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Feeding is critical for survival. Yet, patients with chronic pain often lose their appetite and eat less. We previously showed that ad libitum fed male rats continue to feed rather than withdraw from a brief noxious stimulus. This study examined the effects of a sustained noxious stimulus on feeding by testing ad libitum fed male rats for five eating behaviors -latency to eat, time taken to eat each chip, pauses and scanning during eating, and the number of chocolate chips eaten -during the hour following a sham injection or an injection of a low (0.5%) or moderate (1.5%) dose of formalin into the hind paw. Sham-injected rats showed no pain-related behaviors, rats injected with 0.5% formalin showed very few pain-related behaviors, and rats injected with 1.5% formalin showed favoring, lifting and licking of the injured paw with a characteristic biphasic time course. Besides taking less time to commence eating during the first phase of formalin pain, rats injected with either dose of formalin did not differ from sham-injected rats on any of the other eating measures. Rats injected with 0.5% formalin showed no pain behaviors during eating, whereas those given 1.5% formalin typically ate while not exhibiting any pain behaviors but occasionally ate while favoring the paw, rarely while lifting the paw, and never while licking the paw. These results show that eating is a protected activity even in the presence of persistent pain in male rats. Keywords eating behavior; formalin; chocolate A decrease in appetite and eating problems are common complaints associated with acute and chronic pain. In a sample of older adult outpatients with non-malignant chronic pain, approximately 40% reported eating problems [1]. Even among a non-clinical population of children and adolescents surveyed for acute and chronic pain, over 50% attributed appetite problems to their pain experience [2]. Anorexia is extremely prevalent in migraine sufferers, occurring in > 80% of sufferers during attacks [3]. The timing of appetite loss coincides well with the appearance of head pain and precedes the onset of symptoms more directly associated with loss of appetite such as nausea and vomiting [3].In an animal model of migraine pain, male rats that received noxious chemical stimulation of the dura ate less than those given vehicle stimulation in the first four hours following stimulation [3]. However, dural stimulation produces cutaneous facial allodynia [4,5] and

ObjectivesTo evaluate medical trainees’ attitudes toward refugee patients in a refugee host country, and to identify educational needs. MethodsA 54-question cross-sectional questionnaire was administered to a convenience sample of 81 post-graduate medical trainees at Mbarara Regional Referral Hospital, Uganda, in 2016. Descriptive statistics on medical trainees’ attitudes and educational needs regarding care for refugees were calculated. One-way ANOVA was used to assess relationships between an attitude scale and respondent characteristics. Reliability and validity of the survey items and attitude scale were assessed using Cronbach’s alpha, item-to-scale correlation, and factor analysis. ResultsThe mean score on the attitude scale of 2.8 (SD=1.7) indicated positive attitudes toward refugees. All respondents had contact with refugees, and 89% (n=72) reported a need for further training. Many specifically indicated the need for training in use of translators, support personnel, and behavioral health.  Cronbach’s alpha values of greater than 0.7 indicated good internal consistency. Item-to-scale correlation and factor analysis validate the use of an attitude scale. ANOVA showed no significant difference between mean attitude scores in gender (F(1,77)=0.11, p=0.7367), country of origin (F(1.78) =0.53, p=0.8723), or year of study (F(4,74) =0.31, p=0.8273). ConclusionsMedical trainees in Uganda report positive attitudes toward refugees and a need for additional education in refugee care in multiple specific areas. This study piloted the use of an attitude scale for refugee healthcare providers with promising validity and reliability. Use of these questions could inform curriculum development in refugee host countries.

This study tested whether the duration of microarousals from sleep evoked by innocuous air-puff is affected by intra-RVM administration of neurotensin and bicuculline, pharmacological manipulations that affect ON and OFF cell activity. Air-puff evoked microarousal duration was unaffected by 0.05 ng neurotensin, but decreased by 502 ng neurotensin, and 5 and 50 ng bicuculline. These results suggest a putative role for OFF cells in protecting sleep from interruption by non-noxious stimuli.

COVID-19 has heavily impacted the refugee population in the United States due to exposure risks, living and working conditions, and healthcare access, but little is known about outcomes. We reviewed emergency department visits to a Kentucky hospital among 2163 patients from March-December 2020, studying incidence of COVID-19 diagnosis for patients with a primary refugee-associated language compared to English speakers, and outcomes after diagnosis including hospitalization, length of stay, and in-hospital mortality. Patients in the population of interest had higher odds of COVID-19 diagnosis in the hospital (OR = 12.31, 95% CI 7.80–19.40), but, among those with COVID-19, lower odds of hospital admission (OR = 0.58, 95% CI 0.37–0.90) and shorter median length of stay (4.1 vs. 10.5 days) compared to English speakers. The study corroborates reports of comparatively higher COVID-19 incidence in patients speaking a primary refugee-associated language, but implies milder illness severity, possibly reflecting this population’s baseline health.