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Background: Neuroinflammatory diseases are progressive leading to loss of function and disability. Although palliative care (PC) utilization has increased globally, it has scarcely increased in neurology. Objectives: To explore PC attitudes and knowledge among patients with neuroinflammatory diseases, such as multiple sclerosis, neuromyelitis optica spectrum disorder, and myelin oligodendrocyte glycoprotein antibody-associated disease. Methods: A cross-sectional 1-year study was conducted using the Palliative Care Knowledge Scale (PaCKS) and the PC Health Information National Trends Survey (HINTS). Murray's transition theory guided this study, which integrates palliative services including decision making, communication, and coordinated care. Results: The majority of study patients were female (69%) (N = 86) and White (79%). Forty-two percent indicated that they had never heard about PC, 46% said that they knew a little bit about PC, and 12% said that they knew a lot about PC. Fifty percent of patients knew the goals of PC and had knowledge about PC services. Forty-four percent to 60% agreed that PC goals include helping friends and family to cope with a patient's illness, offering social and emotional support, and managing pain and other symptoms. Patients who self-reported being familiar with PC performed significantly better on the PaCKS than those unfamiliar with PC (p < 0.001), and those who self-reported moderate or severe memory loss performed significantly worse on the PaCKS than those with mild memory loss (p = 0.027). There was an association between higher education and PC knowledge and between patients' PaCKS scores and their self-reported HINTS PC knowledge. Conclusions: Patients have partial PC knowledge. Patients require education about PC early in their disease along their illness trajectory. [ABSTRACT FROM AUTHOR]

Introduction: Pain in multiple sclerosis (MS) is common, but literature on pain in children with MS remains scarce. Pain has physical, psychological, and social implications in MS, and both comprehensive assessment and interdisciplinary management approaches are needed. We sought to develop an interdisciplinary interim guideline for the assessment and management of pain in children with MS. Methods and materials: We convened a modified Delphi panel composed of 13 experts in pediatric and adult MS neurology, physiotherapy, pain, patient livedexperience, advanced practice nursing, psychology, physiatry, and MS research. A survey was sent to panelists for anonymous completion. The panel discussed survey themes extracted by the panel chair. The process was repeated twice. Results: Thirteen assessment and treatment recommendations were produced regarding pain in children with MS. Discussion: Future studies will assess implementation of these pain assessment and treatment guidelines in the clinical setting. [ABSTRACT FROM AUTHOR]

Interest in cognitive research in pigs is increasing, but little is known about the impact of environmental conditions on pigs' cognitive capabilities. The present study investigated the effect of environmental enrichment on cognitive performance of pigs in a holeboard spatial task, in which they had to discriminate four baited buckets out of 16. Pigs ( n = 32) were either housed in stimulus-poor, barren pens, or in larger pens enriched with rooting substrates. Pigs were subjected to 30 holeboard trials. Both working memory (WM), that is, the ratio (baited visits/total number of (re)visits to baited buckets), and reference memory (RM), that is, the ratio ((re)visits to baited buckets/total number of visits to all buckets), improved over trials. WM scores were higher in pigs from enriched pens than in pigs from barren pens. Housing did not affect RM scores. Personality type of the pigs, as assessed early in life using a backtest, did not affect WM or RM. In conclusion, housing conditions of pigs did not affect reference memory, but environmental enrichment improved working memory of pigs in a spatial discrimination task. Based on the findings of this study, we suggest that cognitive functioning of pigs may be impaired under commonly used housing conditions. [ABSTRACT FROM AUTHOR]

Abstract: Fermentation of resistant starch might prolong satiety, and, therefore, positively affect behaviour and welfare of restrictedly-fed pigs. The impact of a potentially satiating diet likely depends on housing conditions, such as the availability of rooting material which may serve as a substrate for foraging behaviour. We investigated effects of resistant starch on behaviour of growing pigs in barren housing (B) or on straw bedding (S) in a 2×2 factorial arrangement. Thirty-two groups of eight pigs (approximately 25kg) were assigned to either B- or S-housing, and to native, resistant (NS) or highly digestible pregelatinised starch (PS) in the diet. Pigs were fed at 2.5 times energy requirements for maintenance in two daily meals. Behaviour was recorded in week 3 for five 1-h periods using 2-min instantaneous scan sampling. On day 23, six pigs per group were relocated to respiration chambers. Activity over the 24-h cycle was scored in week 5 using 9-min instantaneous scan sampling. S-housed pigs on the PS-diet were more active over the 24-h cycle than S-housed pigs on the NS-diet, whereas effects of starch type on activity patterns were less obvious in B-housing (starch type×housing interaction, P =0.05). In the morning, when fresh straw was supplied, behaviour was strongly affected by housing, whereas effects of dietary starch were most obvious around the second, afternoon, meal. S-housed pigs were more active, showed more exploration and less oral manipulation of pen mates and fixtures than B-housed pigs. The PS-diet resulted in more aggression over the day than the NS-diet in B-housed pigs, whereas levels of aggression were similar for S-housed pigs on both diets (starch type×housing interaction, P <0.10). Before their second meal, NS-fed pigs showed less locomotion, aggression (P <0.05) and manipulation of pen mates (P <0.10) than PS-fed pigs, which likely reflects reduced restlessness due to enhanced inter-meal satiety in the NS-fed pigs. After the afternoon meal, NS-fed pigs showed less activity, exploration and manipulation of pen fixtures (P <0.05) than PS-fed pigs. In conclusion, dietary resistant starch affected behaviour patterns of restrictedly-fed growing pigs. The decreased activity and reduced preprandial restlessness suggest that fermentable starch enhances interprandial satiety in pigs, and therefore may improve their welfare. Even though effects of resistant starch on activity levels were more obvious in enriched housing, the welfare benefits of fermentable starch may be more pronounced in barren housed pigs as these animals lack an outlet for their increased foraging motivation. [Copyright &y& Elsevier]