home delivered meal service has steadily increased as the participant population has changed with less family support and is becoming older and frailer while congregate participation has decreased. The challenge to marketers is to continue to bring together the need for nutritional assistance in the elderly population and nutritional programs to satisfy that need. The authors have conducted a nutrition service program study that can benefit the industry that serves this segment of the population. This study observes trends and behaviors and can assist the development of new products and services for the aging.

Quantitative ultrasound of the heel: correlation with densitometric measurements at different skeletal sites

To assess the utility of quantitative ultrasound (QUS) of the heel for osteoporosis screening, we studied a group of 170 early postmenopausal women using both QUS of the heel and dual-energy X-ray absorptiometry (DXA) at the spine, hip, forearm, and whole body. On the basis of the linear regression results between QUS and DXA, a 95% bone mineral density (BMD) estimate confidence range was defined. Correlation coefficients between the QUS measurements and DXA ranged from 0.26 to 0.63. The confidence ranges for the estimated BMD based on a QUS measurement of the heel were large, such that an estimation of skeletal BMD at any of the DXA sites measured was not possible. For example, an estimate of the normative anteroposterior spine BMD (i.e. the T-score or the Z-score) based on a calcaneal ultrasound reading would have an error of +/- 1.9 standard deviations. Results for predicting the normative BMD of the other DXA regions were similar, with expected errors ranging from +/- 1.4 to +/- 2.0 standard deviations. We therefore conclude that QUS is not suited for the screening of early postmenopausal women for low axial or peripheral BMD. However, QUS may have a role as an independent predictor of fracture by measuring skeletal properties in addition to bone density.

Health abuse marketing

The Health Care Industry is being challenged by diverse needs and demands from the population at large. A growing market is the chemically dependent and the variety of situations that each individual and substance brings. As the public awareness and education increases, organizations, hospitals and groups are responding. This paper will discuss the behaviors around cigarettes, food, alcohol, co-dependency and drugs along with programs and approaches established to address these issues.

Health issue advertising

"Americans say that the battle against drugs is the chief issue facing the nation" (McQueen and Shribman, 1989). The Wall Street Journal/NBC poll conducted by Peter Hart and Robert Teeter shows a public willingness to experiment with a wide variety of anti-drug efforts. "No single issue has so riveted the nation's attention since the 1982 recession," Messers. Hart and Teeter say in their analysis of the poll. They add that respondents seem willing to try almost anything to solve the drug problem (ibid). How can and does marketing affect this process? This paper will examine some of the methods and effectiveness of advertising in regard to this very timely health issue and societal challenge. For the purposes of this paper, drug discussions refer to alcohol as well. Social marketing in general will be addressed.

Effects of breed type and restricted versus ad libitum feeding on fatty acid composition and cholesterol content of muscle and adipose tissue from mature bovine females

Fatty acid composition and cholesterol content of muscle and adipose tissue from mature cows (N = 101) representing 15 breeds and crosses were determined. An initial group of cows was slaughtered after being fed slightly above the maintenance level for 2 wk; the remaining cows were fed either at the maintenance level or ad libitum for 84 d, then slaughtered. Samples of triceps brachii and longissimus muscle and subcutaneous and perinephric adipose tissue were obtained from each carcass. In addition, phospholipid and triacylglycerol fatty acids from total lipid extracts of triceps brachii muscle and subcutaneous adipose tissue were analyzed for 24 cows that were fed ad libitum or at the maintenance level for 84 d. Breed type effects on fatty acid composition were more pronounced in adipose tissue than in muscle tissue. Total lipid extracts of both triceps brachii and longissimus muscle from animals fed a maintenance diet for 84 d contained higher (P less than .01) percentages (3 to 8%) of polyunsaturated fatty acids (PUFA) and lower percentages (2 to 3%) of saturated fatty acids (SFA) than those from animals fed ad libitum for 84 d. This reflected significant variation in the fatty acids C14:0, C16:0, C18:2, C18:3 and C20:4 for both longissimus and triceps brachii muscle. Fatty acid composition within phospholipid and triacylglycerol fractions was similar regardless of maintenance or ad libitum feeding. Much of the variation in total lipid fatty acid composition appeared to be the result of differences in triacylglycerol:phospholipid ratios. Adipose tissue contained about twice as much cholesterol (mg/100 g wet weight) as muscle tissue. Both breed type and feeding group effects on cholesterol content of muscle tissue were nonsignificant. Values for cholesterol content of adipose tissue from cows fed restricted diets were higher than those from cows fed ad libitum (approximately 55 mg/100 g higher for subcutaneous and 25 mg/100 g for perinephric). The results show that changes in fatty acid composition of bovine tissues can be made genetically and by varying the energy level in the diet. Alteration of the cholesterol content of muscle tissue by these methods does not appear to be feasible.