An increase in pain-free outcome in the ketamine arm was demonstrated by the De Kock et al (1) and Lavand'homme et al (2) studies whose primary outcome was a reduction in prevalence of PPSP.
The prevalence of no PPSP following TKA, using a validated knee scoring system with data collected prospectively, has not been published.
Ketamine has several actions that have created interest in its use as a pre-emptive anti-hyperalgesic agent for the prevention of PPSP.
Any of these individual mechanisms may be contributing to PPSP following apparently successful surgery.
Intraoperative therapies are unlikely to influence pain of ongoing mechanical origin, however hyperalgesia may contribute to lesser degrees of PPSP following TKA and may be amenable to a 'pre-emptive' effect of ketamine combined with spinal anaesthesia.
To that end, PPSP intends to raise $6 million in philanthropic support.
Owning Our Future will enable PPSP to offer more comprehensive services in the tri-county area, counter the forces that oppose fundamental rights, and effect legislative change that will enhance reproductive freedom for all.
PPSP staff work closely with school personnel to ensure continuity of care and consider students' and families' needs.
They also receive postcards on such subjects as puberty, healthy relationships, teen pregnancy, decision making, and STDs/HIV, and communicate with PPSP staff.
PPSP staff train teachers to use STEPS companion materials; facilitate meetings with instructors to generate appropriate responses to specific behavior and/or discuss classroom management; and ensure that schools adhere to district sexual harassment policies and follow mandated reporting procedures.
Youth First staff also work with PPSP staff and other providers near Youth First schools to strengthen their ability to provide sexual health services to pre-adolescents and inform students of the importance of sexual health care.
During the past five years, confidence in the program has grown among PPSP staff, the school staff, and the community.