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Sample records for caras-revisada faces pain

  1. Comparación entre encuestas telefónicas y encuestas «cara a cara» domiciliarias en la estimación de hábitos de salud y prácticas preventivas Telephone versus face-to-face household interviews in the assessment of health behaviors and preventive practices

    Directory of Open Access Journals (Sweden)

    Iñaki Galán

    2004-12-01

    Full Text Available Objetivo: En este estudio se examina la influencia del método de encuesta, telefónica y «cara a cara» domiciliaria, sobre la estimación de los factores de riesgo para la salud asociados al comportamiento y la realización de prácticas preventivas. Material y método: El mismo cuestionario fue administrado en 2 muestras independientes de población de 18-64 años residente en el municipio de Madrid. Una muestra (n = 1.391 realizó la entrevista telefónica y la otra (n = 739, la entrevista «cara a cara» domiciliaria. Se compararon los resultados de las 2 muestras para 28 variables relacionadas con la antropometría, la actividad física, el consumo de alimentos, el consumo de tabaco y alcohol, las prácticas preventivas y la accidentabilidad. Resultados: La muestra telefónica obtuvo una mayor tasa de no contactos (31,8 frente a 22,2% pero un mayor grado de cooperación que la muestra con entrevista «cara a cara» (83 frente a 74%. En total, 19 de las 28 variables mostraron una variación relativa entre ambas encuestas Objective: This study examines the influence of the interview method (telephone or face-to-face in households on the assessment of health behaviors and preventive practices. Material and method: The same questionnaire was completed by two independent samples of the population aged 18-64 years living in the municipality of Madrid. One sample (n = 1,391 subjects completed the questionnaire by telephone interview and the other (n = 739 by face-to-face interview in households. The results of the two samples for 28 variables related to anthropometry, physical activity, food consumption, tobacco and alcohol use, preventive practices and injuries were compared. Results: The telephone sample had a higher rate of failed contact (31.8% vs. 22.2% but a greater degree of cooperation than the sample for the face-to-face interview (83.0% vs. 74.0%. In total, 19 of the 28 variables showed a relative variation of less than 10% between the

  2. Validity, Sensitivity, and Responsiveness of the 11-Face Faces Pain Scale to Postoperative Pain in Adult Orthopedic Surgery Patients.

    Science.gov (United States)

    Van Giang, Nguyen; Chiu, Hsiao-Yean; Thai, Duong Hong; Kuo, Shu-Yu; Tsai, Pei-Shan

    2015-10-01

    Pain is common in patients after orthopedic surgery. The 11-face Faces Pain Scale has not been validated for use in adult patients with postoperative pain. To assess the validity of the 11-face Faces Pain Scale and its ability to detect responses to pain medications, and to determine whether the sensitivity of the 11-face Faces Pain Scale for detecting changes in pain intensity over time is associated with gender differences in adult postorthopedic surgery patients. The 11-face Faces Pain Scale was translated into Vietnamese using forward and back translation. Postoperative pain was assessed using an 11-point numerical rating scale and the 11-face Faces Pain Scale on the day of surgery, and before (Time 1) and every 30 minutes after (Times 2-5) the patients had taken pain medications on the first postoperative day. The 11-face Faces Pain Scale highly correlated with the numerical rating scale (r = 0.78, p Scale is appropriate for measuring acute postoperative pain in adults. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  3. Reconocimiento de caras en la esquizotipia

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    Leticia García-Alvarez

    2013-10-01

    Full Text Available Estudios previos sugieren la existencia de fallos en la percepción de uno mismo en la esquizofrenia y la esquizotipia y, en particular, una percepción inusual de la propia cara y de la de otros en la esquizotipia. El propósito de este estudio fue explorar las posibles diferencias en el reconocimiento de la propia cara y la de otros, entre las personas que puntúan alto y bajo en esquizotipia, además de confirmar si las dimensiones Cognitivo-perceptiva y de Desorganización de la esquizotipia, pero no la dimensión Interpersonal, guardan relación significativa con esas anomalías, según lo observado en estudios previos. La muestra estuvo formada por 219 adolescentes y jóvenes no clínicos, (53% mujeres. Los instrumentos empleados fueron el Self-Face Recognition Questionnaire (SFRQ, el Cuestionario de Personalidad Esquizotípica versión breve (SPQ-B y el ESQUIZO-Q. La media de edad de los participantes fue de 16.3 años (DT = 1.18. Las comparaciones entre quienes puntúan alto y bajo en esquizotipia ofrece apoyo a la hipótesis de que los rasgos positivos (Cognitivo-perceptivos y de Desorganización correlacionan significativamente con las dificultades en el reconocimiento de caras. Las mujeres mostraron mayores dificultades que los varones en el reconocimiento de caras, probablemente debido la tendencia a puntuar más alto en la dimensión Cognitivo-perceptiva.

  4. Effect of Pasteurization on Flavonoids and Carotenoids in Citrus sinensis (L.) Osbeck cv. 'Cara Cara' and 'Bahia' Juices.

    Science.gov (United States)

    Brasili, Elisa; Chaves, Daniela F Seixas; Xavier, Ana Augusta O; Mercadante, Adriana Z; Hassimotto, Neuza M A; Lajolo, Franco M

    2017-02-22

    Orange juice is considered an excellent dietary source of several bioactive compounds with beneficial properties for human health. Citrus sinensis Osbeck cv. 'Cara Cara' is a bud mutation originated from 'Washington' navel orange, also known as 'Bahia' navel orange. The ascorbic acid, flavonoid, and carotenoid contents in pasteurized and nonpasteurized Bahia and Cara Cara juices using two LC-MS/MS platforms were investigated. Higher ascorbic acid content was observed in Bahia compared to Cara Cara in both pasteurized and nonpasteurized juices. Total flavanones content as well as hesperidin levels were higher in Cara Cara with respect to Bahia pasteurized juice. Cara Cara was also characterized by a significantly higher and diversified carotenoid content compared to Bahia juice with a mixture of (Z)-isomers of lycopene, all-E-β-carotene, phytoene, and phytofluene isomers accounting for the highest carotenoid proportion. The exceptionally high carotenoid content of Cara Cara may be particularly interesting for nutritional or functional studies of uncommon carotenes in a citrus food matrix.

  5. Hydraulic modelling of the CARA Fuel element; Desarrollo hidraulico del combustible CARA

    Energy Technology Data Exchange (ETDEWEB)

    Brasnarof, Daniel O; Juanico, Luis [Comision Nacional de Energia Atomica, San Carlos de Bariloche (Argentina). Disenios Avanzados y Evaluacion Economica; Giorgi, M [Comision Nacional de Energia Atomica, General San Martin (Argentina). Dept. de Materiales; Ghiselli, Alberto M; Zampach, Ruben; Fiori, Jose M; Yedros, Pablo A [Comision Nacional de Energia Atomica, General San Martin (Argentina). Dept. de Ensayos no Destructivos

    2004-07-01

    The CARA fuel element is been developing by the National Atomic Energy Commission for both Argentinean PHWRs. In order to keep the hydraulic restriction in their fuel channels, one of CARA's goals is to keep its similarity with both present fuel elements. In this paper is presented pressure drop test performed at a low-pressure facility (Reynolds numbers between 5x10{sup 4} and 1,5x10{sup 5}) and rational base models for their spacer grid and rod assembly. Using these models, we could estimate the CARA hydraulic performance in reactor conditions that have shown to be satisfactory. (author) [Spanish] Con el objeto de validar la similitud hidraulica del elemento combustible CARA con los actuales combustibles de Atucha y Embalse, se realizaron ensayos de perdida de carga en el circuito CBP del CAC con un nuevo diseno de separador de mejor desempeno hidraulico. Se presenta aqui el analisis de los mismos, de los cuales se validaron modelos de base racional para estimar las restricciones hidraulicas de los distintos componentes estructurales (separadores, grillas y barras combustibles) en funcion del flujo refrigerante. Se estimo asi la caida de presion del CARA dentro del canal combustible Embalse en condiciones nominales de reactor, siendo la misma similar al del combustible actual de 37 barras. (autor)

  6. As múltiplas faces de Duas caras: telenovela e contemporáneidade

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    Geraldo Carlos do Nascimento

    2008-12-01

    Full Text Available Abstract This essay aims at presenting an introductory study to the Brazilian soap opera Duas caras (2007/2008, Aguinaldo Silva, produced and exhibited by Rede Globo de Televisão. The text considers aspects related to intertextuality, particularly those focusing on the reprsentation of ambiguity  and the effects of the television dramatic culture values attached to this procedure.

  7. Kajian Proses Pembuatan Perhiasan Perak Cara Manual dan Masinal

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    Joni Setiawan

    2016-04-01

    Full Text Available Perhiasan dapat dibuat dengan 2 cara yaitu manual dan masinal. Masing-masing cara mempunyai kekurangan dan kelebihan. Oleh karena itu perlu adanya kajian dari dua cara tersebut sehingga bisa mengetahui cara apa yang lebih optimal dalam memproduksi perhiasan. Dalam kajian ini perhiasan yang dibuat adalah cincin dengan bahan perak 100 gram dan dicampur dengan tembaga 5 gram dengan 2 (dua model yaitu model A (cincin motif polos dan model B (cincin motif parang.Metode yang dipakai adalah dengan membandingkan hasil produk dari dua cara tersebut. Parameter yang dibandingkan adalah kualitas, waktu dan biaya dari produk tersebut.Hasil kajian menunjukkan bahwa kadar produk rata-rata dengan cara masinal lebih tlnggi 1,25%dibanding cara manual, dimensi produk rata-rata dengan cara masinal lebih presisi dibanding cara manual. Waktu proses rata-rata dengan cara masinal lebih cepat 97% dibanding cara manual dan biaya produksi cara masinal lebih rendah 63% dibanding cara manual.Dengan melihat hasil kajian tersebut maka dapat disimpulkan bahwa cara masinal lebih efisien dan efektif dibanding cara manual.

  8. Selective attention towards painful faces among chronic pain patients: evidence from a modified version of the dot-probe.

    Science.gov (United States)

    Khatibi, Ali; Dehghani, Mohsen; Sharpe, Louise; Asmundson, Gordon J G; Pouretemad, Hamidreza

    2009-03-01

    Evidence that patients with chronic pain selectively attend to pain-related stimuli presented in modified Stroop and dot-probe paradigms is mixed. The pain-related stimuli used in these studies have been primarily verbal in nature (i.e., words depicting themes of pain). The purpose of the present study was to determine whether patients with chronic pain, relative to healthy controls, show selective attention for pictures depicting painful faces. To do so, 170 patients with chronic pain and 40 age- and education-matched healthy control participants were tested using a dot-probe task in which painful, happy, and neutral facial expressions were presented. Selective attention was denoted using the mean reaction time and the bias index. Results indicated that, while both groups shifted attention away from happy faces (and towards neutral faces), only the control group shifted attention away from painful faces. Additional analyses were conducted on chronic pain participants after dividing them into groups on the basis of fear of pain/(re)injury. The results of these analyses revealed that while chronic pain patients with high and low levels of fear both shifted attention away from happy faces, those with low fear shifted attention away from painful faces, whereas those with high fear shifted attention towards painful faces. These results suggest that patients with chronic pain selectively attend to facial expressions of pain and, importantly, that the tendency to shift attention towards such stimuli is positively influenced by high fear of pain/(re)injury. Implications of the findings and future research directions are discussed.

  9. Muchas Caras: Engaging Spanish Speakers in the Planetarium and K-12 Classroom

    Science.gov (United States)

    Traub-Metlay, Suzanne; Salas, F.

    2008-05-01

    Reaching out to Spanish speakers is increasingly vital to workforce development and public support of space science projects. Fiske Planetarium offers Spanish translations of our newest planetarium shows, such as "Las Muchas Caras del Telescopio Hubble” ("The Many Faces of Hubble") and "Tormenta Espacial” ("Space Storm"). Funded by NASA, "Las Muchas Caras...” showcases the people involved in successful use of the Hubble Space Telescope. From building and launching HST to how proposals are selected and data analyzed, "Las Muchas Caras...” engages viewers to see themselves in careers related to space science. Detailed interviews with real people who work with HST reveal the humanity behind the science. Awesome imagery provided by HST inspires viewers to look at the night sky themselves. In partnership with NASA's TIMED mission, LASP and Space Science Institute, Fiske Planetarium translated its original planetarium show - "Space Storm” - into "Tormenta Espacial". This show explores the Sun-Earth connection and explains how solar activity affects technology and life on Earth. Solar scientists from NOAA's Space Environment Center and the University of Colorado at Boulder contributed to provide scientific accuracy. Show content and accompanying educational materials are aligned with state and national science standards. Curricular materials extend the planetarium experience into the K-12 classroom so that students inspired and engaged by the show continue to see real-life applications and workplace opportunities. Fiske Planetarium offers "Las Muchas Caras...” and "Tormenta Espacial” to other planetariums at a minimal rate, including technical support for the life of the show. Versions of "The Many Faces of Hubble” and "Space Storm” are available with no spoken dialogue so that languages other than English or Spanish may be accommodated.

  10. Viewing pain and happy faces elicited similar changes in postural body sway.

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    Juan Gea

    Full Text Available Affective facial expressions are potent social cues that can induce relevant physiological changes, as well as behavioral dispositions in the observer. Previous studies have revealed that angry faces induced significant reductions in body sway as compared with neutral and happy faces, reflecting an avoidance behavioral tendency as freezing. The expression of pain is usually considered an unpleasant stimulus, but also a relevant cue for delivering effective care and social support. Nevertheless, there are few data about behavioral dispositions elicited by the observation of pain expressions in others. The aim of the present research was to evaluate approach-avoidance tendencies by using video recordings of postural body sway when participants were standing and observing facial expressions of pain, happy and neutral. We hypothesized that although pain faces would be rated as more unpleasant than the other faces, they would provoke significant changes in postural body sway as compared to neutral facial expressions. Forty healthy female volunteers (mean age 25 participated in the study. Amplitude of forward movements and backward movements in the anterior-posterior and medial-lateral axes were obtained. Statistical analyses revealed that pain faces were the most unpleasant stimuli, and that both happy and pain faces were more arousing than neutral ones. Happy and pain faces also elicited greater amplitude of body sway in the anterior-posterior axes as compared with neutral faces. In addition, significant positive correlations were found between body sway elicited by pain faces and pleasantness and empathic ratings, suggesting that changes in postural body sway elicited by pain faces might be associated with approach and cooperative behavioral responses.

  11. My Brain Reads Pain in Your Face, Before Knowing Your Gender.

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    Czekala, Claire; Mauguière, François; Mazza, Stéphanie; Jackson, Philip L; Frot, Maud

    2015-12-01

    Humans are expert at recognizing facial features whether they are variable (emotions) or unchangeable (gender). Because of its huge communicative value, pain might be detected faster in faces than unchangeable features. Based on this assumption, we aimed to find a presentation time that enables subliminal discrimination of pain facial expression without permitting gender discrimination. For 80 individuals, we compared the time needed (50, 100, 150, or 200 milliseconds) to discriminate masked static pain faces among anger and neutral faces with the time needed to discriminate male from female faces. Whether these discriminations were associated with conscious reportability was tested with confidence measures on 40 other individuals. The results showed that, at 100 milliseconds, 75% of participants discriminated pain above chance level, whereas only 20% of participants discriminated the gender. Moreover, this pain discrimination appeared to be subliminal. This priority of pain over gender might exist because, even if pain faces are complex stimuli encoding both the sensory and the affective component of pain, they signal a danger. This supports the evolution theory relating to the necessity of quickly reading aversive emotions to ensure survival but might also be at the basis of altruistic behavior such as help and compassion. This study shows that pain facial expression can be processed subliminally after brief presentation times, which might be helpful for critical emergency situations in clinical settings. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  12. Effect of Face-to-Face Education on Anxiety and Pain in Children with Minor Extremity Injuries Undergoing Outpatient Suturing in Emergency Department.

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    Bigdeli Shamloo, Marzieh Beigom; Zonoori, Sahar; Naboureh, Abbas; Nasiri, Morteza; Bahrami, Hadi; Maneiey, Mohammad; Bayatiani, Fatemeh Allahyari

    2018-01-15

    To assess the effect of face-to-face education on anxiety and pain in children with minor extremity injuries undergoing outpatient suturing. Children in intervention and control groups received face-to-face education (10 minutes) and no specific education, respectively. The anxiety and pain was measured using Modified-Yale Preoperative Anxiety Scale, and pain by Faces Pain Scale-Revised, respectively in 3 stages viz, pre-procedure and pre-intervention, post-procedure. Children in the intervention group were less anxious than the control at pre-procedure and post-intervention stage (41.1 (13.8) vs. 46.3 (19.1), respectively, P=0.03) and post-procedure and post-intervention stage (32.3 (17.2) vs. 40.2 (12.9), respectively, P=0.01). Children in the intervention group experienced less pain than the control at pre-procedure and post-intervention stage (3.9 (3.8) vs. 4.9 (3.1), respectively, Panxiety and pain in children undergoing suturing in the emergency department.

  13. Hydraulic modelling of the CARA Fuel element

    International Nuclear Information System (INIS)

    Brasnarof, Daniel O.; Juanico, Luis; Giorgi, M.; Ghiselli, Alberto M.; Zampach, Ruben; Fiori, Jose M.; Yedros, Pablo A.

    2004-01-01

    The CARA fuel element is been developing by the National Atomic Energy Commission for both Argentinean PHWRs. In order to keep the hydraulic restriction in their fuel channels, one of CARA's goals is to keep its similarity with both present fuel elements. In this paper is presented pressure drop test performed at a low-pressure facility (Reynolds numbers between 5x10 4 and 1,5x10 5 ) and rational base models for their spacer grid and rod assembly. Using these models, we could estimate the CARA hydraulic performance in reactor conditions that have shown to be satisfactory. (author) [es

  14. Facing the experience of pain: A neuropsychological perspective

    Science.gov (United States)

    Fabbro, Franco; Crescentini, Cristiano

    2014-09-01

    Pain is an experience that none of us would like to have but that each one of us is destined to experience in our lives. Despite its pervasiveness, the experience of pain remains problematic and complex in its depth. Pain is a multidimensional experience that involves nociception as well as emotional and cognitive aspects that can modulate its perception. Following a brief discussion of the neurobiological mechanisms underlying pain, the purpose of this review is to discuss the main psychological, neuropsychological, cultural, and existential aspects which are the basis of diverse forms of pain, like the pain of separation from caregivers or from ourselves (e.g., connected to the thought of our death), the suffering that we experience observing other people's pain, the pain of change and the existential pain connected to the temporal dimension of the mind. Finally, after a discussion of how the mind is able to not only create but also alleviate the pain, through mechanisms such as the expectation of the treatment and the hope of healing, we conclude by discussing neuropsychological research data and the attitude promoted by mindfulness meditation in relation to the pain. An attitude in which, instead to avoid and reject the pain, one learns to face mindfully the experience of pain.

  15. El apoyo social en estudiantes universitarios y su relación con las comunicaciones cara a cara y las comunicaciones mediadas por las Tecnologías de la Información y la Comunicación (TIC

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    Camilo Madariaga

    2016-01-01

    Full Text Available Partiendo de que el apoyo social es provisto tanto en comunicaciones cara a cara como en aquellas mediadas por las TIC; el presente artículo analiza la forma en que desde ambos modelos de comunicación este se da en un grupo de estudiantes universitarios. La información se recolectó con la escala Assis. Los apoyos material y emocional se recibieron mayoritariamente por la comunicación cara a cara, lo que sugiere que es la modalidad predominante tanto en hombres como mujeres (60,1 % para su provisión social. Sin embargo, que el apoyo informativo sea más recibido por la comunicación mediada por las TIC, pone de relieve su alto nivel de penetración social y su impacto en las formas de interactuar. Se estableció que la existencia de una relación entre el apoyo emocional y el sexo es mayor en mujeres. Lo mismo ocurre entre su provisión y la edad, especialmente en personas más jóvenes, y aunque se esperaba hallar una relación entre la edad y las modalidades de comunicación, al final no se estableció. Para los universitarios ambos modelos de comunicación son complementarios y facilitan la provisión de apoyo de manera integral, en un continuo. Abstract Given that social support is provided in face-to-face communications and ICT mediated communication, this article discusses the types of social support from both communication models in a group of college students. The information was collected with Assis scale. The material and emotional support is mainly given by the face-to-face communication, suggesting that is the predominant form, both men and women (60.1% for the provision of social support. However, the informational support is more received by mediated communication ICT, demonstrating its high level of social penetration and its impact on ways of interacting. The existence of a relationship between emotional support and sex was established, being higher in women. Similarly between its provision and age, being higher in younger

  16. CARA project

    International Nuclear Information System (INIS)

    Bergallo, Juan E.; Brasnarof, Daniel O.

    2000-01-01

    The CARA (Advanced Fuels for Argentine Reactors) Project successfully completed its first stage, phase one, last year. The performance of this fuel has been partially examined, using CNEA and CONUAR facilities and personnel. With the results obtained in this stage, determined by the corresponding tests and verification of the fuel behavior, the performance of the second stage started immediately afterwards. Works performed and results obtained during the development of the second stage are generally described in this paper. (author)

  17. Painful faces-induced attentional blink modulated by top-down and bottom-up mechanisms

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    Chun eZheng

    2015-06-01

    Full Text Available Pain-related stimuli can capture attention in an automatic (bottom-up or intentional (top-down fashion. Previous studies have examined attentional capture by pain-related information using spatial attention paradigms that involve mainly a bottom-up mechanism. In the current study, we investigated the pain information–induced attentional blink (AB using a rapid serial visual presentation (RSVP task, and compared the effects of task-irrelevant and task-relevant pain distractors. Relationships between accuracy of target identification and individual traits (i.e., empathy and catastrophizing thinking about pain were also examined. The results demonstrated that task-relevant painful faces had a significant pain information–induced AB effect, whereas task-irrelevant faces a near-significant trend of this effect, supporting the notion that pain-related stimuli can influence the temporal dynamics of attention. Furthermore, we found a significant negative correlation between response accuracy and pain catastrophizing score in task-relevant trials. These findings suggest that active scanning of environmental information related to pain produces greater deficits in cognition than does unintentional attention toward pain, which may represent the different ways in which healthy individuals and patients with chronic pain process pain-relevant information. These results may provide insight into the understanding of maladaptive attentional processing in patients with chronic pain.

  18. CARA design criteria for HWR fuel burnup extension

    International Nuclear Information System (INIS)

    Florido, P.C.; Cirimello, R.O.; Bergallo, J.E.; Marino, A.C.; Delmastro, D.F.; Brasnarof, D.O.; Gonzalez, J.H.; Juanico, L.A.

    2002-01-01

    A new concept for HWR fuel bundles, namely CARA, is presented. The CARA design allows to improve all the major performances in the PHWR fuel technology. Among others, it reaches higher burnup and thermohydraulic safety margins, together with lower fuel pellet temperatures and Zry/HM mass ratio. Moreover, it keeps the fuel mass content per unit length and the channel pressure drop by using a single diameter of fuel rods. (author)

  19. ¿Por qué las caras de otras etnias nos parecen iguales?

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    Beatriz Martín-Luengo

    2013-11-01

    Full Text Available ¿Por qué a veces somos incapaces de distinguir entre personas de otra etnia? Una razón puede ser porque no recordamos de la misma manera las caras dependiendo de la etnia a la que pertenecen. Actualmente existen varias teorías que explican por qué nuestra memoria es mejor para caras de nuestra propia etnia, como son las teorías del procesamiento perceptivo de caras, las teorías basadas en la cognición social del procesamiento de caras y las teorías híbridas entre las perceptivas y las basadas en cognición social. En este artículo repasamos y explicamos a grandes rasgos cada uno de estos acercamientos teóricos.

  20. Projet pilote de cybergouvernement dans les Caraïbes | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Les pays des Caraïbes sont de plus en plus nombreux à adopter les technologies de l'information et de la communication (TIC) dans leur processus de modernisation du secteur public. En 2003, les ... Linkage for Education and Research in Nursing (LEARN), une initiative de TIC-D dans les Caraïbes. Les infirmières ...

  1. Face piercing (body art: choosing pleasure vs. possible pain and posture instability

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    Eric eMatheron

    2011-09-01

    Full Text Available Piercings (body art, i.e. with jewelry are more and more widespread. They can induce various complications such as infections, allergies, headaches, and various skin, cartilage, or dental problems which will lead to economic effects on health-care systems. We draw attention to other possible side effects resulting from face piercing complications such as eye misalignment, decreased postural control efficiency, and nonspecific chronic back pain. We found that the origin was pierced jewelry on the face. Removing the jewelry restored eye alignment, improved postural control, and alleviated back pain in a lasting way. This observation is important for health; further investigations would be of interest.

  2. CARA, new concept of advanced fuel element for HWR

    International Nuclear Information System (INIS)

    Florido, P.C.; Crimello, R.O.; Bergallo, J.E.; Marino, A.C.; Delmastro, D.F.; Brasnarof, D.O.; Gonzalez, J.H.

    1999-01-01

    All Argentinean NPPs (2 in operation, 1 under construction), use heavy water as coolant and moderator. With very different reactor concepts (pressure Vessel and CANDU type designs), the fuel elements are completely different in its concepts too. Argentina produces both types of fuel elements at a manufacturing fuel element company, called CONUAR. The very different fuel element's designs produce a very complex economical behavior in this company, due to the low production scale. The competitiveness of the Argentinean electric system (Argentina has a market driven electric system) put another push towards to increase the economical competitiveness of the nuclear fuel cycle. At present, Argentina has a very active Slightly Enriched Uranium (SEU) Program for the pressure vessel HWR type, but without strong changes in the fuel concept itself. Then, the Atomic Energy Commission in Argentina (CNEA) has developed a new concept of fuel element, named CARA, trying to achieve very ambitious goals, and substantially improved the competitiveness of the nuclear option. The ambitious targets for CARA fuel element are compatibility (a single fuel element for all Argentinean's HWR) using a single diameter fuel rod, improve the security margins, increase the burnup and do not exceed the CANDU fabrication costs. In this paper, the CARA concept will be presented, in order to explained how to achieve all together these goals. The design attracted the interest of the nuclear power operator utility (NASA), and the fuel manufacturing company (CONUAR). Then a new Project is right now under planning with the cooperation of three parts (CNEA - NASA - CONUAR) in order to complete the whole development program in the shortest time, finishing in the commercial production of CARA fuel bundle. At the end of the this paper, future CARA development program will be described. (author)

  3. Diferencias de género en el reconocimiento de caras emocionales: ¿son los hombres menos eficientes?

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    Ana Ruiz-Ibáñez

    2017-08-01

    Full Text Available RESUMEN Como indican las investigaciones sobre recuerdo de estímulos con valencia emocional, las emociones influyen sobre la memoria. Muchos estudios sobre reconocimiento de caras y expresiones faciales emocionales se han centrado en diferencias entre grupos de edad (jóvenes y mayores o diferencias sexuales (hombres y mujeres. No obstante, este tipo de estudios ha arrojado resultados contradictorios, por lo que sería necesario profundizar en la implicación del género. El objetivo principal de nuestra investigación consiste en analizar las diferencias en el reconocimiento de fotografías de caras con expresiones faciales emocionales entre dos grupos, el primero compuesto por hombres y el segundo por mujeres, formados por estudiantes universitarios entre 18 y 30 años. Los resultados mostraron diferencias estadísticamente significativas en el reconocimiento de caras, presentando las mujeres un mejor reconocimiento corregido (probabilidad de aciertos menos probabilidad de falsas alarmas que los hombres. Sin embargo, otras variables analizadas, como el tiempo o la eficiencia, no ofrecen resultados concluyentes. Además, en el grupo de varones se encontró una correlación negativa significativa entre el tiempo empleado y la eficiencia en la tarea. Estos datos proporcionan apoyo tanto a la hipótesis de la diferencia de género en el reconocimiento de caras, a favor de las mujeres, como a las que proponen un procesamiento cognitivo diferenciado de estímulos faciales en ambos sexos. Finalmente, se argumenta la necesidad de mayor investigación, relacionada con variables como la edad o el nivel social-cultural. ABSTRACT: As research in recollection of stimuli with emotional valence indicates, emotions influence memory. Many studies in face and emotional facial expression recognition have focused on age (young and old people and gender-associated (men and women differences. Nevertheless, this kind of studies has produced contradictory results

  4. CARA CVN: inherently safe fuel element for PHWR power plants

    International Nuclear Information System (INIS)

    Brasnarof, Daniel O.; Lestani, Hector A.; Agueda, Horacio C.; Marino, Armando C.; Florido, Pablo C.; Daverio, Hernando

    2007-01-01

    This paper presents design alternatives of the CARA fuel element with negative void reactivity coefficient (CVN) enhancing the PHWR safety for L-LOCA sequences. This design enhances the safety and the operation performance in Atucha and Embalse without changes in the operation conditions. This new design balances wide performance margins of CARA SEU 0.9% previous design, with new intrinsic safety requirements without economic penalties. (author) [es

  5. ¿Qué pasa en el cerebro de los perros cuando ven caras humanas?

    Directory of Open Access Journals (Sweden)

    Laura V. Cuaya

    2016-05-01

    Full Text Available Cuando tu perro te ve, no sólo se iluminan sus ojos, también su cerebro. Aquí resumimos un experimento que realizamos para conocer el procesamiento cerebral de las caras humanas en perros, utilizando imágenes de resonancia magnética funcional, en el que encontramos actividad en la corteza temporal, frontal y el núcleo caudado. La actividad en la corteza temporal sugiere que los perros procesan las caras de manera similar a nosotros. Fue inesperado encontrar actividad en el núcleo caudado, porque sugiere que los perros procesan las caras humanas como recompensas, incluso si son caras de humanos desconocidos.

  6. Experimental orofacial pain and sensory deprivation lead to perceptual distortion of the face in healthy volunteers.

    Science.gov (United States)

    Dagsdóttir, Lilja Kristín; Skyt, Ina; Vase, Lene; Baad-Hansen, Lene; Castrillon, Eduardo; Svensson, Peter

    2015-09-01

    Patients suffering from persistent orofacial pain may sporadically report that the painful area feels "swollen" or "differently," a phenomenon that may be conceptualized as a perceptual distortion because there are no clinical signs of swelling present. Our aim was to investigate whether standardized experimental pain and sensory deprivation of specific orofacial test sites would lead to changes in the size perception of these face areas. Twenty-four healthy participants received either 0.2 mL hypertonic saline (HS) or local anesthetics (LA) into six regions (buccal, mental, lingual, masseter muscle, infraorbital and auriculotemporal nerve regions). Participants estimated the perceived size changes in percentage (0 % = no change, -100 % = half the size or +100 % = double the size), and somatosensory function was checked with tactile stimuli. The pain intensity was rated on a 0-10 Verbal Numerical Rating Scale (VNRS), and sets of psychological questionnaires were completed. HS and LA were associated with significant self-reported perceptual distortions as indicated by consistent increases in perceived size of the adjacent face areas (P ≤ 0.050). Perceptual distortion was most pronounced in the buccal region, and the smallest increase was observed in the auriculotemporal region. HS was associated with moderate levels of pain VNRS = 7.3 ± 0.6. Weak correlations were found between HS-evoked perceptual distortion and level of dissociation in two regions (P pain and transient sensory deprivation evoked perceptual distortions in all face regions and overall demonstrated the importance of afferent inputs for the perception of the face. We propose that perceptual distortion may be an important phenomenon to consider in persistent orofacial pain conditions.

  7. Face Piercing (Body Art): Choosing Pleasure vs. Possible Pain and Posture Instability

    Science.gov (United States)

    Matheron, Eric; Kapoula, Zoï

    2011-01-01

    Piercings (body art, i.e., with jewelry) are more and more widespread. They can induce various complications such as infections, allergies, headaches, and various skin, cartilage, or dental problems, and represent a public health problem. We draw attention to possible side effects resulting from face piercing complications observed on four young adults such as eye misalignment, decreased postural control efficiency, and non-specific chronic back pain with associated comorbidity. We found that the origin was pierced jewelry on the face. Removing the jewelry restored eye alignment, improved postural control, and alleviated back pain in a lasting way. We suggest that pierced facial jewelry can disturb somaesthetic signals driven by the trigeminal nerve, and thus interfere with central integration processes, notably in the cerebellum and the vestibular nucleus involved in postural control and eye alignment. Facial piercings could induce sensory–motor conflict, exacerbate, or precipitate a pre-existing undetermined conflict, which leads pain and complaints. These findings are significant for health; further investigations would be of interest. PMID:21960975

  8. Importance of music for facing the experience of pain. Comment on “Facing the experience of pain: A neuropsychological perspective” by Fabbro and Crescentini

    Science.gov (United States)

    Masataka, Nobuo

    2014-09-01

    Attempts to cope with the experience of pain have been numerous and have had a long history. Among others, mindfulness meditation is one of the oldest of them. It first emerged in ancient India and since then has been practiced up to the present, possibly as one of the most prevalent methods. There is a general consensus that the practice of such meditation can lead to a reduction of perceived pain most effectively, as argued by Fabbro and Crescentini [1]. As a first step of the attempt to practice such meditation, one is required not to defend oneself when faced with a painful experience, or to avoid or withdraw from the experience. However, this is not an easy task for anyone because humans, as Homo loquense[3], are born with an almost predispositional tendency to discard or to devalue conflicting knowledge because simultaneously holding conflicting cognitions makes them feel discomfort. Ancient Greeks already knew that, and in Aesop's fable, when a fox sees high-hanging grapes, his desire to eat grapes and inability to reach them are in conflict. The fox then overcomes this conflict by deciding that the grapes are sour and not worth eating. This conflict is the phenomenon referred to as cognitive dissonance in the field of psychology, and is closely connected to the entirety of human evolution. That is, the emergence of language must have led to the proliferation of cognitive dissonances, and if they had not been overcome, language and knowledge would have been discarded and further human evolution would have been stopped in its tracks. Thus, difficulty of facing pain is a "burden" imposed upon humans, who acquired language as a way to construct divergent and highly sophisticated cultures for their living.

  9. Hydraulic Design of the CARA Fuel Assembly for Atucha-I

    International Nuclear Information System (INIS)

    Juanico, Luis; Brasnarof, Daniel

    2000-01-01

    In this paper a hydraulic model of the CARA fuel assembly within the Atucha I fuel channel is developed. Besides, a experimental test running in the CBP low pressure loop have been designed.This model is used for design purpose of the assembly system such as the whole channel pressure drop remains the same that it is at the present.It is observed that choosing the right thickness and hole surface of the assembly system, it is possible tune up the CARA pressure drop, releases the azimuth alignment condition on the fuel element neighbors

  10. Challenges faced by nurses in managing pain in a critical care setting.

    Science.gov (United States)

    Subramanian, Pathmawathi; Allcock, Nick; James, Veronica; Lathlean, Judith

    2012-05-01

    To explore nurses' challenges in managing pain among ill patients in critical care. Pain can lead to many adverse medical consequences and providing pain relief is central to caring for ill patients. Effective pain management is vital since studies show patients admitted to critical care units still suffer from significant levels of acute pain. The effective delivery of care in clinical areas remains a challenge for nurses involved with care which is dynamic and constantly changing in critically ill. Qualitative prospective exploratory design. This study employed semi structured interviews with nurses, using critical incident technique. Twenty-one nurses were selected from critical care settings from a large acute teaching health care trust in the UK. A critical incident interview guide was constructed from the literature and used to elicit responses. Framework analysis showed that nurses perceived four main challenges in managing pain namely lack of clinical guidelines, lack of structured pain assessment tool, limited autonomy in decision making and the patient's condition itself. Nurses' decision making and pain management can influence the quality of care given to critically ill patients. It is important to overcome the clinical problems that are faced when dealing with pain experience. There is a need for nursing education on pain management. Providing up to date and practical strategies may help to reduce nurses' challenges in managing pain among critically ill patients. Broader autonomy and effective decision making can be seen as beneficial for the nurses besides having a clearer and structured pain management guidelines. © 2011 Blackwell Publishing Ltd.

  11. Tradução e adaptação transcultural de duas escalas para avaliação da dor em crianças e adolescentes Cross-cultural adaptation and translation of two pain assessment tools in children and adolescents

    Directory of Open Access Journals (Sweden)

    Flavia Claro da Silva

    2008-08-01

    Full Text Available OBJETIVO:Traduzir, retrotraduzir e adaptar culturalmente o conteúdo da Face, Legs, Activity, Cry, Consolability (FLACC e da Escala de Faces Revisada (FPS-R para avaliação da dor em crianças escolares e adolescentes brasileiros. MÉTODOS: Foi realizada tradução da escala original do inglês para o português. As escalas obtidas foram retrotraduzidas e revisadas de maneira independente. A adaptação transcultural incluiu a submissão das versões revisadas das escalas a 12 experts visando melhorar a compreensão, correspondência e aceitação dos itens. Um pré-teste foi realizado em uma amostra de conveniência (20 pacientes e 22 profissionais de saúde para avaliação do conteúdo das escalas. Os pacientes com câncer, entre 7 e 17 anos de idade, encontravam-se em acompanhamento no ambulatório ou na enfermaria de pediatria do Instituto Nacional de Câncer. RESULTADOS: Após a incorporação das recomendações dos diferentes profissionais participantes do processo de tradução, retrotradução e avaliação de conteúdo das escalas, o pré-teste mostrou que 90 e 100%, respectivamente, compreenderam o conteúdo das escalas, tendo a pontuação média para compreensão variado entre 8,8 e 10,0, em uma escala de 0 a 10 na qual os escores mais elevados indicam melhor compreensão. CONCLUSÕES: Ambas as escalas se mostraram de fácil compreensão para avaliação da dor em crianças e adolescentes brasileiros com câncer.OBJECTIVE: To translate, back-translate and cross-culturally adapt the content of the FLACC (Face, Legs, Activity, Cry, Consolability and Faces Pain Scale-Revised (FPS-R scales for the evaluation of pain in Brazilian young students and adolescents. METHODS: The original scales in English were translated into Brazilian Portuguese. Scales thus obtained were back translated and reviewed. Cross-cultural adaptation included the submission of the reviewed version of the scales to 12 experts to obtain data on comprehensibility

  12. CARA Project: development of the advanced ULE fuel element for heavy water nuclear power plants

    International Nuclear Information System (INIS)

    Brasnarof, Daniel O.; Marino, Armando C.; Florido, Pablo C.; Munoz, C.; Bianchi, Daniel R.; Giorgis, Miguel A.

    2006-01-01

    The CARA Project (Spanish acronym of Combustible Avanzado para Reactores Argentinos) is a national fuel element technology development, compatible with our nuclear power plants (Atucha I, Embalse and Atucha II). It takes into account the experience obtained in our nuclear organisations (CNEA-CONUAR-NASA). The goal of the CARA fuel element is the performance improvement for those reactors and the enhancing of their normal operative conditions. The CARA design allows the burnup extension by using 52 rods of the same diameter. Likewise it keeps good thermo-hydraulic behaviour. The fuel bundle can be directly used in nuclear power plants with horizontal channels. By using an additional system it can be installed in the PHWR with vertical channels. The expected profits, by the use of the CARA in our reactors, broadly guaranty the recovery of the fund for its development, due to a reduction of the NPP fuels and back end cost. We estimate a reduction in the generation cost between 20 or 25 % in relation to the present one if we use 0.85 or 0.90% SEU (Slightly Enriched Uranium). The use of the CARA fuel in our reactors will also reduce the amount of spent fuel to be treated. The shortening could be between 17 to 27 % in Atucha I in relation to the present ULE (0.85%), between 38 to 46% for Embalse, and 45 to 53% for Atucha II. The mechanical behaviour and hydraulic compatibility have been verified. Several CARA prototypes were fabricated with a new design of the end plate and with new processes for the welding for the rods. We present in this paper the current status of the CARA fuel element development. (author) [es

  13. CO-OCCURRENCE OF CHRONIC HEAD, FACE AND NECK PAIN, AND DEPRESSION IN WAR VETERANS WITH POST-TRAUMATIC STRESS DISORDER.

    Science.gov (United States)

    Muhvić-Urek, Miranda; Vukšić, Željka; Simonić-Kocijan, Sunčana; Braut, Vedrana; Braut, Alen; Uhač, Ivone

    2015-09-01

    This study investigated the relationship between chronic head, face and neck pain, and the level of depression in Croatian war veterans with post-traumatic stress disorder (PTSD). The presence of self-reported pain, pain on digital palpation, and pain severity in masticatory and neck muscles, temporomandibular joints and sinuses, as well as the level of depression were assessed in a group of war veterans with PTSD (n=52). Control groups consisted of war veterans without PTSD (n=50) and healthy men that were not engaged in war actions and were free from PTSD (n=50). The number of self-reported pain and number of painful sites were correlated with the level of depression. More self-reported pain and painful sites were recorded in the group of war veterans with PTSD as compared with either war veterans without PTSD or healthy men. Furthermore, PTSD patients mostly suffered from severe depression. There was a statistically significant positive correlation between all investigated pain parameters and level of depression. As the most important finding, the present study demonstrated chronic head, face and neck pain to be related to depression in PTSD patients.

  14. Comparative Analysis of Thermohydraulic Margins in Embalse Power Station, CARA Vs. CANDU with Cobra IV-HW

    International Nuclear Information System (INIS)

    Daverio, H; Juanico, L

    2000-01-01

    Comparative analysis of thermohydraulic margins were studied of the CANDU 37 and CARA fuel bundles (FB) in Embalse power station with COBRA IV-HW code ., the geometry of the bundle laying on the channel was particularly modeled and discussing the results in comparison with former calculations with 1/6 simetry .The CARA design with enriched uranium (0.9 %) and extended burn up lets maintain the current thermohydraulic nominal margins , while compared with CANDU 37 rods FB enriched , the CARA design permits widely improve the current margins

  15. Effects of aromatherapy massage on face-down posture-related pain after vitrectomy: a randomized controlled trial.

    Science.gov (United States)

    Adachi, Naho; Munesada, Minako; Yamada, Noriko; Suzuki, Haruka; Futohashi, Ayano; Shigeeda, Takashi; Kato, Satoshi; Nishigaki, Masakazu

    2014-06-01

    Postoperative face-down posturing (FDP) is recommended to optimize the effects of intraocular gas tamponade after vitrectomy. However, patients undergoing FDP usually experience physical and psychological burdens. This 3-armed, randomized, single-center trial investigated the effects of aromatherapy on FDP-related physical pain. Sixty-three patients under FDP were randomly allocated to one of three treatment groups: aromatherapy massage with essential oil (AT), oil massage without essential oil (OT), and a control group. The AT and OT groups received 10 minutes of massage by ward nurses trained by an aromatherapist, while the control group received usual care. Outcomes were assessed as short-term (pre- to post-intervention) and long-term (first to third postoperative day) changes in physical pain in five body regions using face-scale. The AT and OT groups both revealed similar short-term pain reductions after intervention, compared with the control group. Regarding long-term effects, neither group experienced significant effects until the second day. Significantly more pain reduction compared with usual care occurred on the third day, mainly in the AT group, though there were few significant differences between the AT and OT groups. In conclusion, this study suggests that simple oil massage is an effective strategy for immediate pain reduction in patients undergoing FDP, while aromatherapy may have a long-term effect on pain reduction. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  16. Pengembangan Bisnis Rahasia Dagang dengan Cara Franchise

    OpenAIRE

    Idris, Isran

    2012-01-01

    Pembangunan ekonomi suatu negara tidak boleh hanya mengandalkan keunggulan  komperatif (comperative advantage), tetapi harus diiringi dengan keunggulan kompetitif (kompetitif advantage), bahkan banyak negara pada saat ini justru mengadalkan keunggulan kompetitif seperti Hak Kekayaan Intelektual sebagai dasar membangun perekonomian. Franchise adalah salah satu cara pembiakan usaha yang bertujuan melipat gandakan nilai ekonomi Hak Kekayaan Intelektual khusnya Rahasia Dagang yang sangat terkenal...

  17. Pengembangan Bisnis Rahasia Dagang dengan Cara Franchise

    OpenAIRE

    Idris, Isran

    2010-01-01

    Pembangunan ekonomi suatu negara tidak boleh hanya mengandalkan keunggulan komperatif (comperative advantage), tetapi harus diiringi dengan keunggulan kompetitif (kompetitif advantage), bahkan banyak negara pada saat ini justru mengadalkan keunggulan kompetitif seperti Hak Kekayaan Intelektual sebagai dasar membangun perekonomian. Franchise adalah salah satu cara pembiakan USAha yang bertujuan melipat gandakan nilai ekonomi Hak Kekayaan Intelektual khusnya Rahasia Dagang yang sangat terkenal...

  18. Ganglio centinela en melanoma de cara: abordaje inicial

    Directory of Open Access Journals (Sweden)

    Enrique Cadena Piñeros

    2012-07-01

    de la cara a quien se practicó resección local amplia del tumor y extracción de los centinelas marcados por linfogammagrafía y a la vez disección de los relevos ganglionares positivos para drenaje demostrados por este estudio de medicina nuclear.

  19. El tratamiento inmediato de algunas heridas de la cara. Algunos conceptos esenciales

    Directory of Open Access Journals (Sweden)

    Pere Gabarro

    1941-04-01

    Además la abundancia de cavidades en la cara hace que casi siempre haya un drenaje natural de las heridas, o en todo caso es fácil producirlo quirúrgicamente. Con ello los tejidos lacerados y las secreciones y exudaciones propias de las heridas, son de fácil evacuación. Todo ello ayuda a combatir la posible infección secundaria y por ello podemos, y debemos seguir, en la cara, un tratamiento diferente de el de las otras partes del cuerpo.

  20. Integrity, behavior and proposal of CARA fuel irradiation with empty negative coefficient

    International Nuclear Information System (INIS)

    Marino, Armando C.; Brasnarof, Daniel O.; Demarco, Gustavo L.; Agueda, Horacio C.

    2007-01-01

    The main issues of the CARA fuel, CVN version, are its negative void reactivity coefficient and an extraction burnup of ∼20000 MWd/ton U. The analysis of the fuel rod behaviour, under the irradiation conditions of the Embalse, Atucha I and II NPPs, are the key to recognize their demanding under operation, to review the classic issues of the PHWR fuels and to prepare a programme of experimental irradiations in order to demonstrate the CARA concept, to assess the fuel integrity, to improve the performance and the enhancement of the safety margins. (author) [es

  1. Painful stimulation and transient blocking of nerve transduction due to local anesthesia evoke perceptual distortions of the face in healthy volunteers.

    Science.gov (United States)

    Skyt, Ina; Dagsdóttir, Lilja; Vase, Lene; Baad-Hansen, Lene; Castrillon, Eduardo; Roepstorff, Andreas; Jensen, Troels Staehelin; Svensson, Peter

    2015-04-01

    Anecdotally, orofacial pain patients sometimes report that the painful face area feels "swollen." Because there are no clinical signs of swelling, such illusions may represent perceptual distortions. In this study, we examine whether nociceptive stimulation can lead to perceptual distortion of the face in a way similar to that of local anesthesia. Sixteen healthy participants received injections of .4 mL hypertonic saline to induce short-term nociceptive stimulation, .4 mL mepivacaine (local anesthetic) to transiently block nerve transduction, and .4 mL isotonic saline as a control condition. Injections were administered in both the infraorbital and the mental nerve regions. Perceptual distortions were conceptualized as perceived changes in magnitude of the injected areas and the lips, and they were measured using 1) a verbal subjective rating scale and 2) a warping procedure. Prior to the study, participants filled in several psychological questionnaires. This study shows that both nociceptive stimulation (P blocking of nerve transduction (P face. A test-retest experiment including 9 new healthy subjects supported the results. Perceptual distortions were positively correlated with the psychological variable of dissociation in several conditions (P face is important to understand the possible implications of perceptual distortions in orofacial pain disorders (and possibly other chronic pain states). Such information may ultimately open up new avenues of treatment for persistent orofacial pain. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  2. [Impact of disabling chronic pain: results of a cross-sectional population study with face-to-face interview].

    Science.gov (United States)

    Cabrera-Leon, Andrés; Cantero-Braojos, Miguel Ángel

    2017-11-16

    To assess the impact of disabling chronic pain (DCP) on quality of life, work, consumption of medication and usage of health services. Cross-sectional population study with face-to-face interview. Andalusian Health Survey (2011 edition). 6,507 people over the age of 16 (p=q=0.5; confidence level=95%; sampling error=1.49, design effect=1.52). Not applicable. Dependent variable: DCP: population limited in their activity by any of the CP specified in the survey. quality of life, absence from work, consumption of medication and utilization of health services. Compared to a population without CP, DCP impact is 6 points less on the mental quality of life and 12 points on the physical one, medication consumption is triple, health services utilization is almost double, and long absence from work is triple. On the other hand, a population with nondisabling chronic pain (nDCP) presents similar results to a population without CP. We have considered DCP as another CP category because of its huge impact, as is shown in our study, on the study variables. On the contrary, the population with nDCP does not obtain significant impact differences when compared to the population without CP. Therefore, we believe that Primary Care and Public Health should lead different prevention strategies for DCP as well as for the identification of the nDCP population to decrease its possible deterioration towards DCP. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  3. The neurologist facing pain in dementia.

    Science.gov (United States)

    Álvaro González, Luis Carlos

    2015-01-01

    Ageing, a common background in dementia, is usually associated with painful disorders. Nevertheless, the use of analgesics is limited due to poor communication. On the other hand, dementia lesions are placed in the nociceptive pathways. For this reason, the painful experience becomes different and distinctive for every lesional type. The lateral nociceptive pathway (lateral thalamic nuclei and primary parietal cortex), which is in charge of the primary pain perception, is preserved in dementia. Thereafter, the shear painful perception, including pain intensity and threshold, remains unmodified. Distinctly, the medial pain pathways are affected by dementia lesions. In this pathway are included: the intralaminar thalamic nuclei, the pons (locus ceruleus:LC), the mesencephalon (periaacueductal grey substance: PGS), the hypothalamus (paraventricular nuclei, mamilary tuberculum) and different areas of the parietal (primary, secondary, operculum), temporal (amigdala, hypoccampus) and frontal (anterior cingular: ACC). As a consequence, the features of pain executed by these areas will be compromised: the cognitive assessment, the mood and emotion inherent to pain, the pain memory or the autonomic responses are modified in dementia. Specifically, in Alzheimer's disease (AD) there is a reduction in the anticipatory and avoidance responses and also a flattening of the autonomic responses. These are essentially secondary to the degenerative changes in the medial temporal (pain memory) and ACC (cognitive and mood aspects) areas. In vascular dementias, there is a cortico-subcortical deafferentation secondary to the white matter lesions. The consequence is the presence of hyperpathy and hyperalgesia. In the frontotemporal dementias, there is a reduction in pain expressivity. It is linked to the lesions in the orbitofrontal and anterior temporal areas, which are responsible of the emotional aspects of pain. In Parkinson's disease, painful conditions are a common characteristic

  4. Pengaruh Cara Kematian Dan Tahapan Penurunan Kesegaran Ikan Terhadap Kualitas Pasta Ikan Nila (Oreochromis Niloticus)

    OpenAIRE

    Wibowo, Imam Restu; Darmanto, YS; Anggo, Apri Dwi

    2014-01-01

    Kualitas produk hasil perikanan dipengaruhi oleh kesegaran ikan. Pengolahan merupakan salah satu cara untuk mempertahankan daya awet dan juga meningkatkan nilai ekonomis ikan. Pasta ikan merupakan salah satu alternatif penganekaragaman produk berbasis produk gel. Pasta ikan merupakan makanan yang berasal dari bahan baku lumatan daging ikan yang ditambahkan dengan tepung, garam dan berbagai jenis sayuran. Cara kematian ikan dan tahapan penurunan kesegaran ikan dapat mempengaruhi kualitas produ...

  5. "Hiding in Plain Sight": An Interview with Cara Hoffman

    Science.gov (United States)

    Hosey, Sara

    2014-01-01

    Cara Hoffman's work enacts George Orwell's imperative to "pay attention to the obvious" (an idea that several sympathetic characters repeat in her 2011 novel "So Much Pretty"), probing aspects of twenty-first century life in the United States that have become so accepted as to be unremarkable, such as epidemic levels of…

  6. Utilizando instrumentos para avaliação da percepção de dor em pré-escolares face a procedimento doloroso Using tools for pain perception assessment in hospitalized pre-school children submitted to painful procedure

    Directory of Open Access Journals (Sweden)

    Lisabelle Mariano Rossato

    1999-09-01

    Full Text Available Este estudo teve como objetivos: verificar se a escala de faces de intensidade de dor possibilita ao pré-escolar identificar sua experiência dolorosa; identificar comportamentos indicadores de dor em pré-escolares submetidos a procedimentos doloroso conhecer palavras utilizadas pelo pré-escolar para descrever a dor em relação a procedimento doloroso. Para tanto foram aplicados três instrumentos em 41 crianças hospitalizadas submetidas a curativo ou coleta de sangue. Os instrumentos utilizados foram escala de faces, indicadores comportamentais e palavras descritoras de dor. A maioria dos pré-escolares compreendeu e utilizou corretamente a escala de faces, o que foi evidenciado pelo movimento crescente 0 (sem dor® 4 (dor máxima na escolha das faces antes e depois do procedimento doloroso. Os comportamentos choro imóvel e franzir a testa predominaram como indicadores comportamentais, mostrando-se intensificados na vigência do procedimento. As verbalizações do pré-escolar relativas a sua dor revelaram uma tendência na utlização de termos concretos e de natureza avaliativa ou indicativa, resultando em conceitos variados e pouco precisos.The aim of this study was evaluate the utilization of tools for pain perception assessment in 41 hospitalized preschool children submitted to painful procedures: care of wounds or blood extraction. The utilizaded tools were the faces scale, behaviorial indicators and words which describe the pain. Most of the pre-schoolers understood and correctly answered to the faces scale, which can be noticed by the crescent moviment 0 (no pain® 4 (maximum pain during the choice of faces before and after the painful procedure. Crying, immortility and forehead wriking were the predominant behavioral indicators, intensified during the procedure. Preschoolers verbalizations about their pain showed up to be concret terms or evaluative-indicative nature, esulting in variable, precise or weakly precise concepts.

  7. PS-CARA: Context-Aware Resource Allocation Scheme for Mobile Public Safety Networks

    Directory of Open Access Journals (Sweden)

    Zeeshan Kaleem

    2018-05-01

    Full Text Available The fifth-generation (5G communications systems are expecting to support users with diverse quality-of-service (QoS requirements. Beside these requirements, the task with utmost importance is to support the emergency communication services during natural or man-made disasters. Most of the conventional base stations are not properly functional during a disaster situation, so deployment of emergency base stations such as mobile personal cell (mPC is crucial. An mPC having moving capability can move in the disaster area to provide emergency communication services. However, mPC deployment causes severe co-channel interference to the users in its vicinity. The problem in the existing resource allocation schemes is its support for static environment, that does not fit well for mPC. So, a resource allocation scheme for mPC users is desired that can dynamically allocate resources based on users’ location and its connection establishment priority. In this paper, we propose a public safety users priority-based context-aware resource allocation (PS-CARA scheme for users sum-rate maximization in disaster environment. Simulations results demonstrate that the proposed PS-CARA scheme can increase the user average and edge rate around 10.3% and 32.8% , respectively because of context information availability and by prioritizing the public safety users. The simulation results ensure that call blocking probability is also reduced considerably under the PS-CARA scheme.

  8. Pengaruh Cara Kematian Ikan Dan Tahapan Penurunan Kondisi Kesegaran Ikan Terhadap Kualitas Pasta Ikan Gurami (Osphronemous Gouramy)

    OpenAIRE

    Nugroho, Danuar Adi; Darmanto, YS; Romadhon, -

    2014-01-01

    Cara kematian ikan dapat mempengaruhi kualitas produk olahannya sehingga diperlukan bahan baku dengan tingkat kesegaran tertentu untuk menghasilkan bahan baku produk olahan yang baik. Salah satu produk olahan tersebut adalah pasta ikan. Tujuan dari penelitian ini adalah mengetahui pengaruh cara kematian dan penurunan kesegaran ikan yang berbeda terhadap kualitas pasta ikan gurami (Osphronemus gouramy). Rancangan percobaan yang digunakan pada penelitian utama adalah eksperimental laboratories ...

  9. Mucoceles en Cara Ventral de Lengua: Reporte de 6 casos y manejo quirúrgico

    OpenAIRE

    Del Valle, Sol C.

    2002-01-01

    El "Mucocele" como todos sabemos es un término clínico que corresponde histopatológicamente a un fenómeno de retención o extravasación de moco, causado por obstrucción o ruptura del ducto de una glándula salival menor. La localización más frecuente es la mucosa del labio inferior seguida de mucosa bucal, paladar, y pocas veces en cara ventral de lengua. (1-2) Se estudiaron 6 pacientes con diagnóstico clínico de mucocele en cara ventral de lengua que acudieron el Servicio de Patología Clínica ...

  10. Postoperative Self-Report of Pain in Children: Interscale Agreement, Response to Analgesic, and Preference for a Faces Scale and a Visual Analogue Scale

    Directory of Open Access Journals (Sweden)

    Clément de Tovar

    2010-01-01

    Full Text Available OBJECTIVE: To augment available validation data for the Faces Pain Scale – Revised (FPS-R and to assess interscale agreement and preference in comparison with the Coloured Analogue Scale (CAS in pediatric acute pain.

  11. [Adaptation strategies faced with chronic pain].

    Science.gov (United States)

    Bioy, Antoine

    2017-05-01

    Chronic pain constitutes a challenge for patients. It makes them uneasy with regard to their personality, their corporality and their life balance, and leaves long-lasting effects on their experience as a patient. The development of adaptation strategies and resources to deal with chronic pain is therefore essential. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Gambaran Pengetahuan Remaja Puteri Terhadap Nyeri Haid (Dismenore dan Cara Penanggulangannya

    Directory of Open Access Journals (Sweden)

    Erlina Rustam

    2015-01-01

    Full Text Available AbstrakDismenore merupakan gangguan menstruasi yang sering terjadi pada remaja putri. Untuk mengobatinya penderita cendrung menggunakan tindakan Farmakologi dan non Farmakologi. Telah dilakukan penelitian tentang gambaran pengetahuan dan cara menanggulangi dismenore pada remaja putri mahasiswi STIFARM Padang angkatan 2013 dengan jumlah responden 56 orang. Penelitian ini bersifat deskriptif dengan pengambilan data dilakukan dengan menggunakan kuesioner dan disajikan dalam bentuk tabel. Parameter yang digunakan adalah pengetahuan tentang menstruasi, dismenore dan tindakan yang dilakukan ketika mengalami dismenore. Dari penelitian didapat hasil yang tinggi dari pengetahuan remaja putri mengenai pengertian, lama dan penyebab menstruasi, pengetahuan yang rendah tentang siklus dan hormon yang berperan dalam menstruasi. Mempunyai pengetahuan yang tinggi terhadap dismenore seperti pengertian dismenore, usia yang sering mengalami dismenore, derajat dan penyebab dismenore. Tindakan yang dilakukan untuk mengatasi dismenore adalah tindakan non farmakologi (17,86%. Secara Farmakologi remaja putri menggunakan obat tradisional daun sirih (67,00%, Sedangkan yang memilih obat jadi adalah OJ-2 (40,00%. Efek samping obat yang dirasakan adalah mengantuk (56,52%. Alasan pemilihan obat adalah karena cepat menghilangkan nyeri (97,83%. Disarankan untuk melakukan penyuluhan tentang cara pengobatan dismenore baik secara Farmakologi maupun nonfarmakologi.Kata kunci: Dismenore, pengetahuan, pengobatanAbstractDysmenorrhea is the most common gynecologic health problem presented among female adolescents. To treat this condition, patients tend to either use pharmacologic or non farmacologic treatments available. A research had been done on the description of knowledge and how to over come a dysmenorrhea in female students of STIFARM Padang with sample 56 students. This is a descriptive study with data collection is done by using a questionnaire and presented in tabular form

  13. EVALUATION OF LOWER FACE HEIGHTS AND RATIOS ACCORDING TO SEX. 213\tEvaluación de las alturas y proporciones de la parte inferior de la cara en relación al sexo

    Directory of Open Access Journals (Sweden)

    Ayla Kurkcuoglu

    2016-03-01

    Full Text Available La determinación de las relaciones de altura de la cara inferior proporciona información importante para el tratamiento de ortodoncia, los enfoques quirúrgicos y la identificación fiable en lmedicina forense. Este estudio se realizó con el objetivo de determinar la altura de la índices bajos de la cara de estudiantes de la Universidad Baskent y evidenciar las posibles diferencias por sexo. El estudio se realizó en 95 mujeres y 101 varones,18 a25 años, un total de 196 estudiantes turcos voluntarios. Las imágenes fotogramétricas laterales fueron adquiridos por la misma persona para todos los sujetos en la posición natural de la cabeza, con la boca cerrada en la postura normal. Las imágenes se transfirieron a un entorno de computación. La determinación de seis puntos antropométricos en el plano vertical, la medición de sus distancias relativas y el cálculo de siete relaciones se realizó por la misma persona en todas las fotografías. Se observó una diferencia significativa en función del sexo de los sujetos que fue identificada en los siete parámetros medidos entre los puntos de referencia antropométricas. Cuando se evaluaron las relaciones de altura facial inferior la más grande era la altura bermellón superior / inferior proporción de altura bermellón, tanto en hombres como en mujeres, y el más pequeño era el alto / superior bermellón del labio superior altura en mujeres y el labio superior de elevación / altura de la parte inferior del rostro en los hombres. Postulamos que el conocimiento de determinados índices faciales y sus diferencias según el sexo y la raza puede servir como una guía para la planificación de la terapia en las diferentes intervenciones quirúrgicas, el control en ortodoncia y lla identificación personal. The determination of the lower face height ratios provides significant information for orthodontic treatment, surgical approaches and for a reliable identification in forensic medicine

  14. Validity of the Korean Version of the Face, Legs, Activity, Cry, and Consolability Scale for Assessment of Pain in Dementia Patients.

    Science.gov (United States)

    Moon, Yeonsil; Kim, Yoon Sook; Lee, Jongmin; Han, Seol Heui

    2017-11-01

    Pain is often associated with a more rapid progression of cognitive and functional decline, and behavioral disturbance in dementia. Therefore, it is essential to accurately assesses pain for proper intervention in patients with dementia. The Face, Legs, Activity, Cry, and Consolability (FLACC) scale is an excellent behaviour scale which includes most of the domains that are recommended by the American Geriatrics Society to evaluate when assessing pain in patients with dementia. The purpose of this study was to develop the Korean version of the FLACC (K-FLACC) and to verify its reliability and validity in assessing pain of elderly patients with dementia. We developed the K-FLACC to consist of the five domains (face, legs, activity, cry, and consolability) with scores of 0, 1, and 2 for each domain and a total score ranging from 0 to 10 as in the original FLACC. Eighty-eight patients with dementia who visited Konkuk University Medical Center were evaluated. The K-FLACC revealed good validity as compared to the Numeric Rating Scale (NRS; r = 0.617, P dementia in Korea. © 2017 The Korean Academy of Medical Sciences.

  15. EKSPLORASI HIJUAN PAKAN BABI DAN CARA PENGGUNAANNYA PADA PETERNAKAN BABI TRADISIONAL DI PROVINSI BALI

    Directory of Open Access Journals (Sweden)

    K. Budaarsa

    2015-06-01

    Full Text Available Penelitian ini bertujuan untuk mengetahui jenis-jenis hijauan yang diberikan sebagai pakan ternak babi dan cara penggunaannya di propvinsi Bali. Penelitian dilakukan dengan metode survei di seluruh kabupaten dan kota di Bali. Pengambilan sampel dilakukan dengan teknik stratified random sampling, dengan pengelompokan atas dataran rendah dan dataran tinggi di masing-masing kabupaten dan kota. Pada masing-masing kelompok di ambil 2 orang peternak babi tradisional, sehingga ada 4 peternak yang diwawancarai di masing-masing kabupaten dan kota atau 32 peternak di seluruh Bali. Hasil survei menunjukkan bahwa ada perbedaan hijauan yang diberikan oleh peternak di dataran rendah dan dataran tinggi. Jenis hijauan yang diberikan di dataran rendah antara lain: batang pisang (Musa paradisiaceae, kangkung (Ipomaea aquatica, biah-biah (Limnocharis flava, dan eceng gondok (Eichornia crassipes. Sedamgkan di dataran tinggi antara lain: batang pisang (Musa paradisiaceae, ketela rambat (Ipomaea batatas, daunt alas (Colocasia esculenta daun lamtoro (Leucaena leucocephala dan dag-dagse (Pisonia alba. Batang pisang dominan (95 % diberikan di dataran rendah maupun di dataran tinggi. Pemberian hijauan ada dengan cara direbus ada yang diberikan dalam bentuk segar. Kesimpulan dari penelitian ini adalah terdapat keragaman jenis hijauan pakan babi dan cara pemberiannya antara di dataran rendah dengan dataran tinggi di Bali. Batang pisang merupakan hijauan yang paling banyak digunakan untuk pakan babi pada peternakan babi tradisional, baik pada dataran rendah maupun dataran tinggi.

  16. La cara auditiva: El reconocimiento de las personas a través de la voz

    Directory of Open Access Journals (Sweden)

    Alba Mónica Casado Ramos

    2014-04-01

    Full Text Available Cuando escuchamos a alguien hablar, aunque no lo veamos ni conozcamos, obtenemos diferentes tipos de información a partir de su voz: su mensaje lingüístico, su estado emocional y también, por extraño que parezca, una imagen de sus características físicas, una especie de “cara auditiva”. Si el hablante es alguien conocido, podemos además saber quién es, es decir, podemos identificarlo únicamente por la idiosincrasia de su voz. Cuando voz y cara aparecen juntas, la información obtenida a partir de ambas modalidades sensoriales se integra para crear una imagen global y completa del hablante.

  17. Middle Man Concept for In-Orbit Collision Risks Mitigation, CAESAR and CARA Examples

    Science.gov (United States)

    Moury, Monique; Newman, Lauri K.; Laporte, Francois

    2014-01-01

    This paper describes the conjunction analysis which has to be performed using data provided by JSpOC. This description not only demonstrates that Collision Avoidance is a 2- step process (close approach detection followed by risk evaluation for collision avoidance decision) but also leads to the conclusion that there is a need for a Middle Man role. After describing the Middle Man concept, this paper introduces two examples with their similarities and particularities: the American civil space effort delivered by the NASA CARA team (Conjunction Assessment Risk Analysis) and the French response CAESAR (Conjunction Assessment and Evaluation Service: Alerts and Recommendations). For both, statistics are presented and feedbacks discussed. All together, around 80 satellites are served by CARA and/or CAESAR. Both processes regularly evolve in order either to follow JSpOC upgrades or to improve analysis according to experience acquired during the past years.

  18. Perbedaan Cara Penyebaran Suspensi terhadap Jumlah Bakteri pada Media Eosin Methylene Blue Agar

    Directory of Open Access Journals (Sweden)

    Ahmad Nuzuludin Kadri

    2015-06-01

    Full Text Available Dalam rangka pengawasan mutu secara biologis dilakukan pengujian laboratorium untuk mengisolasi dan melakukan jumlah penghitungan jumlah bakteri patogen (enumerasi. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan cara penyebaran suspensi dengan menggunakan batang gelas bengkok, mikropipet dan ose terhadap jumlah bakteri yang terhitung pada media Eosin Methylene Blue Agar. Sampel diambil dari air susu kambing yang kemudian dihitung jumlah bakteri-nya dengan tiga kelompok perlakuan yaitu menggunakan batang gelas bengkok, mikropipet dan ose. Data hasil penelitian dianalisis menggunakan sidik ragam, bila hasilnya berbeda nyata maka dilanjutkan dengan uji Duncan. Jumlah bakteri yang terhitung dengan menggunakan batang gelas bengkok, mikropipet dan ose per ml berturut-turut mengandung 9.722.222 cfu, 68.944.444 cfu dan 116.444.444 cfu. Dengan sidik ragam, perlakuan cara penyebaran dengan menggunakan mikropipet dan ose berbeda sangat nyata (P<0,01 terhadap jumlah bakteri yang terhitung dengan menggunakan batang gelas bengkok. Setelah di uji dengan uji Duncan, rata-rata jumlah bakteri yang terhitung dengan menggunakan mikropipet dan ose lebih tinggi sangat nyata (P<0,01 dibandingkan dengan menggunakan batang gelas bengkok, sedangkan rata-rata jumlah bakteri yang terhitung menggunakan ose lebih tinggi sangat nyata (P<0,01 dibandingkan dengan menggunakan mikropipet. Kesimpulan dari penelitian ini adalah terdapat perbedaan cara penyebaran suspensi dengan menggunakan batang gelas bengkok,mikropipet dan ose terhadap jumlah bakteri pada media EMBA. Penyebaran bakteri menggunakan ose lebih banyak (P<0,01 dibandingkan mikropipet dan batang gelas bengkok. Sedangkan penyebaran bakteri menggunakan mikropipet lebih banyak (P<0,01 dibandingkan dengan gelas bengkok.

  19. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2009-01-01

    Full Text Available Los pseudoaneurismas son complicaciones infrecuentes de los infartos del miocardio. Consisten en un saco pericárdico que comunica con la cavidad ventricular a través de un cuello de menor diámetro. Se presenta el caso de una paciente de 68 años de edad, con DM II e HTA, sufre Infarto Agudo del Miocardio en Mayo del 2008, presentando disnea y tos por una semana, con diaforesis profusa de inicio súbito y síncope sin dolor precordial. El electrocardiograma reporta zonas de isquemia transmural y subendocárdica en caras inferolateral y lateral alta, respectivamente, y zona eléctricamente inactivable en cara inferior. El ecocardiograma transtorácico muestra el ventrículo izquierdo con dilatación severa, disminución de la fracción de eyección (25% y un pseudoaneurisma de la pared inferior con cuello de 3 mm a través del cual se evidencia flujo bidireccional, de entrada al ventrículo durante la diástole y salida al pseudoaneurisma en sístole. El flujo bidireccional y el gasto cardíaco disminuido contribuyen a evitar el taponamiento cardiaco, sin embargo, en condiciones de mayor demanda el pseudoaneurisma podría perforarse y ocasionar dicha entidad. De ello, la importancia del diagnostico diferencial con los aneurismas verdaderos, lo cual permite llevar a cabo la terapéutica adecuada y evitar tal complicación.

  20. Application of the capsaicin 8% cutaneous patch in neuropathic pain of the head and face: A case series.

    Science.gov (United States)

    Gaul, Charly; Resch, Sonja

    2015-05-01

    Treatment of neuropathic or neuralgic head and facial pain due to dental, traumatic or surgical nerve lesions or post-herpetic neuropathy is often challenging. We are reporting on four patients with neuropathic pain syndromes successfully treated with a capsaicin 8% patch in the affected area of the head or face. Treatment with the capsaicin 8% patch seems to be effective and safe for application to the facial and head region. The capsaicin 8% patch might be an additional treatment option if first-line treatment with anticonvulsants or antidepressants was ineffective or limited by side effects. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Pseudoaneurisma Ventricular Izquierdo en Cara Inferior con Flujo Bidireccional

    Directory of Open Access Journals (Sweden)

    Adrián J Da Silva-De Abreu

    2011-01-01

    Full Text Available Los pseudoaneurismas son complicaciones infrecuentes de los infartos del miocardio. Consisten en un saco pericárdico que comunica con la cavidad ventricular a través de un cuello de menor diámetro. Se presenta el caso de una paciente de 68 años de edad, con DM II e HTA, sufre Infarto Agudo del Miocardio en Mayo del 2008, presentando disnea y tos por una semana, con diaforesis profusa de inicio súbito y síncope sin dolor precordial. El electrocardiograma reporta zonas de isquemia transmural y subendocárdica en caras inferolateral y lateral alta; respectivamente, y zona eléctricamente inactivable en cara inferior. El ecocardiograma transtorácico muestra el ventrículo izquierdo con dilatación severa, disminución de la fracción de eyección (25% y un pseudoaneurisma de la pared inferior con cuello de 3 mm a través del cual se evidencia flujo bidireccional: de entrada al ventrículo durante la diástole y salida al pseudoaneurisma en sístole. El flujo bidireccional y el gasto cardíaco disminuido contribuyen a evitar el taponamiento cardiaco, sin embargo, en condiciones de mayor demanda el pseudoaneurisma podría perforarse y ocasionar dicha entidad. De ello, la importancia del diagnostico diferencial con los aneurismas verdaderos, lo cual permite llevar a cabo la terapéutica adecuada y evitar tal complicación. Palabras claves: Pseudoaneurisma, Infarto del Miocardio, Diabetes.

  2. Chronic orofacial pain.

    Science.gov (United States)

    Renton, T

    2017-07-01

    The issues specific to trigeminal pain include the complexity of the region, the problematic impact on daily function and significant psychological impact (J Dent, 43, 2015, 1203). By nature of the geography of the pain (affecting the face, eyes, scalp, nose, mouth), it may interfere with just about every social function we take for granted and enjoy (J Orofac Pain, 25, 2011, 333). The trigeminal nerve is the largest sensory nerve in the body, protecting the essential organs that underpin our very existence (brain, eyes, nose, mouth). It is no wonder that pain within the trigeminal system in the face is often overwhelming and inescapable for the affected individual. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Evaluating the Risk of Child Abuse: The Child Abuse Risk Assessment Scale (CARAS)

    Science.gov (United States)

    Chan, Ko Ling

    2012-01-01

    The present study developed the Child Abuse Risk Assessment Scale (CARAS), an actuarial instrument for the assessment of the risk of physical child abuse. Data of 2,363 Chinese parents (47.7% male) living in Hong Kong were used in the analyses. Participants were individually interviewed with a questionnaire assessing their perpetration of child…

  4. La comunicación y la asertividad del discurso durante las interacciones grupales presenciales y por computadora Communication and assertiveness on the discourse during face-to-face and computer-mediated group interactions

    Directory of Open Access Journals (Sweden)

    Nancy Noemí Terroni

    2009-04-01

    Full Text Available En este trabajo se reportan los resultados del análisis reticular en la comunicación, y los puntajes de la asertividad del discurso de los partipantes de pequeños grupos que resuelven una tarea de recuperación de memoria (La guerra de los fantasmas, Bartlett, 1932. El diseño es cuasiexperimental y los 90 participantes alumnos de la Universidad Nacional de Mar del Plata, debieron reconstruir la misma en forma grupal colaborativa. Los sujetos fueron asignados aleatoriamente a los grupos y a las dos condiciones (grupos cara a cara y mediados por computadora. Se registraron las interacciones presenciales mediante video filmaciones y las electrónicas quedaron almacenadas en el canal de chat. En general, la asertividad del discurso y la comunicación presentaron asociaciones significativas, con algunas diferencias según el canal comunicacional empleado. Se discuten estos resultados con relación al tipo de tarea y a las restricciones de los medios electrónicos.This work reports the results of reticular analysis in communication, and the scores from the discourse assertiveness of the participants of small groups who solve a recall memory task (The war of the ghosts, Bartlett, 1932. The design is a quasi-experimental one and the 90 subjects, students from Mar del Plata University had to reconstruct the same story in collaborative groups. The subjects were assigned in an aleatory way, to both conditions (face to face and computer-mediated groups. The subjects' interactions in face-to-face communication groups were recorded in video films and the electronic ones were stored in the chat channel. In general, the discourse assertiveness and the communication presented significant associations, with some differences according to the communication channel used. These results are discussed about the type of task and the restrictions of the electronic media.

  5. Chapter 8: US geological survey Circum-Arctic Resource Appraisal (CARA): Introduction and summary of organization and methods

    Science.gov (United States)

    Charpentier, R.R.; Gautier, D.L.

    2011-01-01

    The USGS has assessed undiscovered petroleum resources in the Arctic through geological mapping, basin analysis and quantitative assessment. The new map compilation provided the base from which geologists subdivided the Arctic for burial history modelling and quantitative assessment. The CARA was a probabilistic, geologically based study that used existing USGS methodology, modified somewhat for the circumstances of the Arctic. The assessment relied heavily on analogue modelling, with numerical input as lognormal distributions of sizes and numbers of undiscovered accumulations. Probabilistic results for individual assessment units were statistically aggregated taking geological dependencies into account. Fourteen papers in this Geological Society volume present summaries of various aspects of the CARA. ?? 2011 The Geological Society of London.

  6. Support vector machine for automatic pain recognition

    Science.gov (United States)

    Monwar, Md Maruf; Rezaei, Siamak

    2009-02-01

    Facial expressions are a key index of emotion and the interpretation of such expressions of emotion is critical to everyday social functioning. In this paper, we present an efficient video analysis technique for recognition of a specific expression, pain, from human faces. We employ an automatic face detector which detects face from the stored video frame using skin color modeling technique. For pain recognition, location and shape features of the detected faces are computed. These features are then used as inputs to a support vector machine (SVM) for classification. We compare the results with neural network based and eigenimage based automatic pain recognition systems. The experiment results indicate that using support vector machine as classifier can certainly improve the performance of automatic pain recognition system.

  7. PENGARUH KUALITAS POLA ASUH ORANG TUA, CARA BELAJAR DAN PERAN KELOMPOK TEMAN SEBAYA TERHADAP PRESTASI BELAJAR MATA PELAJARAN EKONOMI

    Directory of Open Access Journals (Sweden)

    Asti Nuris Soraya

    2016-06-01

    Full Text Available Berdasarkan observasi awal di MA YPI Klambu, diketahui bahwa belum semua siswa kelas XI IPS memperoleh prestasi belajar yang optimal. Adanya pengaruh positif antara kualitas pola asuh orang tua, cara belajar dan peran kelompok teman sebaya terhadap prestasi belajar siswa.Populasi penelitian adalah seluruh siswa kelas XI IPS MA YPI Klambu tahun ajaran 2014/2015. Jumlah sampel sebanyak 50 orang. Metode pengumpulan data menggunakan angket dan dokumentasi. Sedangkan metode analisis data yang digunakan adalah analisis deskriptif dan statistik inferensial. Hasil penelitian menunjukkan kualitas pola asuh orang tua, cara belajar dan peran kelompok teman sebaya berpengaruh positif terhadap prestasi belajar. Kualitas pola asuh orang tua, cara belajar dan peran kelompok teman sebaya berpengaruh sebesar 65,1% secara simultan. Kualitas pola asuh orang tua berpengaruh sebesar 9,12%, cara belajar 14,06% dan peran kelompok teman sebaya 8,6% secara parsial. Kesimpulan penelitian berupa kualitas pola asuh orang tua, cara belajar dan peran kelompok teman sebaya berpengaruh positif terhadap prestasi belajar berdasarkan analisis parsial dan simultan. Saran yang diajukan: orang tua diharapkan menerapkan pola asuh demokratis dalam mendidik anak-anaknya, siswa diharapkan mempunyai cara belajar yang efektif untuk mendapatkan prestasi belajar yang baik, dan dianjurkan siswa mempunyai kelompok teman sebaya yang menunjang prestasi belajarnya. Based on preliminary observations in MA YPI Klambu, it is known that not all students of class XI IPS obtain optimum learning achievement. The positive influence the quality of parenting parents, learning and the role of peer groups on learning achievement siswa.Populasi research were all students of class XI IPS MA YPI Klambu the academic year 2014/2015. The total sample of 50 people. Methods of data collection using questionnaires and documentation. While the method of data analysis used is descriptive and inferential statistical

  8. Pour un tourisme durable dans la Grande Caraïbe

    OpenAIRE

    Dehoorne, Olivier; Nicolas, Fabiola; Saffache, Pascal

    2008-01-01

    IntroductionLe développement des activités touristiques dans les territoires de la Caraïbe s’impose comme l’alternative aux traditionnelles économies de plantation en difficulté. Si les produits de l’agriculture continuent d’être une importante source de revenus pour les Etats de la région, force est de reconnaître que leur déclin se précipite : les derniers marchés protégés s’ouvrent et les microéconomies insulaires sont confrontées à des concurrences internationale et intrarégionale qui les...

  9. Cultural adaptation to Brazilian Portuguese of the Face, Legs, Activity, Cry, Consolability revised (FLACCr scale of pain assessment

    Directory of Open Access Journals (Sweden)

    Edna Aparecida Bussotti

    2015-08-01

    Full Text Available AbstractObjective: to perform the translation into Brazilian Portuguese and cultural adaptation of the Face, Legs, Activity, Cry, Consolability revised (FLACCr scale, with children under 18 years old, affected by cerebral palsy, presenting or not cognitive impairment and unable to report their pain.Method: methodological development study of translation into Portuguese and cultural adaptation of the FLACCr. After approval by the ethics committee, the process aimed at translation and back-translation, evaluation of translation and back-translation using the Delphi technique and assessment of cultural equivalence. The process included the five categories of the scale and the four application instructions, considering levels of agreement equal to or greater than 80%.Results: it was necessary three rounds of the Delphi technique to achieve consensus among experts. The agreement achieved for the five categories was: Face 95.5%, Legs 90%, Activity 94.4%, Cry 94.4% and Consolability 99.4%. The four instructions achieved the following consensus levels: 1st 99.1%, 2nd 99.2%, 3rd 99.1% and 4th 98.3%.Conclusion: the method enabled the translation and cultural adaptation of the FLACCr. This is a study able to expand the knowledge of Brazilian professionals on pain assessment in children with CP

  10. Introduction to the 2008 Circum-Arctic Resource Appraisal (CARA) professional paper

    Science.gov (United States)

    Gautier, Donald L.; Moore, Thomas E.; Moore, Thomas E.; Gautier, D.L.

    2017-11-15

    The amount of yet-to-find oil and gas in the high northern latitudes is one of the great uncertainties of future energy supply. The possibility of extensive new petroleum developments in the Arctic Ocean is of interest to the Arctic nations, to petroleum companies, and to those concerned with the delicate and changing Arctic environment. The U.S. Geological Survey (USGS) 2008 Circum-Arctic Resource Appraisal (CARA) had the express purpose of conducting a geologically based assessment of undiscovered petroleum north of the Arctic Circle, thereby providing an initial evaluation of resource potential. 

  11. Adicciones beneficiosas y adicciones perjudiciales: dos caras de la misma moneda

    OpenAIRE

    Rafael López

    2016-01-01

    En este artículo obtenemos un isomorfismo entre las adicciones beneficiosas y las perjudiciales en un contexto de elección binaria en tiempo discreto. La equivalencia obtenida de este modo nos permite estudiar los dos fenómenos (los dos tipos de adicciones) como dos caras de la misma moneda. Además de la visión teórica que proporciona, esta dualidad también resulta particularmente útil porque permite trasladar fácilmente los resultados obtenidos en el campo de las adicciones perjudiciales al ...

  12. Interepisode Sleep Bruxism Intervals and Myofascial Face Pain.

    Science.gov (United States)

    Muzalev, Konstantin; Lobbezoo, Frank; Janal, Malvin N; Raphael, Karen G

    2017-08-01

    Sleep bruxism (SB) is considered as a possible etiological factor for temporomandibular disorder (TMD) pain. However, polysomnographic (PSG) studies, which are current "gold standard" diagnostic approach to SB, failed to prove an association between SB and TMD. A possible explanation could be that PSG studies have considered only limited characteristics of SB activity: the number of SB events per hour and, sometimes, the total duration of SB per night. According to the sports sciences literature, lack of adequate rest time between muscle activities leads to muscle overloading and pain. Therefore, the aim of this study was to determine whether the intervals between bruxism events differ between patients with and without TMD pain. Two groups of female volunteers were recruited: myofascial TMD pain group (n=124) and non-TMD control group (n=46). From these groups, we selected 86 (69%) case participants and 37 (80%) controls who had at least two SB episodes per night based on PSG recordings. A linear mixed model was used to compare case and control groups over the repeated observations of interepisode intervals. The duration of interepisode intervals was statistically similar in the case (mean [standard deviation {SD}] 1137.7 [1975.8] seconds)] and control (mean [SD] 1192.0 [1972.0] seconds) groups. There were also a similar number of SB episodes per hour and a total duration of SB episodes in both groups. The current data fail to support the idea that TMD pain can be explained by increasing number of SB episodes per hour of sleep or decreasing the time between SB events. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  13. Multi-dimensionality of chronic pain of the oral cavity and face

    Science.gov (United States)

    2013-01-01

    Orofacial pain in its broadest definition can affect up to 7% of the population. Its diagnosis and initial management falls between dentists and doctors and in the secondary care sector among pain physicians, headache neurologists and oral physicians. Chronic facial pain is a long term condition and like all other chronic pain is associated with numerous co-morbidities and treatment outcomes are often related to the presenting co-morbidities such as depression, anxiety, catastrophising and presence of other chronic pain which must be addressed as part of management . The majority of orofacial pain is continuous so a history of episodic pain narrows down the differentials. There are specific oral conditions that rarely present extra orally such as atypical odontalgia and burning mouth syndrome whereas others will present in both areas. Musculoskeletal pain related to the muscles of mastication is very common and may also be associated with disc problems. Trigeminal neuralgia and the rarer glossopharyngeal neuralgia are specific diagnosis with defined care pathways. Other trigeminal neuropathic pain which can be associated with neuropathy is caused most frequently by trauma but secondary causes such as malignancy, infection and auto-immune causes need to be considered. Management is along the lines of other neuropathic pain using accepted pharmacotherapy with psychological support. If no other diagnostic criteria are fulfilled than a diagnosis of chronic or persistent idiopathic facial pain is made and often a combination of antidepressants and cognitive behaviour therapy is effective. Facial pain patients should be managed by a multidisciplinary team. PMID:23617409

  14. Soutien analytique pour les pays d'Afrique et des Caraïbes en ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Juristes et économistes internationaux contre la pauvreté (JEICP) est un regroupement qui cherche à aider les pays d'Afrique et des Caraïbes à tirer pleinement parti de leur intégration à l'économie mondiale. Cet organisme estime qu'en dépit des progrès considérables accomplis au cours de la dernière décennie, bon ...

  15. Fatty acid trophic markers and trophic links among seston, crustacean zooplankton and the siphonophore Nanomia cara in Georges Basin and Oceanographer Canyon (NW Atlantic

    Directory of Open Access Journals (Sweden)

    Sergio Rossi

    2008-06-01

    Full Text Available Fatty acid concentrations expressed as percentages of total fatty acid pools in seston, stage V copepodites of Calanus finmarchicus, adults of the euphausiid Meganyctiphanes norvegica, and the physonect siphonophore Nanomia cara were used to elucidate trophic links in Georges Basin and Oceanographer Canyon in September 2003. Seston at both locations was refractory and comprised mainly of saturated fatty acids. Phytoplankton did not contribute significantly to the fatty acid composition of seston or higher trophic levels. Only four fatty acids, i.e. 14:0, 16:0, 16:1 (n–7 and 18:1 (n–7, were transferred from seston to C. finmarchicus or M. norvegica, which suggested weak trophic interactions. Fatty acids transferred from the two species of crustaceans to N. cara included the same four fatty acids, along with three polyunsaturated fatty acids found in relatively high concentrations in both crustaceans, i.e. 20:3 (n–6, 20:5 (n–3 and 22:6 (n–3. In addition, 18:1 (n–9, which occurred in relatively high concentrations only in M. norvegica, and 18:0 and 18:2 (n–6, which were found in low concentrations in both crustaceans, also appeared to be transferred to N. cara. Overall, fatty acid trophic markers proved useful for identifying trophic links to N. cara.

  16. CARA MENGHILANGKAN RASA DAN BAU PADA PENGOLAHAN AIR MINUM

    Directory of Open Access Journals (Sweden)

    Sri Soewasti Soesanto

    2012-12-01

    Full Text Available Salah satu syarat kualitas air minum adalah tidak berwarna, tidak ada rasa, dan tidak berbau. Kebanyakan konsumen air minum menilai baik tidaknya kualitas air minum hanya secara visual, keruh atau jernih, berwarna atau tidak dan dengan indera pengecap apakah ada rasa atau tidak serta dengan indera pencium; berbau atau tidak. Tulisan ini hanya akan membahas dua aspek yaitu rasa dan bau yang sering dikeluhkan oleh konsumen.Sumber kontaminasi yang menimbulkan rasa dan bau dalam air dapat bersifat alami maupun anthropogenik.Untuk menghilangkan rasa dan bau karena sebab alami ada beberapa pilihan cara pengolahan yaitu sedimentasi konvensional secara gaya berat (Conventional Gravity Sedimentatin = CGS dan pengembangan udara terlarut (Dissolved Air Flotation = DAF, ozonisasi dan filtrasi dengan karbon aktif granular (Granular Activated Carbon = GAC. 

  17. Pain Intensity Moderates the Relationship Between Age and Pain Interference in Chronic Orofacial Pain Patients.

    Science.gov (United States)

    Boggero, Ian A; Geiger, Paul J; Segerstrom, Suzanne C; Carlson, Charles R

    2015-01-01

    BACKGROUND/STUDY CONTEXT: Chronic pain is associated with increased interference in daily functioning that becomes more pronounced as pain intensity increases. Based on previous research showing that older adults maintain well-being in the face of pain as well as or better than their younger counterparts, the current study examined the interaction of age and pain intensity on interference in a sample of chronic orofacial pain patients. Data were obtained from the records of 508 chronic orofacial pain patients being seen for an initial evaluation from 2008 to 2012. Collected data included age (range: 18-78) and self-reported measures of pain intensity and pain interference. Bivariate correlations and regression models were used to assess for statistical interactions. Regression analyses revealed that pain intensity positively predicted pain interference (R(2) = .35, B = 10.40, SE = 0.62, t(507) = 16.70, p theories, including socioemotional selectivity theory, which posits that as people age, they become more motivated to maximize positive emotions and minimize negative ones. The results highlight the importance of studying the mechanisms older adults use to successfully cope with pain.

  18. Amérique latine et Caraïbes | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Nos projets qui tirent parti des connaissances régionales et mondiales renforcent notre quête de solutions durables. Quel est notre but ? La viabilité à long terme du développement en Amérique latine et dans les Caraïbes par la croissance économique, l'accès équitable aux services de soins de santé et sociaux, des ...

  19. Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS: A practical and evidence-based framework for clinical rehabilitation management

    Directory of Open Access Journals (Sweden)

    Johan A. Franck

    2015-10-01

    Full Text Available The volume of information on new treatment techniques supporting the restoration of arm-hand function (AHF and arm-hand skill performance (ASHP in stroke survivors overwhelms therapists in everyday clinical practice when choosing the appropriate therapy. The Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS is designed for paramedical staff to structure and implement training of AHF and AHSP in stroke survivors. The CARAS is based on four constructs: (a stratification according to the severity of arm–hand impairment (using the Utrecht Arm/Hand -Test [UAT], (b the individual’s rehabilitation goals and concomitant potential rehabilitation outcomes, (c principles of self-efficacy, and (d possibilities to systematically incorporate (new technology and new evidence-based training elements swiftly. The framework encompasses three programs aimed at treating either the severely (UAT 0-1, moderately (UAT 2-3, or mildly (UAT 4-7 impaired arm-hand. Program themes are: taking care of the limb and prevention of complications (Program 1, task-oriented gross motor grip performance (Program 2, and functional AHSP training (Program 3. Each program is preceded and followed by an assessment. Training modularity facilitates rapid interchange/adaptation of sub-elements. Proof-of-principle in clinical rehabilitation has been established. The CARAS facilitates rapid structured design and provision of state-of-the-art AHF and ASHP treatment in stroke patients.

  20. PENGARUH LAMA DAN CARA PENYIMPANAN TERHADAP PERKEMBANGAN KANDUNGAN AFLATOKSIN PADA GAPLEK DI RUMAH TANGGA

    Directory of Open Access Journals (Sweden)

    Sukati Saidin

    2012-11-01

    Full Text Available Aflatoksin yang mencemari makanan dapat menyebabkan timbulnya kanker hati. Gaplek merupakan salah satu komoditi yang dapat tercemar aflatoksin. Ada beberapa daerah di Indonesia yang menggunakan gaplek sebagai makanan pokok. Karena gaplek pada umumnya disimpan sampai panen berikutnya maka ada peluang untuk tercemar aflatoksin. Karena itu perlu diteliti sampai berapa jauh pencemaran aflatoksin pada gaplek. Tujuan penelitian untuk mengetahui pengaruh lama dan cara penyimpanan terhadap cemaran aflatoksin pada gaplek.Gaplek yang sudah dikeringkan dengan cara yang lazim dilakukan di daerah dengan makanan pokok gaplek dibagi menjadi 3 bagian. Bagian pertama disimpan di lantai semen terbuka, bagian kedua disimpan dalam bakul terbuka dan bagian ketiga di simpan dalam karung goni yangdiikat. Analisa kandungan aflatoksin dan kadar air gaplek dilakukan pada permulaan dan 4, 8, 12, 16 dan 20 minggu dalam penyimpanan.Perkembangan cemaran aflatoksin gaplek dalam penyimpanan ini mengungkapkan makin lama gaplek disimpan makin tinggi kadar aflatoksinnya. Rata-rata kadar air gaplek selama penyimpanan berkisar antara 13,1% sampai 14,0%. Gaplek yang disimpan di lantai menunjukkan kandungan aflatoksin tertinggi, diikuti oleh gaplek yang disimpan dalam bakul dan dalam karung.Hasil penelitian ini mengungkapkan bahwa sampai waktu panen berikutnya sekitar 10 bulan, kandungan aflatoksin gaplek yang disimpan di dalam karung diikat belum mencapai taraf yang menbahayakan kesehatan.

  1. Perubahan Pola Konsumsi Pangan Sumber Zat Goitrogenik Sianida dan Cara Pengolahannya Melalui Penyuluhan Gizi

    Directory of Open Access Journals (Sweden)

    Farida Wahyu Ningtyias

    2014-12-01

    Full Text Available Kabupaten Jember masih menghadapi masalah gizi gangguan akibat kekurangan iodium (GAKI, sebagian besar kecamatannya termasuk dalam kategori daerah endemik GAKI. Salah satu penyebabnya adalah faktor goitrogenik sianida yang mengganggu pembentukan hormon tiroid. Keberadaannya pada beberapa sayuran yang biasa dikonsumsi masyarakat menyebabkan diperlukannya pola konsumsi dan proses pengolahan yang baik agar aman dikonsumsi. Penelitian ini bertujuan mengubah pola konsumsi goitrogenik sianida dan cara pengolahannya melalui penyuluhan gizi dan demonstrasi cara pengolahan pangan sumber goitrogenik sianida yang benar. Penelitian ini adalah sebuah penelitian kuasi eksperimental dengan rancangan pretest-posttest control design. Jumlah sampel sebanyak 196 ibu rumah tangga, terdiri dari 98 orang di setiap kelompok perlakuan dan kontrol. Penelitian dilakukan di Kecamatan Arjasa Kabupaten Jember pada bulan Maret hingga Mei 2013. Hasil penelitian menunjukkan adanya peningkatan konsumsi bahan mentah sumber goitrogenik sebesar 25,98 gram. Namun, tidak terjadi peningkatan konsumsi sianida, justru menurun sebesar 9,09 miligram pada kelompok perlakuan. Hal ini terjadi karena pemilihan cara pengolahan yang tepat sesuai materi intervensi, yaitu beralih ke kulub dan rebus berkuah. Namun penurunan ini tidak signifikan (p = 0,56. Materi tentang GAKI dan cara mereduksi kadar sianida pada bahan pangan sumber goitrogenik sianida bisa dijadikan materi penyuluhan dalam program pencegahan GAKI di Kabupaten Jember. Changes in Food Pattern and Food Processing of Source Substance Goitrogenic Cyanide Through Nutrition Counseling Jember still encounter the problem of nutrition iodine deficiency disorders (IDD, most of the district are included in the category of endemic areas. One reason is the cyanide goitrogenic factors that can interfere with the function of the thyroid hormone. Its presence in some commonly consumed vegetables society, causes the need for patterns of

  2. "Different by Degree": Ella Cara Deloria, Zora Neale Hurston, and Franz Boas Contend with Race and Ethnicity.

    Science.gov (United States)

    Hoefel, Roseanne

    2001-01-01

    American Indian ethnographer and linguist Ella Cara Deloria and African American folklorist and writer Zora Neale Hurston did fieldwork for Franz Boas, the father of modern anthropology. Both were shocked by how American racism empowered white people's historical actions. By correcting stereotypes through their work, they reasserted the role of…

  3. An Evolutionary Perspective on Pain Communication

    Directory of Open Access Journals (Sweden)

    Leander Steinkopf

    2016-06-01

    Full Text Available Pain serves as a signal to elicit care from others. In turn, displaying pain might be attractive because of the benefits it might bring. Additionally, displaying pain is easy, because helpers distinguish poorly between genuine pain and faked pain. Hence, helpers face the problem of distinguishing true sufferers from free riders, while sufferers face the problem of communicating need convincingly. This article will propose solutions to these adaptive problems. Based on theoretical arguments and on empirical insights from lie detection research, it will be argued that the credibility of pain signals cannot be found in features of the signal itself, but in its context. Namely, pain is obviously credible when the context features unforgeable cues, such as an open wound or the enlarged abdomen of a pregnant woman, but also external cues such as the ice water in cold pressor tasks. In absence of such cues, pain can become credible through costly consequences, such as refraining from rewarding behaviors for a significant period. However, these adaptive mechanisms for communicating need may not be shaped for modern circumstances such as experimental settings and therapeutic encounters.

  4. [Pain, from symptom to syndrome].

    Science.gov (United States)

    Piano, Virginie

    2017-05-01

    Acute pain is a symptom enabling us to implement a response when faced with an attack. Chronic pain is complex and multifactorial. The care of the patient by a multidisciplinary team comprises the diagnosis of the pain and the putting in place of a treatment for each of its components. This includes physical reconditioning, adaptation strategies and work on the psychological elements relating to the representation of the pain. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Readers of Caras y Caretas on the verge of the radical republic

    OpenAIRE

    Di Mare, María Fabiola

    2016-01-01

    Se propone un análisis de la lectura y los lectores de la revista Caras y Caretas durante el año 1916, momento de cambios en el sistema electoral y político de Argentina, en tanto que en ese año se celebra la primera elección presidencial bajo la Ley Sáenz Peña. Se intenta establecer una interpretación de las representaciones que ofrece la revista sobre sus lectores, a objeto de indagar en sus ámbitos de recepción y prácticas de lectura. Roger Chartier (1995, 2005), Néstor García Canclini (19...

  6. Orofacial pain management: current perspectives

    OpenAIRE

    Romero-Reyes, Marcela; Uyanik, James M

    2014-01-01

    Marcela Romero-Reyes, James M Uyanik Orofacial and Head Pain Service, Department of Oral and Maxillofacial Pathology Radiology and Medicine, New York University College of Dentistry, New York, NY, USA Abstract: Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). Orofacial pain (OFP) can arise from different regions and etiologies. Tem...

  7. A Small Randomized Controlled Pilot Trial Comparing Mobile and Traditional Pain Coping Skills Training Protocols for Cancer Patients with Pain

    Directory of Open Access Journals (Sweden)

    Tamara J. Somers

    2016-01-01

    Full Text Available Psychosocial pain management interventions are efficacious for cancer pain but are underutilized. Recent advances in mobile health (mHealth technologies provide new opportunities to decrease barriers to access psychosocial pain management interventions. The objective of this study was to gain information about the accessibility and efficacy of mobile pain coping skills training (mPCST intervention delivered to cancer patients with pain compared to traditional in-person pain coping skills training intervention. This study randomly assigned participants (N=30 to receive either mobile health pain coping skills training intervention delivered via Skype or traditional pain coping skills training delivered face-to-face (PCST-trad. This pilot trial suggests that mPCST is feasible, presents low burden to patients, may lead to high patient engagement, and appears to be acceptable to patients. Cancer patients with pain in the mPCST group reported decreases in pain severity and physical symptoms as well as increases in self-efficacy for pain management that were comparable to changes in the PCST-trad group (p’s < 0.05. These findings suggest that mPCST, which is a highly accessible intervention, may provide benefits similar to an in-person intervention and shows promise for being feasible, acceptable, and engaging to cancer patients with pain.

  8. A etiologia da "cara inchada", uma periodontite epizoótica dos bovinos The etiology of "cara inchada", a bovine epizootic periodontitis in Brazil

    Directory of Open Access Journals (Sweden)

    Jürgen Döbereiner

    2004-03-01

    Full Text Available Uma versão condensada em português de um artigo de revisão sobre a periodontite da "cara inchada" dos bovinos, publicado em inglês, está apresentada com algumas informações adicionais. A doença foi responsável por grandes perdas de bovinos jovens, principalmente nas décadas de 1970 e l980 no Brazil Central. Em face da periodontite progressiva e a perdas de dentes, os animais não podem se alimentar convenientemente, tornam-se emaciados e podem morrer. A doença foi tida como uma deficiência ou desequilíbrio mineral. Mas as pesquisas de campo e de laboratório, realizadas durante 30 anos, mostraram que trata-se de doença infecciosa multifatorial a ser definida como Periodontite Epizoótica Bovina. Chegou-se à conclusão que os fatores principais para o seu desenvolvimento são: (1 a idade dos bovinos na fase de erupção dos dentes premolares e molares; (2 a presença de bactérias do grupo Bacteroides spp nos espaços subgengivais; e (3 a ingestão com a forragem de concentrações subinibitórias de antibióticos, sobretudo de estreptomicina, produzidos por actinomicetos cujo número é aumentado em solos virgens recém-cultivados na formação de pastagens após a derrubada da mata ou da vegetação de Cerrado; isto leva a um aumento da aderência dos bacteróides ao epitélio gengival e à destruição dos tecidos peridentários. Hoje em dia, a doença perdeu a sua importância e praticamente desapareceu, porque a microbiota do solo entrou novamente em equilíbrio e a abertura de grandes áreas virgens para a pecuária cessou. Porém, novos surtos podem ocorrer em áreas anteriormente positivas para a doença quando, na reforma de pastagens ou capineiras, houver um novo desequilíbrio da microbiota do solo. Outros antibióticos, como a espiramicina e virginiamicina, administrados por via oral ou adicionado a misturas minerais, podem controlar a periodontite.A condensed version in Portuguese of an extensive review on "cara

  9. Chronische Aspecifieke Respiratoire Aandoeningen (CARA) in Nederland. Ontwikkelingen in de kennis van de epidemiologie en etiologie en mogelijkheden voor preventie

    NARCIS (Netherlands)

    Maas IAM; VTV

    1994-01-01

    In dit rapport wordt een overzicht gegeven van de actuele stand van de kennis omtrent etiologie, determinanten en mogelijkheden voor preventie voor chronische aspecifieke luchtwegaandoeningen (CARA). De nadruk ligt in dit rapport op de rol van leefstijlfactoren (roken, voeding en lichamelijke

  10. Written pain neuroscience education in fibromyalgia: a multicenter randomized controlled trial.

    Science.gov (United States)

    van Ittersum, Miriam W; van Wilgen, C Paul; van der Schans, Cees P; Lambrecht, Luc; Groothoff, Johan W; Nijs, Jo

    2014-11-01

    Mounting evidence supports the use of face-to-face pain neuroscience education for the treatment of chronic pain patients. This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia. A double-blind, multicenter randomized controlled clinical trial with 6-month follow-up was conducted. Patients with FM (n = 114) that consented to participate were randomly allocated to receive either written pain neuroscience education or written relaxation training. Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties; the relaxation group received a booklet with relaxation education and a telephone call. The revised illness perception questionnaire, Pain Catastrophizing Scale, and fibromyalgia impact questionnaire were used as outcome measures. Both patients and assessors were blinded. Repeated-measures analyses with last observation carried forward principle were performed. Cohen's d effect sizes (ES) were calculated for all within-group changes and between-group differences. The results reveal that written pain neuroscience education does not change the impact of FM on daily life, catastrophizing, or perceived symptoms of patients with FM. Compared with written relaxation training, written pain neuroscience education improved beliefs in a chronic timeline of FM (P = 0.03; ES = 0.50), but it does not impact upon other domains of illness perceptions. Compared with written relaxation training, written pain neuroscience education slightly improved illness perceptions of patients with FM, but it did not impart clinically meaningful effects on pain, catastrophizing, or the impact of FM on daily life. Face-to-face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM. © 2013 World Institute of Pain.

  11. Territorialisation et enclaves littorales dans les îles de la Caraïbe

    Directory of Open Access Journals (Sweden)

    Michel Desse

    2008-04-01

    Full Text Available Les littoraux de la Caraïbe ont longtemps été considérés comme des espaces de l’envers, ouverts, libres, propriété de l’Etat donc de tous, opposables à la plantation qui hiérarchise la société, structure le paysage et identifie la richesse.Aujourd’hui, les littoraux constituent les centres fonctionnels des îles, annexés parfois privatisés, ils apparaissent fortement territorialisés. Les facteurs qui expliquent ces transformations sont multiples. Les îles connaissent une forte tertiairisation ...

  12. Improving recognition of pain by calling attention to its various faces

    NARCIS (Netherlands)

    Kunz, M; Lautenbacher, S

    2015-01-01

    BACKGROUND: The ability to accurately recognize facial expressions of pain is known to affect clinical decision making and delivery of care. Although recognition accuracy for facial expressions of pain is well above chance level, substantial shortcomings have also been reported which stress the need

  13. PENGARUH MINAT DAN CARA BELAJAR TERHADAP HASIL BELAJAR MATA PELAJARAN EKONOMI SISWA KELAS X IPS MAN 1 KOTA MAGELANG TAHUN AJARAN 2015/2016

    Directory of Open Access Journals (Sweden)

    Sayidah Meyanasari

    2017-06-01

    Full Text Available Tujuan penelitian ini adalah untuk mengetahui apakah ada pengaruh secara simultan maupun parsial antara minat belajar dan cara belajar terhadap hasil belajar mata pelajaran ekonomi siswa kelas X IPS MAN 1 Kota Magelang tahun ajaran 2015/2016. Populasi penelitian ini adalah seluruh siswa kelas X IPS MAN 1 Kota Magelang tahun ajaran 2015/2016 sejumlah 151 siswa dan sampel dalam penelitian adalah seluruh populasi yang berjumlah 151 siswa. Variabel dependen dalam penelitian ini ialah hasil belajar (Y sedangkan variabel independennya meliputi hasil minat belajar (X1 dan cara belajar (X2. Metode pengumpulan data yaitu angket dan dokumentasi. Metode analisis data menggunakan statistik deskriptif, dan regresi linier berganda. Hasil penelitian menunjukkan bahwa ada pengaruh secara simultan antara minat belajar dan cara belajar terhadap hasil belajar sebesar 33,8%. Secara parsial minat belajar berpengaruh terhadap hasil belajar sebesar 3,42%. Cara belajar berpengaruh terhadap hasil belajar sebesar 13,54%. Simpulan dari penelitian ini ialah minat belajar dan cara belajar berpengaruh terhadap hasil belajar mata pelajaran ekonomi siswa kelas X IPS MAN 1 Kota Magelang. The purpose of this research is to find out whether there was a simultaneously or partially influence between the interest and learning method toward the learning outcomes of Economics of the tenth grade social students of MAN 1 Magelang in the academic year of 2015/2016. The population of this research was all of the tenth grade social students of MAN 1 Magelang in the academic year of 2015/2016 (151 students and so was the sample. The dependent variable of this research was the learning outcomes (Y while the independent variable were learning interest (X1 and learning method (X2. Questionnaire and documentation were used as the method of collecting the data. The analytical method used in this research were descriptive statistic and doubled linier regression. The result of the research showed

  14. Relieving idiopathic dental pain without drugs

    Directory of Open Access Journals (Sweden)

    Haryono Utomo

    2011-06-01

    Full Text Available Background: Teeth are commonly obvious source of orofacial pain. Sometimes the pain source is undetectable, thus called as idiopathic dental pain. Since dentist wants to alleviate or eliminate the pains with every effort in their mind, a lot of drugs could be prescribed. Moreover, it is make sense that endodontic treatment or even tooth extraction will be done. Unfortunately, endodontic treatment may also initiate neuropathic tooth pain that is caused by nerve extirpation, thus worsen the pain. Therefore, another cause of dental pain such as referred pain, periodontal disease, or stress which related to psychoneuroimmunology should be considered. In order to prevent from unnecessary drugs or invasive treatment such as root canal treatment and extraction, correct diagnosis and preliminary non-invasive therapies should be done. Purpose: This review elucidates several therapies that could be done by dentists for relieving idiopathic dental pain which includes massage, the “assisted drainage” therapy, modulation of psychoneuroimmunologic status and dietary omega-3. Reviews: Understanding the basic pathogenesis of pain may help in elucidating the effects of non-drug pain therapy such as muscle massage, the “assisted drainage” therapy, omega-3 and psychological stress relieving. These measures are accounted for eliminating referred pain, reducing proinflammatory mediators and relieving unwanted stress reactions consecutively. Psychological stress increases proinflammatory cytokines and thus lowered pain threshold. Conclusion: As an individual treatment, this non-drug therapy is useful in relieving idiopathic dental pain; nevertheless, if they work together the result could be more superior.Latar belakang: Gigi adalah suatu penyebab umum dari nyeri orofasial. Kadang kala penyebab nyeri tidak dapat ditemukan, sehingga disebut sebagai nyeri gigi idiopatik. Karena dokter gigi berupaya untuk mengurangi atau menghilangkan nyeri dengan segala cara

  15. Social dimensions of pain. Comment on “Facing the experience of pain: A neuropsychological perspective” by Fabbro and Crescentini

    Science.gov (United States)

    Avenanti, Alessio; Vicario, Carmelo Mario; Borgomaneri, Sara

    2014-09-01

    In this issue, Fabbro and Crescentini [1] provide an integrative review of neuroscientific, psychological, cultural and philosophical aspects of pain experience and discuss some critical examples of its regulation. Here we focus on the two main social phenomena that are addressed in the review, namely the 'pain of separation' and 'empathy for pain' and further support the idea that these phenomena are intrinsically linked to physical pain, which may provide a 'proximal' physiological base to further understand them. In addition, we discuss the evolutionary 'ultimate' bases of such phenomena and suggest that they are linked to the evolution of parental care in social animals and as such support the development of social bonds. We conclude by considering the effect that positive social relationships and empathy have on the experience of pain.

  16. Aspiring Pain Practitioners in India: Assessing Challenges and Building Opportunities

    Science.gov (United States)

    Bhatnagar, Sushma; Patel, Anuradha; Raja, Srinivasa N

    2018-01-01

    Background: Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. Objectives: The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Subjects and Methods: Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. Results: The major barriers identified were: (1) Inadequate knowledge and absence of structured, educational and training courses, (2) bureaucratic hurdles, and (3) concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. Conclusion: India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is needed to make pain

  17. Aspiring Pain Practitioners in India: Assessing Challenges and Building Opportunities.

    Science.gov (United States)

    Bhatnagar, Sushma; Patel, Anuradha; Raja, Srinivasa N

    2018-01-01

    Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. The major barriers identified were: (1) Inadequate knowledge and absence of structured, educational and training courses, (2) bureaucratic hurdles, and (3) concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is needed to make pain medicine recognized and utilized as a valuable specialty.

  18. Aspiring pain practitioners in India: Assessing challenges and building opportunities

    Directory of Open Access Journals (Sweden)

    Sushma Bhatnagar

    2018-01-01

    Full Text Available Background: Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. Objectives: The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Subjects and Methods: Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. Results: The major barriers identified were: (1 Inadequate knowledge and absence of structured, educational and training courses, (2 bureaucratic hurdles, and (3 concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. Conclusion: India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is

  19. When pain meets … pain-related choice behavior and pain perception in different goal conflict situations.

    Science.gov (United States)

    Schrooten, Martien G S; Wiech, Katja; Vlaeyen, Johan W S

    2014-11-01

    Individuals in pain often face the choice between avoiding pain and pursuing other equally valued goals. However, little is known about pain-related choice behavior and pain perception in goal conflict situations. Seventy-eight healthy volunteers performed a computerized task requiring repeated choices between incompatible options, differing in their effect on probability to receive painful stimulation and money. Depending on group assignment, participants chose between increased pain probability versus decreased money probability (avoidance-avoidance conflict situation); decreased pain probability versus increased money probability (approach-approach conflict situation); or decrease versus increase in both probabilities (double approach/avoidance conflict situation). During the choice task, participants rated painfulness, unpleasantness, threat, and fearfulness associated with the painful stimulation and how they felt. Longer choice latency and more choice switching were associated with higher retrospective ratings of conflict and of decision difficulty, and more equal importance placed on pain avoidance and earning money. Groups did not differ in choice behavior, pain stimulus ratings, or affect. Across groups, longer choice latencies were nonsignificantly associated with higher pain, unpleasantness, threat, and fearfulness. In the avoidance-avoidance group, more choice switching was associated with higher pain-related threat and fearfulness, and with more negative affect. These results of this study suggest that associations between choice behaviors, pain perception, and affect depend on conflict situation. We present a first experimental demonstration of the relationship between pain-related choice behaviors, pain, and affect in different goal conflict situations. This experimental approach allows us to examine these relationships in a controlled fashion. Better understanding of pain-related goal conflicts and their resolution may lead to more effective pain

  20. La protection et la valorisation juridique de la biodiversité de la Caraïbe et des Guyanes : propriété intellectuelle et dispositif APA

    OpenAIRE

    Castets-Renard, Céline

    2012-01-01

    Cet article a pour objectif de montrer les principales conditions nécessaires à l’émergence d’un marché portant sur des ressources génétiques dans la Caraïbe et les Guyanes, dans un souci de valorisation et de protection de la biodiversité, conformément au dispositif d’accès et de partage des avantages prévu par la Convention de Rio sur la biodiversité (1992). This article’s aim is to show the main conditions to encourage the emerging of a market on genetic ressources in Caraïbe and Guyane...

  1. Pain management: the multidisciplinary roessingh back-school rehabilitation program and e-health interventions for chronic pain sufferers

    NARCIS (Netherlands)

    Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.; Wever, Daniel; Söderback, Ingrid

    2015-01-01

    Abstract Multidisciplinary team interventions aiming at breaking the vicious circle of impaired functioning are effective for clients with chronic pain. However, because of the growing number of people with such complaints, these interventions cannot be provided totally on a face-to-face basis.

  2. PENGADAAN TANAH DENGAN CARA JUAL BELI OLEH INSTANSI PEMERINTAH MENURUT PASAL 33 AYAT (3 UUD 1945

    Directory of Open Access Journals (Sweden)

    Dedy Hernawan

    2016-01-01

    konsekuensi yuridis pelaksanaan pengadaan tanah bagi pembangunan untuk kepentingan umum dengan cara jual beli oleh instansi pemerintah dengan pemilik tanah menurut perundang-undangan, membahas cara yang seharusnya dilakukan oleh instansi pemerintah dalam pelaksanaan pengadaan tanah bagi pembangunan untuk kepentingan umum. Hasil penelitian mengenai konsekuensi yuridis pelaksanaan pengadaan tanah bagi pembangunan untuk kepentingan umum dengan cara jual beli sebagaimana diatur dalam UU No. 2 Tahun 2012 tentang Pengadaan Tanah Bagi Pembangunan Untuk Kepentingan Umum, Perpres No. 40 tahun 2014 yang mengakibatkan tanah tersebut menjadi tanah milik pemerintah/pemerintah daerah adalah bertentangan dengan ketentuan yang diatur dalam Pasal 33 ayat (3 UUD 1945 dan ketentuan UUPA No. 5 Tahun 1960. Cara yang seharusnya bagi pembangunan untuk kepentingan umum yang sesuai dengan Pasal 33 ayat (3 UUD 1945 adalah melalui proses pelepasan hak dan/atau pencabutan hak dengan pemberian ganti rugi, seyogyanya besaran ganti rugi tersebut didasarkan pada nilai harga jual beli bukan berdasarkan nilai jual objek pajak. Kata kunci : tanah; jual beli; pelepasan hak

  3. The Effect of Perceived Injustice on Appraisals of Physical Activity: An Examination of the Mediating Role of Attention Bias to Pain in a Chronic Low Back Pain Sample.

    Science.gov (United States)

    Trost, Zina; Van Ryckeghem, Dimitri; Scott, Whitney; Guck, Adam; Vervoort, Tine

    2016-11-01

    The current study examined the relationship between perceived injustice and attentional bias (AB) toward pain among individuals with chronic low back pain asked to perform and appraise the pain and difficulty of a standardized set of common physical activities. A pictorial dot-probe task assessed AB toward pain stimuli (ie, pain faces cueing pain), after which participants performed the physical tasks. Participants also rated face stimuli in terms of pain, sadness, and anger expression. As hypothesized, perceived injustice was positively associated with AB toward pain stimuli; additionally, perceived injustice and AB were positively associated with appraisals of pain and difficulty. Counter to expectations, AB did not mediate the relationship between perceived injustice and task appraisals, suggesting that AB is insufficient to explain this relationship. Exploratory analyses indicated that participants with higher levels of perceived injustice rated stimulus faces as sadder and angrier; no such differences emerged for pain ratings. To our knowledge, this is the first study to examine the association between perceived injustice and AB toward pain, as well as perceived injustice and in vivo appraisals of common physical activity. Results extend existing literature and suggest that attentional and potential interpretive bias should be considered in future research. This article identifies significant associations between perceived injustice, biased attention to pain, and appraisals of common physical activities among individuals with chronic low back pain. These findings suggest targets for intervention as well as directions for future research regarding individuals with high perceptions of injustice related to pain. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  4. Simulation tests for cervical nonorganic signs: a study of face validity.

    Science.gov (United States)

    Vernon, Howard; Proctor, Dan; Bakalovski, Dianna; Moreton, Jesse

    2010-01-01

    The purpose of this study was to develop and determine the face validity of additional cervical nonorganic simulation tests. Four simulation tests were either selected from the literature or newly designed: simulated sitting trunk/shoulder rotation (SR; test no. 1), active vs passive cervical rotation (CR; test no. 2), Libman's test (LT; test no. 3) of pressure over the mastoid process, and side-lying passive shoulder abduction (SA; test no. 4). Three groups, 1 without neck pain (n = 44) and 2 with neck pain (n = 43 and 27), were formed. Outcome measures consisted of questions on provocation of pain (Yes/No) and appropriateness (Yes/No) as well as measurements of cervical rotation (goniometric) and pressure pain threshold (pressure algometer). Group test responses were evaluated and scored. A threshold of acceptance was established at 80% agreement for face validity. Ranges of rotation and pressure threshold values were analyzed with the Student t test. In nonneck pain subjects, all 4 tests were rated as nonpainful and 3 were rated as "appropriate" for neck pain examination (not SR). In neck pain subjects, this test and SA were rated as nonpainful, whereas LT was rated as painful in 26% of subjects. Only CR and LT were rated as "appropriate." In neck pain subjects, passive rotations exceeded actives by 10% to 14% (P = .000). On a second round of testing with a slightly modified method, SR and SA achieved acceptable "appropriateness." Once 2 tests were slightly modified, all 4 tests were found to have acceptable face validity. Further research into the reliability of these tests as well as into the combinations of these tests is warranted. Copyright 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  5. Réglementation des agences privées de sécurité dans les Caraïbes ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Confrontés à la difficulté d'assurer la sécurité des citoyens et des employés, de nombreux gouvernements et entreprises, un peu partout dans le monde, se tournent vers les agences privées de sécurité. Dans les Caraïbes anglophones, les effectifs de ces agences dépassent maintenant ceux des services de police. Malgré ...

  6. A comprehensive Fabry-related pain questionnaire for adult patients.

    Science.gov (United States)

    Üçeyler, Nurcan; Magg, Barbara; Thomas, Phillip; Wiedmann, Silke; Heuschmann, Peter; Sommer, Claudia

    2014-11-01

    Pain may be the earliest symptom in Fabry disease and presents with a distinct phenotype including triggerable pain attacks, evoked pain, pain crises, and chronic pain. Current pain questionnaires do not reflect the special phenotype of Fabry disease-associated pain, which hampers its systematic evaluation as the basis of correct diagnosis and effective treatment. A questionnaire specifically designed to assess Fabry disease-associated pain is thus urgently needed. At the Würzburg Fabry Center for Interdisciplinary Therapy (FAZIT), Germany, we developed and validated the first face-to-face Fabry Pain Questionnaire (FPQ) for adult patients. The initial version of the FPQ was tested in a pilot study with 20 consecutive Fabry disease patients. The performance of the revised FPQ was assessed in a first (n=56) and second (n=20) validation phase in consecutive Fabry disease patients. For this, patients were interviewed at baseline and 2 weeks later. We determined the test-retest reliability and validity of the FPQ in comparison to data obtained with the Neuropathic Pain Symptom Inventory. The FPQ contains 15 questions on the 4 pain phenotypes of Fabry disease (pain attacks, pain crises, evoked pain, chronic pain) in childhood and adulthood, on pain development during life with and without enzyme replacement therapy, and on everyday life impairment due to pain. This first disease-specific questionnaire is a valuable tool for baseline and follow-up assessment of pain in Fabry disease patients and may guide treatment in this distinct pain phenotype. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. Tratamiento ortodóncicoquirúrgico de un paciente con síndrome de cara larga

    OpenAIRE

    Meneses López, Abraham

    2014-01-01

    El aumento de la altura facial anteroinferior es también reconocida con otros términos como:Síndrome de cara larga, rotación horaria extrema, fascie adenoidea, exceso maxilar vertical,entre otros. Cuando la severidad de la deformación vertical es tan grande que no se puede obteneruna corrección adecuada mediante la modificación de crecimiento o camuflaje, la combinaciónde Ortodoncia y Cirugía provee la única opción de tratamiento viable. Se presenta el caso de unapaciente adulta con Síndrome ...

  8. What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder? A randomized controlled trial.

    Science.gov (United States)

    Bring, Annika; Åsenlöf, Pernilla; Söderlund, Anne

    2016-05-01

    To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders. A multicentre, randomized, three-group design, with concealed allocation. A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden. Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions. Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention. Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group. An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions. © The Author(s) 2015.

  9. Interpersonal issues between pain physician and patient: strategies to reduce conflict.

    Science.gov (United States)

    Diesfeld, Kate

    2008-11-01

    This article analyzes scholarship on the interpersonal challenges that pain physicians face, with an emphasis on strategies to reduce conflicts within therapeutic relationships. Scholarship on the dilemmas pain physicians face suggests that 1) there are unique and perhaps unrecognized features of pain medicine that generate stress; 2) interpersonal conflict may contribute to stress; and 3) clinicians' biases may interfere with the doctor-patient relationship and with the best practice of pain medicine. Application of a framework based on clinicians' beliefs and Papadimos' reflections on justice and temperance may reduce such conflicts. The challenges of pain medicine may be complicated by the clinician's undisclosed attitudes regarding their roles and their perceptions of pain sufferers. A strategy for physicians to examine their beliefs within a supportive environment may aid physicians caring for people with chronic pain. Papadimos' reflections upon the virtues of justice and tolerance guide this analysis.

  10. Studi Sosial Budaya Masyarakat Suku Anak Dalam Tentang Malaria dan Cara Pemberantasannya

    Directory of Open Access Journals (Sweden)

    Aprioza Yenni

    2017-02-01

    Full Text Available AbstractThe settlement of Suku Anak Dalam in remote areas was malaria endemic and related with geographic condition, temperature, economics and social culture. This study carried out for 7 months in Pagar Desa Village of Musi Banyuasin District of South Sumatera Province as Suku Anak Dalam settlement. The aims of this study was to find out social cultural aspect regarding malaria and preventive behaviour, and the result could give benefits for malaria’s elimination program. Data collected by indepth interview towards 16 informan and focus group discussion towards 3 groups of participant. The data collecting was documented by tape recorder and handycam. Results showed that peoples of Suku Anak Dalam was poor about knowledge, attitude and practices regarding malaria and protection behaviour. The attitude of respondents was good related with taking the information of malaria and expect promotion about malaria and other diseases, and they also hope to involve society and health officer actively.Keywords : Social cultural, Suku anak dalam, malariaAbstrakPemukiman Suku Anak Dalam yang berada di pedalaman menjadi salah satu daerah endemis malaria karena didukung oleh kondisi geografis, suhu udara, social ekonomi dan budaya masyarakat setempat..Penelitian dilakukanselama 7 bulan pada Masyarakat Suku Anak Dalam yang berada di Desa Pagar Desa, Kecamatan Bayung Lencir, Kabupaten Muba, Provinsi Sumatera Selatan. Penelitian ini melihat aspek sosial budaya masyarakat setempat tentang malaria dan cara pemberantasannnya. Manfaat penelitian diharapkan dapat menjadi masukan dalam program pemberantasan malaria. Pengumpulan data dilakukan dengan wawancara mendalam terhadap 16 informan, 3 kelompok diskusi terarah dan pengamatan dibantu alat perekam (tape recorder dan handycam. Hasil penelitian menunjukkan bahwa pengetahuan , sikap dan perilaku masyarakat tentang malaria dan cara pemberantasannya pada umumnya masih kurang/ tidak tahu. Sikap masyarakat cukup baik

  11. Deep Multimodal Pain Recognition: A Database and Comparison of Spatio-Temporal Visual Modalities

    DEFF Research Database (Denmark)

    Haque, Mohammad Ahsanul; Nasrollahi, Kamal; Moeslund, Thomas B.

    2018-01-01

    , exploiting both spatial and temporal information of the face to assess pain level, and second, incorporating multiple visual modalities to capture complementary face information related to pain. Most works in the literature focus on merely exploiting spatial information on chromatic (RGB) video data......PAIN)' database, for RGBDT pain level recognition in sequences. We provide a first baseline results including 5 pain levels recognition by analyzing independent visual modalities and their fusion with CNN and LSTM models. From the experimental evaluation we observe that fusion of modalities helps to enhance...... recognition performance of pain levels in comparison to isolated ones. In particular, the combination of RGB, D, and T in an early fusion fashion achieved the best recognition rate....

  12. In situ synthesis of magnetic CaraPVA IPN nanocomposite hydrogels and controlled drug release

    International Nuclear Information System (INIS)

    Mahdavinia, Gholam Reza; Etemadi, Hossein

    2014-01-01

    In this work, the magnetic nanocomposite hydrogels that focused on targeted drug delivery were synthesized by incorporation of polyvinyl alcohol (PVA), kappa-carrageenan (Cara), and magnetite Fe 3 O 4 nanoparticles. The magnetic nanoparticles were obtained in situ in the presence of a mixture of polyvinyl alcohol/kappa-carrageenan (CaraPVA). The produced magnetite-polymers were cross-linked with freezing–thawing technique and subsequent with K + solution. The synthesized hydrogels were thoroughly characterized by transmittance electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD), thermal gravimetric analysis (TGA), Fourier transform infrared spectroscopy (FT-IR), and vibrating sample magnetometer (VSM) techniques. The dynamic swelling kinetic models of hydrogels were analyzed according to the first- and second-order kinetic models and were found that the experimental kinetics data followed the second-order model well. Drug loading and release efficiency were evaluated by diclofenac sodium (DS) as the model drug. The in vitro drug release studies from hydrogels exhibited significant behaviors on the subject of physiological simulated pHs and external magnetic fields. Investigation on the antibacterial activity revealed the ability of drug-loaded hydrogels to inactivate the Gram-positive Staphylococcus aureus (S. aureus) bacteria. The mucoadhesive properties of the hydrogels were studied and the hydrogels containing kappa-carrageenan showed good mucoadhesiveness in both simulated gastric and intestinal conditions. - Highlights: • In situ synthesis of magnetic kappa-carrageenan/PVA nanocomposite hydrogel. • Low salt sensitivity of magnetic nanocomposite hydrogels was observed. • The release of diclofenac sodium from hydrogels was pH-dependent. • The release of diclofenac sodium from magnetic hydrogels was affected by external magnetic field. • The hydrogels containing carrageenan component showed high mucoadhesiveness

  13. In situ synthesis of magnetic CaraPVA IPN nanocomposite hydrogels and controlled drug release

    Energy Technology Data Exchange (ETDEWEB)

    Mahdavinia, Gholam Reza, E-mail: grmnia@maragheh.ac.ir; Etemadi, Hossein

    2014-12-01

    In this work, the magnetic nanocomposite hydrogels that focused on targeted drug delivery were synthesized by incorporation of polyvinyl alcohol (PVA), kappa-carrageenan (Cara), and magnetite Fe{sub 3}O{sub 4} nanoparticles. The magnetic nanoparticles were obtained in situ in the presence of a mixture of polyvinyl alcohol/kappa-carrageenan (CaraPVA). The produced magnetite-polymers were cross-linked with freezing–thawing technique and subsequent with K{sup +} solution. The synthesized hydrogels were thoroughly characterized by transmittance electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD), thermal gravimetric analysis (TGA), Fourier transform infrared spectroscopy (FT-IR), and vibrating sample magnetometer (VSM) techniques. The dynamic swelling kinetic models of hydrogels were analyzed according to the first- and second-order kinetic models and were found that the experimental kinetics data followed the second-order model well. Drug loading and release efficiency were evaluated by diclofenac sodium (DS) as the model drug. The in vitro drug release studies from hydrogels exhibited significant behaviors on the subject of physiological simulated pHs and external magnetic fields. Investigation on the antibacterial activity revealed the ability of drug-loaded hydrogels to inactivate the Gram-positive Staphylococcus aureus (S. aureus) bacteria. The mucoadhesive properties of the hydrogels were studied and the hydrogels containing kappa-carrageenan showed good mucoadhesiveness in both simulated gastric and intestinal conditions. - Highlights: • In situ synthesis of magnetic kappa-carrageenan/PVA nanocomposite hydrogel. • Low salt sensitivity of magnetic nanocomposite hydrogels was observed. • The release of diclofenac sodium from hydrogels was pH-dependent. • The release of diclofenac sodium from magnetic hydrogels was affected by external magnetic field. • The hydrogels containing carrageenan component showed high

  14. Vapocoolant Anesthesia for Cosmetic Facial Rejuvenation Injections: A Randomized, Prospective, Split-Face Trial.

    Science.gov (United States)

    Zeiderman, Matthew R; Kelishadi, Shahrooz Sean; Tutela, John Paul; Rao, Arun; Chowdhry, Saeed; Brooks, Ronald M; Wilhelmi, Bradon J

    2018-01-01

    Background: Minimally invasive cosmetic procedures are the most commonly performed aesthetic techniques by plastic surgeons. Patients are interested in a pain-free experience. Surgeons desire patient satisfaction and time-efficient utilization of office staff and resources. Clinical evidence exists for use of vapocoolant technology to reduce pain associated with intravenous cannulation in the pediatric population and in hemodialysis patients. Applying vapocoolant technology to facial rejuvenation is a novel approach to decrease pain associated with neurotoxin or filler injection. Methods: A randomized, prospective study was conducted, testing 15 subjects receiving filler injections and another 15 patients receiving neurotoxin injections using a split-face model. The vapocoolant spray used was composed of a 95:5 ratio of 1,1,1,3,3-pentafluoropropane and 1,1,1,2-tetrafluoroethane. Within each group, individual patients randomly received injection (filler or neurotoxin) alone versus injection (filler or neurotoxin) plus vapocoolant on an equivalent half of his or her face. An independent examiner recorded from each patient on a scale of 1 to 10 perceived pain for injection alone versus injection plus vapocoolant spray. Results were calculated as a percentage change of pain scores experienced after injection for each person between the control (nonvapocoolant) and treatment (vapocoolant) sides of the face. Results: Vapocoolant spray at the time of cosmetic facial injections leads to a 59% decrease in perceived pain score with neurotoxin injections (range, 0%-100% change) and 64% decrease in perceived pain score with filler injections (range, 0%-100% change). These results were statistically significant with P reduces pain associated with facial rejuvenation procedures.

  15. A telephonic intervention for promoting occupational re-integration in work-disabled individuals with musculoskeletal pain.

    Science.gov (United States)

    Sullivan, Michael J L; Simon, Gregory

    2012-06-01

    The purpose of the present research was to examine the feasibility of a telephonic occupational rehabilitation program. A sample of 23 individuals with chronic musculoskeletal pain was enrolled in the telephonic version of the Progressive Goal Attainment Program (PGAP-Tel). The PGAP-Tel is a risk-targeted intervention designed to reduce pain-related disability consequent to musculoskeletal injury. Treatment outcomes of PGAP-Tel were compared to a group of individuals with chronic musculoskeletal pain, who participated in the face-to-face format of the PGAP. Results showed that PGAP-Tel was acceptable to the majority of participants (76%) to whom it was offered. There were indications that engagement and adherence issues were more problematic in PGAP-Tel than in the face-to-face intervention. Both groups showed comparable reductions in pain, depression, fear of symptom exacerbation, and self-reported disability. Participants in the face-to-face intervention showed greater reduction in catastrophic thinking than participants in PGAP-Tel. Finally, 26% of participants in PGAP-Tel had resumed some form of employment at treatment termination compared to 56% of the participants in the face-to-face intervention. Given the low cost of the PGAP-Tel intervention and the accessibility advantages of a telephonic delivery, this type of intervention might be an important resource for targeting occupational disability in rural or remote communities when face-to-face services are not available.

  16. The face of pain--a pilot study to validate the measurement of facial pain expression with an improved electromyogram method.

    Science.gov (United States)

    Wolf, Karsten; Raedler, Thomas; Henke, Kai; Kiefer, Falk; Mass, Reinhard; Quante, Markus; Wiedemann, Klaus

    2005-01-01

    The purpose of this pilot study was to establish the validity of an improved facial electromyogram (EMG) method for the measurement of facial pain expression. Darwin defined pain in connection with fear as a simultaneous occurrence of eye staring, brow contraction and teeth chattering. Prkachin was the first to use the video-based Facial Action Coding System to measure facial expressions while using four different types of pain triggers, identifying a group of facial muscles around the eyes. The activity of nine facial muscles in 10 healthy male subjects was analyzed. Pain was induced through a laser system with a randomized sequence of different intensities. Muscle activity was measured with a new, highly sensitive and selective facial EMG. The results indicate two groups of muscles as key for pain expression. These results are in concordance with Darwin's definition. As in Prkachin's findings, one muscle group is assembled around the orbicularis oculi muscle, initiating eye staring. The second group consists of the mentalis and depressor anguli oris muscles, which trigger mouth movements. The results demonstrate the validity of the facial EMG method for measuring facial pain expression. Further studies with psychometric measurements, a larger sample size and a female test group should be conducted.

  17. Evaluation of musculoskeletal pain management practices in rural nursing homes compared with evidence-based criteria.

    Science.gov (United States)

    Decker, Sheila A; Culp, Kennith R; Cacchione, Pamela Z

    2009-06-01

    Chronic pain, mainly associated with musculoskeletal diagnoses, is inadequately and often inappropriately treated in nursing home residents. The purpose of this descriptive study is to identify the musculoskeletal diagnoses associated with pain and to compare pain management of a sample of nursing home residents with the 1998 evidence-based guideline proposed by the American Geriatrics Society (AGS). The sample consists of 215 residents from 13 rural Iowa nursing home homes. The residents answered a series of face-to-face questions that addressed the presence/absence of pain and completed the Mini Mental State Examination (MMSE). Data on pain were abstracted from the Minimum Data Set (MDS). Analyses included descriptive statistics, cross tabulations, and one-way analysis of variance. Residents' responses to the face-to-face pain questions yielded higher rates of pain compared with the MDS pain data. Resident records showed that acetaminophen was the most frequently administered analgesic medication (30.9%). Propoxyphene, not an AGS-recommended opioid, was also prescribed for 23 residents (10.7%). Of the 70 residents (32.6%) expressing daily pain, 23 (32.9%) received no scheduled or pro re nata analgesics. There was no significant difference between MMSE scores and number of scheduled analgesics. Additionally, residents' self-reported use of topical agents was not documented in the charts. The findings suggest that the 1998 AGS evidence-based guideline for the management of chronic pain is inconsistently implemented.

  18. Deep Multimodal Pain Recognition: A Database and Comparison of Spatio-Temporal Visual Modalities

    DEFF Research Database (Denmark)

    Haque, Mohammad Ahsanul; Nasrollahi, Kamal; Moeslund, Thomas B.

    2018-01-01

    , exploiting both spatial and temporal information of the face to assess pain level, and second, incorporating multiple visual modalities to capture complementary face information related to pain. Most works in the literature focus on merely exploiting spatial information on chromatic (RGB) video data...... recognition performance of pain levels in comparison to isolated ones. In particular, the combination of RGB, D, and T in an early fusion fashion achieved the best recognition rate....

  19. Pain, physical functioning, and overeating in obese rheumatoid arthritis patients: do thoughts about pain and eating matter?

    Science.gov (United States)

    Somers, Tamara J; Wren, Anava A; Blumenthal, James A; Caldwell, David; Huffman, Kim M; Keefe, Francis J

    2014-08-01

    Obese rheumatoid arthritis (RA) patients have higher levels of pain, disability, and disease activity than do nonobese patients with RA. Patients' health-related thoughts about arthritis and weight may be important to consider in obese patients with RA who face the dual challenge of managing RA and weight. The objective of this study was to examine the relationships of pain catastrophizing, self-efficacy (ie, confidence) for arthritis management and self-efficacy for weight management to important outcomes in obese patients with RA. We expected that after controlling for demographic and medical variables, higher levels of pain catastrophizing and lower levels of confidence would account for significant and unique variance in pain, physical functioning, and overeating. Participants had a diagnosis of RA and a body mass index of 28 kg/m or greater and completed self-report questionnaires assessing pain, physical functioning, overeating, pain catastrophizing, self-efficacy for arthritis management, self-efficacy for weight management, and a 6-minute walk test. Pain catastrophizing, self-efficacy for arthritis, and self-efficacy for weight management were significantly and uniquely related to RA-related outcomes. Pain catastrophizing was a significant independent predictor of pain severity (β = 0.38); self-efficacy for arthritis was a significant independent predictor of self-report physical functioning (β = -0.37) and the 6-minute walk performance (β = 0.44), and self-efficacy for weight management was a significant independent predictor of overeating (β = -0.58). Pain catastrophizing, self-efficacy for arthritis, and self-efficacy for weight management each contributed uniquely to relate to key outcomes in obese patients with RA. Clinicians should consider assessment of thought processes when assessing and intervening with patients who face dual health challenges; unique intervention approaches may be needed for addressing the challenges of arthritis and weight.

  20. Dos caras del secuestro. // Two faces of kidnapping.

    Directory of Open Access Journals (Sweden)

    Mario Elkin Ramírez

    2008-12-01

    Full Text Available This article aims to apply the psychoanalytic thought to the kidnapping phenomenon both from the executant’s view and the victims’ view. The attempt to erase the subjectivity of both parts in order to reduce the victim to an exchange value and increase the kidnapping felony to an industry is clarified in this text. All of it kept within the bounds of the capitalist discourse, that which writes the contemporary times. // Este artículo tiene por objetivo aplicar la reflexión psicoanalítica al fenómeno del secuestro, tanto del lado de los verdugos como del lado de las víctimas. En el texto se elucida la tentativa de borramiento de la subjetividad de ambas partes, para reducir a la víctima a un valor de cambio y elevar el crimen del secuestro a una industria. Todo ello pensado bajo el fondo del discurso capitalista, como aquel que escribe la época contemporánea.

  1. Analisis Kadar Kofein Kopi Luwak Dengan Variasi Jenis Kopi, Spesies Luwak Dan Cara Pengolahan Dengan Metoda TlC Scanner

    Directory of Open Access Journals (Sweden)

    Rahma Yulia

    2016-07-01

    Full Text Available Telah dilakukan penelitian analisis kadar kofein kopi luwak dengan variasi jenis kopi, spesies luwak dan cara pengolahan dengan metoda TLC Scanner. Analisis dilakukan dengan menggunakan 8 sampel kopi luwak R.Ab.K ; R.Ab.B ; R.Ph.K ; R.Ph.B ; A.Ab.K ; A.Ab.B ; A.Ph.K ; A.Ph.B yang diekstraksi dengan pelarut diklorometana ( DCM . Pemisahan dengan KLT dilakukan dengan fasa diam plat silika gel GF254 dan fasa gerak campuran diklorometana : metanol ( 9,5 : 0,5 . Kadar kofein dihitung dengan menggunakan persamaan regresi y = 2715,112 + 4,389x dan memberikan persentase kadar berturut-turut 1,91 ; 2,04 ; 1,30 ; 1,89 ; 1,29 ; 1,45 ; 1,25 ; 1,42 %. Kadar kofein paling tinggi diberikan oleh kopi robusta yang diberikan pada luwak A. binturong dan diolah secara basah dengan persentase 2,04 %. Sedangkan kadar kofein paling rendah diberikan oleh kopi arabika yang diberikan pada luwak P. hermophroditus dengan persentase 1,25 %. Pengolahan data dengan statistik anova tiga jalan SPSS 21 menunjukkan hasil bahwa jenis kopi, variasi luwak dan cara pengolahan memberikan pengaruh yang signifikan terhadap kadar kofein dengan p < 0,05.

  2. Las jácaras a lo divino: un inédito de Cáncer y Velasco

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    González Maya, Juan C.

    2009-06-01

    Full Text Available This essay reveals an unpublished composition by Jerónimo de Cáncer y Velasco, illustrious poet from the XVIIth Century. Found in a manuscript of the Hispanic Society of New York, it’s an excellent example of the author’s style, specialist in plays on words. This work pertains to the genre called “jácaras” referred to the divine in which Cáncer was a real expert. Influenced by Quevedo’s “jácaras” the poet makes good use of the underworld parlance as an amusement instrument with the unknown Francisco de Asís transformed into a rogue from the XVIIth Century.El presente trabajo saca a la luz una composición inédita de Jerónimo de Cáncer y Velasco, ilustre poeta del siglo XVII. Encontrada en un manuscrito de la Hispanic Society de Nueva York es una excelente muestra del estilo del autor, especialista en los juegos del lenguaje, sobre todo en la disemia. Pertenece al género de lo que se ha dado en denominar «jácaras a lo divino», del que Cáncer fue un auténtico especialista. Influido por las jácaras de Quevedo, el poeta aprovecha el lenguaje de la germanía como instrumento de diversión a costa de un desconocido Francisco de Asís, convertido en un auténtico truhán del siglo XVII.

  3. Tourisme, écotourisme et stratégies de développement dans la Caraïbe

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    Dominique Augier

    2008-09-01

    Full Text Available Le secteur du tourisme et des services s’est imposé comme le véritable moteur des économies insulaires de la Caraïbe depuis la fin de années 1980, décennie. Dans ces territoires confrontés à la crise des traditionnelles économies de plantations, le tourisme a pris une importance considérable (19,2  milliards de dollars US pour une croissance moyenne annuelle de 7% depuis 1990. Cependant les modalités du développement touristique actuelles ne sont pas sans poser certains problèmes d’ordre économique (faiblesses des retombées locales et environnemental (concentration des flux. Les territoires de la Caraïbe insulaire développent de nouvelles stratégies touristiques autour de l’écotourismeTourism has become the driving force of the island economies of the Caribbean   basin since the latter part of the 1980s. Within this island realm, the traditional plantation economies have gone through an economic crisis while tourism. On the other hand,  has taken on considerable importance (19.2 billion dollars and a 7% annual growth rate since 1990. Nevertheless this growth has not been without its economic problems (a low level of local linkages and environmental (concentration of tourist flows. Caribbean island tourism is now concentrating its efforts on developing new strategies based on ecotourism perspectives.Tourism, ecotourism and development strategies in the Caribbean

  4. Las dos caras del nuevo prosumidor 2.0 ¿héroe o asesino de marcas?

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    Sanchez, Xiomara

    2016-01-01

    Full Text Available El concepto de web 2.0 ha revolucionado y cambiado la manera de pensar de las personas en el mundo. uno de esos cambios se da respecto a la definición del consumidor, ya que la evolución lo ha llevado tanto a consumir como producir contenidos en la red, lo que desde la publicidad conlleva a una fuerte reflexión con respecto a su "doble faceta" a sus “dos caras”; de lo anterior nacen interrogantes como ¿Cuál es más fuerte? o será que ¿Las dos tienen la misma fuerza? o también ¿Cuándo juegan el rol de héroes o asesinos? El contenido de este documento permite evidenciar el estudio de importantes variables que intervienen en el contexto del prosumidor y que a su vez permitirían argumentar y abordar la reflexión sobre cuál de las dos facetas o caras prima, si la una por encima de la otra (Consumidor vs Prosumidor o viceversa (Prosumidor vs Consumidor, en el contexto que rodea a una marca desde la web; igualmente se plantean interesantes cuestionamientos sobre cómo aprovechar y equilibrar ambas caras, en pro o en contra, fortaleciendo o deteriorando la identidad digital de una marca, todo esto a partir del poder que ejerce en la actualidad un prosumidor en la red.

  5. Orofacial pain management: current perspectives.

    Science.gov (United States)

    Romero-Reyes, Marcela; Uyanik, James M

    2014-01-01

    Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). Orofacial pain (OFP) can arise from different regions and etiologies. Temporomandibular disorders (TMD) are the most prevalent orofacial pain conditions for which patients seek treatment. Temporomandibular disorders include a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ) or both. Trigeminal neuropathic pain conditions can arise from injury secondary to dental procedures, infection, neoplasias, or disease or dysfunction of the peripheral and/or central nervous system. Neurovascular disorders, such as primary headaches, can present as chronic orofacial pain, such as in the case of facial migraine, where the pain is localized in the second and third division of the trigeminal nerve. Together, these disorders of the trigeminal system impact the quality of life of the sufferer dramatically. A multidisciplinary pain management approach should be considered for the optimal treatment of orofacial pain disorders including both non-pharmacological and pharmacological modalities.

  6. Arthritic pain among Latinos: results from a community-based survey.

    Science.gov (United States)

    Cheriel, Chad; Huguet, Nathalie; Gupta, Shalini; McClure, Heather; Leman, Richard F; Ngo, Duyen L

    2009-11-15

    To examine factors associated with pain among Latinos with arthritis, identify common coping strategies and potentially effective interventions, and determine whether pain levels affect the level of interest in potentially useful programs. Using a convenience sampling approach and a combination of face-to-face and telephone surveys, 588 Latino adults in Oregon with arthritis were interviewed. The intensity of pain during a typical day was assessed using a scale ranging from 0 (no pain) to 10 (worst pain). A score of >or=7 was defined as severe pain. More than 60% of Latinos reported severe pain. Results from an ordinary least square regression indicated that among Latinos with arthritis, women, those with lower levels of education, and those reporting poor or fair self-rated health and functional limitations had higher levels of pain, after controlling for confounders. Those with severe pain were more likely than those with lower levels of pain to use over the counter medicine and home remedies to manage their arthritis. In addition, Latinos with greater pain were more likely to be interested in arthritis management programs. These findings have important implications for public health policy. The strong interest of Latinos in various arthritis and joint pain management programs could prove to be an important avenue for supporting a population with high levels of arthritic pain and lack of health insurance. These pain management programs are all the more appealing, given the availability of a number of evidence-based, low-cost interventions.

  7. BENDER GESTALT VISUALMOTOR TEST AND CARAS TEST: A EXAM OF CONSTRUCT VALIDITY

    Directory of Open Access Journals (Sweden)

    Cesar Merino Soto

    2011-12-01

    Full Text Available Research with new versions of the Bender Gestalt Test (TGB has hardly attracted attention to the researchers of the Hispanic world, onsidering that this test is one of the most widely used psychological assessments. This study evaluates the construct validity of the modified version of TGB for children, elative to sustainedattention assessed by the Caras Test. Both tests were applied to 90 children, aged between 5 and 8, in standardized conditions. The esults indicate that the shared variance between the two measures is zero, even when applied disattenuated correlations for measurement error; also, no non-linear patterns were detected between the two variables. These correlations were consistent in the total sample and among subgroups of children. We discuss these results with respect to the limits of validity of this modified version of TGB in the Spanish language.

  8. Validation of the "Pain Block" concrete ordinal scale for children aged 4 to 7 years.

    Science.gov (United States)

    Jung, Jin Hee; Lee, Jin Hee; Kim, Do Kyun; Jung, Jae Yun; Chang, Ikwan; Kwon, Hyuksool; Shin, Jonghwan; Paek, So Hyun; Oh, Sohee; Kwak, Young Ho

    2018-04-01

    Pain scales using faces are commonly used tools for assessing pain in children capable of communicating. However, some children require other types of pain scales because they have difficulties in understanding faces pain scales. The goal of this study was to develop and validate the "Pain Block" concrete ordinal scale for 4- to 7-year-old children. This was a multicenter prospective observational study in the emergency department. Psychometric properties (convergent validity, discriminative validity, responsivity, and reliability) were compared between the "Pain Block" pain scale and the Faces Pain Scale-Revised (FPS-R) to assess the validity of the "Pain Block" scale. A total of 163 children (mean age, 5.5 years) were included in this study. The correlation coefficient between the FPS-R and the Pain Block scale was 0.82 for all participants which increased with age. Agreement between the 2 pain scales was acceptable, with 95.0% of the values within the predetermined limit. The differences in mean scores between the painful group and nonpainful group were 3.3 (95% confidence interval, 2.6-4.1) and 3.8 (95% confidence interval, 3.1-4.6) for FPR-S and Pain Block, respectively. The pain scores for both pain scales were significantly decreased when analgesics or pain-relieving procedures were administered (difference in Pain Block, 2.4 [1.4-3.3]; and difference in FPS-R, 2.3 [1.3-3.3]). The Pain Block pain scale could be used to assess pain in 4- to 7-year-old children capable of understanding and counting up to the number 5, even if they do not understand the FPS-R pain scale.

  9. Evaluación pronóstica del politraumatismo según la escala de trauma revisada

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    Aracelis Dorado Lambert

    2000-09-01

    Full Text Available Se aplicó la escala de trauma revisada a todos los pacientes que ingresaron en la Unidad de Cuidados Intensivos del Hospital Infantil Sur Docente de Santiago de Cuba, en el período comprendido de enero a diciembre de 1998. Los pacientes que en la evaluación por esta escala tenían menos de 4 puntos mostraron una mortalidad del 75 %, el 100 % de los sobrevivientes presentaron secuelas y el 50 % alguna complicación durante su evolución. Del grupo de niños con puntuación superior a los 6 puntos ninguno falleció y solo el 7,4 % presentó secuelas. Los niños con puntuación entre 5 y 6 puntos ocuparon una posición intermedia entre los 2 grupos anteriores. Basado en estos resultados se consideró de mucha utilidad la aplicación de esta Escala, y se recomienda extender su uso a otras unidades.The Revised Trauma Score was used for all patients that were admitted to the Intensive Care Unit of the Southern Teaching Pediatric Hospital in Santiago de Cuba from January to December 1998. Those patients who scored less than 4 points in the evaluation showed a mortalaity rate of 75%; 100% of survivors had sequelae and 50% showed some complications during their recovery. In the group of children with scores over 6 points, died, and only 7.4% had sequelae. Children who scored 5-6 held an intermediate position between the two previous groups. On the basis of these results, the use of this scale was considered to be very useful, so it is recommended to extend its application to the rest of the units.

  10. "Cara inchada" of cattle, an infectious, apparently soil antibiotics-dependant periodontitis in Brazil

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    Döbereiner Jürgen

    2000-01-01

    Full Text Available The objective of this review on the investigation of "cara inchada" in cattle (CI, pursued over the last 30 years, was to elucidate the pathogenicity of the disease and come to proper conclusions on its etiology. CI has been widely considered to be of nutritional origin, caused primarily by mineral deficiency or imbalance. However, the disease consists of a rapidly progressive periodontitis, affecting the periodontal tissues at the level of the premolars and molars during the period of tooth eruption generally starting in young calves. The disease led to great economic losses for farmers in central-western Brazil, after the occupation of new land for cattle raising in the 1960s and 1970s. The lateral enlargement of the maxillary bones of affected calves gave the disease the popular name of "cara inchada", i.e., swollen or enlarged face. The enlargement was found to be due to a chronic ossifying periostitis resulting from the purulent alveolitis of CI. Black-pigmented non-saccharolytic Bacteroides melaninogenicus, always together with Actinomyces (Corynebacterium pyogenes, were isolated in large numbers from the periodontal lesions. B. melaninogenicus could be isolated in small numbers also from the marginal gingiva of a few healthy calves maintained on CI-free farms. "In vitro"-assays showed that streptomycin and actinomycin, as well as the supernatants of cultivates of actinomycetes from soils of CI-prone farms, applied in subinhibitory concentrations to the bacteria tested, enhanced significantly (up to 10 times the adherence of the black-pigmented B.melaninogenicus to epithelial cells of the bovine gingiva. The antibiotics are apparently produced in large quantities by the increased number of soil actinomycetes, including the genus Streptomyces, that develop when soil microflora are modified by cultivating virgin forest or "Cerrado" (tree-savanna for the first time for cattle grazing. The epidemiology of CI now provides strong evidence that

  11. Challenge of improving postoperative pain management: case studies of three acute pain services in the UK National Health Service.

    Science.gov (United States)

    Powell, A E; Davies, H T O; Bannister, J; Macrae, W A

    2009-06-01

    Previous national survey research has shown significant deficits in routine postoperative pain management in the UK. This study used an organizational change perspective to explore in detail the organizational challenges faced by three acute pain services in improving postoperative pain management. Case studies were conducted comprising documentary review and semi-structured interviews (71) with anaesthetists, surgeons, nurses, other health professionals, and managers working in and around three broadly typical acute pain services. Although the precise details differed to some degree, the three acute pain services all faced the same broad range of inter-related challenges identified in the organizational change literature (i.e. structural, political, cultural, educational, emotional, and physical/technological challenges). The services were largely isolated from wider organizational objectives and activities and struggled to engage other health professionals in improving postoperative pain management against a background of limited resources, turbulent organizational change, and inter- and intra-professional politics. Despite considerable efforts they struggled to address these challenges effectively. The literature on organizational change and quality improvement in health care suggests that it is only by addressing the multiple challenges in a comprehensive way across all levels of the organization and health-care system that sustained improvements in patient care can be secured. This helps to explain why the hard work and commitment of acute pain services over the years have not always resulted in significant improvements in routine postoperative pain management for all surgical patients. Using this literature and adopting a whole-organization quality improvement approach tailored to local circumstances may produce a step-change in the quality of routine postoperative pain management.

  12. Physicians' Practice, Attitudes Toward, and Knowledge of Cancer Pain Management in China.

    Science.gov (United States)

    Zhang, Qiongwen; Yu, Chunhua; Feng, Shijian; Yao, Wenxiu; Shi, Huashan; Zhao, Yuwei; Wang, Yongsheng

    2015-11-01

    To evaluate physicians' current practice, attitudes toward, and knowledge of cancer pain management in China. We conducted a face-to-face survey of physicians (oncologists, internists, hematologists) who are responsible for the care of cancer patient of 11 general hospitals in Sichuan, China between December 2011 and December 2013. Statistical analyses were performed using SPSS (SPSS, Chicago, IL) software. A 23-item questionnaire was designed and distributed to 550 physicians in 11 medical facilities in China. Five hundred (90.90%) physicians responded. About one-third (32.6%) of physicians assessed patients' pain rarely, and 85.5% never or occasionally treated patients' cancer pain together with psychologists. More than half of physicians indicated that opioid dose titration in patients with poor pain control and assessment of the cause and severity of pain were urgently needed knowledge for cancer pain management. Inadequate assessment of pain and pain management (63.0%), patients' reluctance to take opioids (62.2%), and inadequate staff knowledge of pain management (61.4%) were the three most frequently cited barriers to physicians' pain management. Physicians' positive attitudes toward cancer pain management need to be encouraged, and active professional analgesic education programs are needed to improve pain management in China. Wiley Periodicals, Inc.

  13. Orofacial pain management: current perspectives

    Directory of Open Access Journals (Sweden)

    Romero-Reyes M

    2014-02-01

    Full Text Available Marcela Romero-Reyes, James M Uyanik Orofacial and Head Pain Service, Department of Oral and Maxillofacial Pathology Radiology and Medicine, New York University College of Dentistry, New York, NY, USA Abstract: Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures. Orofacial pain (OFP can arise from different regions and etiologies. Temporomandibular disorders (TMD are the most prevalent orofacial pain conditions for which patients seek treatment. Temporomandibular disorders include a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ or both. Trigeminal neuropathic pain conditions can arise from injury secondary to dental procedures, infection, neoplasias, or disease or dysfunction of the peripheral and/or central nervous system. Neurovascular disorders, such as primary headaches, can present as chronic orofacial pain, such as in the case of facial migraine, where the pain is localized in the second and third division of the trigeminal nerve. Together, these disorders of the trigeminal system impact the quality of life of the sufferer dramatically. A multidisciplinary pain management approach should be considered for the optimal treatment of orofacial pain disorders including both non-pharmacological and pharmacological modalities. Keywords: pain, orofacial, neuropathic, TMD, trigeminal, headache

  14. A Screening Mechanism Differentiating True from False Pain during Empathy.

    Science.gov (United States)

    Sun, Ya-Bin; Lin, Xiao-Xiao; Ye, Wen; Wang, Ning; Wang, Jin-Yan; Luo, Fei

    2017-09-13

    Empathizing with another's suffering is important in social interactions. Empathic behavior is selectively elicited from genuine, meaningful pain but not from fake, meaningless scenarios. However, the brain's screening mechanism of false information from meaningful events and the time course for the screening process remains unclear. Using EEG combined with principle components analysis (PCA) techniques, here we compared temporal neurodynamics between the observation of pain and no-pain pictures as well as between true (painful expressions and needle-penetrated arms) and false (needle-penetrated faces with neutral expressions) pain pictures. The results revealed that pain vs. no-pain information is differentiated in the very early ERP components, i.e., the N1/P1 for the face and arm pictures categories and the VPP/N170 for the facial expression category while the mid-latency ERP components, N2 and P3, played key roles in differentiating true from false situations. The complex of N2 and P3 components may serve as a screening mechanism through which observers allocate their attentions to more important or relevant events and screen out false environmental information. This is the first study to describe and provide a time course of the screening process during pain empathy. These findings shed new light on the understanding of empathic processing.

  15. Sistema de reconstrucción de caras 3D basado en modelos y multicámara

    OpenAIRE

    Torres Civit, Laura

    2007-01-01

    El objetivo de este proyecto es la definición, la implementación software y el análisis de un procedimiento que nos permita ajustar un modelo facial tridimensional genérico a las características faciales específicas de un individuo a partir de dos imágenes de su rostro, una que muestre su cara vista desde el frente y otra desde el perfil derecho. De esta manera, a partir de dos imágenes 2D, se puede obtener un modelo 3D de una persona en concreto. Esto es muy útil para reali...

  16. PENGARUH DISIPLIN DAN CARA BELAJAR TERHADAP PRESTASI BELAJAR MATA DIKLAT PRODUKTIF ADMINISTRASI PERKANTORAN STANDAR KOMPETENSI MEMAHAMI PRINSIP-PRINSIP PENYELENGGARAAN ADMINISTRASI PERKANTORAN KELAS X PROGRAM KEAHLIAN ADMINISTRASI PERKANTORAN SMK WIDYA P

    Directory of Open Access Journals (Sweden)

    Ernawati Ernawati,

    2012-10-01

    Full Text Available Perumusan masalah penelitian ini adalah: adakah pengaruh disiplin belajar dan cara belajar terhadap prestasi belajar Memahami Prinsip-prinsip Penyelenggaraan Administrasi Perkantoran kelas X SMK Widya Praja Ungaran secara parsial maupun secara simultan?. Populasi penelitian ini adalah siswa kelas X Administrasi perkantoran berjumlah 91 siswa. Analisis data menggunakan analisis regresi berganda, analisis deskriptif persentase. Hasil analisis regresi linier berganda diperoleh persamaan: Y= 27,618+0,323X1+0,392X2. Uji F diperoleh Fhitung = 71,074. Secara parsial (uji t disiplin belajar (x1 diperoleh thitung = 3.321. Variabel cara belajar siswa (X2 diperoleh thitung = 3.921. Secara simultan (R2 disiplin belajar dan cara belajar siswa berpengaruh terhadap prestasi belajar sebesar 60,9%. Simpulan penelitian ini adalah disiplin belajar dan cara belajar berpengaruh terhadap prestasi belajar baik secara simultan maupun parsial. Formulation of this research is: is there any influence learning discipline and learning on learning achievement Understanding Principles Implementation Office Administration class X SMK Widya Praja Ungaran partially or simultaneously?. This study population is students of class X Administrative offices totaling 91 students. Analysis of data using multiple regression analysis, descriptive analysis of the percentage. The results of multiple linear regression analysis obtained by the equation: Y = 27.618 +0.323 X1 +0.392 X2. The F obtained Fhitung = 71.074. Partially (t test disciplinary learning (x1 obtained thitung = 3321. Variable student learning (X2 obtained thitung = 3921. Simultaneously (R2 disciplinary learning and how learning affects students' learning achievement by 60.9%. The conclusions of this research is the discipline of learning and how learning affects the learning achievement either simultaneously or partially.

  17. Unilateral nasal pain with migraine features.

    Science.gov (United States)

    Alvarez, Mónica; Montojo, Teresa; de la Casa, Beatriz; Vela, Lydia; Pareja, Juan A

    2013-09-01

    Migraine attacks exclusively felt in the face are very rare, the pain involving the territories supplied by the second and third branches of the trigeminal nerve. Two patients suffering from heminasal pain attacks accompanied with typical migrainous features and responsive to oral or intranasal triptans - but not to intranasal lidocaine or oxymetazoline. In one patient, the attacks could be precipitated upon slight touching on the tip of the nose, in the other attacks were preceded by the nasal sensation typically heralding sneezing. Migraine pain mostly develops within the innervation territory of the first branch of the trigeminal nerve, which includes the nose. Therefore, episodes of unilateral nasal pain with migrainous features could be considered a migraine with unusual topography (nasal migraine). Painful nasal attacks occasionally preceded by stimulation of trigeminal afferents in the nose, could be conceived of as migraine-tic syndrome.

  18. Validación de la Escala de Identidad Étnica Multigrupo-Revisada en adolescentes inmigrantes y autóctonos residentes en España

    Directory of Open Access Journals (Sweden)

    laura lara

    2016-02-01

    Full Text Available En este estudio analizamos las propiedades psicométricas y la estructura factorial de la adaptación al español de la Escala de Identidad Étnica Multigrupo Revisada (Eiem-R. Participaron 1002 adolescentes residentes en España, la mitad inmigrantes de primera generación(67.7% nacidos en Latinoamérica, 13.6% en Europa del Este, 13.2% en África, 3.6% en Asia y 2% en el resto de Europa, así como sus padres y madres y la otra mitad autóctonos (nacidos en España, así como sus padres y madres. Los análisis factoriales exploratorios y confirmatorios apoyan que la escala mide los dos componentes de la identidad étnica propuestos -exploración y compromiso- por los autores originales, y que estos se encuentran correlacionados. Los análisis también mostraron casi completos niveles de invarianza de esta estructura factorial al comparar entre sexos, etapas de adolescencia y autóctonos e inmigrantes.

  19. Validación de la Escala de Identidad Étnica Multigrupo- Revisada en adolescentes inmigrantes y autóctonos residentes en España

    Directory of Open Access Journals (Sweden)

    Laura Lara

    2016-01-01

    Full Text Available En este estudio analizamos las propiedades psicométricas y la estructura factorial de la adaptación al español de la Escala de Identidad étnica Multigrupo Revisada (Eiem-R. Participaron 1002 adolescentes residentes en España, la mitad inmigrantes de primera generación (67.7% nacidos en Latinoamérica, 13.6% en Europa del Este, 13.2% en áfrica, 3.6% en Asia y 2% en el resto de Europa, así como sus padres y madres y la otra mitad autóctonos (nacidos en España, así como sus padres y madres. Los análisis factoriales exploratorios y confirmatorios apoyan que la escala mide los dos componentes de la identidad étnica propuestos -exploración y compromiso- por los autores originales, y que estos se encuentran correlacionados. Los análisis también mostraron casi completos niveles de invarianza de esta estructura factorial al comparar entre sexos, etapas de adolescencia y autóctonos e inmigrantes.

  20. Unilateral facial pain and lung cancer

    International Nuclear Information System (INIS)

    Shakespeare, T.P.; Stevens, M.J.

    1996-01-01

    Facial pain in lung cancer patients may be secondary to metastatic disease to the brain or skull base. Since 1983 there have been 19 published reports of hemi-facial pain as a non-metastatic complication of lung carcinoma. This report describes an additional case in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. A clinical diagnosis of trigeminal neuralgia was made after a normal brain CT scan. Later on the patient complained of global lethargy, weight loss and haemoptysis. A chest X-ray disclosed a 6 cm right hilar mass that was further defined with a whole body CT scan. The neural mechanism of the unilateral facial pain is discussed and the literature reviewed. 14 refs., 1 tab

  1. Unilateral facial pain and lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shakespeare, T.P.; Stevens, M.J. [Royal North Shore Hospital, Crows Nest, NSW (Australia)

    1996-02-01

    Facial pain in lung cancer patients may be secondary to metastatic disease to the brain or skull base. Since 1983 there have been 19 published reports of hemi-facial pain as a non-metastatic complication of lung carcinoma. This report describes an additional case in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. A clinical diagnosis of trigeminal neuralgia was made after a normal brain CT scan. Later on the patient complained of global lethargy, weight loss and haemoptysis. A chest X-ray disclosed a 6 cm right hilar mass that was further defined with a whole body CT scan. The neural mechanism of the unilateral facial pain is discussed and the literature reviewed. 14 refs., 1 tab.

  2. [Multimodal distraction to relieve pain in children undergoing acute medical procedures].

    Science.gov (United States)

    Miller, Kate; Rodger, Sylvia; Bucolo, Sam; Wang, Xue-Qing; Kimble, Roy M

    2009-10-01

    Non-pharmacological approaches to pain management have been used by therapists for decades to reduce the anxiety and pain experienced by children during burn care procedures. With a greater understanding of pain and the principles behind what causes a child to be distracted, combined with access to state of the art technology, we have developed an easy to use, hand held multimodal distraction device (MMD). MMD is an interactive device that prepares the child for a procedure and uses developmentally appropriate distraction stories and games during the procedures to alleviate anxiety and pain. This paper summarizes the results of three randomized control trials. The trials aimed to understand the effectiveness of MMD as a distraction and preparation tool in reducing anxiety and pain in children undergoing burns and non-burns medical procedures compared to pure pharmacological approaches Standard Distraction (SD) and off the shelf video games (VG). Three separate prospective randomized control trials involving 182 children having 354 dressing changes were conducted in the burns and orthopedic departments at Royal Children's Hospital, Brisbane, Australia, to address the above aims. Pain and anxiety scores were completed for the child, caregiver and nursing staff according to the Modified Faces, Legs, Activity, Cry and Consolability Scale, Faces Pain Scale-Revised, Visual Analogue Scale and Wong-Baker Faces Pain Rating Scale. Procedural length was recorded. MMD as a preparation and distraction tool were shown to have a significant impact on child, parent and nursing staff reported anxiety and pain during procedures compared to standard care and video games (P positive effect on clinical time and was shown to sustain its impact on pain and time with further dressing changes. MMD is more effective in reducing the pain and anxiety experienced by children in acute medical procedures as compared with SD and VG. MMD is continuing to be trialed and is continuing to show

  3. An Educational Intervention to Reduce Pain and Improve Pain Management for Malawian People Living With HIV/AIDS and Their Family Carers: A Randomized Controlled Trial.

    Science.gov (United States)

    Nkhoma, Kennedy; Seymour, Jane; Arthur, Antony

    2015-07-01

    Advances being made in improving access to HIV drugs in resource-poor countries mean HIV patients are living longer, and, therefore, experiencing pain over a longer period of time. There is a need to provide effective interventions for alleviating and managing pain. To assess whether a pain educational intervention compared with usual care reduces pain severity and improves pain management in patients with HIV/AIDS and their family carers. This was a randomized, parallel group, superiority trial conducted at HIV and palliative care clinics of two public hospitals in Malawi. A total of 182 adults with HIV/AIDS (Stage III or IV) and their family carers participated; carer participants were those individuals most involved in the patient's unpaid care. The educational intervention comprised a 30 minute face-to-face meeting, a leaflet, and a follow-up telephone call at two weeks. The content of the educational intervention covered definition, causes, and characteristics of pain in HIV/AIDS; beliefs and myths about pain and pain medication; assessment of pain; and pharmacological and nonpharmacological management. The primary outcome was average pain severity measured by the Brief Pain Inventory-Pain Severity subscale. Assessments were recorded at baseline before randomization and at eight weeks after randomization. Of the 182 patient/carer dyads randomly allocated, 157 patient/carer dyads completed the trial. Patients in the intervention group experienced a greater decrease in pain severity (mean difference = 21.09 points, 95% confidence interval = 16.56-25.63; P HIV/AIDS and their family carers. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  4. Les violences politiques dans les Etats de la Caraïbe insulaire (1945 à nos jours)

    OpenAIRE

    Jalabert, Laurent

    2003-01-01

    La violence politique dans les Etats indépendants de la Caraïbe insulaire (Cuba, Haïti, Saint-Domingue, Jamaïque, Trinidad…) de 1945 à nos jours est une caractéristique constante des pratiques politiques en vigueur dans ces pays. La violence politique s’y est érigée au titre de « culture politique », aussi bien à l’intérieur de régimes autoritaires (Cuba, Haïti, Saint-Domingue), que dans les processus de transition démocratique (Haïti, Saint-Domingue), voire dans les démocraties (Jamaïque, Tr...

  5. Localization of pain and self-reported rape in a female community sample.

    Science.gov (United States)

    Chandler, Helena K; Ciccone, Donald S; Raphael, Karen G

    2006-01-01

    Studies suggest that rape increases risk of medically unexplained pain in women. At present it is not clear whether rape is associated with pain at specific locations or at multiple locations. In this study we tested the hypothesis that rape was associated with a preferential increase in risk of pelvic pain that was not explained by pain at other sites. We relied on an existing community study that oversampled women with fibromyalgia and major depression. Localization was assessed by asking about pain at four sites: pelvic region; jaw/face; headache; and lower back. Three groups were identified using a structured telephone interview: Abuse Only (sexual/physical abuse excluding rape); Rape+Abuse (rape in addition to other sexual/physical abuse); and No Abuse. Compared with the No Abuse group, the Rape+Abuse group was eight times more likely to have pelvic pain and 3.7 times more likely to have jaw/face pain after we controlled for the effect of widespread pain. Rape was not associated with lower back pain or headache. The Abuse Only group did not show a preferential increase in risk of pain at any of the four locations that were assessed. After controlling for pain at other locations, we found that the Rape + Abuse group was 10 times more likely to report pelvic pain than the No Abuse group (Prape was uniquely associated with pelvic pain. Future efforts to account for pain in the aftermath of rape must specify a mechanism that can simultaneously cause widespread pain as well as increase risk of localized pain.

  6. Ghanaian nurses' knowledge of invasive procedural pain and its effect on children, parents and nurses.

    Science.gov (United States)

    Anim-Boamah, Oboshie; Aziato, Lydia; Adabayeri, Victoria May

    2017-09-11

    To explore Ghanaian nurses' knowledge of invasive procedural pain in children who are in hospital and to identify the effect of unrelieved pain on children, parents and nurses. An exploratory, descriptive and qualitative design was adopted. A purposive sampling technique was used and individual face-to-face, semi-structured interviews were conducted with 16 registered nurses from four children's units at a hospital in the Eastern Region of Ghana. Thematic and content analyses were performed. Four themes emerged: types of invasive procedure; pain expression; pain assessment; and effects of unrelieved pain. Participants had adequate knowledge of painful invasive procedures, however, they were not aware of the range of available validated pain assessment tools, using observations and body language instead to assess pain. Ghanaian nurses require education on the use of validated rating scales to assess procedural pain in children. The inclusion of pain assessment and management in pre-registration curricula could improve knowledge. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  7. Music and the reduction of post-operative pain.

    Science.gov (United States)

    Dunn, Kelly

    The prevention and treatment of post-operative pain, and the promotion of comfort are the challenges facing practitioners working in the recovery room setting. Surgical pain produces autonomic, psychological, immunological and behavioural responses that can delay or inhibit normal healing. Nurses spend more time with patients experiencing pain than any other healthcare professional. Therefore, they are in an ideal position to consider other pain-relieving strategies to complement the analgesics currently used. The studies reviewed cannot prove that music is effective in reducing post-operative pain, because the research methodology in the majority is poor. Patients, experience of listening to music post-operatively was positive, aiding distraction and increasing comfort. This shows the difference between inconsistent results for the objective measures of pain and what the patient is reporting.

  8. Growth and Financial Liberalization under Capital Collateral Constraints: The Striking Case of the Stochastic AK model with CARA Preferences

    OpenAIRE

    Raouf Boucekkine; Giorgio Fabbri; Patrick A. Pintus

    2013-01-01

    Ce working paper a fait l'objet d'une publication in Economics Letters, 122(2):303-307, 2014; We consider a small-open, collateral-constrained AK economy. We show that the combination of CARA preferences and uncertainty on capital inflows in such an economy generates long-term (expected) growth while the deterministic counterpart does not. In this framework, long-term growth is entirely driven by precautionary savings. In particular, we show that the asymptotic growth rate of the expected cap...

  9. Los rayos X. Sus dos caras en la realidad y en la ficción fílmica

    Directory of Open Access Journals (Sweden)

    María Cristina TARRES

    2017-06-01

    Full Text Available Este trabajo centrado en el cortometraje Roentgen intenta escudriñar dos caras en el marco de los Rayos X: la rescatabley digna evocación de su descubridor y la desfigurada de unos personajes ficcionales, ganados por la ambición,que, dispuestos a lograr sus objetivos a cualquier precio, adquieren carnadura real.Desde ambas perspectivas, este filme se valora de utilidad para estudiantes y graduados en ciencias médicas porquees capaz de enfrentarlos indirecta y directamente a la cima y a la sima del alma humana.

  10. Pain in adolescent girls receiving human papillomavirus vaccine with concomitantly administered vaccines.

    Science.gov (United States)

    Walter, Emmanuel B; Kemper, Alex R; Dolor, Rowena J; Dunne, Eileen F

    2015-02-01

    Using the Faces Pain Scale - Revised, we assessed injection site pain 10 minutes after vaccination in young females randomized to receive either quadrivalent human papillomavirus vaccine (HPV4) before or after concomitantly administered vaccines. Although pain was modestly more after HPV4 injection than after other vaccines, the pain intensity after HPV4 injection was significantly less in those who received HPV4 before receiving other concomitant vaccines.

  11. Medical emergencies facing general practitioners: Drugs for the doctor's bag

    OpenAIRE

    Janković Slobodan

    2014-01-01

    General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever), morphine (for severe pain), naloxone (for heroin poisoning), ceftriaxone (for meningococcal ...

  12. Postoperative pain management experiences among school-aged children: a qualitative study.

    Science.gov (United States)

    Sng, Qian Wen; Taylor, Beverley; Liam, Joanne Lw; Klainin-Yobas, Piyanee; Wang, Wenru; He, Hong-Gu

    2013-04-01

    To explore postoperative pain management experiences among school-aged children. Ineffective postoperative pain management among children has been commonly reported. School-aged children are able to evaluate how their pain is managed and what their preferred strategies are. Most studies in pain management have adopted quantitative methods and have overlooked children's pain management experiences. This is a qualitative study using face-to-face interviews. Data were collected from 15 school-aged children admitted to a tertiary hospital in Singapore by in-depth interviews conducted between November 2010 and January 2011. Data were analysed by thematic analysis. Five themes were identified: children's self-directed actions to relieve their postoperative pain (e.g. using cognitive-behavioural methods of distraction and imagery, physical method of positioning, sleeping and drinking, seeking other people's help by informing parents and crying and using pain medications); children's perceptions of actions parents take for their postoperative pain relief (assessing pain, administering pain medications, using various cognitive-behavioural, physical methods and emotional support strategies, assisting in activities and alerting health professionals); children's perception of actions nurses take for their postoperative pain relief (administering medication, using cognitive-behavioural methods, emotional support strategies and helping with activities of daily living) and suggestions for parents (using distraction and presence) and nurses (administering medications, distraction and positioning) for their postoperative pain relief improvement. This study contributed to the existing knowledge about children's postoperative pain management based on their own experiences. Children, their parents and nurses used various strategies, including pain medication and non-pharmacological methods, especially distraction, for children's postoperative pain relief. This study provides evidence

  13. Efektivitas Pengolahan Air Limbah Batik dengan Cara Kimia dan Biologi

    Directory of Open Access Journals (Sweden)

    Istihanah Nurul Eskani

    2016-04-01

    Full Text Available Kebanyakan industri batik membuang air limbah ke lingkungan tanpa diolah terlebih dahulu dengan alasan keterbatasan tempat, dana dan penguasaan teknologi. Beberapa cara pengolahan air limbah telah dilakukan untuk mengatasi penurunan mutunlingkungan akibat pembuangan air limbah.Telah dilakukan penelitian proses pengolahan air limbah batik secara kimia, biologi aerob dan biologi anaerob. Proses kimia dilaksanakan dengan menambahkan koagulan tawas dan kapur ke dalam air limbah batik. Proses biologi aerob dijalankan dalam reaktor terbuka selama 5 hari, sedang proses biologi anaerob  dijalankan dalam reaktor tertutup selama 12 hari. Hasil proses kemudian diukur parameter warna, COD dan alkalinitasnya.Hasil penelitian pengolahan air limbah batik secara kimia dapat menurunkan parameter warna yang berasal dari zat warna Naphtol sebesar 83,15 %, COD sebesar 28,82% dan pH hasil proses 7. Proses biologi anaerob menurunkan parameter warna sebesar 94,95%, COD sebesar 59,89% dan pH hasil proses 5. Proses biologi aerob dapat menurunkan parameter warna yang berasal dari zat warna Naphtol sebesar 97,82%, COD sebesar 72, 88% dan pH hasil proses 6,5. Sehingga dapat disimpulkan bahwa pengolahan limbah cair batik secara biologi aerob lebih efektif daripada pengolahan secara biologi anaerob maupaun secara kimia. Kata kunci : pengolahan air limbah batik, proses kimia, proses biologi

  14. The effect of patient-practitioner communication on pain: a systematic review.

    Science.gov (United States)

    Mistiaen, P; van Osch, M; van Vliet, L; Howick, J; Bishop, F L; Di Blasi, Z; Bensing, J; van Dulmen, S

    2016-05-01

    Communication between patients and health care practitioners is expected to benefit health outcomes. The objective of this review was to assess the effects of experimentally varied communication on clinical patients' pain. We searched in July 2012, 11 databases supplemented with forward and backward searches for (quasi-) randomized controlled trials in which face-to-face communication was manipulated. We updated in June 2015 using the four most relevant databases (CINAHL, Cochrane Central, Psychinfo, PubMed). Fifty-one studies covering 5079 patients were included. The interventions were separated into three categories: cognitive care, emotional care, procedural preparation. In all but five studies the outcome concerned acute pain. We found that, in general, communication has a small effect on (acute) pain. The 19 cognitive care studies showed that a positive suggestion may reduce pain, whereas a negative suggestion may increase pain, but effects are small. The 14 emotional care studies showed no evidence of a direct effect on pain, although four studies showed a tendency for emotional care lowering patients' pain. Some of the 23 procedural preparation interventions showed a weak to moderate effect on lowering pain. Different types of communication have a significant but small effect on (acute) pain. Positive suggestions and informational preparation seem to lower patients' pain. Communication interventions show a large variety in quality, complexity and methodological rigour; they often used multiple components and it remains unclear what the effective elements of communication are. Future research is warranted to identify the effective components. © 2015 European Pain Federation - EFIC®

  15. Modificação da microbiota associada às lesões peridentárias da "cara inchada" em bezerros transferidos para área indene

    Directory of Open Access Journals (Sweden)

    Dutra Iveraldo S.

    2000-01-01

    Full Text Available Observações sobre a epizootiologia da "cara inchada" dos bovinos (CI indicam que animais clinicamente positivos se recuperam espontâneamente quando transferidos para área indene. No presente estudo, 13 bovinos com lesões peridentárias progressivas da "cara inchada" foram transferidos para área indene com a finalidade de se verificar a evolução clínica da doença e a composição da microbiota da bolsa peridentária em duas situações distintas: (1 nas lesões progressivas e (2 quando da recuperação clínica. O estudo bacteriológico semi-quantitativo e qualitativo foi realizado tendo como referência a percentagem de Bacteroides pigmentados de negro presentes nos cultivos. Nas lesões progressivas a percentagem média destes microrganismos foi de 71,3%. Após 4 a 7 meses da transferência os animais se recuperaram espontaneamente, observando-se uma melhora na condição nutricional, desaparecimento do abaulamento facial e do odor fétido bucal e cicatrização com epitelização das lesões peridentárias. Na avaliação da composição da micro-biota das bolsas peridentárias dos bezerros quando clinicamente recuperados, este mesmo grupo de micorganismos representou em média 1,7%. Os resultados revelaram a ocorrência de uma predominância de Bacteroides pigmentados de negro nas lesões peridentárias progressivas da "cara inchada"e sua remissão quantitativa percentual após a recuperação clínica dos animais, consubstanciando as evidências de sua natureza infecciosa primária.

  16. Cognitive modulation of pain and predictive coding. Comment on “Facing the experience of pain: A neuropsychological perspective” by Fabbro and Crescentini

    Science.gov (United States)

    Pagnoni, Giuseppe; Porro, Carlo A.

    2014-09-01

    Pain is a phenomenologically complex experience whose sensory and psychological dimensions are deeply intertwined. In their perspective article, Fabbro and Crescentini [1] review the physiological and neural mechanisms underlying nociception and its cognitive modulation within the broader concept of suffering, which includes psychological pain [2] in its culturally mediated and existentially nuanced forms. The tight link between affective and cognitive processes, on the one hand, and pain, on the other, is illustrated by examining in turn the placebo effect, empathy for other people's afflictions, clinical depression, and the role that mindfulness-based practices may play in alleviating suffering.

  17. The language of pain: A short study

    Directory of Open Access Journals (Sweden)

    Arun Rathnam

    2010-01-01

    Full Text Available Background: Pain perception is a very controversial topic in child patients. It is affected by various factors such as fear, anxiety, previous experiences, parental factors, and pain threshold. The communication of such pain by the child to the parent is also very confusing with children having rudimentary and developing communication skills. A study to evaluate the pain perception of children and the parental understanding of the children′s pain would be helpful in this scenario. The effect on behavior due to pain is also attempted in this particular study. Materials and Methods: A cross-sectional study of 100 children aged between 5-13 years accompanied by either parent was performed. Data collection was done with the help of questionnaires, which assessed the parental understanding of the child′s pain. Pain perception recording was done with the Visual Analog Scale of Faces (VASOF. The behavior of the child was noted using the Frankl′s behavior rating scale. Data was collated and statistical analysis was performed using the SPSS (version 10 software. Results and conclusion: The results show that parental factors such as education, work culture, influence parental understanding of pain. VASOF proves to be a reliable tool for pain perception in children. Behavior of the child shows a positive correlation to pain perception.

  18. Racial bias in neural empathic responses to pain.

    Directory of Open Access Journals (Sweden)

    Luis Sebastian Contreras-Huerta

    Full Text Available Recent studies have shown that perceiving the pain of others activates brain regions in the observer associated with both somatosensory and affective-motivational aspects of pain, principally involving regions of the anterior cingulate and anterior insula cortex. The degree of these empathic neural responses is modulated by racial bias, such that stronger neural activation is elicited by observing pain in people of the same racial group compared with people of another racial group. The aim of the present study was to examine whether a more general social group category, other than race, could similarly modulate neural empathic responses and perhaps account for the apparent racial bias reported in previous studies. Using a minimal group paradigm, we assigned participants to one of two mixed-race teams. We use the term race to refer to the Chinese or Caucasian appearance of faces and whether the ethnic group represented was the same or different from the appearance of the participant' own face. Using fMRI, we measured neural empathic responses as participants observed members of their own group or other group, and members of their own race or other race, receiving either painful or non-painful touch. Participants showed clear group biases, with no significant effect of race, on behavioral measures of implicit (affective priming and explicit group identification. Neural responses to observed pain in the anterior cingulate cortex, insula cortex, and somatosensory areas showed significantly greater activation when observing pain in own-race compared with other-race individuals, with no significant effect of minimal groups. These results suggest that racial bias in neural empathic responses is not influenced by minimal forms of group categorization, despite the clear association participants showed with in-group more than out-group members. We suggest that race may be an automatic and unconscious mechanism that drives the initial neural responses to

  19. Racial Bias in Neural Empathic Responses to Pain

    Science.gov (United States)

    Contreras-Huerta, Luis Sebastian; Baker, Katharine S.; Reynolds, Katherine J.; Batalha, Luisa; Cunnington, Ross

    2013-01-01

    Recent studies have shown that perceiving the pain of others activates brain regions in the observer associated with both somatosensory and affective-motivational aspects of pain, principally involving regions of the anterior cingulate and anterior insula cortex. The degree of these empathic neural responses is modulated by racial bias, such that stronger neural activation is elicited by observing pain in people of the same racial group compared with people of another racial group. The aim of the present study was to examine whether a more general social group category, other than race, could similarly modulate neural empathic responses and perhaps account for the apparent racial bias reported in previous studies. Using a minimal group paradigm, we assigned participants to one of two mixed-race teams. We use the term race to refer to the Chinese or Caucasian appearance of faces and whether the ethnic group represented was the same or different from the appearance of the participant' own face. Using fMRI, we measured neural empathic responses as participants observed members of their own group or other group, and members of their own race or other race, receiving either painful or non-painful touch. Participants showed clear group biases, with no significant effect of race, on behavioral measures of implicit (affective priming) and explicit group identification. Neural responses to observed pain in the anterior cingulate cortex, insula cortex, and somatosensory areas showed significantly greater activation when observing pain in own-race compared with other-race individuals, with no significant effect of minimal groups. These results suggest that racial bias in neural empathic responses is not influenced by minimal forms of group categorization, despite the clear association participants showed with in-group more than out-group members. We suggest that race may be an automatic and unconscious mechanism that drives the initial neural responses to observed pain in

  20. A time for psycho-spiritual transcendence: The experiences of Iranian women of pain during childbirth.

    Science.gov (United States)

    Taghizdeh, Z; Ebadi, A; Dehghani, M; Gharacheh, M; Yadollahi, P

    2017-12-01

    The description of women's experiences of childbirth improves our understandings of the nature of childbirth, women's suffering and pain during childbirth. This study aimed to explore women's experiences of pain during childbirth. A qualitative study was conducted using a conventional content analysis method proposed by Graneheim and Lundman (2004). In-depth face to face semi-structured interviews were held with 17 women who met inclusion criteria for participation in this study. The women's experiences of pain during childbirth was described as 'a time for psycho-spiritual transcendence'. Categories developed during the data analysis were 'conflicting emotions towards pain', 'new insight towards labor pain', 'self-actualization' and 'spiritual development'. Most participants had positive experiences and attitudes towards pain during childbirth influenced by cultural, context and religious factors. According to this study, 'transcendental progression' was an eminent feeling that created positive inner feelings along with self-actualization in women. This provides a new insight on labor pain and helps healthcare providers understand the effect of pain during childbirth on women's spiritual, mental and psychological needs. Copyright © 2017. Published by Elsevier Ltd.

  1. Using a New Measurement to Evaluate Pain Relief Among Cancer Inpatients with Clinically Significant Pain Based on a Nursing Information System: A Three-Year Hospital-Based Study.

    Science.gov (United States)

    Wang, Wei-Yun; Chu, Chi-Ming; Sung, Chun-Sung; Ho, Shung-Tai; Wu, Yi-Syuan; Liang, Chun-Yu; Wang, Kwua-Yun

    2016-11-01

    Developing a new measurement index is the first step in evaluating pain relief outcomes. Although the percentage difference in pain intensity (%PID) is the most popular indicator, this indicator does not take into account the goal of pain relief. Therefore, the aims of this study were to develop a pain relief index (PRI) for outcome evaluation and to examine the index using demographic characteristics of cancer inpatients with clinically significant pain. Retrospective cohort study. A national hospital. All cancer inpatients. Pain intensity was assessed using a numerical rating scale, a faces pain scale or the Face, Legs, Activity, Cry, Consolability (FLACC) Behavioral Tool. Using a nursing information system, a pain score database containing data from 2011 through 2013 was analyzed. Cancer patients representing 93,812 hospitalizations were considered in this study. We focused on cancer patients for whom the worst pain intensity (WPI) was ≥ 4 points. PRI values of -62.02% to -72.55% were observed in the WPI ≥ 7 and 4 ≤ WPI ≤ 6 groups. Significant (P 65 years old, those who were admitted to the medicine or gynecology and those who had a hospital stay > 30 days. This hospital-based study demonstrated that the PRI is an effective and valid measure for evaluating outcome data using an electronic nursing information system. We will further define the meaningful range of percentage difference in PRI from various perspectives. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Self-Efficacy for Pain Communication Moderates the Relation Between Ambivalence Over Emotional Expression and Pain Catastrophizing Among Patients With Osteoarthritis.

    Science.gov (United States)

    Van Denburg, Alyssa N; Shelby, Rebecca A; Caldwell, David S; O'Sullivan, Madeline L; Keefe, Francis J

    2018-04-06

    Pain catastrophizing (ie, the tendency to focus on and magnify pain sensations and feel helpless in the face of pain) is one of the most important and consistent psychological predictors of the pain experience. The present study examined, in 60 patients with osteoarthritis pain who were married or partnered: 1) the degree to which ambivalence over emotional expression and negative network orientation were associated with pain catastrophizing, and 2) whether self-efficacy for pain communication moderated these relations. Hierarchical multiple linear regression analyses revealed a significant main effect for the association between ambivalence over emotional expression and pain catastrophizing; as ambivalence over emotional expression increased, the degree of pain catastrophizing increased. In addition, the interaction between ambivalence over emotional expression and self-efficacy for pain communication was significant, such that as self-efficacy for pain communication increased, the association between ambivalence over emotional expression and pain catastrophizing became weaker. Negative network orientation was not significantly associated with pain catastrophizing. Findings suggest that higher levels of self-efficacy for pain communication may help weaken the effects of ambivalence over emotional expression on pain catastrophizing. In light of these results, patients may benefit from interventions that target pain communication processes and emotion regulation. This article examines interpersonal processes involved in pain catastrophizing. This study has the potential to lead to better understanding of maladaptive pain coping strategies and possibly better prevention and treatment strategies. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  3. Narrar la historia: la internacionalización de las ideas en las portadas de Punch-Puk-Caras y Caretas

    OpenAIRE

    Díaz Juárez, María Virginia

    2017-01-01

    Esta investigación tiene por objeto el estudio de la caricatura como género de opinión en la revista inglesa Punch, la estadounidense Puck y la uruguaya Caras y Caretas. Si bien pertenecen a distintos países, las tres fueron fundadas durante el siglo XIX. El trabajo presenta una aproximación a cómo las distintas publicaciones plasman los acontecimientos y personajes de la época por medio de la caricatura. Existe un gran valor testimonial en ellas que permite conocer la Historia desde otro lug...

  4. Music benefits on postoperative distress and pain in pediatric day care surgery

    Directory of Open Access Journals (Sweden)

    Valeria Calcaterra

    2014-09-01

    Full Text Available Postoperative effect of music listening has not been established in pediatric age. Response on postoperative distress and pain in pediatric day care surgery has been evaluated. Forty-two children were enrolled. Patients were randomly assigned to the music-group (music intervention during awakening period or the non-music group (standard postoperative care. Slow and fast classical music and pauses were recorded and played via ambient speakers. Heart rate, blood pressure, oxygen saturation, glucose and cortisol levels, faces pain scale and Face, Legs, Activity, Cry, Consolability (FLACC Pain Scale were considered as indicators of response to stress and pain experience. Music during awakening induced lower increase of systolic and diastolic blood pressure levels. The non-music group showed progressive increasing values of glycemia; in music-group the curve of glycemia presented a plateau pattern (P<0.001. Positive impact on reactions to pain was noted using the FLACC scale. Music improves cardiovascular parameters, stress-induced hyperglycemia. Amelioration on pain perception is more evident in older children. Positive effects seems to be achieved by the alternation of fast, slow rhythms and pauses even in pediatric age.

  5. Music benefits on postoperative distress and pain in pediatric day care surgery.

    Science.gov (United States)

    Calcaterra, Valeria; Ostuni, Selene; Bonomelli, Irene; Mencherini, Simonetta; Brunero, Marco; Zambaiti, Elisa; Mannarino, Savina; Larizza, Daniela; Albertini, Riccardo; Tinelli, Carmine; Pelizzo, Gloria

    2014-08-12

    Postoperative effect of music listening has not been established in pediatric age. Response on postoperative distress and pain in pediatric day care surgery has been evaluated. Forty-two children were enrolled. Patients were randomly assigned to the music-group (music intervention during awakening period) or the non-music group (standard postoperative care). Slow and fast classical music and pauses were recorded and played via ambient speakers. Heart rate, blood pressure, oxygen saturation, glucose and cortisol levels, faces pain scale and Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale were considered as indicators of response to stress and pain experience. Music during awakening induced lower increase of systolic and diastolic blood pressure levels. The non-music group showed progressive increasing values of glycemia; in music-group the curve of glycemia presented a plateau pattern (PMusic improves cardiovascular parameters, stress-induced hyperglycemia. Amelioration on pain perception is more evident in older children. Positive effects seems to be achieved by the alternation of fast, slow rhythms and pauses even in pediatric age.

  6. Pain is prevalent and persisting in cancer survivors: differential factors across age groups.

    Science.gov (United States)

    Moye, Jennifer; June, Andrea; Martin, Lindsey Ann; Gosian, Jeffrey; Herman, Levi I; Naik, Aanand D

    2014-04-01

    The Institute of Medicine documents a significant gap in care for long term side effects of cancer treatment, including pain. This paper characterizes age differences in the prevalence and predictive characteristics of pain to guide clinicians in identification and treatment. A sample of 170 adults with head and neck, esophageal, gastric, or colorectal cancers were recruited from two regional Veterans Administration Medical Centers. Face to face interviews were conducted 6, 12, and 18 months after diagnosis with the PROMIS scale to assess pain and PHQ-9 scale to assess depression. Descriptive statistics characterized incidence and prevalence of pain impact and intensity ratings. Multivariate linear hierarchical regression identified clinical characteristics associated with pain in older versus younger age groups. Clinically significant pain was endorsed in one third (32%) of the sample, with younger adults reporting higher levels of the impact of pain on daily activities and work, and also higher pain intensity ratings than older adults. In younger adults, pain ratings were most associated with lower social support and higher depression, as well as advanced cancer stage. In older adults, pain was multifactorial, associated with baseline comorbidities, adjuvant treatment, and both combat post-traumatic stress disorder (PTSD) and depression. Pain is a significant persisting problem for one in three cancer survivors, requiring ongoing assessment, even months later. Important differences in pain's determinants and impact are present by age group. Identification and treatment of pain, as well as associated conditions such as depression, may improve the quality of life in cancer survivors. Published by Elsevier Ltd.

  7. Children's selective attention to pain and avoidance behaviour: the role of child and parental catastrophizing about pain.

    Science.gov (United States)

    Vervoort, Tine; Trost, Zina; Van Ryckeghem, Dimitri M L

    2013-10-01

    The present study investigated selective attention to pain in children, its implications for child avoidance behaviour, and the moderating role of dimensions comprising child and parental catastrophizing about pain (ie, rumination, magnification, and helplessness). Participants were 59 children (31 boys) aged 10-16 years and one of their parents (41 mothers). Children performed a dot-probe task in which child facial pain displays of varying pain expressiveness were presented. Child avoidance behaviour was indexed by child pain tolerance during a cold-pressor task. Children and parents completed measures of child and parent pain catastrophizing, respectively. Findings indicated that both the nature of child selective attention to pain and the impact of selective attention upon child avoidance behaviour were differentially sensitive to specific dimensions of child and parental catastrophizing. Specifically, findings showed greater tendency to shift attention away from pain faces (i.e.,, attentional avoidance) among children reporting greater pain magnification. A similar pattern was observed in terms of parental characteristics, such that children increasingly shifted attention away from pain with increasing levels of parental rumination and helplessness. Furthermore, child attentional avoidance was associated with greater avoidance behaviour (i.e., lower pain tolerance) among children reporting high levels of pain magnification and those whose parents reported greater rumination about pain. The current findings corroborate catastrophizing as a multidimensional construct that may differentially impact outcomes and attest to the importance of assessing both child and parental characteristics in relation to child pain-related attention and avoidance behaviour. Further research directions are discussed. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  8. Emotion regulatory function of parent attention to child pain and associated implications for parental pain control behaviour.

    Science.gov (United States)

    Vervoort, Tine; Trost, Zina; Sütterlin, Stefan; Caes, Line; Moors, Agnes

    2014-08-01

    We investigated the function of parental attention to child pain in regulating parental distress and pain control behaviour when observing their child performing a painful (cold pressor) task (CPT); we also studied the moderating role of parental state anxiety. Participants were 62 schoolchildren and one of their parents. Parental attention towards or away from child pain (ie, attend to pain vs avoid pain) was experimentally manipulated during a viewing task pairing unfamiliar children's neutral and pain faces. Before and after the viewing task, parental distress regulation was assessed by heart rate (HR) and heart rate variability (HRV). In a subsequent phase, parents observed their own child perform a CPT task, allowing assessment of parental pain control behaviour (indexed by latency to stop their child's CPT performance) and parental distress, which was assessed via self-report before and after observation of child CPT performance. Eye tracking during the viewing task and self-reported attention to own child's pain confirmed successful attention manipulation. Further, findings indicated that the effect of attentional strategy on parental emotion regulation (indexed by HR, self-report) and pain control behaviour depended on parents' state anxiety. Specifically, whereas low anxious parents reported more distress and demonstrated more pain control behaviour in the Attend to Pain condition, high anxious parents reported more distress and showed more pain control behaviour in the Avoid Pain condition. This inverse pattern was likewise apparent in physiological distress indices (HR) in response to the initial viewing task. Theoretical/clinical implications and further research directions are discussed. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  9. Past, Present, and Future of Informed Consent in Pain and Genomics Research: Challenges Facing Global Medical Community.

    Science.gov (United States)

    Compagnone, Christian; Schatman, Michael E; Rauck, Richard L; Van Zundert, Jan; Kraus, Monika; Primorac, Dragan; Williams, Frances; Allegri, Massimo; Saccani Jordi, Gloria; Fanelli, Guido

    2017-01-01

    In recent decades, there has been a revision of the role of institutional review boards with the intention of protecting human subjects from harm and exploitation in research. Informed consent aims to protect the subject by explaining all of the benefits and risks associated with a specific research project. To date, there has not been a review published analyzing issues of informed consent in research in the field of genetic/Omics in subjects with chronic pain, and the current review aims to fill that gap in the ethical aspects of such investigation. Despite the extensive discussion on ethical challenges unique to the field of genetic/Omics, this is the first attempt at addressing ethical challenges regarding Informed Consent Forms for pain research as the primary focus. We see this contribution as an important one, for while ethical issues are too often ignored in pain research in general, the numerous arising ethical issues that are unique to pain genetic/Omics suggest that researchers in the field need to pay even greater attention to the rights of subjects/patients. This article presents the work of the Ethic Committee of the Pain-Omics Group (www.painomics.eu), a consortium of 11 centers that is running the Pain-Omics project funded by the European Community in the 7th Framework Program theme (HEALTH.2013.2.2.1-5-Understanding and controlling pain). The Ethic Committee is composed of 1 member of each group of the consortium as well as key opinion leaders in the field of ethics and pain more generally. © 2016 The Authors. Pain Practice published by Wiley Periodicals, Inc. on behalf of World Institute of Pain.

  10. El peronismo mendocino de cara a las elecciones de 1973

    Directory of Open Access Journals (Sweden)

    Patricia E. Olguín

    2013-01-01

    Full Text Available El retorno a las urnas y el triunfo electoral del peronismo en 1973 clausuraron una etapa marcada por una profunda crisis de legitimidad que había sido abierta por el derrocamiento de Perón en 1955. La reorganización política del “movimiento” en la proscripción, en la provincia de Mendoza, exhibió una intermitente tensión entre quienes adherían al peronismo “verticalista” y un grupo de dirigentes que creó partidos llamados “neoperonistas”, cuyo ascenso encontró un límite en las elecciones a gobernador y vicegobernador de 1966. La rehabilitación de la actividad política en 1971 reavivó las rencillas internas entre las distintas fracciones peronistas para obtener un lugar en las candidaturas en vistas del proceso electoral de 1973. La unificación de algunos sectores no terminó con los conflictos intrapartidarios luego de la victoria en las urnas, los cuales salieron a la superficie apenas iniciado el gobierno de Alberto Martínez Baca. El propósito de este trabajo es analizar el proceso de des - composición que sufrió el peronismo mendocino luego del derrocamiento de Perón en 1955, su posterior reorganización de cara a las elecciones generales de 1973 y el resultado de los comicios.

  11. Prevalence of sleep disturbance in chronic pain.

    Science.gov (United States)

    Karaman, S; Karaman, T; Dogru, S; Onder, Y; Citil, R; Bulut, Y E; Tapar, H; Sahin, A; Arici, S; Kaya, Z; Suren, M

    2014-01-01

    Sleep is a vital function for human beings, which can be affected by several factors. Chronic pain is one of these factors where it is the most frequent cause for seeking medical care in combination with insomnia. The aim of this study is to examine the prevalence and relationship between sleep disturbance and chronic pain. After approval, a total of 85 Family Medicine Units from over 170 in Tokat were randomly selected using a 50% sampling. A sample of 2635 subjects, over the age of 19 years, who were registered with the selected Family Medicine Units, were assessed due to gender, age group, and the urban/rural population size of Tokat using the stratified sampling method. The sample size distribution was calculated as 1515 urban subjects, 1120 rural subjects; 1345 female subjects, 1290 male subjects; 1123 subjects between 20-39 years of age, 1103 subjects between the ages of 40-64, and 409 subjects over 64 years of age. After sampling, subjects were invited to participate in the study via an invitation letter, and agreeing individuals were taken to the Family Medicine Unit for face-to-face meetings. Written, informed consent was obtained, along with demographic data. The presence of chronic pain was recorded. According to the presence of chronic pain, all subjects were separated into two groups as Group Chronic Pain and Group Non-Chronic Pain. The visual analog scale for pain intensity, and Pittsburgh Sleep Quality Index for sleep quality, were performed with all subjects. A multiple linear regression model was used to assess the predictors of sleep quality. Analyses were conducted using the Statistical Package for Social Sciences program (SPSS Inc., Chicago, IL, USA), version 20.0. The statistical significance for all analyses was set at p 5. A moderate positive correlation was found between the global Pittsburgh Sleep Quality Index and Visual Analog Scale scores (r = 0.310, p < 0.01). A multiple linear regression analysis showed that age, gender, income, Visual

  12. Are we looking in the wrong place? Implications for behavioural-based pain assessment in rabbits (Oryctolagus cuniculi and beyond?

    Directory of Open Access Journals (Sweden)

    Matthew C Leach

    Full Text Available BACKGROUND: Successful observation of behaviour depends upon knowing both which behaviours to look for and focusing on the appropriate areas of the body to observe them. Behaviour based scoring systems have become increasingly widely used to assess animal pain and distress. Although studies are available demonstrating which behaviours need to be observed, there has been little attempt to assess how effectively observers apply such information when viewing an animal's behaviour. METHODOLOGY/PRINCIPAL FINDINGS: This study used historical video recordings of New Zealand white rabbits (Oryctolagus cuniculi considered to be experiencing varying degrees of post-operative pain to assess the pattern of observation and the ability to assess pain exhibited by both experienced and inexperienced human participants (n = 151. Eye tracking equipment was used to identify how quickly, how frequently, for how long different areas of the rabbit's body were attended to by the participants. Simple visual analogue scoring was used to assess the pain experienced in each sequence. The results demonstrate that irrespective of their experience or gender, observers focus first, more frequently and for longer on the face, compared to the abdomen, ears, back and hindquarters of the rabbit and that participants were poor at identifying rabbits in pain. Observing the back and hindquarters was correlated with 'correct' assessments and observing the face was correlated with 'incorrect' assessments. CONCLUSIONS: In conclusion, irrespective of experience and gender, observers focused on the face when using behaviour to assess pain and were unable to effectively identify rabbits in pain. Focusing on the face is unlikely to be effective when using behavioural indicators of pain since they involve other body areas. Alternatively, if animals exhibit pain-related facial expressions, then it could improve our ability to assess pain. In addition, these results have potential

  13. Stellate ganglion block for persistent idiopathic facial pain

    Directory of Open Access Journals (Sweden)

    Poonam Patel

    2016-01-01

    Full Text Available Persistent idiopathic facial pain is a facial pain disorder without any identifiable cause. A patient has persistent facial pain without any objective sign on clinical examination or investigations. There are associated psychological problems such as depression and anxiety. This condition is poorly responsive to therapy with anticonvulsants or analgesics. Stellate ganglion block interrupts the sympathetic supply to head, neck, and upper extremities. This block can be used to alleviate pain of sympathetic origin in head and neck region as well as upper extremities. We report a case of a middle-aged female with persistent idiopathic facial pain on the right side of face with no response to analgesics and anticonvulsants. Her pain was provoked by exposure to cold weather or wind. Assuming a sympathetic component to her pain, we did a right-sided stellate ganglion block for her with local anesthetic and steroid. The patient had significant pain relief (>80% after the block. This indicates that the sympathetic nervous system plays a major role in initiation and perpetuation of this pain condition. Stellate ganglion block can be done early in such patients both as a diagnostic and therapeutic modality.

  14. STRES DAN CARA MENGATASINYA DALAM PERSPEKTIF PSIKOLOGI

    Directory of Open Access Journals (Sweden)

    MUSRADINUR

    2016-07-01

    Full Text Available Depression in daily life can give less flavor / discomfort, but it can also provide a sense of comfort. As an element that gives a sense of comfort it can be utilized, can be enjoyed, as well as the taste them, as well as a driving force to get ahead in life. As a factor that gives disires, it will cause a lot of complaints, in a state of acute anxiety in the form, in the form of chronic, physical or mental disorder, boredom, fatigue and eventually death. Management of depression is certainly pursuant nature. When he weighed on benefits in his life should be enjoyed. When he raises depression, in a state of acute, there are various alternatives to resolve it, either to the stress itself or its aftermath. In a state of chronic disorders that arise must be dealt with treatment. Here the role of the cooperation of various fields of medicine necessary if the interference is onganik. Psiklatri important role precisely in the face of such disorders. In the face of psychiatric disorders mural there are options on how to face up to the psychotherapy and pharmacotherapy.

  15. Postoperative Pain in Children After Dentistry Under General Anesthesia.

    Science.gov (United States)

    Wong, Michelle; Copp, Peter E; Haas, Daniel A

    2015-01-01

    The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4-6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use. The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R ≥ 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics.

  16. Validity and Reliability of the Turkish Chronic Pain Acceptance Questionnaire

    Science.gov (United States)

    Akmaz, Hazel Ekin; Uyar, Meltem; Kuzeyli Yıldırım, Yasemin; Akın Korhan, Esra

    2018-05-29

    Pain acceptance is the process of giving up the struggle with pain and learning to live a worthwhile life despite it. In assessing patients with chronic pain in Turkey, making a diagnosis and tracking the effectiveness of treatment is done with scales that have been translated into Turkish. However, there is as yet no valid and reliable scale in Turkish to assess the acceptance of pain. To validate a Turkish version of the Chronic Pain Acceptance Questionnaire developed by McCracken and colleagues. Methodological and cross sectional study. A simple randomized sampling method was used in selecting the study sample. The sample was composed of 201 patients, more than 10 times the number of items examined for validity and reliability in the study, which totaled 20. A patient identification form, the Chronic Pain Acceptance Questionnaire, and the Brief Pain Inventory were used to collect data. Data were collected by face-to-face interviews. In the validity testing, the content validity index was used to evaluate linguistic equivalence, content validity, construct validity, and expert views. In reliability testing of the scale, Cronbach’s α coefficient was calculated, and item analysis and split-test reliability methods were used. Principal component analysis and varimax rotation were used in factor analysis and to examine factor structure for construct concept validity. The item analysis established that the scale, all items, and item-total correlations were satisfactory. The mean total score of the scale was 21.78. The internal consistency coefficient was 0.94, and the correlation between the two halves of the scale was 0.89. The Chronic Pain Acceptance Questionnaire, which is intended to be used in Turkey upon confirmation of its validity and reliability, is an evaluation instrument with sufficient validity and reliability, and it can be reliably used to examine patients’ acceptance of chronic pain.

  17. iACT-CEL: A Feasibility Trial of a Face-to-Face and Internet-Based Acceptance and Commitment Therapy Intervention for Chronic Pain in Singapore

    Directory of Open Access Journals (Sweden)

    Su-Yin Yang

    2017-01-01

    Full Text Available Psychological interventions are increasingly utilising online or mobile phone based platforms to deliver treatment, including that for people with chronic pain. The aims of this study were to develop an adapted form of Acceptance and Commitment Therapy (ACT for chronic pain in Singapore and to test the feasibility of elements of this treatment delivered via the internet and email. Methods. Thirty-three participants recruited from a tertiary pain management clinic and via the clinic website participated in this program over a period of five weeks with a 3-month follow-up. Treatment outcomes were assessed at three assessment time points. Results. 90.9% of participants completed the program, with 81.8% reporting high treatment satisfaction. Significant changes in depression, t=3.08, p=0.002 (baseline to posttreatment, t=3.28, p=0.001 (baseline to follow-up, and pain intensity, t=2.15, p=0.03 (baseline to follow-up were found. Mainly small effect sizes (d=0.09–0.39 with a moderate effect size (d=0.51 for depression were found at posttreatment. Clinically meaningful improvement in at least one outcome was demonstrated in 75.8% of participants. Conclusions. An adaptation of ACT for people with chronic pain in Singapore appears promising. Optimal treatment design and more effective ways to target outcomes and processes measured here are required.

  18. Face-to-face comparison of the predictive validity of two models of neuropathic pain in the rat: analgesic activity of pregabalin, tramadol and duloxetine.

    Science.gov (United States)

    Le Cudennec, Camille; Castagné, Vincent

    2014-07-15

    We compared the preclinical analgesic activity of three marketed drugs with different pharmacological properties, pregabalin, tramadol and duloxetine, described as effective against neuropathic pain in the clinic. These drugs were tested against evoked pain in two different neuropathic models in the rat, the Bennett (CCI) and the Chung (SNL) models. The selected endpoints were tactile allodynia, tactile hyperalgesia, heat hyperalgesia and cold allodynia. Although all three drugs displayed analgesic activity, the effects observed varied according to the behavioral evaluation. Pregabalin showed clear analgesic effects against cold allodynia and tactile hyperalgesia in both the CCI and Chung models. Tramadol was active against all four endpoints in the Chung model with similar effects in the CCI model, apart from tactile allodynia. Duloxetine inhibited tactile allodynia and heat hyperalgesia in both neuropathic pain models. It also displayed efficacy against tactile hyperalgesia in the CCI model and against cold allodynia in the Chung model. These data confirm that the CCI and the Chung models of neuropathic pain do not detect the activity of analgesics with the same sensitivity. Furthermore, the mode of stimulation (tactile or thermal) and the type of endpoint (allodynia or hyperalgesia) can further influence the observed efficacy of gold standards as well as novel compounds developed for treating neuropathic pain symptoms. Copyright © 2014. Published by Elsevier B.V.

  19. Perception of pain and its control: all that we don’t know yet

    Directory of Open Access Journals (Sweden)

    Mario Tiengo

    2008-04-01

    Full Text Available Neurophysiology of pain is comprehensible (at least within certain levels until events related to classic physics are concerned. In order to face the topic of the perception of the pain we have to analyze the mental factors like the suggestion (placebo, the emotional events and the tone of humor. The perception of the pain can be explored in the world of quanti.

  20. The reliability of measuring pain distribution and location using body pain diagrams in patients with acute whiplash-associated disorders.

    Science.gov (United States)

    Southerst, Danielle; Stupar, Maja; Côté, Pierre; Mior, Silvano; Stern, Paula

    2013-09-01

    The objective of this study was to measure the interexaminer reliability of scoring pain distribution using paper and electronic body pain diagrams in patients with acute whiplash-associated disorder and to assess the intermethod reliability of measuring pain distribution and location using paper and electronic diagrams. We conducted an interexaminer reliability study on 80 participants recruited from a randomized controlled trial on the conservative management of acute grade I/II whiplash-associated disorder. Participants were assessed for inclusion/exclusion criteria by an experienced clinician. As part of the baseline assessment, participants independently completed paper and electronic pain diagrams. Diagrams were scored independently by 2 examiners using the body region method. Interexaminer and intermethod reliability was computed using intraclass correlation coefficients (ICCs) for pain distribution and κ coefficient for pain location. We used Bland-Altman plots to compute limits of agreement. The interexaminer reliability was ICC = 0.925 for paper and ICC = 0.997 for the electronic body pain diagram. The intermethod reliability for measuring pain distribution ranged from ICC = 0.63 to ICC = 0.93. For pain location, the intermethod reliability varied from κ = 0.23 (posterior neck) to κ = 0.90 (right side of the face). We found good to excellent interexaminer reliability for scoring 2 versions of the body pain diagram. Pain distribution and pain location were reliably and consistently measured on body pain diagrams using paper and electronic methods; therefore, clinicians and researchers may choose either medium when using body pain diagrams. Copyright © 2013 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  1. Pain Intensity and Its Objective Determinants Following Implant ...

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... has been shown to result with a lower pain score than the conventional techniques. ..... Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery. Head Face Med ...

  2. Gender, age and ethnicity influence on pain levels and analgesic use in the acute whiplash injury.

    Science.gov (United States)

    Koren, L; Peled, E; Trogan, R; Norman, D; Berkovich, Y; Israelit, S

    2015-06-01

    Initial pain level in the acute whiplash injury is the most consistent predictor of transformation to a chronic pain syndrome. The risk factors for those early pain levels were, to our knowledge, scarcely evaluate to this date. We set to evaluate whether gender, age or ethnicity comprise a risk factor for those initial pain levels. Further, gender, age and ethnicity have been shown to be bias factors in pain management. We investigated if gender, age or ethnicity are bias factor in pain management in the face of a standardized pain treatment protocol in the acute whiplash injury. We reviewed 2,538 patients with acute whiplash injury that were treated at our emergency department (ED). Gender, age and ethnicity were investigated as risk factors for elevated visual analog scale (VAS) scores. Those factors were also investigated as bias in pain medication administration in the face of a standardized analgesic protocol. Women had significantly higher VAS scores (p = 0.009). Age and ethnicity did not influence pain levels. There was no influence of gender or age on pain medication administration. The Jewish patients (the majority in Israel) were administered fewer pain medication (p whiplash injury. Age and ethnicity have less impact on those pain levels. A pain management protocol might reduce bias in pain management in the acute whiplash injury in the ED. The Jewish population tends to be less receptive to pain medication administration.

  3. 'Living within your limits': activity restriction in older people experiencing chronic pain.

    Science.gov (United States)

    Mackichan, Fiona; Adamson, Joy; Gooberman-Hill, Rachael

    2013-11-01

    although maintaining activity is key to successful pain management, and important to health and wellbeing, it is known that older people in pain frequently alter or reduce activity levels. A 'fear-avoidance' model is often used to explain avoidance of activity in the face of pain. However, this model is not intended to take account of the wider context in which activity changes take place, nor older people's own explanations for their behaviour. to investigate the reasons why older people in the community adjust their activity levels when living with chronic pain. thirty-one people aged between 67 and 92 were purposively sampled from respondents to a community-based cross-sectional survey. All participants had reported long-term pain and were interviewed about this. Data were collected and analysed using a qualitative constructivist grounded theory approach. explanations for deliberative reduction or ceasing of activities reflected a desire to prevent pain exacerbation, thereby avoiding medical intervention. It also reflected a desire to safeguard autonomy in the face of pain in older age. Restrictions were often rationalised as normal in older age, although co-existing accounts of perseverance and frustration with limitation were also evident. a rational desire to avoid pain exacerbation and medical intervention motivated restrictions to activity. However, deliberative limitation of activity has the potential to compromise autonomy by increasing social isolation and de-conditioning. Supporting older people with pain to be active requires sensitivity to the function of activity restriction, especially as a means of preventing deterioration.

  4. Neuropathic Pain Experiences of Spinal Cord Injury Patients.

    Science.gov (United States)

    Li, Chin-Ching; Lin, Hung-Ru; Tsai, Ming-Dar; Tsay, Shiow-Luan

    2017-11-09

    Neuropathic pain (NP) is a common, severe problem that affects spinal cord injury (SCI) patients. Only SCI patients truly understand the impact and extent of this type of pain. The aim of this study was to understand the NP experienced by SCI patients and the influence of this type of pain on their daily life. A qualitative design was used. An interview guide including a semistructured questionnaire and in-depth interviews was conducted with SCI patients with NP in a neurorehabilitation department at a medical center in northern Taiwan. The data were collected using a purposive sampling method. Content analysis was performed on the interview data, which were obtained from 13 SCI patients with NP. Three themes and eight subthemes were identified that described the NP experience of the participants and the influence of NP on their daily life. The three themes included elusive pain (changing and individual pain sensations, erratically haunting threat, and phantom limb sensations), complicated feelings about pain (converting depression into an active attitude toward life, having feelings of anticipation and anxiety about future pain relief, and facing and experiencing pain), and renewed hope (bravely fighting pain and seeking pain relief methods). This study revealed three important themes of NP experienced by SCI patients, including elusive pain, complicated feelings about pain, and renewed hope. Nurses should understand the nature of NP, provide a thorough pain assessment, and design a proper pain management plan to care effectively for patients with NP.

  5. Understanding patient requirements for technology systems that support pain management in palliative care services: A qualitative study.

    Science.gov (United States)

    Allsop, Matthew J; Taylor, Sally; Bennett, Michael I; Bewick, Bridgette M

    2017-11-01

    Approaches to pain management using electronic systems are being developed for use in palliative care. This article explores palliative care patients' perspectives on managing and talking about pain, the role of technology in their lives and how technology could support pain management. Face-to-face interviews were used to understand patient needs and concerns to inform how electronic systems are developed. A total of 13 interviews took place with a convenience sample of community-based patients with advanced cancer receiving palliative care through a hospice. Data were analysed using framework analysis. Four meta-themes emerged: Technology could be part of my care; I'm trying to understand what is going on; My pain is ever-changing and difficult to control; and I'm selective about who to tell about pain. Patients described technology as peripheral to existing processes of care. To be relevant, systems may need to take account of the complexity of a patient's pain experience alongside existing relationships with health professionals.

  6. Nonpharmacologic Pain Management Interventions in German Nursing Homes: A Cluster Randomized Trial.

    Science.gov (United States)

    Kalinowski, Sonja; Budnick, Andrea; Kuhnert, Ronny; Könner, Franziska; Kissel-Kröll, Angela; Kreutz, Reinhold; Dräger, Dagmar

    2015-08-01

    The reported prevalence of pain among nursing home residents (NHRs) is high. Insufficient use of analgesics, the conventional pain management strategy, is often reported. Whether and to what extent nonpharmacologic therapies (NPTs) are used to manage the pain of NHRs in Germany is largely unknown. The aim of this cluster-randomized trial was to assess the NPTs provided and to enhance the application and prescription of NPTs in NHRs on an individual level. There were six nursing homes in the intervention group and six in the control group. There were 239 NHRs, aged ≥65 years, with an average Mini-Mental State Examination score of at least 18 at baseline. Pain management interventions (cluster level) included an online course for physicians and 1-day seminar for nurses. Data on NPT applied by nurses and therapeutic NPT prescribed by physicians were obtained from residents' nursing documentation. Face-to-face interviews with NHRs assessed the NPT received. At baseline, 82.6% of NHR (mean age 83 years) were affected by pain, but less than 1 in 10 received NPT. The intervention did not result in a significant increase in the NPT applied by nurses, but did significantly increase the therapeutic NPT prescribed by physicians. Residents were active in using NPT to self-manage their pain. Given the prevalence of pain in NHRs, there is a clear need to improve pain management in this population. Extended use of NPT offers a promising approach. We recommend that nurses provide residents with education on pain-management techniques to support them in taking a proactive role in managing their pain. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  7. Latin-American guidelines for opioid use in chronic nononcologic pain.

    Science.gov (United States)

    Lara-Solares, Argelia; Aguayo Zamora, Carlos; Amescua García, César; Garcia, João Batista Santos; Berenguel Cook, María Del Rosario; Bonilla Sierra, Patricia; Campos Kraychete, Durval; Flores Cantisani, José Alberto; Guerrero, Carlos; Guillén Núñez, María Del Rocío; Hernández Castro, John Jairo; Hernández Ortíz, Andrés; Jreige Iskandar, Aziza; Lech, Osvandré; Macías Guerra, Jacqueline; Ramírez Samayoa, Gerardo; Rangel Morillo, Edwin; Rico Pazos, María Antonieta; Sempértegui Gallegos, Manuel

    2017-05-01

    Latin-American experts in the use of opioids in patients with chronic nononcologic pain (CNOP) have updated existing recommendations to current Latin-American reality. Several key opinion leaders from Latin America participated in a face-to-face meeting in Guatemala (April 2015) to discuss the use of opioids in CNOP. Subgroups of experts worked on specific topics, reviewed the literature and shaped the final manuscript. The expert panel developed guidelines taking into consideration the utility of both opioid and nonopioid analgesics and factors pertaining to their efficacy, safety, adherence, administration and risks for abuse/addiction. Latin-American guidelines for the use of opioids in CNOP should improve pain relief and patients' quality of life by increasing access to these effective agents.

  8. Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study.

    Science.gov (United States)

    Taylor, Sally; Allsop, Matthew J; Bekker, Hilary L; Bennett, Michael I; Bewick, Bridgette M

    2017-07-01

    Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.

  9. Fortalecimiento de habilidades de pensamiento e inteligencia emocional: los desafíos del docente policial de cara a los nuevos escenarios institucionales

    OpenAIRE

    Torres Prieto, Camilo; Sastre Cifuentes, Asceneth María

    2016-01-01

    Estudio documental de corte exploratorio orientado a identificar y analizar las habilidades de pensamiento y de inteligencia emocional necesarias para desempeñarse de manera exitosa como Comandantes de una Estación de policía, de cara a los retos que suponen los nuevos escenarios institucionales. Mediante un análisis de los diferentes tipos de habilidades de pensamiento e inteligencia emocional en relación con las funciones, se determinó cuales presentaban una mayor prevalencia. Con base en ...

  10. Sex differences in social cognition: The case of face processing.

    Science.gov (United States)

    Proverbio, Alice Mado

    2017-01-02

    Several studies have demonstrated that women show a greater interest for social information and empathic attitude than men. This article reviews studies on sex differences in the brain, with particular reference to how males and females process faces and facial expressions, social interactions, pain of others, infant faces, faces in things (pareidolia phenomenon), opposite-sex faces, humans vs. landscapes, incongruent behavior, motor actions, biological motion, erotic pictures, and emotional information. Sex differences in oxytocin-based attachment response and emotional memory are also mentioned. In addition, we investigated how 400 different human faces were evaluated for arousal and valence dimensions by a group of healthy male and female University students. Stimuli were carefully balanced for sensory and perceptual characteristics, age, facial expression, and sex. As a whole, women judged all human faces as more positive and more arousing than men. Furthermore, they showed a preference for the faces of children and the elderly in the arousal evaluation. Regardless of face aesthetics, age, or facial expression, women rated human faces higher than men. The preference for opposite- vs. same-sex faces strongly interacted with facial age. Overall, both women and men exhibited differences in facial processing that could be interpreted in the light of evolutionary psychobiology. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Idiopathic ophthalmodynia and idiopathic rhinalgia: two topographic facial pain syndromes.

    Science.gov (United States)

    Pareja, Juan A; Cuadrado, María L; Porta-Etessam, Jesús; Fernández-de-las-Peñas, César; Gili, Pablo; Caminero, Ana B; Cebrián, José L

    2010-09-01

    To describe 2 topographic facial pain conditions with the pain clearly localized in the eye (idiopathic ophthalmodynia) or in the nose (idiopathic rhinalgia), and to propose their distinction from persistent idiopathic facial pain. Persistent idiopathic facial pain, burning mouth syndrome, atypical odontalgia, and facial arthromyalgia are idiopathic facial pain syndromes that have been separated according to topographical criteria. Still, some other facial pain syndromes might have been veiled under the broad term of persistent idiopathic facial pain. Through a 10-year period we have studied all patients referred to our neurological clinic because of facial pain of unknown etiology that might deviate from all well-characterized facial pain syndromes. In a group of patients we have identified 2 consistent clinical pictures with pain precisely located either in the eye (n=11) or in the nose (n=7). Clinical features resembled those of other localized idiopathic facial syndromes, the key differences relying on the topographic distribution of the pain. Both idiopathic ophthalmodynia and idiopathic rhinalgia seem specific pain syndromes with a distinctive location, and may deserve a nosologic status just as other focal pain syndromes of the face. Whether all such focal syndromes are topographic variants of persistent idiopathic facial pain or independent disorders remains a controversial issue.

  12. A prospective randomised control study: reduction of children's pain expectation using a picture book during blood withdrawal.

    Science.gov (United States)

    Zieger, B; Praskova, M; Busse, E; Barth, M

    2013-05-01

    Blood drawings are very painful and stressful for children. In a prospective control group study we investigated if using a picture book could reduce the children's pain expectation. In addition, the children's pain experience and the observed pain behaviour was monitored. Block-randomization were used and 120 children at the age of 6-12 years who were visiting the general pediatric and coagulation outpatient clinics were included in this study. Pain expectation and experience were assessed with the Face-Pain-Scale-Revised and the pain behavior with the Faces-Legs-Activity-Cry-Consolability Scale. Multivariate covariance analysis was used for data analysis. The results showed that with statistical controlling the influence of the primary pain expectation (baseline) the pain expectation before blood withdrawal was reduced significantly (p=0.001) and effectively (ES=0.56) using the picture book. Children who received no local anaesthesia reported that they felt less pain during blood drawing after reading the picture book. The few children with local anaesthesia reported no benefit from the picture book. The observed use of local anaesthesia was very heterogeneous. The results recommend the usage of this picture book in everyday practice, if the use of local anaesthesia could not be used in an appropriate way. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Effects of music therapy and distraction cards on pain relief during phlebotomy in children.

    Science.gov (United States)

    Aydin, Diler; Sahiner, Nejla Canbulat

    2017-02-01

    To investigate three different distraction methods (distraction cards, listening to music, and distraction cards + music) on pain and anxiety relief in children during phlebotomy. This study was a prospective, randomized, controlled trial. The sample consisted of children aged 7 to 12years who required blood tests. The children were randomized into four groups, distraction cards, music, distraction cards + music, and controls. Data were obtained through face-to-face interviews with the children, their parents, and the observer before and after the procedure. The children's pain levels were assessed and reported by the parents and observers, and the children themselves who self-reported using Wong-Baker FACES. The children's anxiety levels were also assessed using the Children's Fear Scale. Two hundred children (mean age: 9.01±2.35years) were included. No difference was found between the groups in the self, parent, and observer reported procedural pain levels (p=0.72, p=0.23, p=0.15, respectively). Furthermore, no significant differences were observed between groups in procedural child anxiety levels according to the parents and observer (p=0.092, p=0.096, respectively). Pain and anxiety relief was seen in all three methods during phlebotomy; however, no statistically significant difference was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Pain in older adults should not be seen as part of ageing.

    Science.gov (United States)

    Cann, Paul

    2008-12-01

    A life in pain is something no one should have to face but a new report from Help the Aged shows how many older people are doing just that. Giving dignified, high quality care should be the first priority of all working in the care sector. The role pain management plays in delivering this goal is essential.

  15. El semanario popular ilustrado Caras y Caretas y las transformaciones del paisaje cultural de la modernidad Buenos Aires 1898-1908

    OpenAIRE

    Szir, Sandra M

    2016-01-01

    Esta tesis se propone estudiar el surgimiento de la prensa periódica ilustrada de carácter masivo e indagar sus efectos en el proceso de masificación de la cultura visual de la Argentina de fines del siglo XIX y comienzos del XX a través del caso del semanario Caras y Caretas. El periódico más celebrado de su tipo, fue a partir de su aparición en Buenos Aires el 8 de octubre de 1898, el primero que utilizó en forma sostenida los procesos de reproducción...

  16. Validity and Reliability of the Turkish Chronic Pain Acceptance Questionnaire

    Directory of Open Access Journals (Sweden)

    Hazel Ekin Akmaz

    2018-05-01

    Full Text Available Background: Pain acceptance is the process of giving up the struggle with pain and learning to live a worthwhile life despite it. In assessing patients with chronic pain in Turkey, making a diagnosis and tracking the effectiveness of treatment is done with scales that have been translated into Turkish. However, there is as yet no valid and reliable scale in Turkish to assess the acceptance of pain. Aims: To validate a Turkish version of the Chronic Pain Acceptance Questionnaire developed by McCracken and colleagues. Study Design: Methodological and cross sectional study. Methods: A simple randomized sampling method was used in selecting the study sample. The sample was composed of 201 patients, more than 10 times the number of items examined for validity and reliability in the study, which totaled 20. A patient identification form, the Chronic Pain Acceptance Questionnaire, and the Brief Pain Inventory were used to collect data. Data were collected by face-to-face interviews. In the validity testing, the content validity index was used to evaluate linguistic equivalence, content validity, construct validity, and expert views. In reliability testing of the scale, Cronbach’s α coefficient was calculated, and item analysis and split-test reliability methods were used. Principal component analysis and varimax rotation were used in factor analysis and to examine factor structure for construct concept validity. Results: The item analysis established that the scale, all items, and item-total correlations were satisfactory. The mean total score of the scale was 21.78. The internal consistency coefficient was 0.94, and the correlation between the two halves of the scale was 0.89. Conclusion: The Chronic Pain Acceptance Questionnaire, which is intended to be used in Turkey upon confirmation of its validity and reliability, is an evaluation instrument with sufficient validity and reliability, and it can be reliably used to examine patients’ acceptance

  17. The Placebo Response in Pediatric Abdominal Pain-Related Functional Gastrointestinal Disorders: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Hoekman, Daniël R; Zeevenhooven, Judith; van Etten-Jamaludin, Faridi S; Douwes Dekker, Iuke; Benninga, Marc A; Tabbers, Merit M; Vlieger, Arine M

    2017-03-01

    To investigate the magnitude and determinants of the placebo response in studies with pediatric abdominal pain-related functional gastrointestinal disorders. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and CINAHL were searched for systematic reviews and randomized placebo-controlled trials concerning children 4-18 years of age with an abdominal pain-related functional gastrointestinal disorder. The primary outcome was the pooled proportion of subjects assigned to placebo with improvement as defined by the authors. The effect of trial characteristics on the magnitude of the placebo response was investigated using univariate meta-regression analysis. Twenty-one trials were identified. The pooled proportion of subjects with improvement was 41% (95% CI, 34%-49%; 17 studies) and with no pain was 17% (95% CI, 8%-32%; 7 studies). The pooled standardized mean difference on the Faces Pain Scales compared with baseline was -0.73 (95% CI, -1.04 to -0.42; 8 studies). There was significant heterogeneity across studies with respect to both outcomes. Lower dosing frequency (P = .04), positive study (P = .03), longer duration of treatment (P pain. Response on Faces Pain Scales was greater in studies conducted in the Middle East (P = .002), in studies that did not report the randomization schedule (P = .02), and in studies with a higher percentage of females (P = .04). Approximately 41% of children with abdominal pain-related functional gastrointestinal disorders improve on placebo. Several trial characteristics are correlated significantly with the proportion of patients with no pain on placebo and with the magnitude of the placebo response on Faces Pain Scales. These data could be valuable for the design of future studies. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Vivências de mulheres à dor no infarto do miocárdio Vivencias de mujeres frente al dolor en el infarto del miocardio Experiences of women in face of pain from acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Fernanda Carneiro Mussi

    2006-06-01

    to understand the meanings of the experience of pain suffered by women during acute myocardial infarction (AMI and to identify their immediate actions in face of pain. This qualitative research used the Symbolic Interactionism theory and the Grounded Theory methodology. Forty-three wo-men were interviewed at the University Hospital. The central category expressing the pain experience was that it was "a break with day-to-day life". The categories that expressed such break revealed that in face of increasing pain those women felt dominated and afraid of dying because they had lost control over their bodies and their lives. They did not recognize the occurrence of AMI and at first resisted to look for assistance by attempting to alleviate the pain. In face of the unbearable pain and their impotence to control it, they asked for God's salvation and help from surrounding people and finally resorted to medical assistance.

  19. Tailored Web-Based Interventions for Pain: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Martorella, Geraldine; Boitor, Madalina; Berube, Melanie; Fredericks, Suzanne; Le May, Sylvie; Gélinas, Céline

    2017-11-10

    Efforts have multiplied in the past decade to underline the importance of pain management. For both acute and chronic pain management, various barriers generate considerable treatment accessibility issues, thereby providing an opportunity for alternative intervention formats to be implemented. Several systematic reviews on Web-based interventions with a large emphasis on chronic pain and cognitive behavioral therapy have been recently conducted to explore the influence of these interventions on pain management However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated. The primary aim of this systematic review was to answer the following research question: What is the effect of tailored Web-based pain management interventions for adults on pain intensity compared with usual care, face-to-face interventions, and standardized Web-based interventions? A secondary aim was to examine the effects of these interventions on physical and psychological functions. We conducted a systematic review of articles published from January 2000 to December 2015. We used the DerSimonian-Laird random effects models with 95% confidence intervals to calculate effect estimates for all analyses. We calculated standardized mean differences from extracted means and standard deviations, as outcome variables were measured on different continuous scales. We evaluated 5 different outcomes: pain intensity (primary outcome), pain-related disability, anxiety, depression, and pain catastrophizing. We assessed effects according to 3 time intervals: short term (Web-based intervention showed benefits immediately after, with small effect sizes (Web-based interventions did not prove to be more efficacious than standardized Web-based interventions in terms of pain intensity, pain-related disability, anxiety, and depression. An interesting finding was that some efficacy was shown on pain

  20. Violencia en la pareja, las caras del fenómeno

    Directory of Open Access Journals (Sweden)

    Luz Elena Ocampo Otálvaro

    2011-01-01

    Full Text Available Este trabajo pretende mostrar las diversas caras o facetas del fenómeno de la violencia en la pareja, el mismo que en la literatura es conocido como violencia conyugal, violencia doméstica, violencia por parte del compañero íntimo, etc. Se identifica como un problema de salud pública, debido a los altos costos que genera y la manera como lesiona la vida cotidiana de quienes lo padecen. Se manifiesta en el seno de las relaciones de pareja, e irradia hacia los diversos ámbitos de interacción de los actores: mujer, varón, niño, niña. Involucra a todo el grupo o los grupos familiares de quienes lo viven, y puede lesionar de forma severa a los mismos. Se revisan aspectos del fenómeno, como el hecho que no sólo se presenta en las relaciones en las que la pareja tenga una unión de hecho, sino también en parejas de novios. No solo afecta a las mujeres o a las niñas; también afecta a los hombres. Tampoco es exclusivo de las parejas heterosexuales; los estudios muestran que entre parejas del mismo sexo también está presente. Se trata entonces de un fenómeno universal, multicausal, multidimensional, de salud y de tipo legal, que genera consecuencias que incluyen desde un problema de autoestima, de ansiedad, de depresión, de estrés hasta la muerte misma.

  1. Use, perceived effectiveness, and gender differences of pain relief strategies among the community-dwelling elderly in Taiwan.

    Science.gov (United States)

    Yu, Hsing-Yi; Tang, Fu-In; Yeh, Ming-Chen; Kuo, Benjamin Ing-Tiau; Yu, Shu

    2011-03-01

    Pain is a common problem among the elderly. The entire scope of chronic pain relief strategies used by community elderly is still unclear. A limited number of studies have investigated this issue from diverse culture perspectives. In the present study, we investigated the use and perceived effectiveness of pain relief strategies adopted by the elderly; gender differences between frequently used relief strategies were also explored. Two hundred nineteen participants living in Taiwan City, Taiwan, were recruited by a random sampling method and interviewed face to face. The prevalence of chronic pain among the elderly was 42.0% (n = 92). The elderly tended to adopt multiple strategies (mean ± SD = 9.08 ± 3.56; range = 2-18) to relieve their chronic pain. In three domains of pain relief strategies, conventional medicine was used more frequently than complementary and alternative medicine and psychologic approaches. Most pain relief strategies were ineffective. Among the 22 strategies used, no strategy was reported as "much improved" by a majority of users. The top five pain relief strategies used by men and women were the same. Elderly women tended to adopt more psychologic approaches, such as acceptance and ignoring to relieve pain, than men. The findings suggest that nurses should pay more attention to the issue of chronic pain relief and provide the elderly with more effective pain relief strategies. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  2. A 35-year trend analysis for back pain in Austria: the role of obesity.

    Science.gov (United States)

    Großschädl, Franziska; Freidl, Wolfgang; Rásky, Eva; Burkert, Nathalie; Muckenhuber, Johanna; Stronegger, Willibald J

    2014-01-01

    The prevalence of back pain is constantly increasing and a public health problem of high priority. In Austria there is a lack of empirical evidence for the development of back pain and its related factors. The present study aims to investigate trends in the prevalence of back pain across different subpopulations (sex, age, obesity). A secondary data analysis based on five nationally representative cross-sectional health surveys (1973-2007) was carried out. Face-to-face interviews were conducted in private homes in Austria. Subjects aged 20 years and older were included in the study sample (n = 178,818). Obesity was defined as BMI≥30 kg/m2 and adjusted for self-report bias. Back pain was measured as the self-reported presence of the disorder. The age-standardized prevalence of back pain was 32.9% in 2007; it was higher among women than men (pAustria and can be used to plan controlled promotion programs. Further monitoring is recommended in order to control risk groups and plan target group-specific prevention strategies. In Austria particular emphasis should be on obese individuals. We recommend conducting prospective studies to confirm our results and investigate causal relationships.

  3. POTENTIAL USE OF MELATONIN IN PROCEDURAL ANXIETY AND PAIN IN CHILDREN UNDERGOING BLOOD WITHDRAWAL.

    Science.gov (United States)

    Marseglia, L; Manti, S; D'Angelo, G; Arrigo, T; Cuppari, C; Salpietro, C; Gitto, E

    2015-01-01

    The recognition of the value of pain, especially in the pediatric population, has increased over the last decade. It is known that pain-related anxiety can increase perceived pain intensity. There are several different approaches to the treatment of pre-procedural anxiety and procedural pain in children. Melatonin, a neurohormone with the profile of a novel hypnotic-anaesthetic agent, plays an important role in anxiolysis and analgesia. This study investigated the effects of oral melatonin premedication to reduce anxiety and pain in children having blood samples taken. The investigations were carried out on 60 children, aged 1-14 years, divided into 2 equal groups. Using a computer-generated randomization schedule, patients were given either melatonin orally (0.5 mg/kg BW, max 5 mg) or placebo 30 min before blood draw. Pre-procedural anxiety was assessed using the scale from the Children’s Anxiety and Pain Scales, while procedural pain used the Face, Legs, Activity, Cry and Consolability assessment tool for children under the age of 3 years, Faces Pain Scale-Revised for children aged 3-8 years and Numeric Rating Scale for children over the age of 8 years. Oral administration of melatonin before the blood withdrawal procedure significantly reduced both anxiety (pchildren under 3 years and pchildren over 3 years). These data support the use of melatonin for taking blood samples due to its anxiolytic and analgesic properties. Further studies are needed to support the routine use of melatonin to alleviate anxiety and pain in pediatric patients having blood samples taken.

  4. The relationship between ethnicity and the pain experience of cancer patients: A systematic review

    Directory of Open Access Journals (Sweden)

    Wingfai Kwok

    2014-01-01

    Full Text Available Background: Cancer pain is a complex multidimensional construct. Physicians use a patient-centered approach for its effective management, placing a great emphasis on patient self-reported ratings of pain. In the literature, studies have shown that a patient′s ethnicity may influence the experience of pain as there are variations in pain outcomes among different ethnic groups. At present, little is known regarding the effect of ethnicity on the pain experience of cancer patients; currently, there are no systematic reviews examining this relationship. Materials and Methods: A systematic search of the literature in October 2013 using the keywords in Group 1 together with Group 2 and Group 3 was conducted in five online databases (1 Medline (1946-2013, (2 Embase (1980-2012, (3 The Cochrane Library, (4 Pubmed, and (5 Psycinfo (1806-2013. The search returned 684 studies. Following screening by inclusion and exclusion criteria, the full text was retrieved for quality assessment. In total, 11 studies were identified for this review. The keywords used for the search were as follows: Group 1-Cancer; Group 2- Pain, Pain measurement, Analgesic, Analgesia; Group 3- Ethnicity, Ethnic Groups, Minority Groups, Migrant, Culture, Cultural background, Ethnic Background. Results: Two main themes were identified from the included quantitative and qualitative studies, and ethnic differences were found in: (1 The management of cancer pain and (2 The pain experience. Six studies showed that ethnic groups face barriers to pain treatment and one study did not. Three studies showed ethnic differences in symptom severity and one study showed no difference. Interestingly, two qualitative studies highlighted cultural differences in the perception of cancer pain as Asian patients tended to normalize pain compared to Western patients who engage in active health-seeking behavior. Conclusion: There is an evidence to suggest that the cancer pain experience is different between

  5. Improving School Nurse Pain Assessment Practices for Students With Intellectual Disability.

    Science.gov (United States)

    Quinn, Brenna L; Smolinski, Megan

    2017-01-01

    School nurses are afforded minimal resources related to assessing pain in students with intellectual disability (ID) and have called for continuing education. The purpose of this study was to measure the effectiveness of an education program regarding best practices for assessing pain in students with ID. Educational sessions were presented to 248 school nurses. Pre-, post-, and follow-up surveys measured (1) difficulty school nurses face when assessing pain, (2) knowledge and use of pain assessment methods, and (3) intent to change and actual changes to professional practices. Participants experienced less difficulty assessing pain following the educational program. Almost all participants intended to change pain assessment practices, but large caseloads limited new practice adoption. Policy makers must consider population size and acuity when determining school nurse staffing. Trainings and other resources should be made available to school nurses in order to make pain assessments for students with ID more thorough and efficient.

  6. Venezuela : Vargas : Centrale thermo-électrique de Tacoa dans les années 1980 : littoral caraïbe de Catia La Mar

    OpenAIRE

    Pouyllau , Michel

    1981-01-01

    La Centrale thermo-électrique de Tacoa (connue actuellement comme Complejo Generador Josefina Joaquina Sánchez de Tacoa) a été construite en plusieurs étapes sur le littoral caraïbe de Catia La Mar (quartier Arrecife). Elle participe à l'approvisionnement électrique du Littoral de l'Etat de Vargas (villes de La Guaira, Maiquetia) ainsi que, pour partie, de la capitale Caracas. L'image correspond à une extension réalisée à la fin des années 1970 par Electricidad de Caracas et la compagnie belg...

  7. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial

    OpenAIRE

    Akhtar, Muhammad Waseem; Karimi, Hossein; Gilani, Syed Amir

    2017-01-01

    Background & Objective: Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical thera...

  8. Orofacial neuropathic pain reduces spontaneous burrowing behavior in rats.

    Science.gov (United States)

    Deseure, K; Hans, G

    2018-07-01

    It was recently reported that spontaneous burrowing behavior is decreased after tibial nerve transection, spinal nerve transection and partial sciatic nerve ligation. It was proposed that spontaneous burrowing could be used as a measure of the impact of neuropathic pain after peripheral nerve injury. It has remained unclear whether the reduction in burrowing behavior is caused directly by pain or hypersensitivity in the affected limbs, making it more difficult to perform burrowing, or by a pain induced decrease in the general wellbeing, thus reducing the motivation to burrow. We studied burrowing behavior after infraorbital nerve injury, a model of orofacial neuropathic pain that does not affect the limbs. Burrowing behavior was significantly reduced after infraorbital nerve injury. Isolated face grooming and responsiveness to mechanical von Frey stimulation of the infraorbital nerve territory were significantly increased after infraorbital nerve injury, indicative, respectively, of spontaneous pain and mechanical allodynia. It is concluded that spontaneous burrowing may provide a measure of the global impact of pain on the animal's wellbeing after peripheral nerve injury and incorporation of this behavioral assay in preclinical drug testing may improve the predictive validity of currently used pain models. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Orofacial pain and symptoms of temporomandibular disorders in Finnish and Thai populations.

    Science.gov (United States)

    Sipilä, Kirsi; Tolvanen, Mimmi; Mitrirattanakul, Somsak; Sitthisomwong, Panupen; Järvelin, Marjo-Riitta; Taanila, Anja; Anttonen, Vuokko; Lahti, Satu

    2015-07-01

    Cultural or ethnic factors may play an important role in subjects' pain reports. The aim of the study was to compare the prevalence of orofacial pain symptoms between Finnish and Thai populations. The Finnish study population comprised the Northern Finland Birth Cohort 1966, of which 5696 subjects participated in the present study. The Thai sample consisted of 1501 randomly selected people living in 10 different districts in Bangkok. Data on orofacial pain was collected based on questionnaires. After adjusting for age, gender and education, the logistic regression analysis showed that Thai subjects had an increased risk for reporting oral pain (OR = 4.5, 95% CI = 3.7-5.4), tooth pain (OR = 2.0, 95% CI = 1.8-2.4) and pain in the face (OR = 1.5, 95% CI = 1.2-1.7). It can be concluded that Thai people report more orofacial pain symptoms than Finnish subjects. Cross-cultural factors exist in the background of reporting pain symptoms in the oral and facial area.

  10. Prevalent musculoskeletal pain as a correlate of previous exposure to torture

    DEFF Research Database (Denmark)

    Olsen, Dorte Reff; Montgomery, Edith; Bojholm, S

    2006-01-01

    AIM: To research possible associations between previous exposure to specific torture techniques and prevalent pain in the head and face, back, and feet. METHODS: 221 refugees, 193 males and 28 females, previously exposed to torture in their home country, were subject to a clinical interview...... was general abuse of the whole body (OR 5.64, 95% CI 1.93-16.45). CONCLUSION: In spite of many factors being potentially co-responsible for prevalent pain, years after the torture took place it presents itself as strongly associated with specific loci of pain, with generalized effects, and with somatizing....

  11. Relationship among perceived stress, anxiety, depression and craniocervical pain in nursing professionals under stress at work

    OpenAIRE

    Pozzebon,Daniela; Piccin,Chaiane Facco; Silva,Ana Maria Toniolo da; Corrêa,Eliane Castilhos Rodrigues

    2016-01-01

    Abstract Introduction: The appearance and evolution of some clinical pain conditions may be influenced by stress and other psychosocial factors. Face, head and cervical muscles may increase their activity and tension in the presence of stress, leading to craniocervicomandibular pain in individuals exposed to stress. Objective: To assess the relationship among perceived stress, anxiety, depression and craniocervicomandibular pain in nursing professionals under stress at work. Materials and...

  12. Review of pain content in three-year preregistration pediatric nursing courses in the United Kingdom.

    Science.gov (United States)

    Twycross, Alison; Roderique, Lynda

    2013-12-01

    The results of several studies suggest that gaps remain in nurses' knowledge about pain in children, and particularly regarding pain assessment, analgesic drugs, and nondrug methods, suggesting a need to explore the pain content of preregistration nursing curricula. Over the past decade, the way nurse education is delivered has changed with the advent of the internet and the use of virtual learning environments. This study, therefore, explored the depth and breadth of pain content in 3-year preregistration pediatric nursing courses across the U.K. as well as ascertaining how this content is delivered. The leads for pediatric nursing at all 56 U.K. higher education institutions running the 3-year preregistration pediatric nursing course were e-mailed a questionnaire. Participants were asked to indicate whether topics are covered in the program, and if so how it was delivered. Results suggest that preregistration pediatric nursing courses in the U.K. do not always equip students to manage pain effectively in clinical practice. There appears to be limited content on pain in nursing curricula, with several institutions not covering key topics. Most teaching is delivered face to face with limited workbooks and virtual learning activities. Further research is needed in this area to ascertain the impact of this on the quality of care provided. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  13. Classificação morfofuncional dos dentes de saguis-de-tufo-branco (Callithrix jacchus, Callitrichidae, saguis-de-tufo-preto (C. penicillata e saguis-de-cara-branca (C. geoffroyi Morphofunctional classification of teeth of marmosets-tufted white (Callithrix jacchus, Callitrichidae, marmosets-tufted black (C. penicillata, and marmosets white-face (C. geoffroyi

    Directory of Open Access Journals (Sweden)

    Bruno Machado Bertassoli

    2013-09-01

    Full Text Available Realizou-se um estudo para analisar morfologicamente os dentes do saguis-de-tufo-branco (C. jacchus, saguis-de-tufo-preto (C. penicillata e saguis-de-cara-branca (C. geoffroyi, para compara-los entre si e com outras espécies já descritas na literatura. Utilizou-se dentes das três espécies para analises macroscópicas, microscópicas e ultraestrutural e os resultados correlacionados com os obtidos com outras espécies citadas na literatura. Chegou-se a conclusão de que: as três espécies apresentaram uma fórmula dentária idêntica, chegando a um total de 32 dentes, expressa na fórmula 2x: incisivos 2/2; caninos 1/1; pré-molares 3/3 e molares 2/2, estes são classificados como diplodontes, anelodontes, bunodontes, e braquiodontes.A study was conducted to analyze the morphology of the teeth of white-tufted-ear-marmoset (C. jacchus black-tufted-ear-marmoset (C. penicillata and marmosets-white-faced (C. geoffroyi, to compare them among themselves and with other species described in the literature. Teeth of the three species were submitted to macroscopic, microscopic and ultrastructural analyzes. The results were correlated with those of other species. We concluded that: the three species have a similar dental formula, reaching a total of 32 teeth, expressed in the formula 2x: incisors 2/2; canines 1/1, pre-molars 3/3 and molars 2/2, ich are classified as diplodont, anelodont, bunodont and brachyodont.

  14. New low back pain in nurses: work activities, work stress and sedentary lifestyle.

    Science.gov (United States)

    Yip, Vera Yin Bing

    2004-05-01

    Low back pain is common among nurses. Previous studies have shown that the risk of low back pain increases rapidly with greater amounts of physical work and psychological stress, but is inversely related to leisure activities. However, these previous studies were predominantly retrospective in design and not many took account of three factors simultaneously. This 12-month prospective study examined the relationships between work activities, work stress, sedentary lifestyle and new low back pain. A total of 144 nurses from six Hong Kong district hospitals completed a face-to-face baseline interview, which was followed-up by a telephone interview. The main study measures were demographic characteristics, work activities, work stress, physical leisure activities and the nature of new low back pain during the 12-month follow-up period. Level of work stress, quality of relationships at work, level of enjoyment experienced at work, and work satisfaction were self-reported. Fifty-six (38.9%) nurses reported experiencing new low back pain. Sedentary leisure time activity was not associated with new low back pain. Being comparatively new on a ward (adjusted relative risk 2.90), working in bending postures (adjusted relative risk 2.76) and poor work relationships with colleagues (adjusted relative risk 2.52) were independent predictors of new low back pain. The findings of this study suggest that low back pain is a common problem in the population of nurses in Hong Kong. Being comparatively new on a ward, bending frequently during work and having poor work relationships with colleagues are independent predictors of new low back pain. Training for high-risk work activities and ergonomic assessment of awkward work postures are essential. Moreover, relaxation and team-building workshops for nurses, especially those who are less experienced in the type of work on their current ward, are recommended.

  15. Influence of pilates mat and apparatus exercises on pain and balance of businesswomen with chronic low back pain.

    Science.gov (United States)

    Lee, Chae-Woo; Hyun, Ju; Kim, Seong Gil

    2014-04-01

    [Purpose] The purpose of this study was to examine the influence of mat Pilates and apparatus Pilates on pain and static balance of businesswomen with chronic back pain. [Subjects and Methods] Participants were randomly allocated to Pilates mat exercises (PME) or Pilates apparatus exercise (PAE), and performed the appropriate Pilates exercises 3 days per week for 8 weeks. In order to measure the improvement in the participants' static balance ability as a result of the exercise, the sway length and sway velocity of the subjects were measured before and after the experiment while the subjects stood on a Balance Performance Monitor (BPM) facing the front wall for 30 seconds with their eyes open. The visual analogue scale (VAS) was used to measure the degree of pain. [Results] The VAS score, sway length, and sway velocity of both groups decreased significantly after the experiment, but the PME group showed a greater decrease than the PAE group. [Conclusion] PME showed greater improvement in pain level and balance compared with PAE in this research. Since the subjects of this study were patients with low back pain, PME is assumed to have been more suitable and effective because it uses body weight to strengthen core muscles rather than heavier apparatuses as in PAE.

  16. ALTERNATIF CARA DETEKSI KANDUNGAN IODIUM PADA GARAM BERIODIUM DI PASAR

    Directory of Open Access Journals (Sweden)

    Yuniar Rosmalina

    2012-11-01

    Full Text Available Mengingat tingginya biaya yang diperlukan dalam menganalisa kandungan iodium pada garam secara laboratorium, serta pentingnya partisipasi masyarakat dalam penanggulangan masalah gangguan akibat kekurangan iodium, maka diperlukan teknologi sederhana untuk mendeteksi iodium pada garam iodium yang diperjualbelikan di pasar. Untuk itu telah dilakukan penelitian mengenai beberapa cara mendeteksi iodium pada garam menggunakan sumber karbohidrat dan sumber zat pereduksi, seperti Dioscorea Hispida Dennst (gadung, Manihot utilissima (singkong, atau Rubber seed (biji karet. Berdasarkan jenis dan jumlah campuran yang digunakan ada 6 formula yang diuji pada penelitian pendahuluan yaitu formula ICo, IICo, IC1, IIC1, ISo, dan IISo. Pada penelitian lanjutan, formula yang terpilih diuji menggunakan garam iodium yang dibeli dari pasar di Kodya Bogor. Hasil penelitian menunjukkan bahwa formula IICo dan IIC1 menggunakan perasan singkong atau gadung, serta formula IISo menggunakan parutan biji karet, dapat digunakan sebagai alat untuk mendeteksi kadar iodium pada garam beriodium. Formula IICo terdiri dari 4 ml perasan gadung atau singkong, dicampur dengan 45 g garam beriodium dan 8 ml asam cuka 25 persen. Formula IIC1 sama seperti formula IICo, tapi menggunakan gadung yang telah disimpan tiga minggu, dan singkong yang telah disimpan dua minggu. Formula IISo terdiri dari 7 gr parutan biji karet, ditambah dengan 45 g garam iodium dan 16 ml asam sitrat. Hasil penelitian lanjutan menunjukkan hanya 11.1 persen garam beriodium di Kodya Bogor mempunyai kandungan diatas 30 ppm, dan 88.9 persen dibawah 30 ppm. Garam beriodium yang mempunyai kandungan di atas 30 ppm akan menunjukkan warna biru atau ungu, dan yang mempunyai kandungan dibawah 30 ppm akan menunjukkan warna cokelat, warna biru yang tidak stabil atau tidak menunjukkan perubahan warna.

  17. DAMPAK NEGATIF PERKEMBANGAN TEKNOLOGI INFORMATIKA DAN KOMUNIKASI DAN CARA ANTISIFASINYA

    Directory of Open Access Journals (Sweden)

    I Gede Ratnaya

    2011-03-01

    Full Text Available Sampai saat ini perkembangan ilmu pengetahuan telah menghantarkan masyarakat menuju babak baru yaitu babak yang memanfaatkan peralatan-peralatan yang merupakan hasil dari teknologi. Penggunaan tenaga manusia yang semakin hari semakin kecil volumenya sering kali menyebabkan orang kehilangan pekerjaannya karena tugasnya telah tergantikan oleh peralatan atau mesin. Sebagai sarana penyampaian informasi dan komunikasi, komputer bisa dipakai sebagai sarana berinternetan. Lewat internet orang bisa mencari bermacam-macam informasi dan berkomunikasi. Peran yang dapat diberikan oleh aplikasi teknologi informasi ini adalah mendapatkan informasi untuk kehidupan pribadi seperti informasi tentang kesehatan, hobi, rekreasi, dan rohani. Selain memberikan keuntungan, ternyata peralatan teknologi informasi dan komunikasi juga memberikan dampak negatif bagi penggunanya. Dampak negatif tersebut muncul sebagai akibat dari penggunaan yang salah atau tidak bertanggung jawab dari yang menggunakan. Beberapa dampak negatif tersebut adalah 1. Anak lebih banyak menghabiskan waktu menonton TV ketimbang melakukan hal lainnya (seperti belajar dan olah raga, 2. Anak kehilangan kemampuan berbaur dengan masyarakat dan cenderung nyaman dengan kehidupan online, 3 Adanya pelanggaran hak cipta, 4.  Kejahatan di internet, 5. Penyebaran virus komputer, dan 6. Pornografi, perjudian, penipuan, tayangan kekerasan. Adapun cara mengatasi dampak-dampak negatif tersebut adalah : 1. Gunakan teknologi untuk menjalin hubungan dengan orang yang sudah dikenal, 2. Cari komunitas positif  yang sering melakukan pertemuan didunia nyata, 3. Perlunya penegakkan hukum yang berlaku dengan dibentuknya polisi internet, 4. Menghindari pemakaian telepon seluler yang berfitur canggih oleh anak-anak dibawah umur dan lebih mengawasi penggunaan telepon seluler, 5. Perbanyak membaca buku-buku yang bersifat edukatif dan bersifat keimanan serta aplikasi komputer yang bersifat mendidik, dan 6. Perlunya pengaturan

  18. Perinatal maternal stress and serotonin signaling: effects on pain sensitivity in offspring.

    Science.gov (United States)

    Knaepen, Liesbeth; Pawluski, Jodi L; Patijn, Jacob; van Kleef, Maarten; Tibboel, Dick; Joosten, Elbert A

    2014-07-01

    It has been estimated that 20% of pregnant women are facing perinatal stress and depression. Perinatal maternal stress has been shown to increase pain sensitivity in offspring. For the treatment of their depressive symptoms, pregnant women are frequently prescribed selective serotonin reuptake inhibitors (SSRIs). Since the descending pain inhibitory circuit matures perinatally, perinatal SSRI exposure has been shown to affect pain sensitivity in offspring. In the present review, we summarize experimental and clinical evidence for the effect of perinatal maternal stress and SSRI exposure on pain sensitivity in offspring. Both experimental and clinical studies show the effect of perinatal maternal stress on regulation of the hypothalamic-pituitary-adrenal (HPA) system and the serotonin pain inhibitory system. Alterations in these two systems likely underlie long-term alterations in the development of pain sensitivity. This review sheds light on the effect of perinatal maternal stress and treatment with SSRIs on offspring pain sensitivity, in relation to the developing HPA system and 5-HT signaling. © 2013 Wiley Periodicals, Inc.

  19. Automated detection of pain from facial expressions: a rule-based approach using AAM

    Science.gov (United States)

    Chen, Zhanli; Ansari, Rashid; Wilkie, Diana J.

    2012-02-01

    In this paper, we examine the problem of using video analysis to assess pain, an important problem especially for critically ill, non-communicative patients, and people with dementia. We propose and evaluate an automated method to detect the presence of pain manifested in patient videos using a unique and large collection of cancer patient videos captured in patient homes. The method is based on detecting pain-related facial action units defined in the Facial Action Coding System (FACS) that is widely used for objective assessment in pain analysis. In our research, a person-specific Active Appearance Model (AAM) based on Project-Out Inverse Compositional Method is trained for each patient individually for the modeling purpose. A flexible representation of the shape model is used in a rule-based method that is better suited than the more commonly used classifier-based methods for application to the cancer patient videos in which pain-related facial actions occur infrequently and more subtly. The rule-based method relies on the feature points that provide facial action cues and is extracted from the shape vertices of AAM, which have a natural correspondence to face muscular movement. In this paper, we investigate the detection of a commonly used set of pain-related action units in both the upper and lower face. Our detection results show good agreement with the results obtained by three trained FACS coders who independently reviewed and scored the action units in the cancer patient videos.

  20. A modified Delphi survey on the signs and symptoms of low back pain: indicators for an interventional management approach.

    Science.gov (United States)

    Cid, José; De La Calle, José L; López, Esther; Del Pozo, Cristina; Perucho, Alfredo; Acedo, María Soledad; Bedmar, Dolores; Benito, Javier; De Andrés, Javier; Díaz, Susana; García, Juan Antonio; Gómez-Caro, Leticia; Gracia, Adolfo; Hernández, José María; Insausti, Joaquín; Madariaga, María; Moñino, Pedro; Ruiz, Manuel; Uriarte, Estrella; Vidal, Alfonso

    2015-01-01

    Low back pain (LBP) symptoms and signs are nonspecific. If required, diagnostic blocks may find the source of pain, but indicators of suspect diagnosis must be defined to identify anatomical targets. To reach a consensus from an expert panel on the indicators for the most common causes of LBP. A 3-round (2 telematic and 1 face-to-face) modified Delphi survey with a questionnaire on 78 evidence-based indicators of 7 LBP etiologies was completed by 23 experts. 98.7% of the questionnaire was consensuated. The most accepted indicators were for zygapophysial joint pain, painful ipsilateral paravertebral palpation, worsening with trunk extension, paravertebral musculature spasm on the affected articulation, and referred pain above the knee, without radicular pattern. For sacroiliac joint pain, unilateral pain when seating, with at least 3 described provoking tests: Approximation; gapping; Patrick's; Gaenslen's; thigh thrust; Fortin finger; and Gillet's tests. For discogenic pain, midline pain that may be provoked by pressure on the spinal processes at the affected level; for quadratus lumborum muscle, painful palpation on both the L1 level paravertebral region, referred to iliac crest, and the iliac crest, referred to greater trochanter. For iliopsoas muscle, pain elicited by thigh flexion, referred to buttock, inguinal region, and anterior thigh. For pyramidal muscle, pain while sitting on the affected side and positive Freiberg's test. For radicular pain, paresthesias and positive Lassègue's test at 60°. Seventy-seven diagnostic suspect indicators of LBP conditions were consensuated. These may facilitate conservative or interventional pain management decision-making. © 2013 World Institute of Pain.

  1. Effects of Distant Reiki On Pain, Anxiety and Fatigue in Oncology Patients in Turkey: A Pilot Study.

    Science.gov (United States)

    Demir, Melike; Can, Gulbeyaz; Kelam, Ayhan; Aydıner, Aydın

    2015-01-01

    Fatigue, stress and pain are common symptoms among cancer patients, affecting the quality of life. The purpose of the present study was to determine the effect of distant Reiki on pain, anxiety and fatigue in oncology patients. Participants in the control group received usual medical and nursing care during their stay. The intervention group received usual care plus five distant Reiki sessions, one each night for 30 min. A face to face interview was performed and patient personal and illness related characteristics were evaluated using the Patient Characteristics form. Pain, stress and fatigue were evaluated according to a numeric rating scale. The experimental group was predominantly composed of women (71.4%), married individuals (40%), and primary school graduates (40%). The control group was predominantly male (72.7%), married (60%), and primary school graduates (60%). The control group demonstrated greater levels of pain (p=0.002), stress (p=0.001) and fatigue (p=0.001). The Reiki group pain score (pReiki may decreasepain, anxiety and fatigue in oncology patients.

  2. The revised FLACC score: Reliability and validation for pain assessment in children with cerebral palsy

    DEFF Research Database (Denmark)

    Pedersen, Line Kjeldgaard; Rahbek, Ole; Nikolajsen, Lone

    2015-01-01

    AbstractBackground and aims Pain in children with cerebral palsy (CP) is difficult to assess and is therefore not sufficiently recognized and treated. Children with severe cognitive impairments have an increased risk of neglected postoperative, procedural and chronic pain resulting in decreased...... quality of life. The r-FLACC (revised Face, Legs, Activity, Cry and Consolability) pain score is an internationally acclaimed tool for assessing pain in children with CP because of its ease to use and its use of core pain behaviours. In addition the r-FLACC pain score may be superior to other pain...... of the r-FLACC pain score for use in Danish children with CP. Methods Twenty-seven children aged 3–15 years old with CP were included after orthopaedic surgery. Two methods for assessment of postoperative pain were used. Pain intensity was assessed by r-FLACC, with a 2 min standardized video recording...

  3. Laparoscopy in unexplained abdominal pain: surgeon's perspective

    International Nuclear Information System (INIS)

    Abdullah, M.T.; Waqar, S.H.; Zahid, M.A.

    2016-01-01

    Unexplained abdominal pain is a common but difficult presenting feature faced by the clinicians. Such patients can undergo a number of investigations with failure to reach any diagnosis. The objective of this study was to evaluate the use of laparoscopy in the diagnosis and management of patients with unexplained abdominal pain. Methods: This cross-sectional study was conducted at Pakistan Institute of Medical Sciences Islamabad from January 2009 to December 2013. This study included 91 patients of unexplained abdominal pain not diagnosed by routine clinical examination and investigations. These patients were subjected to diagnostic laparoscopy for evaluation of their conditions and to confirm the diagnosis. These patients presented 43% of patients undergoing investigations for abdominal pain. Patients diagnosed with gynaecological problems were excluded to see surgeon's perspective. The findings and the outcomes of the laparoscopy were recorded and data was analyzed. Results: Unexplained abdominal pain is common in females than in males. The most common laparoscopic findings were abdominal tuberculosis followed by appendicitis. Ninety percent patients achieved pain relief after laparoscopic intervention. Conclusion: Laparoscopy is both beneficial and safe in majority of patients with unexplained abdominal pain. General surgeons should acquire training and experience in laparoscopic surgery to provide maximum benefit to these difficult patients. (author)

  4. A prospective intra-individual evaluation of silk compared to Biobrane for the treatment of superficial burns of the hand and face.

    Science.gov (United States)

    Schiefer, Jennifer Lynn; Arens, Elena; Grigutsch, Daniel; Rath, Rebekka; Hoffmann, Alexandra; Fuchs, Paul Christian; Schulz, Alexandra

    2017-05-01

    An ever-increasing number of commercially available dressings have been applied to treat superficial burns with the aim to reduce pain and inflammation and lead to a fast wound healing and scar reduction. Nevertheless the search for cheap and effective wound dressing proceeds. Dressilk ® consisting of silkworm silk showed good results for wound healing in regards to scarring, biocompatibility and reduction of inflammation and pain. Therefore it seemed to be an interesting product for the treatment of superficial burns. In a prospective intra-individual study the healing of superficial burns was evaluated after the treatment with Dressilk ® and Biobrane ® in 30 patients with burns of the hand and face. During wound healing pain, active bleeding, exudation, dressing change and inflammation were evaluated using the Verbal Rating Scale 1-10. Three months later scar appearance was assessed by VSS (Vancouver Scar Scale) and POSAS (Patient and Observer Scar Scale). With regard to re-epithelialization, pain, inflammation and acute bleeding both dressings were equivalent. High subjective satisfaction rates were reported for both Dressilk ® and Biobrane ® dressings in regard to comfort and mobility of the face. Biobrane ® , applied as a glove was subjectively preferred for burns of the hand. Regarding their cost efficiency Dressilk ® was clearly superior to Biobrane ® . Long-term results were similar. The "ideal" wound dressing maximizes patients' comfort while reducing pain and promoting wound healing. Dressilk ® and Biobrane ® both provided an effective and safe healing environment, showing low overall complication rates with respect to infection and exudation on superficial burns of the hand and face. Therefore Dressilk ® , being clearly superior to Biobrane ® in cost efficiency is an interesting alternative especially for the treatment of superficial burns of faces. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  5. Diffuse optical tomography activation in the somatosensory cortex: specific activation by painful vs. non-painful thermal stimuli.

    Directory of Open Access Journals (Sweden)

    Lino Becerra

    2009-11-01

    Full Text Available Pain is difficult to assess due to the subjective nature of self-reporting. The lack of objective measures of pain has hampered the development of new treatments as well as the evaluation of current ones. Functional MRI studies of pain have begun to delineate potential brain response signatures that could be used as objective read-outs of pain. Using Diffuse Optical Tomography (DOT, we have shown in the past a distinct DOT signal over the somatosensory cortex to a noxious heat stimulus that could be distinguished from the signal elicited by innocuous mechanical stimuli. Here we further our findings by studying the response to thermal innocuous and noxious stimuli.Innocuous and noxious thermal stimuli were applied to the skin of the face of the first division (ophthalmic of the trigeminal nerve in healthy volunteers (N = 6. Stimuli temperatures were adjusted for each subject to evoke warm (equivalent to a 3/10 and painful hot (7/10 sensations in a verbal rating scale (0/10 = no/max pain. A set of 26 stimuli (5 sec each was applied for each temperature with inter-stimulus intervals varied between 8 and 15 sec using a Peltier thermode. A DOT system was used to capture cortical responses on both sides of the head over the primary somatosensory cortical region (S1. For the innocuous stimuli, group results indicated mainly activation on the contralateral side with a weak ipsilateral response. For the noxious stimuli, bilateral activation was observed with comparable amplitudes on both sides. Furthermore, noxious stimuli produced a temporal biphasic response while innocuous stimuli produced a monophasic response.These results are in accordance with fMRI and our other DOT studies of innocuous mechanical and noxious heat stimuli. The data indicate the differentiation of DOT cortical responses for pain vs. innocuous stimuli that may be useful in assessing objectively acute pain.

  6. Conformado por vía coloidal de recubrimientos en la cara interna de un tubo de acero

    Directory of Open Access Journals (Sweden)

    Ferrari, B.

    2004-04-01

    Full Text Available The development of new coating processes has important limitations related to the films thickness and the geometry of the coating substrates. In this work, two colloidal forming processes are proposed for manufacturing ceramic and metallic coatings on the inner surface of a steel pipe. Ceramic coatings of CaCO3 have been formed by electrophoretic deposition (EPD. Aqueous stable suspensions were prepared and a electrophoretic cell was designed, in which the steel tube to be coated acted simultaneously as container and working electrode. Nickel films were prepared by filling the pipe with the suspension and rotating to fully wet the steel surface. Nickel suspensions were formulated focusing an improved wettability and adherence to the steel surface by using binders. From these processes, ceramic and metallic coatings with 300- 350 μm in thickness, homogeneous and strongly adhered to the inner surface of the steel pipe have been obtained.

    El desarrollo de las tecnologías de fabricación de recubrimientos presenta importantes limitaciones relativas a los espesores de las capas fabricadas y a la geometría de los substratos a recubrir. En este trabajo se proponen dos procesos de conformado coloidal de revestimientos cerámicos y metálicos en la cara interna de un tubo de acero. El revestimiento cerámico (CaCO3 se ha conformado por deposición electroforética (EPD. Para ello se han preparado suspensiones estables de CaCO3 en agua, y se ha diseñado una célula electroforética en la que el tubo es a la vez el contenedor y el electrodo de trabajo. El revestimiento metálico (níquel se ha fabricado por vertido de una suspensión estable sobre el propio tubo de acero. Para ello se han acondicionado las suspensiones con el objetivo de mejorar el mojado y la adherencia sobre el acero. A partir de los procesos de EPD y vertido se han obtenido revestimientos cerámicos y metálicos, respectivamente, con espesores de 300-350 μm, homogéneos y

  7. Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents.

    Science.gov (United States)

    Fisher, Emma; Law, Emily; Palermo, Tonya M; Eccleston, Christopher

    2015-03-23

    Chronic pain is common during childhood and adolescence and is associated with negative outcomes such as increased severity of pain, reduced function (e.g. missing school), and low mood (e.g. high levels of depression and anxiety). Psychological therapies, traditionally delivered face-to-face with a therapist, are efficacious at reducing pain intensity and disability. However, new and innovative technology is being used to deliver these psychological therapies remotely, meaning barriers to access to treatment such as distance and cost can be removed or reduced. Therapies delivered with technological devices, such as the Internet, computer-based programmes, smartphone applications, or via the telephone, can be used to deliver treatment to children and adolescents with chronic pain. To determine the efficacy of psychological therapies delivered remotely compared to waiting-list, treatment-as-usual, or active control treatments, for the management of chronic pain in children and adolescents. We searched four databases (CENTRAL, MEDLINE, EMBASE, and PsycINFO) from inception to June 2014 for randomised controlled trials of remotely delivered psychological interventions for children and adolescents (0 to 18 years of age) with chronic pain. We searched for chronic pain conditions including, but not exclusive to, headache, recurrent abdominal pain, musculoskeletal pain, and neuropathic pain. We also searched online trial registries for potential trials. A citation and reference search for all included studies was conducted. All included studies were randomised controlled trials that investigated the efficacy of a psychological therapy delivered remotely via the Internet, smartphone device, computer-based programme, audiotapes, or over the phone in comparison to an active, treatment-as-usual, or waiting-list control. We considered blended treatments, which used a combination of technology and face-to-face interaction. We excluded interventions solely delivered face-to-face

  8. Widespread pain: is an improved classification possible?

    Science.gov (United States)

    MacFarlane, G J; Croft, P R; Schollum, J; Silman, A J

    1996-09-01

    The classification of widespread pain, proposed by the American College of Rheumatology (ACR) for use in the clinic as a screen for fibromyalgia, as described, does not require truly widespread pain. Studies considering the epidemiology of widespread pain per se may therefore require a definition with greater face validity, which might also show enhanced associations with other physical and psychological measures. We aimed to develop a more coherent definition of widespread pain for use in epidemiological studies and to compare performance in identifying individuals with significant morbidity. A group of 172 subjects who had participated in a community based study on the occurrence of pain were identified and categorized by their pain experience as indicated on line drawings of the body according to ACR definition and to a new, more stringent definition that required the presence of more diffuse limb pain. A number of other clinical and psychological measures were recorded for these individuals and the association between their pain status measures and these other variables was assessed and compared. Persons satisfying the newly proposed definition for chronic widespread pain, in comparison with those who satisfied only the present ACR definition, had a significantly higher score on the General Health Questionnaire [median difference (MD) 7.95% CI 1.13], a higher score on the Health and Fatigue Questionnaire (MD 10.95% CI 0.15), and greater problems with sleep (sleep problem score MD 4.95% CI 0.9). Those satisfying the new definition also had a greater number of tender points on examination (MD 3.95% CI -1.7). The morbidity of those satisfying only the present ACR definition was closer to persons who had regional pain. A redefinition of widespread pain has produced a group of subjects whose pain is (a) likely to be more "widespread" and (b) is associated more strongly with factors such as psychological disturbance, fatigue, sleep problems, and tender points, and

  9. Attentional Bias to Threat-Related Information Among Individuals With Dental Complaints: The Role of Pain Expectancy.

    Science.gov (United States)

    Dehghani, Mohsen; Mohammadi, Somayyeh; Sharpe, Louise; Khatibi, Ali

    2018-01-01

    Expecting pain can be perceived as a threat may involve recruitment of cognitive strategies (such as attentional avoidance) which might help the person to reduce distress. The ecological validity of the paradigms aiming to study the attentional biases toward or away from threatening stimuli by manipulating the perception of threat in experimental settings has been questioned. Therefore, the current study aims to investigate the attentional bias toward or away from the threat when a confrontation with a real threatening and painful condition would be expected (i.e., dental treatment). One hundred and twenty-seven patients referred to three dentistry clinics for a dental treatment (experiment participants) and 30 individuals with no dental complaints (control participants) completed this study. Patients were randomly allocated to a high pain expectancy (HPE: n = 65) or a low pain expectancy (LPE: n = 62) expectancy condition. All participants completed questionnaires of distress, fear of pain, and fear of dental pain. Furthermore, they participated in a dot-probe task that assessed their attention to painful faces, dental pictures, and happy faces. In addition, before the treatment, participants reported their anticipated pain intensity and after the treatment, they reported the pain intensity that they perceived during the treatment using two separate visual analog scales. Patients in the HPE group showed a bias away from dental pictures compared to LPE and control group participants. HPE group patients also reported greater pain intensity during the treatment compared to LPE patients. Greater attentional bias away from dental pictures among HPE patients was associated with higher levels of fear of pain, fear of dental pain, and stress. Avoidance of highly salient threatening images can be seen as an unhelpful emotion-regulation strategy that individuals use to manage their fears. However, in this study, avoidance was associated with poorer outcomes.

  10. Attentional Bias to Threat-Related Information Among Individuals With Dental Complaints: The Role of Pain Expectancy

    Directory of Open Access Journals (Sweden)

    Mohsen Dehghani

    2018-05-01

    Full Text Available Expecting pain can be perceived as a threat may involve recruitment of cognitive strategies (such as attentional avoidance which might help the person to reduce distress. The ecological validity of the paradigms aiming to study the attentional biases toward or away from threatening stimuli by manipulating the perception of threat in experimental settings has been questioned. Therefore, the current study aims to investigate the attentional bias toward or away from the threat when a confrontation with a real threatening and painful condition would be expected (i.e., dental treatment. One hundred and twenty-seven patients referred to three dentistry clinics for a dental treatment (experiment participants and 30 individuals with no dental complaints (control participants completed this study. Patients were randomly allocated to a high pain expectancy (HPE: n = 65 or a low pain expectancy (LPE: n = 62 expectancy condition. All participants completed questionnaires of distress, fear of pain, and fear of dental pain. Furthermore, they participated in a dot-probe task that assessed their attention to painful faces, dental pictures, and happy faces. In addition, before the treatment, participants reported their anticipated pain intensity and after the treatment, they reported the pain intensity that they perceived during the treatment using two separate visual analog scales. Patients in the HPE group showed a bias away from dental pictures compared to LPE and control group participants. HPE group patients also reported greater pain intensity during the treatment compared to LPE patients. Greater attentional bias away from dental pictures among HPE patients was associated with higher levels of fear of pain, fear of dental pain, and stress. Avoidance of highly salient threatening images can be seen as an unhelpful emotion-regulation strategy that individuals use to manage their fears. However, in this study, avoidance was associated with poorer outcomes.

  11. A 35-year trend analysis for back pain in Austria: the role of obesity.

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    Franziska Großschädl

    Full Text Available The prevalence of back pain is constantly increasing and a public health problem of high priority. In Austria there is a lack of empirical evidence for the development of back pain and its related factors. The present study aims to investigate trends in the prevalence of back pain across different subpopulations (sex, age, obesity.A secondary data analysis based on five nationally representative cross-sectional health surveys (1973-2007 was carried out. Face-to-face interviews were conducted in private homes in Austria. Subjects aged 20 years and older were included in the study sample (n = 178,818. Obesity was defined as BMI≥30 kg/m2 and adjusted for self-report bias. Back pain was measured as the self-reported presence of the disorder.The age-standardized prevalence of back pain was 32.9% in 2007; it was higher among women than men (p<0.001, higher in older than younger subjects (p<0.001 and higher in obese than non-obese individuals (p<0.001. During the investigation period the absolute change in the prevalence of back pain was +19.4%. Among all subpopulations the prevalence steadily increased. Obese men showed the highest increase of and the greatest risk for back pain.These results help to understand the development of back pain in Austria and can be used to plan controlled promotion programs. Further monitoring is recommended in order to control risk groups and plan target group-specific prevention strategies. In Austria particular emphasis should be on obese individuals. We recommend conducting prospective studies to confirm our results and investigate causal relationships.

  12. PENGARUH KUALITAS POLA ASUH ORANG TUA, CARA BELAJAR, DAN MOTIVASI BELAJAR TERHADAP PRESTASI BELAJAR AKUNTANSI SISWA KELAS XI DAN XII KOMPETENSI KEAHLIAN AKUNTANSI SMK GATRA PRAJA KOTA PEKALONGAN TAHUN PELAJARAN 2013/2014

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    Eva Yulianti

    2014-11-01

    Full Text Available Prestasi belajar dipengaruhi oleh beberapa faktor, diantaranya yaitu kualitas pola asuh orang tua, cara belajar, dan motivasi belajar. Prestasi belajar akuntansi di SMK Gatra Praja Kota Pekalongan masih rendah. Masih ada 57 % siswa belum mencapai KKM yang ditetapkan sekolah yaitu ≥70. Tujuan penelitian ini untuk mengetahui adanya pengaruh kualitas pola asuh orang tua, cara belajar, dan motivasi belajar akuntansi di SMK Gatra Praja Kota Pekalongan baik secara parsial maupun simultan. Penelitian ini merupakan penelitian kuantitatif. Metode pengumpulan data menggunakan metode dokumentasi dan metode kuesioner. Metode analisis data menggunakan deskriptif persentase, regresi berganda, uji F, uji t, koefisien determinasi simultan(R2 dan koefisien determinasi parsial (r2. Hasil penelitian ini adalah secara parsial ada pengaruh kualitas pola asuh orang tua sebesar 16,2 %, cara belajar sebesar 6,4%, dan motivasi belajar sebesar 6,2% terhadap prestasi belajar akuntansi. Sedangkan secara simultan ada pengaruh kualitas pola asuh orang tua, cara belajar, dan motivasi belajar akuntansi di SMK Gatra Praja Kota Pekalongan tahun ajaran 2013/2014 sebesar 51,1%. Learning achievement is influenced by several factors, among which are quality of parents parenting, learning style, and learning motivation. Learning achievement of Accounting subjects in SMK Gatra Praja Pekalongan City is still low. There are still 57% students have not reached the KKM which has been established by the school is ≥70. The purpose of this study is to investigate the influence of quality of parents parenting, learning style, and learning motivation toward the learning achievement of Accounting subjects either partially or simultaneously. This research is quantitative research. Methods of data collection which are used are documentation and questionnaire method. Methods of data analysis using descriptive percentages, multiple regression, F test, t tes , and simultaneous determination

  13. NON INVASIVE PAIN MANAGEMENT IN POST PARTUM MOTHER WITHEVIDENCE BASED PRACTICE APPROACH

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    Nikmatur Rohmah

    2017-04-01

    Full Text Available Introduction: Pain is a sensation of discomfort that most post-partum mothers complain about, in the case of prolonged pain, the risk of post-partum blues is higher. The usage of evidence based practice method gives a bigger opportunity for nurse and medical attendants to think more critically in making decisions and in performing the appropriate treatment in accordance with the patient's problem and uniqueness. This research aimed to applicate management of non-invasive pain on post partum mother through the approach of evidence based practice. Method: This was a case-study, performed to client Mrs. A P1-1 A0 post sectio caesarea day 1 as there is an indication of suspect cepalo pelvis disproportion secondary arrest. Data were collected at maternity room, dr. Soebandi Regional General Hospital. Using interview, observation, and physical examination. Data analysis was conducted through a descriptive analysis. Result: Through a careful nursing, it is found out that pain location and spreading that generally spotted at the patient’s back during the contraction in the uterus, occurred around the shoulders when evidence-base practice is applied. The basic principle of applying an intervention to non invasive pain based on evidence–base practice are: cutaneous stimulation and distraction, while massaging area was set on the face, while the distraction media was interaction with the baby. Evaluation on evidence –based practice showed that pain is reduced to scale 2, while face and mobilitation become more relaxed. Discussion: Massage was intended to stimulated the production of endorphine and dinorphine that play an important roke to block the pain transmission through the descendent control system. Interaction with the baby was intended to function as a distraction media to dominate the incoming impuls into the ascendant control system,which further may close the gate of the pain transmitter. Both of the interventions were axpected to work

  14. WATER QUALITY ANALYSIS OF LOTIC ECOSYSTEMS OF NERA AND CARAS RIVERS CATCHMENTS USING BENTHIC INVERTEBRATES AS BIOINDICATORS

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    CLAUDIA PETRUCEAN

    2009-01-01

    Full Text Available The study of the two watersheds involved the collection of twenty-four benthic samples from the main tributaries of Nera and Caras rivers, but also from the Nera river. The samples were collected in august 2009 with a benthic net, which had the mesh size of 250 μm, by disturbing the substrate upstream for three minutes, being thus qualitative samples. The next stage, working in the laboratory, consisted in separating the invertebrates from the substrate, sorting them to taxonomic categories and counting them. The data was statistically analized and interpreted. It led to the conclusion that the water quality in the two watersheds is good. In most of the sampling points the major groups of benthic macroinvertebrates were found, some of the sampling points were dominated by the EPT groups (Ephemeroptera, Plecoptera, Trichoptera which is known as a clean freshwater group, sensitive to pollution and human impact.

  15. Prevalence of Fatigue and Associated Factors in a Spinal Cord Injury Population: Data from an Internet-Based and Face-to-Face Surveys.

    Science.gov (United States)

    Cudeiro-Blanco, Javier; Onate-Figuérez, Ana; Soto-León, Vanesa; Avendaño-Coy, Juan; Mordillo-Mateos, Laura; Brocalero-Camacho, Angela; Esclarin-Ruz, Ana; Rotondi, Mario; Aguilar, Juan; Arias, Pablo; Oliviero, Antonio

    2017-08-01

    Fatigue has a profound impact on patients with spinal cord injury (SCI), but only limited treatments are available. The aim of this study was to determine the prevalence of fatigue in SCI and its association with clinical and demographic factors. We used an internet-based survey and a face-to-face interview to estimate the prevalence of fatigue in a SCI population. Fatigue was measured using the Fatigue Severity Scale (FSS). Clinically significant fatigue was defined as FSS scores greater than or equal to four. A total of 253 participants with SCI were included in the study. Clinically significant fatigue was present in one third of our sample. There was no relationship between fatigue and injury level or completeness. We found significant correlations between depression, pain, and level of injury. The relation of fatigue with completeness of injury and spasticity is less clear. Moreover, the online survey and the standard face-to-face interview showed similar results concerning fatigue evaluation. Several factors may contribute to fatigue, however. Future studies should be conducted to clarify which are the most relevant ones and, if possible, to determine which factors are modifiable.

  16. Pain elicited by the Cold Pressor Test: A gender-comparative FACS coding study of spontaneous, faked and inhibited expressions.

    OpenAIRE

    Gil, Luisa; De Sousa, Cristina; Baunninger-Huber, Eva; Schiestl, Cathrin; Toussaint, Kyra; Gruber, Verena; Oliveira, Armando Monica; Duarte, Ana Catarina

    2012-01-01

    Evolutionary theories of pain have conjectured a better ability of males to control their facial expressions of pain, and of females to express and communicate emotions through the face. The present study involved 24 participants (12 men; 12 women). Pain was induced via the Cold Pressor Test (CPT), and three expressive contexts (spontaneous, faked an inhibited) were created through instructions. Elicited pain expressions were FACS coded and frequency, indices were derived for the observed Act...

  17. The efficacy of chiropractic adjustments and PAIN®GONE therapy in the treatment of trapezius myofascial pain syndrome

    OpenAIRE

    2014-01-01

    M.Tech. (Chiropractic) Myofascial trigger points are very common and can become a painful part of most people’s life at one time or another. According to Travell and Simons (1999), active upper trapezius myofascial trigger points are common in patients presenting with neck pain. Myofascial pain syndrome is a regional muscle disorder that is one of the most common causes of persistent pain in the head, face and neck regions (Rachlin, 2002). The PAIN®GONE pen is a device that produces a high...

  18. Idiopathic facial pain related with dental implantation

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    Tae-Geon Kwon

    2016-06-01

    exclusion after other conditions have been considered and eliminated (i.e. it is idiopathic, and is characterized by chronic, constant pain in the absence of any apparent cause in the face or brain. Around 60~70% of the PIFP patients have significant psychiatric findings including the depression, somatization or adjustment disorders. Usually, the medical treatment includes nontricyclic and tricyclic antidepressants (TCAs, beginning with low dose amitriptyline at bedtime and increasing the dose until pain and sleep are improved. Other pharmacological therapy, including topical medications, anticonvulsants and benzodiazepines, is recommended widely as the first line of treatment for PIFP. Since the PIFP is the diagnostic challenge for many implant practitioners, possible misdiagnosis and medico legal dispute can be prevented by thorough understanding of the psychological characteristics of the pain.

  19. Ethnic Differences in Nonverbal Pain Behaviors Observed in Older Adults with Dementia.

    Science.gov (United States)

    Ford, Brianne; Snow, A Lynn; Herr, Keela; Tripp-Reimer, Toni

    2015-10-01

    Research supports using nonverbal pain behaviors to identify pain in persons with dementia. It is unknown whether variations exist among ethnic groups in the expression of nonverbal pain behaviors in this special population. The purpose of this descriptive study was to examine ethnic differences in the presentation and intensity of nonverbal pain behaviors among African American, Caucasian, and Hispanic older adults with dementia when screened for pain by certified nursing assistants. Six certified nursing assistants were trained to review and score 28 video recordings of subjects with dementia for nonverbal pain behaviors using the Non-Communicative Patient's Pain Assessment Instrument. Chi-square was used to examine differences among ethnic groups with regard to the display of nonverbal pain behaviors, and ANOVA was used to evaluate differences in the intensity of overall pain across ethnic groups. Of the 168 assessments, pain words (28%), pain noises (29.8%), and pain faces (28%) were observed most often as indicators of pain. Rubbing, bracing, and restlessness were rarely noted. Chi-square analysis revealed ethnic differences in the expression of pain words (χ(2) = 19.167, p ethnic groups with regards to overall pain intensity. These findings are the first to examine ethnic differences in nonverbal pain behaviors for older adults with dementia. However, future work should examine assessment tendencies of providers in a larger, more diverse sample. Copyright © 2015 American Society for Pain Management Nursing. All rights reserved.

  20. Acupuncture analgesia: The complementary pain management in dentistry

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    Abdurachman Abdurachman

    2011-03-01

    Full Text Available Background: Pain is the most common reason for medical consultation in the United States. Pain is a major symptom in many medical conditions, and can significantly interfere with a person’s quality of life and general functioning. One of the very unpleasant pain is toothache. Conventional treatments for toothache are improving oral hygiene, prescribing analgesics, anti-inflammatory, and also antibiotics if there are infection even extractions are performed if necessary. Another way to conventional approaches, patients may consider acupuncture method. Acupuncture involves the insertion of needles with the width of a human hair along the precise points throughout the body. This process triggers body’s energy normal flow through extra anatomy pathway called meridian. Purpose: This case report is aimed to emphasize the existence of teeth-organ relationships through communication channels outside the lines of communication that has been known in anatomy. Case: Two patients with toothache complaints in the lower right molars came to an acupuncturist who was a medical practitioner. In these cases pain were relieved by acupuncture analgesia. Case management: Two patients were subjected to acupuncture analgesia with different acupuncture points that were customized to the affected tooth, case 1 with the large intestine-4 (Li-4 which located in the hand and case 2 with bladder-25 (Bl-25 which located in the back of the body. Ninety percent of pain was relieved in 40 seconds. Conclusion: Pain in toothache can be relieved using acupuncture analgesia technique, using meridian as an extra anatomy pathway. Nevertheless, treating the source of pain by dental practitioner is mandatory.Latar belakang: Nyeri adalah alasan paling umum yang menyebabkan orang datang berkonsultasi kepada profesional medis di Amerika Serikat. Nyeri merupakan gejala utama dalam kasus medis, dan dapat mengganggu kualitas hidup dan kegiatan umum seseorang secara signifikan. Salah satu

  1. Validation of a Modified German Version of the Brief Pain Inventory for Use in Nursing Home Residents with Chronic Pain.

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    Budnick, Andrea; Kuhnert, Ronny; Könner, Franziska; Kalinowski, Sonja; Kreutz, Reinhold; Dräger, Dagmar

    2016-02-01

    The Brief Pain Inventory (BPI) has been psychometrically evaluated worldwide in adult patients with cancer-related and chronic pain in several languages, but never in nursing home residents with chronic pain. To address this gap, we evaluated the validity of a modified version of the BPI, the BPI for nursing home residents (BPI-NHR) in individuals who resided in German nursing homes. One analytic sample included 137 nursing home residents (mean age, 83.3 years; SD, 8.0 years) without any missing values. An extended sample also included individuals with previous missing values that were substituted with the personal mean (n = 163; mean age, 83.3 years; SD, 8.3 years). Principal axis factoring with oblimin rotation was used to compute the final 2-factor solution for the substituted sample. These factors explained 71.7% of the variance. Internal consistency was calculated using Cronbach α, and showed excellent results. Concurrent validity was tested using nonparametric correlation analyses of the BPI-NHR with the pain medication scale. The present findings support the reliability and validity of the BPI-NHR for very old nursing home residents. Further evaluation of this measure is needed to examine face validity and the effect of multimorbidity on pain interference with function. In this article we present psychometric properties of the BPI originally developed to assess cancer pain, extended to measure chronic nonmalignant pain in younger and middle-aged patients, and now further developed to measure pain intensity and interference with function among very old nursing home residents. Thus, the BPI-NHR might assist clinicians and researchers interested in assessment of pain intensity and interference in elderly individuals who reside in nursing homes. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  2. Modulation of neural circuits underlying temporal production by facial expressions of pain.

    Science.gov (United States)

    Ballotta, Daniela; Lui, Fausta; Porro, Carlo Adolfo; Nichelli, Paolo Frigio; Benuzzi, Francesca

    2018-01-01

    According to the Scalar Expectancy Theory, humans are equipped with a biological internal clock, possibly modulated by attention and arousal. Both emotions and pain are arousing and can absorb attentional resources, thus causing distortions of temporal perception. The aims of the present single-event fMRI study were to investigate: a) whether observation of facial expressions of pain interferes with time production; and b) the neural network subserving this kind of temporal distortions. Thirty healthy volunteers took part in the study. Subjects were asked to perform a temporal production task and a concurrent gender discrimination task, while viewing faces of unknown people with either pain-related or neutral expressions. Behavioural data showed temporal underestimation (i.e., longer produced intervals) during implicit pain expression processing; this was accompanied by increased activity of right middle temporal gyrus, a region known to be active during the perception of emotional and painful faces. Psycho-Physiological Interaction analyses showed that: 1) the activity of middle temporal gyrus was positively related to that of areas previously reported to play a role in timing: left primary motor cortex, middle cingulate cortex, supplementary motor area, right anterior insula, inferior frontal gyrus, bilateral cerebellum and basal ganglia; 2) the functional connectivity of supplementary motor area with several frontal regions, anterior cingulate cortex and right angular gyrus was correlated to the produced interval during painful expression processing. Our data support the hypothesis that observing emotional expressions distorts subjective time perception through the interaction of the neural network subserving processing of facial expressions with the brain network involved in timing. Within this frame, middle temporal gyrus appears to be the key region of the interplay between the two neural systems.

  3. Drug repositioning: playing dirty to kill pain.

    Science.gov (United States)

    Bastos, Leandro Francisco Silva; Coelho, Márcio Matos

    2014-01-01

    The number of approved new molecular entity drugs has been decreasing as the pharmaceutical company investment in research and development is increasing. As we face this painful crisis, called an innovation gap, there is increasing awareness that development of new uses of existing drugs may be a powerful tool to help overcome this obstacle because it takes too long, costs too much and can be risky to release drugs developed de novo. Consequently, drug repositioning is emerging in different therapeutic areas, including the pain research area. Worldwide, pain is the main reason for seeking healthcare, and pain relief represents an unmet global clinical need. Therefore, development of analgesics with better efficacy, safety and cost effectiveness is of paramount importance. Despite the remarkable advancement in research on cellular and molecular mechanisms underlying pain pathophysiology over the past three decades, target-based therapeutic opportunities have not been pursued to the same extent. Phenotypic screening remains a more powerful tool for drug development than target-based screening so far. It sounds somewhat heretical, but some multi-action drugs, rather than very selective ones, have been developed intentionally. In the present review, we first critically discuss the utility of drug repositioning for analgesic drug development and then show examples of 'old' drugs that have been successfully repositioned or that are under investigation for their analgesic actions. We conclude that drug repositioning should be more strongly encouraged to help build a bridge between basic research and pain relief worldwide.

  4. Effect Supermint oil (Peppermint oil on children's pain during Colonoscopy

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    M Najafi

    2014-04-01

    Full Text Available Introduction: Pain during colonoscopy, especially in children, including the challenges faced by the medical team. The aim of study was investigation the analgesic effect Supermint oil (peppermint oil on pain in children during colonoscopy. Methods and Materials: In this clinical trial study, 101 children (7-14 years old candidate colonoscopy were randomly divided into two groups, respectively. About half an hour before the colonoscopy case group (n=51 was administrated oral drops Supermint oil (peppermint oil. Patients were filled a pediatric pain questionnaire. In control group (n=50 filled a questionnaire without any administration. Data were analyzed using SPSS version 11.5 and (T-test and Paired sample t-test, Corraletion,Man withney. Results: Mean value of pain, duration of colonoscopy in control group was 5/60+1/85 and in case group was 4/20+1/70 and this diference was significant (P

  5. Familiar face + novel face = familiar face? Representational bias in the perception of morphed faces in chimpanzees

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    Yoshi-Taka Matsuda

    2016-08-01

    Full Text Available Highly social animals possess a well-developed ability to distinguish the faces of familiar from novel conspecifics to induce distinct behaviors for maintaining society. However, the behaviors of animals when they encounter ambiguous faces of familiar yet novel conspecifics, e.g., strangers with faces resembling known individuals, have not been well characterised. Using a morphing technique and preferential-looking paradigm, we address this question via the chimpanzee’s facial–recognition abilities. We presented eight subjects with three types of stimuli: (1 familiar faces, (2 novel faces and (3 intermediate morphed faces that were 50% familiar and 50% novel faces of conspecifics. We found that chimpanzees spent more time looking at novel faces and scanned novel faces more extensively than familiar or intermediate faces. Interestingly, chimpanzees looked at intermediate faces in a manner similar to familiar faces with regards to the fixation duration, fixation count, and saccade length for facial scanning, even though the participant was encountering the intermediate faces for the first time. We excluded the possibility that subjects merely detected and avoided traces of morphing in the intermediate faces. These findings suggest a bias for a feeling-of-familiarity that chimpanzees perceive familiarity with an intermediate face by detecting traces of a known individual, as 50% alternation is sufficient to perceive familiarity.

  6. The Relationship between Marital Status and Psychological Resilience in Chronic Pain.

    Science.gov (United States)

    Wade, James B; Hart, Robert P; Wade, James H; Bajaj, Jasmohan S; Price, Donald D

    2013-01-01

    We examined the relationship between marital status and a 2-stage model of pain-related effect, consisting of pain unpleasantness and suffering. We studied 1914 chronic pain patients using multivariate analysis of covariance (MANCOVA) to clarify whether marital status was a determinant factor in the emotional or ideational suffering associated with chronic pain after controlling for pain sensation intensity, age, and ethnicity. Marital status was unrelated to immediate unpleasantness (P = 0.08). We found a strong association with emotional suffering (P < 0.0001) but not with negative illness beliefs (P = 0.44). Interestingly, widowed subjects experienced significantly less frustration, fear, and anger than all other groups (married, divorced, separated, or single). A final MANCOVA including sex as a covariate revealed that the emotional response to pain was the same for both widow and widower. Only those individuals whose spouse died experienced less emotional turmoil in the face of a condition threatening their lifestyle. These data suggest that after experiencing the death of a spouse, an individual may derive some "emotional inoculation" against future lifestyle threat.

  7. The Relationship between Marital Status and Psychological Resilience in Chronic Pain

    Directory of Open Access Journals (Sweden)

    James B. Wade

    2013-01-01

    Full Text Available We examined the relationship between marital status and a 2-stage model of pain-related effect, consisting of pain unpleasantness and suffering. We studied 1914 chronic pain patients using multivariate analysis of covariance (MANCOVA to clarify whether marital status was a determinant factor in the emotional or ideational suffering associated with chronic pain after controlling for pain sensation intensity, age, and ethnicity. Marital status was unrelated to immediate unpleasantness (. We found a strong association with emotional suffering ( but not with negative illness beliefs (. Interestingly, widowed subjects experienced significantly less frustration, fear, and anger than all other groups (married, divorced, separated, or single. A final MANCOVA including sex as a covariate revealed that the emotional response to pain was the same for both widow and widower. Only those individuals whose spouse died experienced less emotional turmoil in the face of a condition threatening their lifestyle. These data suggest that after experiencing the death of a spouse, an individual may derive some “emotional inoculation” against future lifestyle threat.

  8. Cancer pain in the opioid-addicted patient: can we treat it right?

    Science.gov (United States)

    Modesto-Lowe, Vania; Girard, Lisa; Chaplin, Margaret

    2012-01-01

    Although cancer elicits an array of physical and emotional symptoms, pain is often identified as the most distressing. Cancer pain may result from the primary tumor, metastasis, surgery, radiation, chemotherapy, or medical comorbidities. Although treatment with opioid analgesics is accepted as appropriate therapy for cancer-related pain, under treatment may persist among certain patients. Opioid-addicted individuals represent a challenging and heterogeneous population to treat. Addiction is linked to psychopathology and antisocial behaviors (eg, lying) which often complicate evaluation. Chronic exposure to opioids may lead to physiologic dependence and its correlates, tolerance and hyperalgesia. Given the variability and subjectivity of the cancer pain experience, there are no objective measures which capture the adequacy of pain control. Thus, when faced with complaints of uncontrolled pain, clinicians must consider a differential diagnosis of tolerance, disease progression, addiction, pseudoaddiction, chemical coping, or even criminal behavior. This article explores the cognitive, behavioral, and physiological correlates of opioid addiction that may impact cancer pain management. It also discusses risk reduction strategies for opioid misuse and research directions that may lead to improved clinical outcomes in these patients.

  9. "Let's stick together"--a grounded theory exploration of interprofessional working used to provide person centered chronic back pain services.

    Science.gov (United States)

    Howarth, Michelle; Warne, Tony; Haigh, Carol

    2012-11-01

    Chronic back pain is a global phenomenon and a common reason why patients seek help from health professionals. Person-centered interprofessional working is acknowledged as the main strategy for chronic back pain management; however, the complexity of chronic pain can present significant challenges for teams. Although methods used by interprofessional teams to collaborate have been previously explored, how they work together to deliver person-centered chronic back pain care has received limited attention. The aim of this study was to explore person-centered care from the perspectives of people with chronic back pain and the interprofessional teams who cared for them. A grounded theory methodology was used to capture the interprofessional team's perspectives of person-centered working. A purposive sample of four chronic back pain management teams participated in semi-structured face-to-face interviews and focus groups. Data were thematically analyzed using a constant comparative method. Three categories emerged, collective efficacy, negotiated space and team maturity, which illustrated the attributes of interprofessional teams that influenced person-centered working. The findings suggest that collective efficacy matures over time within a negotiated coalesced space and re-enforces the need for teams to stick together to ensure effective person-centered care.

  10. Neurophysiological traces of interpersonal pain: How emotional autobiographical memories affect event-related potentials.

    Science.gov (United States)

    Rohde, Kristina B; Caspar, Franz; Koenig, Thomas; Pascual-Leone, Antonio; Stein, Maria

    2018-03-01

    The automatic, involuntary reactivation of disturbing emotional memories, for example, of interpersonal pain, causes psychological discomfort and is central to many psychopathologies. This study aimed at elucidating the automatic brain processes underlying emotional autobiographical memories by investigating the neurophysiological dynamics within the first second after memory reactivation. Pictures of different individualized familiar faces served as cues for different specific emotional autobiographical memories, for example, for memories of interpersonal pain and grievances or for memories of appreciation in interpersonal relationships. Nineteen subjects participated in a passive face-viewing task while multichannel electroencephalogram was recorded. Analyses of event-related potentials demonstrated that emotional memories elicited an early posterior negativity and a stronger late positive potential, which tended to be particularly enhanced for painful memories. Source estimations attributed this stronger activation to networks including the posterior cingulate and ventrolateral prefrontal cortices. The findings suggest that the reactivation of emotional autobiographical memories involves privileged automatic attention at perceptual processing stages, and an enhanced recruitment of neural network activity at a postperceptual stage sensitive to emotional-motivational processing. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. The use of CAM and conventional treatments among primary care consulters with chronic musculoskeletal pain.

    Science.gov (United States)

    Artus, Majid; Croft, Peter; Lewis, Martyn

    2007-05-04

    Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM). Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be. To determine CAM use among patients with chronic musculoskeletal pain who have consulted about their pain in primary care. Face-to-face interview-based survey. Three general practices in North Staffordshire. Respondents to a population pain survey who had reported having musculoskeletal pain in the survey and who had consulted about their pain in primary care in the previous 12 months as well as consenting to further research and agreeing to an interview. Information was gathered about their pain and the use of all treatments for pain, including CAM, in the previous year. 138 interviews were completed. 116 participants (84%) had used at least one CAM treatment for pain in the previous year. 65% were current users of CAM. The ratio of over-the-counter CAM use to care from a CAM provider was 3:2. 111 participants (80%) had used conventional treatment. 95 (69%) were using a combination of CAM and conventional treatment. Glucosamine and fish oil were the most commonly used CAM treatments (38%, 35% respectively). Most CAM treatments were scored on average as being helpful, and users indicated that they intended to use again 87% of the CAM treatments they had already used. We provide direct evidence that most primary care consulters with chronic musculoskeletal pain have used CAM in the previous year, usually in combination with conventional treatments. The high prevalence and wide range of users experiences of benefit and harm from CAM strengthen the argument for more research into this type of medicine to quantify benefit and assess safety. The observation that most users of conventional medicine also used CAM

  12. A Pilot Randomized Controlled Trial of a Guided Self-Help Intervention to Manage Chronic Orofacial Pain.

    Science.gov (United States)

    Goldthorpe, Joanna; Lovell, Karina; Peters, Sarah; McGowan, Linda; Nemeth, Imola; Roberts, Christopher; Aggarwal, Vishal R

    2017-01-01

    To conduct a pilot trial to test the feasibility of a guided self-help intervention for chronic orofacial pain. A pilot randomized controlled trial was conducted to compare the intervention with usual treatment. A total of 37 patients with chronic orofacial pain were randomized into either the intervention group (n = 19) or the usual treatment (control) group (n = 18). Validated outcome measures were used to measure the potential effectiveness of the intervention over a number of domains: physical and mental functioning (Short Form 36 [SF-36]); anxiety and depression (Hospital Anxiety and Depression Scale [HADS]); pain intensity and interference with life (Brief Pain Inventory [BPI]); disability (Manchester Orofacial Pain Disability Scale [MOPDS]); and illness behavior (Revised Illness Perceptions Questionnaire [IPQr]). Bootstrap confidence intervals were computed for the treatment effect (ES) posttreatment and at 3 months follow-up and adjusted for baseline values of the outcome measure by using analysis of covariance. At posttreatment and the 3-month follow-up, 11 participants in the intervention group and 7 in the control group failed to complete outcome measures. The intervention was acceptable and could be feasibly delivered face to face or over the telephone. Although the pilot trial was not powered to draw conclusions about the effectiveness, it showed significant (P orofacial pain. It showed potential effectiveness on outcome domains related to functioning and illness perception. Further research is needed to understand the cost effectiveness of the intervention for chronic orofacial pain.

  13. Efficient conditioned pain modulation despite pain persistence in painful diabetic neuropathy.

    Science.gov (United States)

    Granovsky, Yelena; Nahman-Averbuch, Hadas; Khamaisi, Mogher; Granot, Michal

    2017-05-01

    Alleviation of pain, by either medical or surgical therapy, is accompanied by transition from less efficient, or pro-nociceptive, to efficient conditioned pain modulation (CPM). Spontaneous decrease or resolution of pain with disease progression is reported for some patients with painful diabetic neuropathy (PDN). To explore whether CPM changes similarly in parallel to spontaneous resolution of pain in PDN patients. In this cross-sectional study, thirty-three patients with PDN underwent psychophysical assessment of pain modulation on the forearm, remote from the clinical pain. Pain duration was not correlated with neuropathic pain intensity, yet, it correlated with CPM efficiency; patients with longer pain duration had same pain level, but more efficient CPM than those with short-pain duration (ρ = -0.417; P = 0.025, Spearman correlation). Patients with pain more than 2 years (median split) expressed efficient CPM that was not different from that of healthy controls. These patients also had lower temporal summation of pain than the short-pain duration patients group ( P < 0.05). The 2 patient groups did not differ in clinical pain characteristics or use of analgesics. Pro-nociception, expressed by less efficient CPM and high temporal summation that usually accompanies clinical painful conditions, seems to "normalize" with chronicity of the pain syndrome. This is despite continuing pain, suggesting that pro-nociceptivity in pain syndromes is multifactorial. Because the pain modulation profile affects success of therapy, this suggests that different drugs might express different efficacy pending on duration of the pain in patients with PDN.

  14. Chronic pain in multiple sclerosis: A 10-year longitudinal study.

    Science.gov (United States)

    Young, Jamie; Amatya, Bhasker; Galea, Mary P; Khan, Fary

    2017-07-01

    Pain is a common symptom associated with multiple sclerosis (MS), and has lasting effects on an individual's functional capacity and quality of life. A wide range of prevalence rates of pain (between 23% and 90%)have been reported in MS and this is mainly due to the methodological differences amongst the studies such as variability in patient sources, method of sampling and the definition of pain used. Chronic pain in MS, defined as pain lasting for greater than 3-6 months, can have a significant impact on their biopsychosocial health, including negative impact on activities of daily living, relationships and social participation. The long-term course of MS-related pain and its impact in an Australian cohort over a 7-year period has been investigated earlier. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. This was a prospective longitudinal study conducted at the Rehabilitation Department of Royal Melbourne Hospital (RMH), a tertiary referral hospital in Victoria and Australia. The source of participants was from the RMH MS database and contains detailed MS patient information including demographic data, diagnosis details (using McDonald's criteria), pain characteristics. Structured face-face interviews and validated measures were used, which include the visual analogue scale (VAS); chronic pain grade (CPG); the assessment of quality of life (AQoL) and the carer strain index (CSI). The mean age of the participants (n=70) was 55.3 years and majority (70%) were female. The mean age of the participants (n=70) was 55.3 years and majority (70%) were female. The findings show that over time (10 years), participants report having greater bilateral bodily pain and greater description of pain as 'worse

  15. The role of spatial frequency information in the decoding of facial expressions of pain: a novel hybrid task.

    Science.gov (United States)

    Wang, Shan; Eccleston, Christopher; Keogh, Edmund

    2017-11-01

    Spatial frequency (SF) information contributes to the recognition of facial expressions, including pain. Low-SF encodes facial configuration and structure and often dominates over high-SF information, which encodes fine details in facial features. This low-SF preference has not been investigated within the context of pain. In this study, we investigated whether perpetual preference differences exist for low-SF and high-SF pain information. A novel hybrid expression paradigm was used in which 2 different expressions, one containing low-SF information and the other high-SF information, were combined in a facial hybrid. Participants are instructed to identify the core expression contained within the hybrid, allowing for the measurement of SF information preference. Three experiments were conducted (46 participants in each) that varied the expressions within the hybrid faces: respectively pain-neutral, pain-fear, and pain-happiness. In order to measure the temporal aspects of image processing, each hybrid image was presented for 33, 67, 150, and 300 ms. As expected, identification of pain and other expressions was dominated by low-SF information across the 3 experiments. The low-SF preference was largest when the presentation of hybrid faces was brief and reduced as the presentation duration increased. A sex difference was also found in experiment 1. For women, the low-SF preference was dampened by high-SF pain information, when viewing low-SF neutral expressions. These results not only confirm the role that SF information has in the recognition of pain in facial expressions but suggests that in some situations, there may be sex differences in how pain is communicated.

  16. Maintaining professionalism in today's business environment: ethical challenges for the pain medicine specialist.

    Science.gov (United States)

    Lebovits, Allen

    2012-09-01

    There are many external influences in today's market force that impair the relationship between the pain medicine specialist and the patient, and ultimately prevent optimal quality of care. This article explores the ethical challenges facing the pain medicine specialist in today's increasingly "business" environment and will offer solutions for maintaining the professionalism of pain medicine. Four commonly encountered bioethical principles in the practice of pain medicine are reviewed: beneficence, nonmaleficence, justice, and autonomy. The following ethical challenges of the pain medicine specialist are reviewed: practicing outside ones specialty area, practice characteristics, the consultant role, the economic lure of aggressive intervention, not evaluating for and treating comorbid psychopathology, reimbursement pressures, workers' compensation, and use of unproven methods. Solutions offered include collegial associations, social responsibility, legislative initiatives, pain education, interdisciplinary evaluation and treatment, improved relationships with third-party payers, reduced racial disparities, and ethics education. Ethics is the "roadmap" that enables the pain medicine specialist to navigate the increasingly murky waters of practicing pain management today by maintaining the professionalism necessary to combat today's "business" pressures. Wiley Periodicals, Inc.

  17. Effect of pilocarpine on the formalin-induced orofacial pain in rats

    Directory of Open Access Journals (Sweden)

    Esmaeal Tamaddonfard

    2012-06-01

    Full Text Available In this study, the effects of subcutaneous (SC injection of pilocarpine (a cholinomimetic agent and atropine (a muscarinic receptors antagonist were investigated on a tonic model of orofacial pain in rats. The contribution of the endogenous analgesic opioid system was assessed using naloxone (an opioid receptors antagonist. Tonic orofacial pain was induced by SC injection of a diluted formalin solution (1%, 50 μL in the right upper lip, and the time spent face rubbing was measured in five min blocks for 1 h. Formalin induced a biphasic (first phase: 0-5 min and second phase: 15-35 min pain response. Pilocarpine significantly (P < 0.05 suppressed both phases of orofacial pain. Atropine did not have any effect and naloxone non-significantly increased the intensity of pain when used alone. In the pre-injection examinations, atropine prevented, but naloxone did not reverse the antinociceptive effect of pilocarpine. The results indicated that SC injection of formalin in the orofacial region induced a marked biphasic pain. Pilocarpine via muscarinic cholinergic receptors produced antinociceptive effect in the orofacial formalin-induced pain. The endogenous opioid analgesic system may not have a role in pilocarpine-induced antinociception.

  18. How Accurate Appraisal of Behavioral Costs and Benefits Guides Adaptive Pain Coping

    Directory of Open Access Journals (Sweden)

    Wiebke Gandhi

    2017-06-01

    Full Text Available Coping with pain is a complex phenomenon encompassing a variety of behavioral responses and a large network of underlying neural circuits. Whether pain coping is adaptive or maladaptive depends on the type of pain (e.g., escapable or inescapable, personal factors (e.g., individual experiences with coping strategies in the past, and situational circumstances. Keeping these factors in mind, costs and benefits of different strategies have to be appraised and will guide behavioral decisions in the face of pain. In this review we present pain coping as an unconscious decision-making process during which accurately evaluated costs and benefits lead to adaptive pain coping behavior. We emphasize the importance of passive coping as an adaptive strategy when dealing with ongoing pain and thus go beyond the common view of passivity as a default state of helplessness. In combination with passive pain coping, we highlight the role of the reward system in reestablishing affective homeostasis and discuss existing evidence on a behavioral and neural level. We further present neural circuits involved in the decision-making process of pain coping when circumstances are ambiguous and, therefore, costs and benefits are difficult to anticipate. Finally, we address the wider implications of this topic by discussing its relevance for chronic pain patients.

  19. Core Competencies in Integrative Pain Care for Entry-Level Primary Care Physicians.

    Science.gov (United States)

    Tick, Heather; Chauvin, Sheila W; Brown, Michael; Haramati, Aviad

    2015-11-01

    The objective was to develop a set of core competencies for graduating primary care physicians in integrative pain care (IPC), using the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies build on previous work in competencies for integrative medicine, interprofessional education, and pain medicine and are proposed for inclusion in residency training. A task force was formed to include representation from various professionals who are involved in education, research, and the practice of IPC and who represent broad areas of expertise. The task force convened during a 1.5-day face-to-face meeting, followed by a series of surveys and other vetting processes involving diverse interprofessional groups, which led to the consensus of a final set of competencies. The proposed competencies focus on interprofessional knowledge, skills, and attitudes (KSAs) and are in line with recommendations by the Institute of Medicine, military medicine, and professional pain societies advocating the need for coordination and integration of services for effective pain care with reduced risk and cost and improved outcomes. These ACGME domain compatible competencies for physicians reflect the contributions of several disciplines that will need to be included in evolving interprofessional settings and underscore the need for collaborative care. These core competencies can guide the incorporation of KSAs within curricula. The learning experiences should enable medical educators and graduating primary care physicians to focus more on integrative approaches, interprofessional team-based, patient-centered care that use evidence-based, traditional and complementary disciplines and therapeutics to provide safe and effective treatments for people in pain. Wiley Periodicals, Inc.

  20. The Influence of Ergonomic Training on Low Back and Neck Pains in Female Hospital Personnel

    Directory of Open Access Journals (Sweden)

    Saeidi

    2014-07-01

    Full Text Available Background Prevalence of low back pain (LBP and neck pain (NP in workers, especially in nurses is high, but their knowledge of ergonomics is not enough. Objectives The aim of this study was to evaluate the impact of ergonomic training on low back pain and neck pain, posture, and function in female hospital personnel of Najaf-Abad, Iran. Patients and Methods In this queasy experimental study, 47 female staffs with LBP or NP were selected through a simple consecutive sampling method. The subjects completed a questionnaire on LBP and NP and were evaluated for posture, back tests, and cost of related treatments. Afterward, they participated in an ergonomic training program, including face to face and group education sessions on ergonomic risk factors for LBP and NP, in the work place. After six months of follow up, all the tests and data collection were repeated and data was analyzed using paired t-test and regression analysis. Results Prevalence of LBP and NP were 87% and 45.7%, respectively. Repetitive motions were the most frequent cause of pain (67%. Pain intensity, posture, risk of musculoskeletal disorders, weight, waist circumference, sick leaves, and the costs of treatments reduced significantly after intervention (P < 0.05. Conclusions With regards to the influence of ergonomic training on improving LBP and NP and decreasing the treatment costs, this intervention beside others can be useful for controlling musculoskeletal disorders in hospital personnel.

  1. Web-based nursing intervention for self-management of pain after cardiac surgery: pilot randomized controlled trial.

    Science.gov (United States)

    Martorella, Géraldine; Côté, José; Racine, Mélanie; Choinière, Manon

    2012-12-14

    Most adults undergoing cardiac surgery suffer from moderate to severe pain for up to 6 days after surgery. Individual barriers and attitudes regarding pain and its relief make patients reluctant to report their pain and ask for analgesic medication, which results in inadequate pain management. More innovative educational interventions for postoperative pain relief are needed. We developed a Web-based nursing intervention to influence patient's involvement in postoperative pain management. The intervention (SOULAGE-TAVIE) includes a preoperative 30-minute Web-based session and 2 brief face-to-face postoperative booster sessions. The Web application generates reflective activities and tailored educational messages according to patients' beliefs and attitudes. The messages are transmitted through videos of a virtual nurse, animations, stories, and texts. The aim of this single-blinded pilot randomized trial was to investigate the preliminary effects of a virtual nursing intervention (SOULAGE-TAVIE) to improve pain relief in patients undergoing cardiac surgery. Participants (N = 60) were adults scheduled for their first cardiac surgery. They were randomly assigned to the experimental group using SOULAGE-TAVIE (n = 30) or the control group using usual care, including an educational pamphlet and postoperative follow-up (n = 30). Data were collected through questionnaires at the time of admission and from day 1 to day 7 after surgery with the help of a blinded research assistant. Outcomes were pain intensity, pain interference with daily activities, patients' pain barriers, tendency to catastrophize in face of pain, and analgesic consumption. The two groups were comparable at baseline across all demographic measures. Results revealed that patients in the experimental group did not experience less intense pain, but they reported significantly less pain interference when breathing/coughing (P = .04). A severe pain interference with breathing/coughing (pain ranked ≥ 7

  2. BOLD responses in somatosensory cortices better reflect heat sensation than pain.

    Science.gov (United States)

    Moulton, Eric A; Pendse, Gautam; Becerra, Lino R; Borsook, David

    2012-04-25

    The discovery of cortical networks that participate in pain processing has led to the common generalization that blood oxygen level-dependent (BOLD) responses in these areas indicate the processing of pain. Physical stimuli have fundamental properties that elicit sensations distinguishable from pain, such as heat. We hypothesized that pain intensity coding may reflect the intensity coding of heat sensation during the presentation of thermal stimuli during fMRI. Six 3T fMRI heat scans were collected for 16 healthy subjects, corresponding to perceptual levels of "low innocuous heat," "moderate innocuous heat," "high innocuous heat," "low painful heat," "moderate painful heat," and "high painful heat" delivered by a contact thermode to the face. Subjects rated pain and heat intensity separately after each scan. A general linear model analysis detected different patterns of brain activation for the different phases of the biphasic response to heat. During high painful heat, the early phase was associated with significant anterior insula and anterior cingulate cortex activation. Persistent responses were detected in the right dorsolateral prefrontal cortex and inferior parietal lobule. Only the late phase showed significant correlations with perceptual ratings. Significant heat intensity correlated activation was identified in contralateral primary and secondary somatosensory cortices, motor cortex, and superior temporal lobe. These areas were significantly more related to heat ratings than pain. These results indicate that heat intensity is encoded by the somatosensory cortices, and that pain evaluation may either arise from multimodal evaluative processes, or is a distributed process.

  3. A case of unilateral atypical orofacial pain with Eagle's syndrome

    Directory of Open Access Journals (Sweden)

    G V Sowmya

    2016-01-01

    Full Text Available Eagle's syndrome is not an uncommon condition, but less known to physicians, where an elongated styloid process or calcified stylohyoid ligament compresses the adjacent anatomical structures leading to orofacial pain. Diagnosis is made with appropriate radiological examination. Nonsurgical treatment options include reassurance, analgesia, and anti.inflammatory medications; and the surgical option includes a transoral or external approach. Here, we present a case report of a male patient, of age38 years, with a chief complaint of unilateral atypical orofacial pain on the right side of his face radiating to the neck region, for the last two months.

  4. Development and Pilot Evaluation of an Online Relapse-Prevention Program Based on Acceptance and Commitment Therapy for Chronic Pain Patients

    NARCIS (Netherlands)

    Fledderus, M.; Schreurs, Karlein Maria Gertrudis; Bohlmeijer, Ernst Thomas; Vollenbroek-Hutten, Miriam Marie Rosé

    2015-01-01

    Background: A significant number of chronic pain patients experience a decline in therapeutic effects after rehabilitation. As face-to-face contacts with health care professionals are not always feasible after treatment, new, innovative, fully automated relapse-prevention programs are highly needed.

  5. Facilitated pronociceptive pain mechanisms in radiating back pain compared with localized back pain

    DEFF Research Database (Denmark)

    Vaegter, Henrik Bjarke; Palsson, Thorvaldur Skuli; Graven-Nielsen, Thomas

    2017-01-01

    Facilitated pain mechanisms and impaired pain inhibition are often found in chronic pain patients. This study compared clinical pain profiles, pain sensitivity, as well as pro-nociceptive and anti-nociceptive mechanisms in patients with localized low back pain (n=18), localized neck pain (n=17......), low back and radiating leg pain (n=18), or neck and radiating arm pain (n=17). It was hypothesized that patients with radiating pain had facilitated pain mechanisms and impaired pain inhibition compared with localized pain patients. Cuff algometry was performed on the non-painful lower leg to assess...... threshold (HPT) at the non-painful hand were also assessed. Clinical pain intensity, psychological distress, and disability were assessed with questionnaires. TSP was increased in patients with radiating back pain compared with localized back pain (Ppain or localized low...

  6. Jovem, mostre a sua cara: um estudo das possibilidades e limites da escolha profissional

    Directory of Open Access Journals (Sweden)

    Maria Sara de Lima Dias

    Full Text Available Este trabalho apresenta o relato de um estudo com o objetivo de analisar as condições psicossociais envolvida nas escolhas dos jovens em seus projetos profissionais, a partir da vivência de uma das autoras no Projeto Jovem, mostre a sua cara!, desenvolvido na Ilha do Mel, Paraná. A Psicologia sociohistórica e a metodologia qualitativa embasaram o estudo realizado, em que foram utilizadas técnicas de orientação profissional. A análise das narrativas produzidas pelos grupos ressaltou aspectos sobre a realidade do trabalho e sobre os limites e as possibilidades de escolhas profissionais, que refletem a situação particular desses jovens. A relevância deste relato centra-se no fato de que qualquer projeto de intervenção requer o conhecimento dos aspectos socioculturais e das dinâmicas próprias de uma comunidade específica como essa. A prática da orientação profissional pretendeu ter contribuído para mobilizar a participação dos jovens no projeto nas suas múltiplas dimensões e ter fornecido subsídios para as instituições envolvidas, tanto neste quanto em outros projetos dessa natureza.

  7. Modulation of neural circuits underlying temporal production by facial expressions of pain.

    Directory of Open Access Journals (Sweden)

    Daniela Ballotta

    Full Text Available According to the Scalar Expectancy Theory, humans are equipped with a biological internal clock, possibly modulated by attention and arousal. Both emotions and pain are arousing and can absorb attentional resources, thus causing distortions of temporal perception. The aims of the present single-event fMRI study were to investigate: a whether observation of facial expressions of pain interferes with time production; and b the neural network subserving this kind of temporal distortions. Thirty healthy volunteers took part in the study. Subjects were asked to perform a temporal production task and a concurrent gender discrimination task, while viewing faces of unknown people with either pain-related or neutral expressions. Behavioural data showed temporal underestimation (i.e., longer produced intervals during implicit pain expression processing; this was accompanied by increased activity of right middle temporal gyrus, a region known to be active during the perception of emotional and painful faces. Psycho-Physiological Interaction analyses showed that: 1 the activity of middle temporal gyrus was positively related to that of areas previously reported to play a role in timing: left primary motor cortex, middle cingulate cortex, supplementary motor area, right anterior insula, inferior frontal gyrus, bilateral cerebellum and basal ganglia; 2 the functional connectivity of supplementary motor area with several frontal regions, anterior cingulate cortex and right angular gyrus was correlated to the produced interval during painful expression processing. Our data support the hypothesis that observing emotional expressions distorts subjective time perception through the interaction of the neural network subserving processing of facial expressions with the brain network involved in timing. Within this frame, middle temporal gyrus appears to be the key region of the interplay between the two neural systems.

  8. Modulation of neural circuits underlying temporal production by facial expressions of pain

    Science.gov (United States)

    Lui, Fausta; Porro, Carlo Adolfo; Nichelli, Paolo Frigio; Benuzzi, Francesca

    2018-01-01

    According to the Scalar Expectancy Theory, humans are equipped with a biological internal clock, possibly modulated by attention and arousal. Both emotions and pain are arousing and can absorb attentional resources, thus causing distortions of temporal perception. The aims of the present single-event fMRI study were to investigate: a) whether observation of facial expressions of pain interferes with time production; and b) the neural network subserving this kind of temporal distortions. Thirty healthy volunteers took part in the study. Subjects were asked to perform a temporal production task and a concurrent gender discrimination task, while viewing faces of unknown people with either pain-related or neutral expressions. Behavioural data showed temporal underestimation (i.e., longer produced intervals) during implicit pain expression processing; this was accompanied by increased activity of right middle temporal gyrus, a region known to be active during the perception of emotional and painful faces. Psycho-Physiological Interaction analyses showed that: 1) the activity of middle temporal gyrus was positively related to that of areas previously reported to play a role in timing: left primary motor cortex, middle cingulate cortex, supplementary motor area, right anterior insula, inferior frontal gyrus, bilateral cerebellum and basal ganglia; 2) the functional connectivity of supplementary motor area with several frontal regions, anterior cingulate cortex and right angular gyrus was correlated to the produced interval during painful expression processing. Our data support the hypothesis that observing emotional expressions distorts subjective time perception through the interaction of the neural network subserving processing of facial expressions with the brain network involved in timing. Within this frame, middle temporal gyrus appears to be the key region of the interplay between the two neural systems. PMID:29447256

  9. Neural synchronization during face-to-face communication.

    Science.gov (United States)

    Jiang, Jing; Dai, Bohan; Peng, Danling; Zhu, Chaozhe; Liu, Li; Lu, Chunming

    2012-11-07

    Although the human brain may have evolutionarily adapted to face-to-face communication, other modes of communication, e.g., telephone and e-mail, increasingly dominate our modern daily life. This study examined the neural difference between face-to-face communication and other types of communication by simultaneously measuring two brains using a hyperscanning approach. The results showed a significant increase in the neural synchronization in the left inferior frontal cortex during a face-to-face dialog between partners but none during a back-to-back dialog, a face-to-face monologue, or a back-to-back monologue. Moreover, the neural synchronization between partners during the face-to-face dialog resulted primarily from the direct interactions between the partners, including multimodal sensory information integration and turn-taking behavior. The communicating behavior during the face-to-face dialog could be predicted accurately based on the neural synchronization level. These results suggest that face-to-face communication, particularly dialog, has special neural features that other types of communication do not have and that the neural synchronization between partners may underlie successful face-to-face communication.

  10. Salt Tolerant Mutants in Potato sp. Cara Induced by Gamma Irradiation and Tissue Culture Technique

    International Nuclear Information System (INIS)

    Sharabash, M.T.; Mohamed, A.A.; Ahmed, F.A.; Afifi, A.M.

    2003-01-01

    Sprouts of 2-3 cm length were cut off from potatoes cv. Cara tubers and sterilized. Apical meristemic tips were sown to produce virus free plantlets. After 6-8 weeks, the new plantlets became at 5-7cm heights. Micro-propagation was begun to obtain sufficient number of plantlets. Plantlets obtained from micro-propagation stage were divided into 3 groups to be exposed to 0.0,20 or 40Gy gamma rays. The dose rate was 27.7rad/sec. Irradiated and unirradiated plantlets were trimmed to be with 5-6 nodes and without leaves. They were transplanted onto 1/2MS [1] liquid medium supplemented with sodium chloride at different concentrations, i.e.,0.0, 2000 or 4000 ppm. Healthy plantlets were chosen, and all unfit ones were excluded. The plantlets were sub-cultured six times on the same fresh medium with the same concentrations of NaCI, with insisting to exclude all unfit plantlets. All maintained healthy plantlets, in the sixth vegetative generation (M 1 V 6 ), grown under salinity stress, whatever the concentration of NaCI, were considered as mutant lines

  11. The human face as a dynamic tool for social communication

    OpenAIRE

    Jack, Rachael E.; Schyns, Philippe G.

    2015-01-01

    As a highly social species, humans frequently exchange social information to support almost all facets of life. One of the richest and most powerful tools in social communication is the face, from which observers can quickly and easily make a number of inferences — about identity, gender, sex, age, race, ethnicity, sexual orientation, physical health, attractiveness, emotional state, personality traits, pain or physical pleasure, deception, and even social status. With the advent of the digit...

  12. Co-creating an online exercise-based rehabilitation programme for people with chronic knee and hip pain based on user preferences and behavioural change techniques.

    Directory of Open Access Journals (Sweden)

    Michael Hurley

    2015-10-01

    Conclusions: Using persuasive technology, human centred design and business modelling we established the features people want from an online programme to manage chronic joint pain. Combining these with BCTs known to be effective in face-to-face behavioural change programmes have enabled us to develop an online resources that will make an effective programme available to many more people to improve their pain, function, general health and wellbeing and quality of life.

  13. An experimental examination of catastrophizing-related interpretation bias for ambiguous facial expressions of pain using an incidental learning task

    Directory of Open Access Journals (Sweden)

    Ali eKHATIBI

    2014-09-01

    Full Text Available Individuals with pain-related concerns are likely to interpret ambiguous pain-related information in a threatening manner. It is unknown whether this interpretation bias also occurs for ambiguous pain-related facial expressions. This study examined whether individuals who habitually attach a catastrophic meaning to pain are characterized by negative interpretation bias for ambiguous pain-related facial expressions. Sixty-four female undergraduates completed an incidental learning task during which pictures of faces were presented, each followed by a visual target at one of two locations. Participants indicated target location by pressing one of two response keys. During the learning phase, happy and painful facial expressions predicted target location. During two test phases, morphed facial expressions of pain and happiness were added, equally often followed by a target at either location. Faster responses following morphs to targets at the location predicted by painful expressions compared to targets at the location predicted by happy expressions were taken to reflect pain-related interpretation bias. During one test phase, faces were preceded by either a safe or threatening context cue. High, but not low, pain-catastrophizers responded faster following morphs to targets at the location predicted by painful expressions than to targets at the other location (when participants were aware of the contingency between expression type and target location. When context cues were presented, there was no indication of interpretation bias. Participants were also asked to directly classify the facial expressions that were presented during the incidental learning task. Participants classified morphs more often as happy than as painful, independent of their level of pain catastrophizing. This observation is discussed in terms of differences between indirect and direct measures of interpretation bias.

  14. Perceptions of adults with overweight/obesity and chronic musculoskeletal pain: An interpretative phenomenological analysis.

    Science.gov (United States)

    Cooper, Lesley; Ells, Louisa; Ryan, Cormac; Martin, Denis

    2018-03-01

    To gain insight into the lived experience of adults with overweight/obesity and chronic musculoskeletal pain. Knowledge gained will inform healthcare professionals about the complexity of the weight-pain relationship and enable more effective engagement with this population. Quantitative studies show links between weight and pain. Adults with overweight/obesity are more likely to experience comorbidity; however, qualitative research describing the complexities of the relationship is limited. A purposive sample of adults with overweight/obesity and chronic musculoskeletal pain participated in face-to-face interviews. Interviews were audio-recorded, transcribed verbatim and analysed using interpretive phenomenological analysis. Eighteen adults (16 female) aged 29-71, body mass index ≥25-46, participated in this study. Three superordinate themes emerged: "pain as a motivator and barrier to weight loss"; "fear of weight causing more damage"; and "activity is positive." Pain motivates some individuals to lose weight while simultaneously inhibiting weight loss efforts. Participants' perception that extra pressure caused by their weight further damaged joints contributed to fear and catastrophising. Fear is often exacerbated by healthcare professionals' descriptions of musculoskeletal damage, or participants' perception of healthcare professionals' attitude towards people with overweight/obesity. Conversely, individuals acknowledged the benefits of increased activity. Adults with overweight/obesity and chronic musculoskeletal pain in this study identified a bidirectional relationship between their weight and pain that challenged their weight loss efforts. Overweight/obesity contributed to fear and catastrophising, which resulted in avoidance of exercise that would have assisted their weight loss. Healthcare professionals need to understand the complex relationship between weight and pain, and their patients' understanding of that relationship. Healthcare professionals

  15. Audiovisual distraction for pain relief in paediatric inpatients: A crossover study.

    Science.gov (United States)

    Oliveira, N C A C; Santos, J L F; Linhares, M B M

    2017-01-01

    Pain is a stressful experience that can have a negative impact on child development. The aim of this crossover study was to examine the efficacy of audiovisual distraction for acute pain relief in paediatric inpatients. The sample comprised 40 inpatients (6-11 years) who underwent painful puncture procedures. The participants were randomized into two groups, and all children received the intervention and served as their own controls. Stress and pain-catastrophizing assessments were initially performed using the Child Stress Scale and Pain Catastrophizing Scale for Children, with the aim of controlling these variables. The pain assessment was performed using a Visual Analog Scale and the Faces Pain Scale-Revised after the painful procedures. Group 1 received audiovisual distraction before and during the puncture procedure, which was performed again without intervention on another day. The procedure was reversed in Group 2. Audiovisual distraction used animated short films. A 2 × 2 × 2 analysis of variance for 2 × 2 crossover study was performed, with a 5% level of statistical significance. The two groups had similar baseline measures of stress and pain catastrophizing. A significant difference was found between periods with and without distraction in both groups, in which scores on both pain scales were lower during distraction compared with no intervention. The sequence of exposure to the distraction intervention in both groups and first versus second painful procedure during which the distraction was performed also significantly influenced the efficacy of the distraction intervention. Audiovisual distraction effectively reduced the intensity of pain perception in paediatric inpatients. The crossover study design provides a better understanding of the power effects of distraction for acute pain management. Audiovisual distraction was a powerful and effective non-pharmacological intervention for pain relief in paediatric inpatients. The effects were

  16. Low Back Pain in Diabetes Mellitus and Importance of Preventive Approach

    Directory of Open Access Journals (Sweden)

    Laleh Abadi

    2012-07-01

    Full Text Available Background: Musculoskeletal pain is known to be a common problem in diabetic patients. Inspite of this fact, there is little information about epidemiology aspect of Low Back Pain (LBPand necessity of taking preventive approach in diabetic patients. The aim of this study was to determinethe prevalence of LBP in diabetic patients and its comparison with non-diabetic subjects.Methods: Low back pain frequency was examined among 317 diabetic patients referred to endocrineclinic, Sina Hospital, Tabriz city, Iran during 3 months interval. The control group included100 participants who were parents of students of Tabriz University. All participants were asked tofill out a questionnaire including Roland Morris Disability Questionnaire (RMDQ and Face PainScale (FPS.Result: Of the 317 diabetic patients, 63.4% (201 reported LBP while in non-diabetic group was47% (47.The average functional disability in diabetic group was 9 while in control group was 7.Inter-correlation between low back pain intensity scale and functional disability were significant(r=0.52, P<0.01.Discussion: Low back pain is a common problem in diabetic patients in terms of intensity, frequencyand functional level of disability.

  17. Time perspective, socioeconomic status, and psychological distress in chronic pain patients.

    Science.gov (United States)

    Dany, Lionel; Roussel, Philippe; Laguette, Vanessa; Lagouanelle-Simeoni, Marie-Claude; Apostolidis, Themis

    2016-01-01

    Time perspective (TP) is a fundamental dimension of the psychological construction of time. It refers to a subjective experience and can be defined as the relationship that individuals and groups have with the present, past, and future. Studies have shown that it is interesting to take into account TP in the field of health, especially for the study of the psychological distress (PD) of individuals faced with aversive situations. We conducted a research, which aimed to explore the relationship between TP and PD in patients with chronic pain. A total of 264 first-time patients (72.3% women; mean age = 49 years) at CHU Timone (Marseille) pain center answered a questionnaire included TP, socioeconomic status, pain beliefs (PB), pain characteristics, and sociodemographic characteristics. Using hierarchical regression analyses adjusted to the characteristics of pain, sociodemographic characteristics, and PB, we can observe significant relationships between different components of TP, socioeconomic status, and PD. These results emphasize the importance of TP as psychosocial variable in the analysis of PD in patients with chronic pain. These results also lead us to point out the role of the socioeconomic status that predicts levels of PD.

  18. Low back pain in diabetes mellitus and importance of preventive approach.

    Science.gov (United States)

    Eivazi, Maghsoud; Abadi, Laleh

    2012-01-01

    Musculoskeletal pain is known to be a common problem in diabetic patients. In spite of this fact, there is little information about epidemiology aspect of Low Back Pain (LBP) and necessity of taking preventive approach in diabetic patients. The aim of this study was to determine the prevalence of LBP in diabetic patients and its comparison with non-diabetic subjects. Low back pain frequency was examined among 317 diabetic patients referred to endocrine clinic, Sina Hospital, Tabriz city, Iran during 3 months interval. The control group included 100 participants who were parents of students of Tabriz University. All participants were asked to fill out a questionnaire including Roland Morris Disability Questionnaire (RMDQ) and Face Pain Scale (FPS). Of the 317 diabetic patients, 63.4% (201) reported LBP while in non-diabetic group was 47% (47).The average functional disability in diabetic group was 9 while in control group was 7. Inter-correlation between low back pain intensity scale and functional disability were significant (r=0.52, P<0.01). Low back pain is a common problem in diabetic patients in terms of intensity, frequency and functional level of disability.

  19. Decoding of faces and face components in face-sensitive human visual cortex

    Directory of Open Access Journals (Sweden)

    David F Nichols

    2010-07-01

    Full Text Available A great challenge to the field of visual neuroscience is to understand how faces are encoded and represented within the human brain. Here we show evidence from functional magnetic resonance imaging (fMRI for spatially distributed processing of the whole face and its components in face-sensitive human visual cortex. We used multi-class linear pattern classifiers constructed with a leave-one-scan-out verification procedure to discriminate brain activation patterns elicited by whole faces, the internal features alone, and the external head outline alone. Furthermore, our results suggest that whole faces are represented disproportionately in the fusiform cortex (FFA whereas the building blocks of faces are represented disproportionately in occipitotemporal cortex (OFA. Faces and face components may therefore be organized with functional clustering within both the FFA and OFA, but with specialization for face components in the OFA and the whole face in the FFA.

  20. Intravenous flurbiprofen axetil can increase analgesic effect in refractory cancer pain

    Directory of Open Access Journals (Sweden)

    Hao Jiqing

    2009-03-01

    Full Text Available Abstract Background The aim of this study was to investigate the analgesic effects of intravenous flurbiprofen axetil for the refractory pain in cancer patients. Methods 2109 patients were screened from the department of medical oncology, the first affiliated hospital of Anhui medical university in China between October of 2007 and October of 2008. Thirty-seven cases of cancer patients who had bad effect from anaesthetic drugs were received administration of intravenous flurbiprofen axetil with dose of 50 mg/5 ml/day. The pain score was evaluated for pre- and post- treatment by Pain Faces Scale criteria, and the side effects were also observed. Results Intravenous flurbiprofen axetil increased the analgesic effects. The total effective rate was 92%. The side effects, such as abdominal pain, alimentary tract bleeding which were found in using NSAIDs or constipation, nausea, vomit, sleepiness which were found in using opioid drugs did not be found. Conclusion Intravenous flurbiprofen axetil could provide better analgesia effects and few side effects to patients with refractory cancer pain. It could also increase analgesia effects when combining with anesthetic drugs in treatment of moderate or severe pain, especially breakthrough pain, and suit to patients who can not take oral drugs for the reason of constipation and psychosomatic symptoms.

  1. Intravenous flurbiprofen axetil can increase analgesic effect in refractory cancer pain

    Science.gov (United States)

    Wu, Hongyang; Chen, Zhendong; Sun, Guoping; Gu, Kangsheng; Pan, Yueyin; Hao, Jiqing; Du, Yingying; Ning, Jie

    2009-01-01

    Background The aim of this study was to investigate the analgesic effects of intravenous flurbiprofen axetil for the refractory pain in cancer patients. Methods 2109 patients were screened from the department of medical oncology, the first affiliated hospital of Anhui medical university in China between October of 2007 and October of 2008. Thirty-seven cases of cancer patients who had bad effect from anaesthetic drugs were received administration of intravenous flurbiprofen axetil with dose of 50 mg/5 ml/day. The pain score was evaluated for pre- and post- treatment by Pain Faces Scale criteria, and the side effects were also observed. Results Intravenous flurbiprofen axetil increased the analgesic effects. The total effective rate was 92%. The side effects, such as abdominal pain, alimentary tract bleeding which were found in using NSAIDs or constipation, nausea, vomit, sleepiness which were found in using opioid drugs did not be found. Conclusion Intravenous flurbiprofen axetil could provide better analgesia effects and few side effects to patients with refractory cancer pain. It could also increase analgesia effects when combining with anesthetic drugs in treatment of moderate or severe pain, especially breakthrough pain, and suit to patients who can not take oral drugs for the reason of constipation and psychosomatic symptoms. PMID:19267934

  2. Successful treatment of mixed (mainly cancer) pain by tramadol preparations.

    Science.gov (United States)

    Kawahito, Shinji; Soga, Tomohiro; Mita, Naoji; Satomi, Shiho; Kinoshita, Hiroyuki; Arase, Tomoko; Kondo, Akira; Miki, Hitoshi; Takaishi, Kazumi; Kitahata, Hiroshi

    2017-01-01

    The patient, a 70-year-old Japanese woman diagnosed with parotid gland cancer, underwent wide excision and reconstruction (facial nerve ablation, nerve transposition). At 1 month after the surgery, she was brought to our hospital's pain medicine department because her postoperative pain and cancer-related pain were poorly controlled. She had already been prescribed a tramadol (37.5 mg)/acetaminophen (325 mg) combination tablet (5 tablets/day). However, in addition to the continuous pain in her face and lower limbs, she was troubled by a trigeminal neuralgia-like prominence ache. Because this pain could not be controlled by an increase to eight combination tablets per day, we switched her medication to a tramadol capsule. At 11 months post-surgery, we then switched her medication to an orally disintegrating tramadol tablet to improve medication adherence of the drug. From 14 months post-surgery, the patient also used a sustained-release tramadol preparation, and she was then able to sleep well. Her current regimen is an orally disintegrating sustained-release tablet combination (total 300 mg tramadol) per day, and she achieved sufficient pain relief. Because tramadol is not classified as a medical narcotic drug, it widely available and was shown here to be extremely useful for the treatment of our patient's mixed (mainly cancer) pain. J. Med. Invest. 64: 311-312, August, 2017.

  3. Pain and pain behavior in burning mouth syndrome: a pain diary study.

    Science.gov (United States)

    Forssell, Heli; Teerijoki-Oksa, Tuija; Kotiranta, Ulla; Kantola, Rosita; Bäck, Marjaliina; Vuorjoki-Ranta, Tiina-Riitta; Siponen, Maria; Leino, Ari; Puukka, Pauli; Estlander, Ann-Mari

    2012-01-01

    To characterize pain related to primary burning mouth syndrome (BMS) in terms of intensity, interference, and distress caused by the pain, as well as factors influencing the pain across a period of 2 weeks, and to study the use of coping and management strategies on a daily basis. Fifty-two female patients with primary BMS completed a 2-week pain diary. Pain intensity, interference, distress, and mood on a 0 to 10 numeric rating scale (NRS), as well as pain amplifying and alleviating factors, were recorded three times a day. The use of treatments (medication or other means) and coping strategies were recorded at the end of each day. Coefficient of variation, repeated measures analysis of variance, and correlative methods were used to assess the between- and within-subject variation, pain patterns, and associations between various pain scores. The overall mean pain intensity score of the 14 diary days was 3.1 (SD: 1.7); there was considerable variation in pain intensity between patients. Most patients experienced intermittent pain. On average, pain intensity increased from the morning to the evening. Intercorrelations between pain intensity, interference, distress, and mood were high, varying between rs = .75 and rs = .93 (P < .001). Pungent or hot food or beverages, stress, and tiredness were the most frequently mentioned pain-amplifying factors. The corresponding pain-alleviating factors were eating, sucking pastilles, drinking cold beverages, and relaxation. Thirty (58%) patients used pain medication and 35% reported using other means to alleviate their BMS pain. There was large variation in the use of coping strategies -between subjects. There were considerable differences in pain, in factors influencing the pain, and in pain behavior across BMS patients. This indicates that patient information and education as well as treatment of BMS pain should be individualized.

  4. 'My pain was stronger than my happiness': experiences of caesarean births from Lebanon.

    Science.gov (United States)

    Kabakian-Khasholian, Tamar

    2013-11-01

    the rising trends in caesarean section have been partially attributed to women's requests. Many studies in developed and very few in developing countries have attempted to understand this phenomenon. This qualitative study explores experiences of women having caesarean section on demand in a middle-income country with a private health-care system. an inductive qualitative design, using face-to-face semi-structured interviews. women were identified and recruited through a perinatal database and selected obstetricians' clinics in the Greater Beirut area in Lebanon. a purposive sample of women who had a caesarean childbirth within the four months preceding the interview, were visited for an interview at home using a semi-structured interview guide. Thematic content analysis was conducted on a sub-sample of 22 women who requested a caesarean birth. lack of information about caesarean sections fosters women's fear from labour pain and acts as the main impetus for women to consider caesareans as the pain free alternative. Findings reveal health-care providers' role in reinforcing beliefs about caesarean sections being the way for pain free deliveries by overestimating the safety of the procedure and disregarding postpartum health issues. caesarean birth is presented to women as a safe option for 'pain free' childbirth. This needs to be considered within the cultural context of understanding safety and pain as well as the dynamics of power in maternity care. Health-care professionals need to explore these dimensions and promote women's informed choice as well as encouraging the normality of birth. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. The use of CAM and conventional treatments among primary care consulters with chronic musculoskeletal pain

    Directory of Open Access Journals (Sweden)

    Lewis Martyn

    2007-05-01

    Full Text Available Abstract Background Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM. Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be. Methods Aims and objectives To determine CAM use among patients with chronic musculoskeletal pain who have consulted about their pain in primary care. Study design Face-to-face interview-based survey. Setting Three general practices in North Staffordshire. Participants Respondents to a population pain survey who had reported having musculoskeletal pain in the survey and who had consulted about their pain in primary care in the previous 12 months as well as consenting to further research and agreeing to an interview. Information was gathered about their pain and the use of all treatments for pain, including CAM, in the previous year. Results 138 interviews were completed. 116 participants (84% had used at least one CAM treatment for pain in the previous year. 65% were current users of CAM. The ratio of over-the-counter CAM use to care from a CAM provider was 3:2. 111 participants (80% had used conventional treatment. 95 (69% were using a combination of CAM and conventional treatment. Glucosamine and fish oil were the most commonly used CAM treatments (38%, 35% respectively. Most CAM treatments were scored on average as being helpful, and users indicated that they intended to use again 87% of the CAM treatments they had already used. Conclusion We provide direct evidence that most primary care consulters with chronic musculoskeletal pain have used CAM in the previous year, usually in combination with conventional treatments. The high prevalence and wide range of users experiences of benefit and harm from CAM strengthen the argument for more research into this type of medicine

  6. Famous face recognition, face matching, and extraversion.

    Science.gov (United States)

    Lander, Karen; Poyarekar, Siddhi

    2015-01-01

    It has been previously established that extraverts who are skilled at interpersonal interaction perform significantly better than introverts on a face-specific recognition memory task. In our experiment we further investigate the relationship between extraversion and face recognition, focusing on famous face recognition and face matching. Results indicate that more extraverted individuals perform significantly better on an upright famous face recognition task and show significantly larger face inversion effects. However, our results did not find an effect of extraversion on face matching or inverted famous face recognition.

  7. Clinical utility of PPPM and FPS-R to quantify post-tonsillectomy pain in children.

    Science.gov (United States)

    de Azevedo, Carolina Brotto; Carenzi, Lucas Rodrigues; de Queiroz, Danielle Leite Cunha; Anselmo-Lima, Wilma T; Valera, Fabiana Cardoso Pereira; Tamashiro, Edwin

    2014-02-01

    As pain is a subjective and difficult parameter to assess in children, we aimed to evaluate the correspondence of two pain scales - parents' post-operative pain measure (PPPM) and faces pain scale-revised (FPS-R) with analgesic intake in the assessment of post-tonsillectomy pain in a pediatric population. Children aged 4-10 years (n=174) undergoing tonsillectomy with or without adenoidectomy had their pain monitored by PPPM and FPS-R over 7 days following surgery. The amount of analgesic (acetaminophen or dipyrone) intake was also recorded each day. Linear regression and correlation analysis were performed for pain scales and Poisson regression model for analgesic administration. To evaluate influence of gender linear regression and logistic regression with random effects were performed. PPPM and FPS-R presented a significant positive correlation (τ=0.5; R(2)=0.36; pFPS-R also showed a significant correlation with analgesic use over the 7 post-operative days (pFPS-R are equivalent pain scales to quantify post-tonsillectomy pain in children and are useful tools in post-tonsillectomy clinical research. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Pain-relevant anxiety affects desire for pain relief, but not pain perception

    Directory of Open Access Journals (Sweden)

    Adriana Banozic

    2017-01-01

    Full Text Available Background: Pain context plays a significant role in the perception of pain. Despite recent interest in vicarious learning and anxiety in pain modulation, there have been no attempts to explore pain modulation by specific environmental cues. Aims: Therefore, the present study evaluated pain responses in the condition that was attributed as either anxiety relevant (AR or anxiety irrelevant. Materials and Methods: Participants were exposed to both conditions through social observational learning. Pain perception was assessed by means of a visual analog scale ranging from 0 = no pain to 10 = maximum imaginable pain. State anxiety, empathy, expectancy, and desire for pain relief were also measured at both neutral and emotionally inducing conditions. Results: No effect of relevancy of anxiety for the pain context on any of the pain-related constructs was found. However, participants in the AR condition reported an increased desire for pain relief. Maximizing similarities between observed and experienced pain context did not enhance observational learning effects in the emotionally inducing condition regardless of its relevance, but significant changes were found in comparison to the affectively neutral group. Conclusions: These results could have potentially significant clinical implications suggesting that even though observing painful procedures does not increase pain it could affect medication usage.

  9. Assessment of pain in children with cerebral palsy focused on translation and clinical feasibility of the revised FLACC score

    DEFF Research Database (Denmark)

    Pedersen, Line Kjeldgaard; Rahbek, Ole; Nikolajsen, Lone

    2015-01-01

    AbstractBackground and aims Assessment of pain in children with cognitive impairment (CI) including cerebral palsy (CP) is difficult. Several pain assessment tools have been developed and validated for use in children with CI. The revised Face, Legs, Activity, Cry and Consolability score (r......). Both the Noncommunicating Childrens's Pain Checklist – Postoperative version (NCCPC-PV) and the Echelle Douleur Enfant San Salvador (DESS) are developed from core pain behaviours for children with CI but have no possibility for individualisation. For successful clinical application a pain assessment......-FLACC) includes core behaviours of children with CI and adds an open-ended descriptor for individualisation (5 items assigned 0–2 points, total range 0–10). Other pain assessment tools including individual pain behaviours are the Individualised Numeric Rating Scale (INRS) and the Paediatric Pain Profile (PPP...

  10. Changes in the vibration sensitivity and pressure pain thresholds in patients with burning mouth syndrome.

    Directory of Open Access Journals (Sweden)

    Brenda de Souza Moura

    Full Text Available To investigate the presence of changes in vibration detection and pressure pain threshold in patients with burning-mouth syndrome (BMS.Case-control study. The sample was composed of 30 volunteers, 15 with BMS and 15 in the control group. The pressure-pain threshold (PPT and vibration-detection threshold (VDT were examined. The clinical evaluation was complemented with the McGill Pain Questionnaire (MPQ, Douleur Neuropathique 4 (DN4 and Beck Depression and Anxiety Inventories (BDI and BAI, respectively.BMS subjects showed a statistically significant higher PPT in the tongue (p = 0.002, right (p = 0.001 and left (p = 0.004 face, and a significant reduction of the VDT in the tongue (p = 0.013 and right face (p = 0.030. Significant differences were also found when comparing the PPT and the VDT of distinct anatomical areas. However, a significant interaction (group × location was only for the PPT. BMS subjects also showed significantly higher levels of depression (p = 0.01, as measured by the BDI, compared to controls; and a significant inverse correlation between the VDT in the left face and anxiety levels was detected.The study of somatosensory changes in BMS and its correlations with the clinical features as well as the levels of anxiety and depression expands current understanding of the neuropathic origin and the possible contribution of psychogenic factors related to this disease.

  11. Efficient conditioned pain modulation despite pain persistence in painful diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Yelena Granovsky

    2017-06-01

    Conclusion:. Pro-nociception, expressed by less efficient CPM and high temporal summation that usually accompanies clinical painful conditions, seems to “normalize” with chronicity of the pain syndrome. This is despite continuing pain, suggesting that pro-nociceptivity in pain syndromes is multifactorial. Because the pain modulation profile affects success of therapy, this suggests that different drugs might express different efficacy pending on duration of the pain in patients with PDN.

  12. Children’s pain and distress while undergoing an acute radiographic examination

    International Nuclear Information System (INIS)

    Björkman, B.; Nilsson, S.; Sigstedt, B.; Enskär, K.

    2012-01-01

    Pain has been highlighted as a main concern for children in conjunction with an acute radiographic examination. The aim of this study was to further investigate children’s pain and distress while undergoing an acute radiographic examination. The study comprised 29 participants with an age range of 5–15 years who were injured and submitted to an acute radiographic examination of the upper or lower extremity when the question at issue was fracture. The Coloured Analogue Scale (CAS) and the Facial Affective Scale (FAS) were used as self-reporting scales to measure the children’s pain and distress. The Face, Legs, Activity, Cry and Consolability Behavioural scale (FLACC) was used as an observation tool to assess behaviours associated with pain in children. Descriptive statistics were used when analysing the scores, and the results showed that children experience pain and distress in conjunction with a radiographic examination after an injury. Spearman’s correlation was used to compare variables, and significant correlations were obtained between the self-reported pain and the observed pain behaviour. Fischer’s Exact test was used to compare groups, and when using the cut-off 3.0 on the self-reporting scale no significant correlation was found concerning the pain reported by children diagnosed with and without a fracture. No significant correlations were found concerning the self-reported distress and pain either, regardless of whether it was a first-time visit and whether a parent was near during the examination.

  13. Clinical assessment of patients with orofacial pain and temporomandibular disorders.

    Science.gov (United States)

    Stern, Ilanit; Greenberg, Martin S

    2013-07-01

    Accurate diagnosis of chronic pain disorders of the mouth, jaws, and face is frequently complex. It is common for patients with chronic orofacial pain to consult multiple clinicians and receive ineffective treatment before a correct diagnosis is reached. This problem is a significant public health concern. Clinicians can minimize error by starting the diagnostic procedure with a careful, accurate history and thorough head and neck examination followed by a thoughtfully constructed differential diagnosis. The possibility that the patient has symptoms of a life-threatening underlying disease rather than a more common dental, sinus, or temporomandibular disorder must always be considered. Published by Elsevier Inc.

  14. Hybrid CNN+LSTM for face recognition in videos

    OpenAIRE

    Bellantonio, Marco

    2016-01-01

    El reconocimiento de caras, junto con la identificación de las acciones y gestos humanos, es en la actualidad una de las aplicaciones informáticas, más exitosas de análisis automatizado del comportamiento humano. Durante los últimos diez años aproximadamente, se ha convertido en un área muy popular de la investigación en computer vision y ha recibido mucha atención por parte de las organizaciones internacionales (Thumos, ChaLearn, etc). [1] El sistema de reconocimiento facial es una aplicació...

  15. Conditioned pain modulation in patients with nonspecific chronic back pain with chronic local pain, chronic widespread pain, and fibromyalgia.

    Science.gov (United States)

    Gerhardt, Andreas; Eich, Wolfgang; Treede, Rolf-Detlef; Tesarz, Jonas

    2017-03-01

    Findings considering conditioned pain modulation (CPM) in chronic back pain (CBP) are contradictory. This might be because many patients with CBP report pain in further areas of the body, and altered CPM might influence spatial extent of pain rather than CBP per se. Therefore, we compared CPM in patients with CBP with different pain extent. Patients with fibromyalgia syndrome (FMS), for whom CPM impairment is reported most consistently, were measured for comparison. Based on clinical evaluation and pain drawings, patients were categorized into chronic local back pain (CLP; n = 53), chronic widespread back pain (CWP; n = 32), and FMS (n = 92). Conditioned pain modulation was measured by the difference in pressure pain threshold (test stimuli) at the lower back before and after tonic heat pain (conditioning stimulus). We also measured psychosocial variables. Pressure pain threshold was significantly increased in CLP patients after tonic heat pain (P pain modulation in CLP was significantly higher than that in CWP and FMS (P painful areas (0-10) were associated with lower CPM (r = 0.346, P = 0.001) in CBP but not in FMS (r = -0.013, P = 0.903). Anxiety and depression were more pronounced in FMS than in CLP or CWP (P values pain inhibition seem to be more indicated the higher the pain extent.

  16. Face-to-Face Activities in Blended Learning

    DEFF Research Database (Denmark)

    Kjærgaard, Annemette

    While blended learning combines online and face-to-face teaching, research on blended learning has primarily focused on the role of technology and the opportunities it creates for engaging students. Less focus has been put on face-to-face activities in blended learning. This paper argues...... that it is not only the online activities in blended learning that provide new opportunities for rethinking pedagogy in higher education, it is also imperative to reconsider the face-to-face activities when part of the learning is provided online. Based on a review of blended learning in business and management...... education, we identify what forms of teaching and learning are suggested to take place face-to-face when other activities are moved online. We draw from the Community of Inquiry framework to analyze how face-to-face activities contribute to a blended learning pedagogy and discuss the implications...

  17. What is the perceived impact of Alexander technique lessons on health status, costs and pain management in the real life setting of an English hospital? The results of a mixed methods evaluation of an Alexander technique service for those with chronic back pain.

    Science.gov (United States)

    McClean, Stuart; Brilleman, Sam; Wye, Lesley

    2015-07-28

    Randomised controlled trial evidence indicates that Alexander Technique is clinically and cost effective for chronic back pain. The aim of this mixed methods evaluation was to explore the role and perceived impact of Alexander Technique lessons in the naturalistic setting of an acute hospital Pain Management Clinic in England. To capture changes in health status and resource use amongst service users, 43 service users were administered three widely used questionnaires (Brief Pain Inventory, MYMOP and Client Service Resource Inventory) at three time points: baseline, six weeks and three months after baseline. We also carried out 27 telephone interviews with service users and seven face-to-face interviews with pain clinic staff and Alexander Technique teachers. Quantitative data were analysed using descriptive statistics and qualitative data were analysed thematically. Those taking Alexander Technique lessons reported small improvements in health outcomes, and condition-related costs fell. However, due to the non-randomised, uncontrolled nature of the study design, changes cannot be attributed to the Alexander Technique lessons. Service users stated that their relationship to pain and pain management had changed, especially those who were more committed to practising the techniques regularly. These changes may explain the reported reduction in pain-related service use and the corresponding lower associated costs. Alexander Technique lessons may be used as another approach to pain management. The findings suggests that Alexander Technique lessons can help improve self-efficacy for those who are sufficiently motivated, which in turn may have an impact on service utilisation levels.

  18. Effectiveness of Different Pain Control Methods in Patients with Knee Osteoarthritis after Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Jin-Lain Ming

    2017-01-01

    Full Text Available The number of patients with knee osteoarthritis has increased in tandem with population aging. Consequently, the number of knee arthroplasties has also risen. The postoperative pain is the biggest challenge faced by patients soon after knee arthroplasty; therefore, this study is among different methods for post-knee arthroplasty pain control. A prospective longitudinal research design was employed; 177 adult patients who proposed for primary knee arthroplasty were enrolled and recruited. The patients were divided into conventional Group 1 (n=120 and patient-controlled analgesia (PCA Group 2 (n=57 according to the treatment methods they received. All patients experience the highest pain level on the day of their surgery; women complained of higher pain levels than men did, while the PCA group had lower postoperative pain. Meanwhile, patients with general anesthesia experienced more pain than those with spinal anesthesia in postoperative period. Patients with a higher postoperative pain index have a smaller optimal knee flexion angle. The PCA group had lower postoperative pain; all patients experienced the highest pain level on the day of their surgery. The results of this study could serve as a reference for nurses where PCA ensures a better postoperative pain control and therefore facilitates recovery and improves the quality of nursing.

  19. Social isolation in women with endometriosis and chronic pelvic pain.

    Science.gov (United States)

    Mellado, Bruna H; Falcone, Ananda C M; Poli-Neto, Omero B; Rosa E Silva, Julio C; Nogueira, Antonio A; Candido-Dos-Reis, Francisco J

    2016-05-01

    To evaluate the perceptions of women with endometriosis and chronic pelvic pain regarding their social ties. A qualitative study was undertaken of women with chronic pelvic pain and endometriosis. Focus groups discussions among four to six participants were performed until saturation at the Clinics Hospital of Ribeirão Preto Medical School, Ribeirão Preto, southwest Brazil, between February 2013 and January 2014. Transcripts were analyzed according to the grounded theory approach and the emerging categories were coded using the WebQDA platform. Six focus group discussions took place, with a total of 29 patients. Social isolation was the main emerging theme. Social isolation was associated with a lack of understanding about endometriosis symptoms and with resignation in face of recurrent pain episodes. Avoiding partner intimacy and isolation from family and friends were components of social isolation. Women with endometriosis develop progressive social isolation after the onset of chronic pelvic pain. This finding is important for the multidisciplinary management of the disease. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. use of combined paracetamol and low dose ketamine in pain control

    African Journals Online (AJOL)

    Setting: The burns ward of Moi Teaching and Referral Hospital, a 750 bed capacity tertiary centre in Western ... Results: Of the Fifty nine patients who were recruited into the study, seventy percent of them were ... in a cylinder, self inflating bag for ventilation, face masks .... Behavioral Tool in Assessing Acute Pain in Critically.

  1. Face recognition system and method using face pattern words and face pattern bytes

    Science.gov (United States)

    Zheng, Yufeng

    2014-12-23

    The present invention provides a novel system and method for identifying individuals and for face recognition utilizing facial features for face identification. The system and method of the invention comprise creating facial features or face patterns called face pattern words and face pattern bytes for face identification. The invention also provides for pattern recognitions for identification other than face recognition. The invention further provides a means for identifying individuals based on visible and/or thermal images of those individuals by utilizing computer software implemented by instructions on a computer or computer system and a computer readable medium containing instructions on a computer system for face recognition and identification.

  2. Painful Intercourse Is Significantly Associated with Evoked Pain Perception and Cognitive Aspects of Pain in Women with Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Meryl J. Alappattu, DPT, PhD

    2015-03-01

    Conclusions: Differences in local pain ratings suggest that women with pelvic pain perceive stimuli in this region as more painful than pain-free women although the magnitude of stimuli does not differ. Alappattu MJ, George SZ, Robinson ME, Fillingim RB, Moawad N, LeBrun EW, and Bishop MD. Painful intercourse is significantly associated with evoked pain perception and cognitive aspects of pain in women with pelvic pain. Sex Med 2015;3:14–23.

  3. Virtual & Real Face to Face Teaching

    Science.gov (United States)

    Teneqexhi, Romeo; Kuneshka, Loreta

    2016-01-01

    In traditional "face to face" lessons, during the time the teacher writes on a black or white board, the students are always behind the teacher. Sometimes, this happens even in the recorded lesson in videos. Most of the time during the lesson, the teacher shows to the students his back not his face. We do not think the term "face to…

  4. The Effect of Microneedle Thickness on Pain During Minimally Invasive Facial Procedures: A Clinical Study.

    Science.gov (United States)

    Sezgin, Billur; Ozel, Bora; Bulam, Hakan; Guney, Kirdar; Tuncer, Serhan; Cenetoglu, Seyhan

    2014-07-01

    Minimally invasive procedures are becoming increasingly popular because they require minimal downtime and are effective for achieving a more youthful appearance. The choice of needle for minimally invasive procedures can be a major factor in the patient's comfort level, which in turn affects the physician's comfort level. In this comparative study, the authors assessed levels of pain and bruising after participants were injected with 30-gauge or 33-gauge (G) microneedles, which are commonly used for minimally invasive injection procedures. Twenty healthy volunteers were recruited for this prospective study. Eight injection points (4 on each side of the face) were determined for each patient. All participants received injections of saline with both microneedles in a randomized, blinded fashion. Levels of pain and bruising were assessed and analyzed for significance. The highest level of pain was in the malar region, and the lowest level was in the glabella. Although all pain scores were lower for the 33-G microneedle, the difference was significant only for the forehead. Because most minimally invasive procedures require multiple injections during the same sitting, the overall procedure was evaluated as well. Assessment of the multiple-injection process demonstrated a significant difference in pain level, favoring the 33-G needle. Although the difference in bruising was not statistically significant between the 2 needles, the degree of bruising was lower with the 33-G needle. For procedures that involve multiple injections to the face (such as mesotherapy and injection of botulinum toxin A), thinner needles result in less pain, making the overall experience more comfortable for the patient and the physician. 3. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

  5. Pain and cardiorespiratory responses of children during physiotherapy after heart surgery.

    Science.gov (United States)

    Araujo, Adriana Sanches Garcia; Klamt, Jyrson Guilherme; Vicente, Walter Villela de Andrade; Garcia, Luis Vicente

    2014-01-01

    The aim of the present study was to determine the occurrence of pain and changes in blood pressure, heart rate, respiratory rate, and arterial oxygen saturation associated with physiotherapy in children undergoing cardiac surgery. Eighteen extubated children were assessed for the presence of pain using the face, legs, activity, cry, consolability scale, and blood pressure, heart rate, respiratory rate and arterial oxygen saturation were simultaneously recorded. The physiological parameters were measured at the following time periods: immediately before physiotherapy, five and 10 minutes after the beginning of physiotherapy, and five minutes after its end. Pain was assessed immediately before physiotherapy, ten minutes after the beginning of physiotherapy and five minutes after its end. Pain and physiological changes were assessed by the Friedman test and the correlation between the physiological parameters and the pain scores was assessed by the Spearman test. Pain increased during physiotherapy and decreased significantly after it compared to pre-physiotherapy scores. Systolic blood pressure and heart rate increased significantly after 10 minutes of the beginning of physiotherapy. Arterial oxygen saturation tended to decrease during physiotherapy and to increase after it, although without significance. The correlation between pain scores and the physiological variables was significant only for systolic blood pressure and heart rate ten minutes after the beginning of physiotherapy. Manipulation after the beginning of physiotherapy seems to be accompanied by significant pain and by important associated cardiovascular changes. Apparent analgesia and improved respiratory function were observed after respiratory physiotherapy.

  6. Documenting pain as the fifth vital sign: a feasibility study in an oncology ward in Sarawak, Malaysia.

    Science.gov (United States)

    Devi, B C R; Tang, T S

    2008-01-01

    Monitoring acute postoperative pain as the fifth vital sign is currently practiced in many developed countries. In Sarawak, pain is an important symptom as 70% of cancer patients present with advanced disease. As the existing validated pain assessment tools were found to be difficult to use, we studied the feasibility of modifying the use of a pain assessment tool, consisting of the short form of the Brief Pain Inventory and the Wong-Baker Faces Scale. This tool was used to document pain in all 169 patients who were admitted for pain control to the oncology ward between July 2000 and June 2001. Nurses were trained in the use of the modified scale before the start of the study. The method was easy to use, and the mean number of days to reduce pain was found to be 3.1 days (SD: 2.9; median: 2 days; range: 1-31 days). At discharge, none in the group with initially mild pain had pain, and the severity of pain for 98% of patients with moderate pain and 61% with severe pain was downgraded to mild pain. The staff found that the tool allowed continuous pain assessment in an objective manner. Copyright 2008 S. Karger AG, Basel.

  7. Perceptions about traditional and novel methods to learn about postoperative pain management: a qualitative study.

    Science.gov (United States)

    Ingadottir, Brynja; Blondal, Katrin; Jaarsma, Tiny; Thylen, Ingela

    2016-11-01

    The aim of this study was to explore the perceptions of surgical patients about traditional and novel methods to learn about postoperative pain management. Patient education is an important part of postoperative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice. A qualitative design with a vignette and semi-structured interviews used for data collection. A purposeful sample of 13 postsurgical patients, who had been discharged from hospital, was recruited during 2013-2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about postoperative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach. Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualized the factors affecting patients' perceptions: (1) 'Trusting the source', sub-categorized into 'Being familiar with the method' and 'Having own prejudgments'; and (2) 'Being motivated to learn' sub-categorized into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'. To implement successfully novel educational methods into postoperative care, healthcare professionals need to be aware of the factors influencing patients' perceptions about how to learn, such as trust and motivation. © 2016 John Wiley & Sons Ltd.

  8. Reading faces and Facing words

    DEFF Research Database (Denmark)

    Robotham, Julia Emma; Lindegaard, Martin Weis; Delfi, Tzvetelina Shentova

    unilateral lesions, we found no patient with a selective deficit in either reading or face processing. Rather, the patients showing a deficit in processing either words or faces were also impaired with the other category. One patient performed within the normal range on all tasks. In addition, all patients......It has long been argued that perceptual processing of faces and words is largely independent, highly specialised and strongly lateralised. Studies of patients with either pure alexia or prosopagnosia have strongly contributed to this view. The aim of our study was to investigate how visual...... perception of faces and words is affected by unilateral posterior stroke. Two patients with lesions in their dominant hemisphere and two with lesions in their non-dominant hemisphere were tested on sensitive tests of face and word perception during the stable phase of recovery. Despite all patients having...

  9. Validation of the French Version of the “Patterns of Activity Measure” in Patients with Chronic Musculoskeletal Pain

    Directory of Open Access Journals (Sweden)

    Charles Benaim

    2017-01-01

    Full Text Available Background. The “Patterns of Activity Measure” (POAM-P is a self-administered questionnaire that assesses “avoidance”, “pacing” and “overdoing” activity patterns in chronic pain patients. Objectives. To adapt the POAM-P to French (“POAM-P/F” and test its validity and reliability in Chronic Musculo-Skeletal Pain patients (CMSP. Methods. We followed the recommended procedure for translation of questionnaires. Five hundred and ninety five inpatients, admitted to a tertiary rehab center in the French-speaking part of Switzerland for chronic pain after orthopedic trauma, were included (sex ratio M/F = 4.36, mean age 43±12. Face, content and criterion validities, internal consistency and reliability were assessed. Data included: TAMPA Scale for Kinesiophobia (TSK, Chronic Pain Coping Inventory (CPCI, Pain Catastrophizing Scale (PCS, Brief Pain Inventory (BPI, Hospital Anxiety and Depression Scale (HADS. Results. Face and content validities were checked during the translation process. Correlations between POAM-P/F-avoidance and TSK, POAM-P/F-pacing and CPCI-pacing, POAM-P/F-overdoing and CPCI-task persistence were highly significant (r>0.3, p 0.8 and test-retest reliability (Intraclass Correlation Coefficients > 0.8. They correlated very differently with the other scales. Discussion and Conclusion. The three POAM-P/F subscales clearly assess different behaviors in CMSP. The POAM-P/F is a suitable questionnaire for classifying French speaking CMSP into avoiders, pacers or overdoers.

  10. “STRUCTURA”, fachada autoportante de ladrillo cara vista para cumplir los requisitos del nuevo CTE DB HE” = “STRUCTURA”, self-supporting face brick façade to comply with the new CTE DB HE requirements”

    Directory of Open Access Journals (Sweden)

    Concepción Río Vega

    2016-08-01

    Full Text Available La fachada autoportante de ladrillo cara vista es el resultado de una profunda reflexión sobre las diferentes soluciones de fachada de ladrillo que se han utilizado a lo largo de la historia. Ha sido promovida por Hispalyt en estrecha colaboración con el Departamento Técnico de Geohidrol S.A., empresa líder en la investigación, fabricación y comercialización de sistemas para cerramientos de fábrica. Cuando se analizan las diferentes soluciones de las fachadas de ladrillo, bajo la óptica de los requisitos del Código Técnico de la Edificación, la fachada autoportante 'STRUCTURA' se manifiesta como la solución óptima por su simplicidad, sus elevadas prestaciones y el bajo coste en recursos auxiliares. La fachada autoportante 'STRUCTURA' se caracteriza porque la hoja exterior del cerramiento se construye totalmente separada del edificio, gravitando sobre sí misma, lo cual permite la disposición de una cámara de aire (ventilada o no con aislamiento térmico continuo. De esta forma se elimina el puente térmico en el encuentro con los frentes de pilares y forjados, mejorando notablemente el rendimiento higrotérmico del edificio con el fin de cumplir el Documento Básico de Ahorro de Energía (DB HE, cuyos requisitos en la nueva versión aprobada en Septiembre de 2013 han experimentado un sustancial incremento respecto de los contenidos en la versión anterior. Desde el punto de vista de la respuesta mecánica, la fachada autoportante se fundamenta en el aprovechamiento del potencial que tienen los muros de ladrillo cuando se utilizan como soportes de sí mismos. A diferencia de las soluciones convencionales o de las que requieren elementos auxiliares de sostén dispuestos planta a planta, con la solución 'STRUCTURA' el muro de ladrillo se analiza como un elemento activo en el comportamiento estructural, de manera que su propio peso contribuye beneficiosamente en la resistencia frente a las acciones horizontales. Abstract The self

  11. Colorectal surgery patients' pain status, activities, satisfaction, and beliefs about pain and pain management.

    Science.gov (United States)

    Brown, Carolyn; Constance, Kristel; Bédard, Denise; Purden, Margaret

    2013-12-01

    This study describes surgical colorectal cancer patients' pain levels, recovery activities, beliefs and expectations about pain, and satisfaction with pain management. A convenience sample of 50 adult inpatients who underwent colorectal surgery for cancer participated. Patients were administered the modified American Pain Society Patient Outcome Questionnaire on postoperative day 2 and asked to report on their status in the preceding 24 hours. Patients reported low current (mean 1.70) and average (mean 2.96) pain scores but had higher scores and greater variation for worst pain (mean 5.48). Worst pain occurred mainly while turning in bed or mobilizing, and 25% of patients experienced their worst pain at rest. Overall, patients expected to have pain after surgery and were very satisfied with pain management. Patients with worst pain scores >7 reported interference with recovery activities, mainly general activity (mean 5.67) and walking ability (mean 5.15). These patients were likely to believe that "people can get addicted to pain medication easily" (mean 3.39 out of 5) and that "pain medication should be saved for cases where pain gets worse" (mean 3.20 out of 5). These beliefs could deter patients from seeking pain relief and may need to be identified and addressed along with expectations about pain in the preoperative nursing assessment. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  12. Changes in the vibration sensitivity and pressure pain thresholds in patients with burning mouth syndrome

    Science.gov (United States)

    Ferreira, Natália dos Reis; Janini, Maria Elisa Rangel

    2018-01-01

    Objective To investigate the presence of changes in vibration detection and pressure pain threshold in patients with burning-mouth syndrome (BMS). Design of the study Case-control study. The sample was composed of 30 volunteers, 15 with BMS and 15 in the control group. The pressure-pain threshold (PPT) and vibration-detection threshold (VDT) were examined. The clinical evaluation was complemented with the McGill Pain Questionnaire (MPQ), Douleur Neuropathique 4 (DN4) and Beck Depression and Anxiety Inventories (BDI and BAI, respectively). Results BMS subjects showed a statistically significant higher PPT in the tongue (p = 0.002), right (p = 0.001) and left (p = 0.004) face, and a significant reduction of the VDT in the tongue (p = 0.013) and right face (p = 0.030). Significant differences were also found when comparing the PPT and the VDT of distinct anatomical areas. However, a significant interaction (group × location) was only for the PPT. BMS subjects also showed significantly higher levels of depression (p = 0.01), as measured by the BDI, compared to controls; and a significant inverse correlation between the VDT in the left face and anxiety levels was detected. Conclusions The study of somatosensory changes in BMS and its correlations with the clinical features as well as the levels of anxiety and depression expands current understanding of the neuropathic origin and the possible contribution of psychogenic factors related to this disease. PMID:29782537

  13. Face Attention Network: An Effective Face Detector for the Occluded Faces

    OpenAIRE

    Wang, Jianfeng; Yuan, Ye; Yu, Gang

    2017-01-01

    The performance of face detection has been largely improved with the development of convolutional neural network. However, the occlusion issue due to mask and sunglasses, is still a challenging problem. The improvement on the recall of these occluded cases usually brings the risk of high false positives. In this paper, we present a novel face detector called Face Attention Network (FAN), which can significantly improve the recall of the face detection problem in the occluded case without comp...

  14. Effects of intra-hippocampal microinjection of vitamin B12 on the orofacial pain and memory impairments induced by scopolamine and orofacial pain in rats.

    Science.gov (United States)

    Erfanparast, Amir; Tamaddonfard, Esmaeal; Nemati, Shaghayegh

    2017-03-01

    In the present study, we investigated the effects of microinjection of vitamin B 12 into the hippocampus on the orofacial pain and memory impairments induced by scopolamine and orofacial pain. In ketamine-xylazine anesthetized rats, the right and left sides of the dorsal hippocampus (CA1) were implanted with two guide cannulas. Orofacial pain was induced by subcutaneous injection of formalin (1.5%, 50μl) into the right vibrissa pad, and the durations of face rubbing were recorded at 3-min blocks for 45min. Morris water maze (MWM) was used for evaluation of learning and memory. Finally, locomotor activity was assessed using an open-field test. Vitamin B 12 attenuated both phases of formalin-induced orofacial pain. Prior administration of naloxone and naloxonazine, but not naltrindole and nor-binaltorphimine, prevented this effect. Vitamin B 12 and physostigmine decreased latency time as well as traveled distance in Morris water maze. In addition, these chemicals improved scopolamine-induced memory impairment. The memory impairment induced by orofacial pain was improved by vitamin B 12 and physostigmine used alone. Naloxone prevented, whereas physostigmine enhanced the memory improving effect of vitamin B 12 in the pain-induced memory impairment. All the above-mentioned chemicals did not alter locomotor activity. The results of the present study showed that at the level of the dorsal hippocampus, vitamin B 12 modulated orofacial pain through a mu-opioid receptor mechanism. In addition, vitamin B 12 contributed to hippocampal cholinergic system in processing of memory. Moreover, cholinergic and opioid systems may be involved in improving effect of vitamin B 12 on pain-induced memory impairment. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. How Well Do Computer-Generated Faces Tap Face Expertise?

    Directory of Open Access Journals (Sweden)

    Kate Crookes

    Full Text Available The use of computer-generated (CG stimuli in face processing research is proliferating due to the ease with which faces can be generated, standardised and manipulated. However there has been surprisingly little research into whether CG faces are processed in the same way as photographs of real faces. The present study assessed how well CG faces tap face identity expertise by investigating whether two indicators of face expertise are reduced for CG faces when compared to face photographs. These indicators were accuracy for identification of own-race faces and the other-race effect (ORE-the well-established finding that own-race faces are recognised more accurately than other-race faces. In Experiment 1 Caucasian and Asian participants completed a recognition memory task for own- and other-race real and CG faces. Overall accuracy for own-race faces was dramatically reduced for CG compared to real faces and the ORE was significantly and substantially attenuated for CG faces. Experiment 2 investigated perceptual discrimination for own- and other-race real and CG faces with Caucasian and Asian participants. Here again, accuracy for own-race faces was significantly reduced for CG compared to real faces. However the ORE was not affected by format. Together these results signal that CG faces of the type tested here do not fully tap face expertise. Technological advancement may, in the future, produce CG faces that are equivalent to real photographs. Until then caution is advised when interpreting results obtained using CG faces.

  16. Paracetamol and morphine for infant and neonatal pain; still a long way to go?

    Science.gov (United States)

    Baarslag, Manuel A; Allegaert, Karel; Van Den Anker, John N; Knibbe, Catherijne A J; Van Dijk, Monique; Simons, Sinno H P; Tibboel, Dick

    2017-01-01

    Pharmacologic pain management in newborns and infants is often based on limited scientific data. To close the knowledge gap, drug-related research in this population is increasingly supported by the authorities, but remains very challenging. This review summarizes the challenges of analgesic studies in newborns and infants on morphine and paracetamol (acetaminophen). Areas covered: Aspects such as the definition and multimodal character of pain are reflected to newborn infants. Specific problems addressed include defining pharmacodynamic endpoints, performing clinical trials in this population and assessing developmental changes in both pharmacokinetics and pharmacodynamics. Expert commentary: Neonatal and infant pain management research faces two major challenges: lack of clear biomarkers and very heterogeneous pharmacokinetics and pharmacodynamics of analgesics. There is a clear call for integral research addressing the multimodality of pain in this population and further developing population pharmacokinetic models towards physiology-based models.

  17. Dancing in pain: pain appraisal and coping in dancers.

    Science.gov (United States)

    Anderson, Ruth; Hanrahan, Stephanie J

    2008-01-01

    This study investigated the relationships between the type of pain experienced (performance pain and injury pain), the cognitive appraisal of pain and pain coping styles in dancers. Fifty-one professional ballet and contemporary dancers (17 males and 34 females), with the mean age of 25.9 years, completed a general pain questionnaire, the Pain Appraisal Inventory, the Survey of Pain Attitudes Control Subscale, and the Sports Inventory for Pain. Multivariate analyses of variance indicated that both the cognitive appraisal of the pain and pain coping styles did not differ according to the type of pain experienced or the pain severity. However, it was found that dancers with performance pain of either low or high severity were more likely to dance in pain than dancers experiencing injury pain. Multiple regression analyses indicated that the appraisal of pain as threatening was predictive of the use of avoidance and catastrophizing pain coping styles. Overall, results indicated that dancers may not differentiate between performance pain and injury pain, or modify their appraisal and coping strategies according to the characteristics of the pain experienced. The study highlighted an opportunity for increased education for dancers in recognizing the difference between pain considered to be a routine aspect of training and pain which is a signal of serious injury.

  18. Comparison of injection pain caused by the DentalVibe Injection System versus a traditional syringe for inferior alveolar nerve block anaesthesia in paediatric patients.

    Science.gov (United States)

    Elbay, M; Şermet Elbay, Ü; Yıldırım, S; Uğurluel, C; Kaya, C; Baydemir, C

    2015-06-01

    To compare paediatric patients' pain during needle insertion and injection in inferior alveoler nerve block (IANB) anaesthesia injected by either a traditional syringe (TS) or the DentalVibe Injection Comfort System (DV). the study was a randomised controlled crossover clinical trial, comprised of 60 children aged 6-12 requiring an operative procedure with IANB anaesthesia on their mandibular molars bilaterally. One of the molar teeth was treated with TS and the contralateral tooth was treated with DV. On each visit, subjective and objective pain was evaluated using the Wond-Baker Faces Pain Rating Scale (PRS) and the Face, Legg, Cry, Consolability Scale (FLACC Scale). Patients were asked which anaesthesia technique they preferred. Data were analysed using Wilcoxon signed rank, Spearman correlation, and Mann-Whitney U tests. There were no statistically significant differences for pain evalution during needle insertion and injection of each injection system. However, a negative correlation was found on the FLACC between age and pain scores during injection after using DV. Paediatric patients experienced similar pain during IANB anaesthesia administered with TS and DV. With increased age, pain values reduced during anaesthetic agent injection with DV according to FLACC. The traditional procedure was preferred to DV in paediatric patients.

  19. Fear of pain in children and adolescents with neuropathic pain and complex regional pain syndrome.

    Science.gov (United States)

    Simons, Laura E

    2016-02-01

    A significant proportion of children and adolescents with chronic pain endorse elevated pain-related fear. Pain-related fear is associated with high levels of disability, depressive symptoms, and school impairment. Because of faulty nerve signaling, individuals with neuropathic pain and complex regional pain syndrome may be more prone to develop pain-related fear as they avoid use of and neglect the affected body area(s), resulting in exacerbated symptoms, muscle atrophy, maintenance of pain signaling, and ongoing pain-related disability. Not surprisingly, effective treatments for elevated pain-related fears involve exposure to previously avoided activities to downregulate incorrect pain signaling. In the context of intensive interdisciplinary pain treatment of youth with neuropathic pain, decreasing pain-related fear is associated with improved physical and psychological functioning, whereas high initial pain-related fear is a risk factor for less treatment responsiveness. An innovative approach to targeting pain-related fear and evidence of a neural response to treatment involving decoupling of the amygdala with key fear circuits in youth with complex regional pain syndrome suggest breakthroughs in our ability to ameliorate these issues.

  20. Neural synchronization during face-to-face communication

    OpenAIRE

    Jiang, J.; Dai, B.; Peng, D.; Zhu, C.; Liu, L.; Lu, C.

    2012-01-01

    Although the human brain may have evolutionarily adapted to face-to-face communication, other modes of communication, e.g., telephone and e-mail, increasingly dominate our modern daily life. This study examined the neural difference between face-to-face communication and other types of communication by simultaneously measuring two brains using a hyperscanning approach. The results showed a significant increase in the neural synchronization in the left inferior frontal cortex during a face-to-...

  1. Spontaneous pain attacks: neuralgic pain

    NARCIS (Netherlands)

    de Bont, L.G.

    2006-01-01

    Paroxysmal orofacial pains can cause diagnostic problems, especially when different clinical pictures occur simultaneously. Pain due to pulpitis, for example, may show the same characteristics as pain due to trigeminal neuralgia would. Moreover, the trigger point of trigeminal neuralgia can either

  2. Finding Silver Linings: A Preliminary Examination of Benefit Finding in Youth With Chronic Pain.

    Science.gov (United States)

    Soltani, Sabine; Neville, Alex; Hurtubise, Karen; Hildenbrand, Aimee; Noel, Melanie

    2018-04-01

    Chronic pain is a pervasive condition in adolescence and is associated with significant psychological distress, functional disability, social isolation, and decreased quality of life for a subset of affected youth. There is a paucity of research examining potential resilience factors and adaptive processes in pediatric chronic pain. Benefit finding refers to the process of perceiving positive consequences in the face of adversity. Previous research on benefit finding in pediatric samples (e.g., oncology; acute injury) has yielded inconsistent results. This is the first study to examine this construct in youth with chronic pain. The objective of the current investigation was to extend previous research on benefit finding to adolescents with chronic pain and to assess relationships between benefit finding, internalizing mental health symptoms (i.e., anxiety, depression, and posttraumatic stress disorder [PTSD]), pain outcomes (pain intensity and interference), and quality of life. Psychometrically sound self-report measures of benefit finding, anxiety, depressive, and PTSD symptoms, pain intensity, pain interference, and quality of life were completed by 145 youth (67.4% female, Mage = 13.3 years, SD = 2.6), referred to a tertiary-level chronic pain program. Benefit finding was significantly correlated with internalizing mental health symptoms, pain outcomes, and quality of life. Further, benefit finding significantly predicted children's self-reported pain intensity, pain interference, and quality of life when controlling for age and sex. Findings suggest that benefit finding is associated with internalizing mental health symptoms, pain outcomes, and quality of life in youth with chronic pain. Future research examining this construct is warranted.

  3. The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial [ISRCTN87413556

    Directory of Open Access Journals (Sweden)

    McRae Sarah E

    2005-03-01

    Full Text Available Abstract Background The management of burn injuries is reported as painful, distressing and a cause of anxiety in children and their parents. Child's and parents' pain and anxiety, often contributes to extended time required for burns management procedures, in particular the process of changing dressings. The traditional method of pharmacologic analgesia is often insufficient to cover the burnt child's pain, and it can have deleterious side effects 12. Intervention with Virtual Reality (VR games is based on distraction or interruption in the way current thoughts, including pain, are processed by the brain. Research on adults supports the hypothesis that virtual reality has a positive influence on burns pain modulation. Methods This study investigates whether playing a virtual reality game, decreases procedural pain in children aged 5–18 years with acute burn injuries. The paper reports on the findings of a pilot study, a randomised trial, in which seven children acted as their own controls though a series of 11 trials. Outcomes were pain measured using the self-report Faces Scale and findings of interviews with parent/carer and nurses. Results The average pain scores (from the Faces Scale for pharmacological analgesia only was, 4.1 (SD 2.9, while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8 Conclusion The study provides strong evidence supporting VR based games in providing analgesia with minimal side effects and little impact on the physical hospital environment, as well as its reusability and versatility, suggesting another option in the management of children's acute pain.

  4. Pain-related worry in patients with chronic orofacial pain.

    Science.gov (United States)

    Davis, C Ervin; Stockstill, John W; Stanley, William D; Wu, Qiang

    2014-07-01

    Pain-related worry is distinct from, but related to, pain catastrophizing (PC) and anxiety. Worry and its relationship with other variables have been studied in people with chronic pain but not in people with chronic orofacial pain. The authors explored the prevalence of trait, general and pain-related worry and the association of worry with higher pain levels and other variables. The authors assessed people who had a diagnosis of chronic orofacial pain by using nonpain-related trait worry, state anxiety, trait anxiety, PC and pain measures. The participants' answers to an open-ended question about what they were most worried about led to the identification of worry domains, including worry about pain. The authors found that worrying about pain was related significantly to worst and least pain levels, pain interference and pain duration, as well as moderated trait worry in predicting pain interference. Although trait worry was not correlated directly with pain, when moderated by PC, it made substantial contributions in predicting pain interference. Participants with chronic orofacial pain reported experiencing substantial levels of trait worry, anxiety, PC and worry about pain that related to pain ratings directly and indirectly. Clinicians should assess pain-related worry in patients with chronic orofacial pain to understand the effects of worry on pain and functioning. Clinicians could treat these patients more effectively by helping them reduce their levels of pain-related worry and focusing on improved coping.

  5. Pain Adaptability in Individuals With Chronic Musculoskeletal Pain Is Not Associated With Conditioned Pain Modulation.

    Science.gov (United States)

    Wan, Dawn Wong Lit; Arendt-Nielsen, Lars; Wang, Kelun; Xue, Charlie Changli; Wang, Yanyi; Zheng, Zhen

    2018-03-27

    Healthy humans can be divided into the pain adaptive (PA) and the pain nonadaptive (PNA) groups; PA showed a greater decrease in pain rating to a cold pressor test (CPT) than PNA. This study examined if the dichotomy of pain adaptability existed in individuals with chronic musculoskeletal pain. CPTs at 2°C and 7°C were used to assess the status of pain adaptability in participants with either chronic nonspecific low back pain or knee osteoarthritis. The participants' potency of conditioned pain modulation (CPM) and local inhibition were measured. The strengths of pain adaptability at both CPTs were highly correlated. PA and PNA did not differ in their demographic characteristics, pain thresholds from thermal and pressure stimuli, or potency of local inhibition or CPM. PA reached their maximum pain faster than PNA (t 41 = -2.76, P adaptability exists in musculoskeletal pain patients. Consistent with the healthy human study, the strength of pain adaptability and potency of CPM are not related. Pain adaptability could be another form of endogenous pain inhibition of which clinical implication is yet to be understood. The dichotomy of pain adaptability was identified in healthy humans. The current study confirms that this dichotomy also exists in individuals with chronic musculoskeletal pain, and could be reliably assessed with CPTs at 2°C and 7°C. Similar to the healthy human study, pain adaptability is not associated with CPM, and may reflect the temporal aspect of pain inhibition. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  6. Prescription opioid abuse, pain and addiction: clinical issues and implications.

    Science.gov (United States)

    Ling, Walter; Mooney, Larissa; Hillhouse, Maureen

    2011-05-01

    Prescription opioid misuse in the USA has increased over threefold since 1990 to epidemic proportions, with substantial increases in prescription opioid use also reported in other countries, such as Australia and New Zealand. The broad availability of prescription pain medications, coupled with public misconceptions about their safety and addictive potential, have contributed to the recent surge in non-medical use of prescription opioids and corresponding increases in treatment admissions for problems related to opioid misuse. Given competing pressures faced by physicians to both diagnose and treat pain syndromes and identify individuals at risk for addictive disorders, the use of opioids in the treatment of pain poses a significant clinical challenge. This paper reviews the interaction between pain and opioid addiction with a focus on clinical management issues, including risk factors for opioid dependence in patients with chronic pain and the use of assessment tools to identify and monitor at-risk individuals. Treatment options for opioid dependence and pain are reviewed, including the use of the partial µ agonist buprenorphine in the management of concurrent pain and opioid addiction. Physicians should strive to find a reasonable balance between minimising potential adverse effects of opioid medications without diminishing legitimate access to opioids for analgesia. The article discusses the need to identify methods for minimising risks and negative consequences associated with opioid analgesics and poses research directions, including the development of abuse-deterrent opioid formulations, genetic risk factors for opioid dependence and opioid-induced hyperalgesia as a potential target for medication therapy. © 2011 Australasian Professional Society on Alcohol and other Drugs.

  7. La cara y la cruz de los 40 años de existencia de la Universidad Estatal Distancia

    Directory of Open Access Journals (Sweden)

    Alonso Rodriguez Chaves

    2017-11-01

    Full Text Available Este ensayo académico de carácter argumentativo invita a dilucidar el proceso de evolución y el trabajo realizado por la Universidad Estatal a Distancia de Costa Rica (UNED a lo largo de sus cuarenta años de existencia; en particular, el impacto que esta ha tenido en la educación costarricense y la efectividad de la modalidad a distancia en el contexto nacional; principalmente como universidad inclusiva y favorecedora de la expansión de la educación y la movilidad social. En el texto, el lector ahonda en procesos de revisión y mejora continua de la gestión, con la cual la Universidad procura validar su quehacer y vigencia. En el último nivel se deja al descubierto una serie de elementos que obliga y compromete a mejorar y modificar de cara a los nuevos tiempos; de igual modo, se invita a las entidades correspondientes a revisar los recursos económicos que se asignan a esta universidad.

  8. Facing aggression: cues differ for female versus male faces.

    Directory of Open Access Journals (Sweden)

    Shawn N Geniole

    Full Text Available The facial width-to-height ratio (face ratio, is a sexually dimorphic metric associated with actual aggression in men and with observers' judgements of aggression in male faces. Here, we sought to determine if observers' judgements of aggression were associated with the face ratio in female faces. In three studies, participants rated photographs of female and male faces on aggression, femininity, masculinity, attractiveness, and nurturing. In Studies 1 and 2, for female and male faces, judgements of aggression were associated with the face ratio even when other cues in the face related to masculinity were controlled statistically. Nevertheless, correlations between the face ratio and judgements of aggression were smaller for female than for male faces (F(1,36 = 7.43, p = 0.01. In Study 1, there was no significant relationship between judgements of femininity and of aggression in female faces. In Study 2, the association between judgements of masculinity and aggression was weaker in female faces than for male faces in Study 1. The weaker association in female faces may be because aggression and masculinity are stereotypically male traits. Thus, in Study 3, observers rated faces on nurturing (a stereotypically female trait and on femininity. Judgements of nurturing were associated with femininity (positively and masculinity (negatively ratings in both female and male faces. In summary, the perception of aggression differs in female versus male faces. The sex difference was not simply because aggression is a gendered construct; the relationships between masculinity/femininity and nurturing were similar for male and female faces even though nurturing is also a gendered construct. Masculinity and femininity ratings are not associated with aggression ratings nor with the face ratio for female faces. In contrast, all four variables are highly inter-correlated in male faces, likely because these cues in male faces serve as "honest signals".

  9. Facing aggression: cues differ for female versus male faces.

    Science.gov (United States)

    Geniole, Shawn N; Keyes, Amanda E; Mondloch, Catherine J; Carré, Justin M; McCormick, Cheryl M

    2012-01-01

    The facial width-to-height ratio (face ratio), is a sexually dimorphic metric associated with actual aggression in men and with observers' judgements of aggression in male faces. Here, we sought to determine if observers' judgements of aggression were associated with the face ratio in female faces. In three studies, participants rated photographs of female and male faces on aggression, femininity, masculinity, attractiveness, and nurturing. In Studies 1 and 2, for female and male faces, judgements of aggression were associated with the face ratio even when other cues in the face related to masculinity were controlled statistically. Nevertheless, correlations between the face ratio and judgements of aggression were smaller for female than for male faces (F(1,36) = 7.43, p = 0.01). In Study 1, there was no significant relationship between judgements of femininity and of aggression in female faces. In Study 2, the association between judgements of masculinity and aggression was weaker in female faces than for male faces in Study 1. The weaker association in female faces may be because aggression and masculinity are stereotypically male traits. Thus, in Study 3, observers rated faces on nurturing (a stereotypically female trait) and on femininity. Judgements of nurturing were associated with femininity (positively) and masculinity (negatively) ratings in both female and male faces. In summary, the perception of aggression differs in female versus male faces. The sex difference was not simply because aggression is a gendered construct; the relationships between masculinity/femininity and nurturing were similar for male and female faces even though nurturing is also a gendered construct. Masculinity and femininity ratings are not associated with aggression ratings nor with the face ratio for female faces. In contrast, all four variables are highly inter-correlated in male faces, likely because these cues in male faces serve as "honest signals".

  10. Facing Aggression: Cues Differ for Female versus Male Faces

    Science.gov (United States)

    Geniole, Shawn N.; Keyes, Amanda E.; Mondloch, Catherine J.; Carré, Justin M.; McCormick, Cheryl M.

    2012-01-01

    The facial width-to-height ratio (face ratio), is a sexually dimorphic metric associated with actual aggression in men and with observers' judgements of aggression in male faces. Here, we sought to determine if observers' judgements of aggression were associated with the face ratio in female faces. In three studies, participants rated photographs of female and male faces on aggression, femininity, masculinity, attractiveness, and nurturing. In Studies 1 and 2, for female and male faces, judgements of aggression were associated with the face ratio even when other cues in the face related to masculinity were controlled statistically. Nevertheless, correlations between the face ratio and judgements of aggression were smaller for female than for male faces (F1,36 = 7.43, p = 0.01). In Study 1, there was no significant relationship between judgements of femininity and of aggression in female faces. In Study 2, the association between judgements of masculinity and aggression was weaker in female faces than for male faces in Study 1. The weaker association in female faces may be because aggression and masculinity are stereotypically male traits. Thus, in Study 3, observers rated faces on nurturing (a stereotypically female trait) and on femininity. Judgements of nurturing were associated with femininity (positively) and masculinity (negatively) ratings in both female and male faces. In summary, the perception of aggression differs in female versus male faces. The sex difference was not simply because aggression is a gendered construct; the relationships between masculinity/femininity and nurturing were similar for male and female faces even though nurturing is also a gendered construct. Masculinity and femininity ratings are not associated with aggression ratings nor with the face ratio for female faces. In contrast, all four variables are highly inter-correlated in male faces, likely because these cues in male faces serve as “honest signals”. PMID:22276184

  11. Physician Contacts and Their Influence on the Appropriateness of Pain Medication in Nursing Home Residents: A Cross-Sectional Study.

    Science.gov (United States)

    Flaig, Tanja Maria; Budnick, Andrea; Kuhnert, Ronny; Kreutz, Reinhold; Dräger, Dagmar

    2016-09-01

    This study assessed the frequency of physician contacts for individual nursing home residents (NHRs) and investigated whether the frequency of contacts influences the appropriateness of pain medication in NHRs. Observational cross-sectional study conducted between March 2009 and April 2010. Forty nursing homes in Berlin and Brandenburg, Germany. A total of 560 NHRs. The number and type of NHR physician contacts were obtained by face-to-face interviews. To assess the appropriateness of pain medication, the German version of the Pain Medication Appropriateness Scale (PMASD) was used. The influence of physician contacts on the appropriateness of pain medication was calculated with a linear mixed-effect model. The proportions of NHRs with at least 1 contact with their attending physicians were 61.8% (primary care physicians), 55.2% (general practitioners), 9.6% (neurologists), 9.4% (other), 5.4% (internists), 2.2% (orthopedic surgeons), and 0.7% (psychiatrists). The number of all physician contacts correlated weakly with the appropriateness of pain medication (r = 0.166, P = .039). With every physician contact, the PMASD score rose by about 2 points (P = .056). Physician care in German nursing homes is mainly provided by primary care physicians. A higher number of physician contacts had a modest impact on more appropriate pain medication use. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  12. Maintenance of Pain in Children With Functional Abdominal Pain.

    Science.gov (United States)

    Czyzewski, Danita I; Self, Mariella M; Williams, Amy E; Weidler, Erica M; Blatz, Allison M; Shulman, Robert J

    2016-03-01

    A significant proportion of children with functional abdominal pain develop chronic pain. Identifying clinical characteristics predicting pain persistence is important in targeting interventions. We examined whether child anxiety and/or pain-stooling relations were related to maintenance of abdominal pain frequency and compared the predictive value of 3 methods for assessing pain-stooling relations (ie, diary, parent report, child report). Seventy-six children (7-10 years old at baseline) who presented for medical treatment of functional abdominal pain were followed up 18 to 24 months later. Baseline anxiety and abdominal pain-stooling relations based on pain and stooling diaries and child- and parent questionnaires were examined in relationship to the persistence of abdominal pain frequency. Children's baseline anxiety was not related to persistence of pain frequency. Children who, however, displayed irritable bowel syndrome (IBS) symptoms at baseline maintained pain frequency at follow-up, whereas in children in whom there was no relationship between pain and stooling, pain frequency decreased. Pain and stool diaries and parent report of pain-stooling relations were predictive of pain persistence but child-report questionnaires were not. The presence of IBS symptoms in school-age children with functional abdominal pain appears to predict persistence of abdominal pain over time, whereas anxiety does not. Prospective pain and stooling diaries and parent report of IBS symptoms were predictors of pain maintenance, but child report of symptoms was not.

  13. Altering gender role expectations: effects on pain tolerance, pain threshold, and pain ratings.

    Science.gov (United States)

    Robinson, Michael E; Gagnon, Christine M; Riley, Joseph L; Price, Donald D

    2003-06-01

    The literature demonstrating sex differences in pain is sizable. Most explanations for these differences have focused on biologic mechanisms, and only a few studies have examined social learning. The purpose of this study was to examine the contribution of gender-role stereotypes to sex differences in pain. This study used experimental manipulation of gender-role expectations for men and women. One hundred twenty students participated in the cold pressor task. Before the pain task, participants were given 1 of 3 instructional sets: no expectation, 30-second performance expectation, or a 90-second performance expectation. Pain ratings, threshold, and tolerance were recorded. Significant sex differences in the "no expectation" condition for pain tolerance (t = 2.32, df = 38, P differ in their pain tolerance, pain threshold, or pain ratings. This is the first empirical study to show that manipulation of expectations alters sex differences in laboratory pain.

  14. Pain and cardiorespiratory responses of children during physiotherapy after heart surgery

    Directory of Open Access Journals (Sweden)

    Adriana Sanches Garcia Araujo

    2014-04-01

    Full Text Available Objective: The aim of the present study was to determine the occurrence of pain and changes in blood pressure, heart rate, respiratory rate, and arterial oxygen saturation associated with physiotherapy in children undergoing cardiac surgery. Methods: Eighteen extubated children were assessed for the presence of pain using the face, legs, activity, cry, consolability scale, and blood pressure, heart rate, respiratory rate and arterial oxygen saturation were simultaneously recorded. The physiological parameters were measured at the following time periods: immediately before physiotherapy, five and 10 minutes after the beginning of physiotherapy, and five minutes after its end. Pain was assessed immediately before physiotherapy, ten minutes after the beginning of physiotherapy and five minutes after its end. Pain and physiological changes were assessed by the Friedman test and the correlation between the physiological parameters and the pain scores was assessed by the Spearman test. Results: Pain increased during physiotherapy and decreased significantly after it compared to pre-physiotherapy scores. Systolic blood pressure and heart rate increased significantly after 10 minutes of the beginning of physiotherapy. Arterial oxygen saturation tended to decrease during physiotherapy and to increase after it, although without significance. The correlation between pain scores and the physiological variables was significant only for systolic blood pressure and heart rate ten minutes after the beginning of physiotherapy. Conclusion: Manipulation after the beginning of physiotherapy seems to be accompanied by significant pain and by important associated cardiovascular changes. Apparent analgesia and improved respiratory function were observed after respiratory physiotherapy.

  15. Gait analysis and weight bearing in pre-clinical joint pain research.

    Science.gov (United States)

    Ängeby Möller, Kristina; Svärd, Heta; Suominen, Anni; Immonen, Jarmo; Holappa, Johanna; Stenfors, Carina

    2018-04-15

    There is a need for better joint pain treatment, but development of new medication has not been successful. Pre-clinical models with readouts that better reflect the clinical situation are needed. In patients with joint pain, pain at rest and pain at walking are two major complaints. We describe a new way of calculating results from gait analysis using the CatWalk™ setup. Rats with monoarthritis induced by injection of Complete Freund's Adjuvant (CFA) intra-articularly into the ankle joint of one hind limb were used to assess gait and dynamic weight bearing. The results show that dynamic weight bearing was markedly reduced for the injected paw. Gait parameters such as amount of normal step sequences, walking speed and duration of step placement were also affected. Treatment with naproxen (an NSAID commonly used for inflammatory pain) attenuated the CFA-induced effects. Pregabalin, which is used for neuropathic pain, had no effect. Reduced dynamic weight bearing during locomotion, assessed and calculated in the way we present here, showed a dose-dependent and lasting normalization after naproxen treatment. In contrast, static weight bearing while standing (Incapacitance tester) showed a significant effect for a limited time only. Mechanical sensitivity (von Frey Optihairs) was completely normalized by naproxen, and the window for testing pharmacological effect disappeared. Objective and reproducible effects, with an endpoint showing face validity compared to pain while walking in patients with joint pain, are achieved by a new way of calculating dynamic weight bearing in monoarthritic rats. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Renal colic and childbirth pain: female experience versus male perception

    Directory of Open Access Journals (Sweden)

    Miah S

    2017-07-01

    Full Text Available Saiful Miah,1,2 Charlotte Gunner,3 Lucy Clayton,4 Suresh Venugopal,5 Nigel R Boucher,5 Bo Parys61Division of Surgery and Interventional Science, University College London, London, UK; 2Urology Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; 3Urology Department, Raigmore Hospital, Inverness, UK; 4Psychiatry Department, Highbury Hospital, Nottingham, UK; 5Urology Department, Chesterfield Royal Infirmary, Chesterfield, UK; 6Urology Department, Rotherham General Hospital, Rotherham, UKIntroductionRenal colic is often described by patients as the worst pain ever experienced.1 Pain during childbirth is also similarly described.2 To date, no study has comparatively evaluated the pain of renal colic to that of childbirth in female patients who have experienced both. Furthermore, no such study has evaluated the perception that men with renal colic have with respect to the pain experienced during childbirth. Here we present our cross-sectional observational study to address these questions. The primary objectives of our study were to answer these questions and highlight the severity of renal colic which is not always faced and treated aggressively.  

  17. Prevalence of chronic spinal pain and identification of associated factors in a sample of the population of São Paulo, Brazil: cross-sectional study.

    Science.gov (United States)

    Depintor, Jidiene Dylese Presecatan; Bracher, Eduardo Sawaya Botelho; Cabral, Dayane Maia Costa; Eluf-Neto, José

    2016-01-01

    Chronic spinal pain, especially low-back pain and neck pain, is a leading cause of years of life with disability. The aim of the present study was to estimate the prevalence of chronic spinal pain among individuals aged 15 years or older and to identify the factors associated with it. Cross-sectional epidemiological study on a sample of the population of the city of São Paulo. Participants were selected using random probabilistic sampling and data were collected via face-to-face interviews. The Hospital Anxiety and Depression Scale (HADS), EuroQol-5D, Alcohol Use Disorders Identification Test (AUDIT), Fagerström test for nicotine dependence and Brazilian economic classification criteria were used. A total of 826 participants were interviewed. The estimated prevalence of chronic spinal pain was 22% (95% confidence interval, CI: 19.3-25.0%). The factors independently associated with chronic spinal pain were: female sex, age 30 years or older, schooling level of four years or less, symptoms compatible with anxiety and high physical exertion during the main occupation. Quality of life and self-rated health scores were significantly worse among individuals with chronic spinal pain. The prevalence of chronic spinal pain in this segment of the population of São Paulo was 22.0%. The factors independently associated with chronic pain were: female sex, age 30 years or older, low education, symptoms compatible with anxiety and physical exertion during the main occupation.

  18. Predicting postoperative pain by preoperative pressure pain assessment.

    Science.gov (United States)

    Hsu, Yung-Wei; Somma, Jacques; Hung, Yu-Chun; Tsai, Pei-Shan; Yang, Chen-Hsien; Chen, Chien-Chuan

    2005-09-01

    The goal of this study was to evaluate whether preoperative pressure pain sensitivity testing is predictive of postoperative surgical pain. Female subjects undergoing lower abdominal gynecologic surgery were studied. A pressure algometer was used preoperatively to determine the pressure pain threshold and tolerance. A visual analog scale (VAS) was used to assess postoperative pain. A State-Trait Anxiety Inventory was used to assess patients' anxiety. Subjects received intravenous patient-controlled analgesia for postoperative pain control. The preoperative pain threshold and tolerance were compared with the postoperative VAS pain score and morphine consumption. Forty women were enrolled. Their preoperative pressure pain threshold and tolerance were 141 +/- 65 kPa and 223 +/- 62 kPa, respectively. The VAS pain score in the postanesthesia care unit and at 24 h postoperatively were 81 +/- 24 and 31 +/- 10, respectively. Highly anxious patients had higher VAS pain scores in the postanesthesia care unit (P pain tolerance was significantly correlated with the VAS at 24 h postoperatively (P pain tolerance after fentanyl administration (mean, 272 +/- 68 kPa) correlated significantly with morphine consumption in the first 24 h postoperatively (P pain tolerance is significantly correlated with the level of postoperative pain. Pain tolerance assessment after fentanyl was administered and fentanyl sensitivity predicted the dose of analgesics used in the first 24 h after surgery. The algometer is thus a simple, useful tool for predicting postoperative pain and analgesic consumption.

  19. Pain and the ethics of pain management.

    Science.gov (United States)

    Edwards, R B

    1984-01-01

    In this article I clarify the concepts of 'pain', 'suffering', 'pains of body', 'pains of soul'. I explore the relevance of an ethic to the clinical setting which gives patients a strong prima facie right to freedom from unnecessary and unwanted pain and which places upon medical professionals two concomitant moral obligations to patients. First, there is the duty not to inflict pain and suffering beyond what is necessary for effective diagnosis, treatment and research. Next, there is the duty to do all that can be done to relieve all the pain and suffering which can be alleviated. I develop in some detail that individuality of pain sensitivity must be taken into account in fulfilling these obligations. I explore the issue of the relevance of informed consent and the right to refuse treatment to the matter of pain relief. And I raise the question of what conditions, if any, should override the right to refuse treatment where pain relief is of paramount concern.

  20. Improvement of burn pain management through routine pain monitoring and pain management protocol.

    Science.gov (United States)

    Yang, Hyeong Tae; Hur, Giyeun; Kwak, In-Suk; Yim, Haejun; Cho, Yong Suk; Kim, Dohern; Hur, Jun; Kim, Jong Hyun; Lee, Boung Chul; Seo, Cheong Hoon; Chun, Wook

    2013-06-01

    Pain management is an important aspect of burn management. We developed a routine pain monitoring system and pain management protocol for burn patients. The purpose of this study is to evaluate the effectiveness of our new pain management system. From May 2011 to November 2011, the prospective study was performed with 107 burn patients. We performed control group (n=58) data analysis and then developed the pain management protocol and monitoring system. Next, we applied our protocol to patients and performed protocol group (n=49) data analysis, and compared this to control group data. Data analysis was performed using the Numeric Rating Scale (NRS) of background pain and procedural pain, Clinician-Administered PTSD Scale (CAPS), Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory Scale (STAIS), and Holmes and Rahe Stress Scale (HRSS). The NRS of background pain for the protocol group was significantly decreased compared to the control group (2.8±2.0 versus 3.9±1.9), and the NRS of procedural pain of the protocol group was significantly decreased compared to the control group (4.8±2.8 versus 3.7±2.5). CAPS and HDRS were decreased in the protocol group, but did not have statistical significance. STAIS and HRSS were decreased in the protocol group, but only the STAIS had statistical significance. Our new pain management system was effective in burn pain management. However, adequate pain management can only be accomplished by a continuous and thorough effort. Therefore, pain control protocol and pain monitoring systems need to be under constant revision and improvement using creative ideas and approaches. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  1. Characterizing individual painDETECT symptoms by average pain severity

    Directory of Open Access Journals (Sweden)

    Sadosky A

    2016-07-01

    Full Text Available Alesia Sadosky,1 Vijaya Koduru,2 E Jay Bienen,3 Joseph C Cappelleri4 1Pfizer Inc, New York, NY, 2Eliassen Group, New London, CT, 3Outcomes Research Consultant, New York, NY, 4Pfizer Inc, Groton, CT, USA Background: painDETECT is a screening measure for neuropathic pain. The nine-item version consists of seven sensory items (burning, tingling/prickling, light touching, sudden pain attacks/electric shock-type pain, cold/heat, numbness, and slight pressure, a pain course pattern item, and a pain radiation item. The seven-item version consists only of the sensory items. Total scores of both versions discriminate average pain-severity levels (mild, moderate, and severe, but their ability to discriminate individual item severity has not been evaluated.Methods: Data were from a cross-sectional, observational study of six neuropathic pain conditions (N=624. Average pain severity was evaluated using the Brief Pain Inventory-Short Form, with severity levels defined using established cut points for distinguishing mild, moderate, and severe pain. The Wilcoxon rank sum test was followed by ridit analysis to represent the probability that a randomly selected subject from one average pain-severity level had a more favorable outcome on the specific painDETECT item relative to a randomly selected subject from a comparator severity level.Results: A probability >50% for a better outcome (less severe pain was significantly observed for each pain symptom item. The lowest probability was 56.3% (on numbness for mild vs moderate pain and highest probability was 76.4% (on cold/heat for mild vs severe pain. The pain radiation item was significant (P<0.05 and consistent with pain symptoms, as well as with total scores for both painDETECT versions; only the pain course item did not differ.Conclusion: painDETECT differentiates severity such that the ability to discriminate average pain also distinguishes individual pain item severity in an interpretable manner. Pain

  2. Structure of a bat assemblage (Mammalia, Chiroptera in Serra do Caraça Reserve, South-east Brazil

    Directory of Open Access Journals (Sweden)

    Falcão Fábio de C.

    2003-01-01

    Full Text Available The Serra do Caraça Reserve is situated in the southern portion of the Espinhaço Mountain Range, and contains areas of "campos de altitude", "cerrado" and atlantic forest. This study had as its objective the registering of the bats species that occur in the reserve. The data collection was carried out in one year through monthly samplings, using mist nets set on trails, and also through hand capture. A total of 246 individuals were collected (0.72 bats/net-hour, distributed across 15 species, belonging to the families Phyllostomidae (83.0%; nine species, Vespertilionidae (12.5%; three species and Molossidae (4.5%; three species. The most abundant species were Sturnira lilium (E. Geoffroy, 1810 (n = 121, 60.5%, Myotis nigricans (Schinz, 1821 (n = 21, 10.5% and Platyrrhinus lineatus (E. Geoffroy, 1810 (n = 10, 5.0%, and less represented were Lasiurus blossevilli (Lesson y Garnot, 1826 (n = 2, 1.0%, Eumops perotis (Schinz, 1821 (n = 2, 1.0% e Vampyressa pusilla (Wagner, 1843 (n = 1, 0.5%. The richness of species found and the non-occurrence of phyllostomines in the reserve could be indicative of some level of forest disturbance.

  3. Surgical Reconstruction of Lower Face Degloving.

    Science.gov (United States)

    Faria, Paulo Esteves Pinto; de Souza Carvalho, Abrahão Cavalcante Gomes; Masalskas, Bárbara; Chihara, Letícia; Sant'Ana, Eduardo; Filho, Osvaldo Magro

    2016-10-01

    One of the most impressive soft tissue injuries is the facial degloving, normally associated with industrial machines and traffic accidents. This injury is characterized by the separation of the skin and cartilage from the bones, compromising the soft tissues correlated in the trauma area, nerves, and blood vessels. A 28-year-old patient, male, was referred to Araçatuba's Santa Casa Hospital, after a motorcycle accident, hitting his face on the sidewalk. The patient was conscious, oriented, denying fainting and unconsciousness during the accident, and complaining of pain in the nasal region of the face. The suture of wounds was performed using 5-0 absorbable sutures for muscle planes, and reconstruction of the septum and nasal cartilages. The skin was sutured with interrupted stitches using 6-0 nylon. After reducing the edema, a slight increase in alar base was observed. Subsequently, the alar base cinch suture was performed aiming to bring the alar bases to a measure of 34.0 mm in diameter. As a conclusion, the knowledge of the anatomy of the region involved, the healing of tissues, and suture techniques for the facial region process were critical to the successful treatment. The evaluation of the alar base in degloving cases can involve aesthetic features.

  4. The American chronic pain crisis and the media: about time to get it right?

    Directory of Open Access Journals (Sweden)

    Schatman ME

    2015-12-01

    Full Text Available Michael E SchatmanUS Pain Foundation, Bellevue, Washington/Middletown, Connecticut, USAOn November 23, 2015, the venerable Wall Street Journal published an article entitled "New Help for Back Pain".1 In this article, the author wrote of "an innovative approach to help patients cope and heal called functional restoration", suggesting that it helps avoid costly diagnostic tests, surgery and other expensive treatments, and the risks of problems potentially associated with opioid analgesics. While the author’s claims regarding interdisciplinary chronic pain management’s potential benefits are accurate, as is so often the case, the media’s inability to comprehend the "big picture" of the American crisis in pain medicine has resulted in yet another much-read yet highly biased and misinformative article that ultimately serves to exacerbate the difficulties with which our patients, and the system that they attempt to navigate, are faced.

  5. Public Higher-Education Systems Face Painful Choices as Three Northeastern States Confront Massive Deficits.

    Science.gov (United States)

    Blumenstyk, Goldie

    1989-01-01

    Massachusetts, Connecticut, and New York face giant deficits in their state budgets. The financial impact of the 1986 federal tax reform law was underestimated by colleges and income estimates were overly optimistic for 1988 and 1989. Unpopular, new taxes are seen as the way to solve the budget crunch. (MLW)

  6. Lactobacillus reuteri DSM 17938 in the Treatment of Functional Abdominal Pain in Children: RCT Study.

    Science.gov (United States)

    Jadrešin, Oleg; Hojsak, Iva; Mišak, Zrinjka; Kekez, Alemka Jaklin; Trbojević, Tena; Ivković, Lana; Kolaček, Sanja

    2017-06-01

    Beneficial therapeutic effect of probiotics has been reported in children with the irritable bowel syndrome (IBS) but not consistently in other functional abdominal pain-related disorders. The aim of the present study was to investigate the effect of Lactobacillus reuteri DSM 17938 in the treatment of functional abdominal pain (FAP) and IBS in children. Children (age 4-18 years) referred to pediatric gastroenterologist at Children's Hospital Zagreb from May 2012 to December 2014, diagnosed as FAP or IBS, were randomized to receive L reuteri DSM 17938 10⁸ CFU daily or placebo. The study was a prospective, randomized, double-blind, placebo-controlled parallel study. Symptoms were evaluated using Wong-Baker FACES pain rating scale for pain and Bristol scale for stool shape and consistence. Data were analyzed for 55 children (26 in the intervention group and 29 in the placebo group). Children in the intervention group had significantly more days without pain (median 89.5 vs 51 days, P = 0.029). Abdominal pain was less severe in children taking probiotics during the second month (P abdominal pain, stool type, or absence from school. Both groups experienced significant reduction in the severity of abdominal pain from first to fourth month, with the reduction more prominent in the intervention group (P pain and significantly more days without pain in children with FAP and IBS.

  7. [Specifications of motivational interviewing within a cognitive-behavioral therapy of chronic pain].

    Science.gov (United States)

    Aguerre, C; Bridou, M; Laroche, F; Csillik, A; Jensen, M

    2015-12-01

    Cognitive and behavioral approach of chronic pain presents encouraging results by improving physical, functional and psychological states of chronic pain patients. This specific treatment is partially based on the acquisition of new adaptive strategies to help the patients to manage more effectively chronic pain and to improve subsequently their subjective well-being. This requires in parallel to give up noxious emotional, cognitive and behavioral attitudes towards pain. Now, we have to admit that numerous therapeutic failures are directly imputable to difficulties introducing and making the indispensable changes continue in pursuit of the fixed therapeutic objectives. Readiness to change could play a considerable role in the success or not of chronic pain treatment. The main objective of this article is to present the data of the current literature concerning the specificities of the process of change in the field of the chronic pain. We present a review of the literature describing at first, the psychological progress made by chronic pain patients longing to manage their suffering better via the trans-theoretical model of intentional change. Secondly, we develop the contributions of the technique of motivational interviewing in the improvement of chronic pain treatment. The identification of the motivational profile of chronic pain patients will determine how motivational interviewing can be conducted to improve their readiness for change. There are several strategies used with chronic pain patients in pre-contemplative and contemplative stages. Therapists may facilitate the problem recognition (help chronic pain patients to become aware of and identify the nature of the difficulties they face when trying to cope with their physical suffering); increase the personal concern (empowering chronic pain patients so that they feel fully involved in what they offer and invest in the therapy); develop the intention of change (ensure that the change becomes truly

  8. Pain-related stress in the Neonatal Intensive Care Unit and salivary cortisol reactivity to socio-emotional stress in 3-month-old very preterm infants.

    Science.gov (United States)

    Provenzi, Livio; Giusti, Lorenzo; Fumagalli, Monica; Tasca, Hilarj; Ciceri, Francesca; Menozzi, Giorgia; Mosca, Fabio; Morandi, Francesco; Borgatti, Renato; Montirosso, Rosario

    2016-10-01

    Very preterm (VPT) infants are hospitalized in the Neonatal Intensive Care Unit (NICU) and exposed to varying levels of skin-breaking procedures (pain-related stress), even in absence of severe clinical conditions. Repeated and prolonged pain exposure may alter hypothalamic-pituitary-adrenal (HPA) axis reactivity in VPT infants. During the post-discharge period, altered HPA axis reactivity has been documented in response to non-social stressors, using salivary cortisol as a biomarker. However, little is known about the effects of NICU pain-related stress on subsequent HPA axis reactivity to socio-emotional stress in infants. We examined the relationship between pain-related stress in NICU and HPA axis reactivity (i.e., salivary cortisol reactivity) to an age-appropriate socio-emotional condition in 37 healthy VPT infants compared to 53 full-term (FT) controls. The number of skin-breaking procedures was obtained across NICU stay for VPT infants. At 3 months (corrected age for prematurity), all infants participated in the maternal Face-to-Face Still-Face (FFSF) procedure, in order to assess HPA axis reactivity to socio-emotional stress (i.e., maternal unresponsiveness). VPT infants exhibited a blunted salivary cortisol reactivity, which was associated with the amount of skin-breaking procedures during NICU: greater pain-related stress predicted lower salivary cortisol reactivity, adjusting for neonatal confounders. These findings further advance our knowledge of how early exposure to pain-related stress in NICU contributes to the programming of an altered HPA axis reactivity to socio-emotional stress in 3-month-old VPT infants, even in the absence of major perinatal complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Opioid Therapy for Chronic Pain: Overview of the 2017 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline.

    Science.gov (United States)

    Rosenberg, Jack M; Bilka, Brandon M; Wilson, Sara M; Spevak, Christopher

    2018-05-01

    The US Department of Veterans Affairs (VA) and US Department of Defense (DoD) revised the 2010 clinical practice guideline (CPG) for the management of opioid therapy for chronic pain, considering the specific needs of the VA and DoD and new evidence regarding prescribing opioid medication for non-end-of-life-related chronic pain. This paper summarizes the major recommendations and compares them with the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids. This Opioid Therapy CPG was developed for VA-DoD service members, veterans, and their families. The VA/DoD Evidence-Based Practice Work Group convened a VA/DoD guideline renewal development effort and conformed to the guidelines established by the VA/DoD Joint Executive Council (JEC) and VA/DoD Health Executive Council (HEC). The panel developed questions, searched and evaluated the literature, developed recommendations using GRADE methodology, and developed algorithms. Passage of the CARA Act by Congress compelled consideration and comparison with the CDC opioid therapy guideline mid-development. There were 18 recommendations made. This article focuses on guideline development and key recommendations with CDC comparisons taken from four major areas, including: initiation and continuation of opioids;type, dose, follow-up, and taper of opioids;risk mitigation;acute pain. Guideline development and recommendations are presented. There was substantial overlap with the CDC opioid guideline. Additionally, there were items particularly relevant to the VA-DoD, including risk mitigation, suicide prevention, and preventing opioid use disorder in young patients. Our guideline highlights avoiding opioid therapy longer than 90 days as a critical juncture.

  10. Obesity impedes functional improvement in youth with chronic pain: An initial investigation.

    Science.gov (United States)

    Stoner, A M; Jastrowski Mano, K E; Weisman, S J; Hainsworth, K R

    2017-10-01

    Youth with chronic pain are at higher risk for obesity than the general population. In youth with chronic pain, obesity exacerbates pain-specific activity limitations, and in adults with chronic pain, obesity perpetuates a cycle of disability. The current study examined whether weight status predicts functional disability outcomes over time in youth with chronic pain. Data were obtained from a retrospective chart review of patients who consented to participate in a longitudinal outcomes study. The Child Activity Limitations Questionnaire was used to assess functional disability at intake, 1-, and 3-month follow-up. Height and weight were measured at intake. A linear mixed model was used to test whether weight status and time predicted functional disability. Trend analysis with polynomial contrasts was used to test whether improvements in functional disability showed a linear trend over time. The linear mixed model analysis showed a main effect of weight, suggesting that youth with higher BMI demonstrated less improvement in functional disability over time. The trend analysis suggested that improvements in functional disability were consistent with a linear trend for both healthy weight and overweight participants, but not for obese participants. These findings demonstrate that obesity impedes improvement in functioning for youth with chronic pain. Despite multidisciplinary pain treatment, youth with comorbid chronic pain and obesity demonstrate greater functional disability at follow-up and little improvement over time. These results support the need for interventions specifically tailored to the unique challenges faced by youth with comorbid chronic pain and obesity. This study shows that obesity impedes improvement in functioning for youth with chronic pain. On the basis of these findings, interventions should be tailored to the unique challenges of this population. © 2017 European Pain Federation - EFIC®.

  11. The Impact of Virtual Reality Distraction on Pain and Anxiety during Dental Treatment in 4-6 Year-Old Children: a Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Asl Aminabadi, Naser; Erfanparast, Leila; Sohrabi, Azin; Ghertasi Oskouei, Sina; Naghili, Armaghan

    2012-01-01

    Dental practitioners have numerous methods to control anxiety and pain in children, and distracting the child appears to be the most common technique used for behavior management during dental procedures. The aim of the present study was to evaluate the influence of using virtual reality eyeglasses on severity of pain and anxiety during dental procedures in pediatric patients. This study included 120 healthy children aged 4-6 years. Children with no previous anxiety disorder were randomly divided into two groups, each consisting of 60 children. The study consisted of 3 consecutive treatment sessions. During the first visit fluoride therapy was carried out in both groups. In the next sessions, the groups received restorative treatment with and without virtual reality eyeglasses in a randomized single-blind-controlled crossover fashion. Then at the end of each session the subjects' pain severity was assessed using Wong Baker FACES Pain Rating Scale and state anxiety was measured by Faces version of the Modified Child Dental Anxiety Scale [MCDAS (f)]. There was a significant decrease in pain perception (P anxiety scores (P virtual reality eyeglasses during dental treatment. Results of this study showed that virtual reality eyeglasses can successfully decrease pain perception and state anxiety during dental treatment. 201103126036N1.

  12. Pain assessment by children and adolescents during intraosseous anaesthesia using a computerized system (QuickSleeper).

    Science.gov (United States)

    Sixou, Jean-Louis; Marie-Cousin, Alexia; Huet, Adeline; Hingant, Bernard; Robert, Jean-Claude

    2009-09-01

    Intraosseous (IO) anaesthesia has been shown to be effective in children. However, the pain associated with anaesthetic injections, and its acceptance by children, have never been studied. The aim of this study was to assess the pain associated with the IO injection of 4% articaine with 1 : 200 000 epinephrine using the computerized QuickSleeper' system in a population of children and adolescents. IO anaesthesia was performed on patients aged 10.4 +/- 2.6 years of age. The patients assessed their pain on a faces pain scale (FPS) and on a visual analogue scale (VAS). The operators were also asked to assess signs of patient pain/discomfort. No pain or mild discomfort was reported by, respectively, 81.8% (FPS) and 83.9% (VAS) of the patients. Some 58.9% of children with previous experience of dental anaesthesia reported that computerized IO anaesthesia was more comfortable than traditional infiltration methods. Operators noted signs of discomfort during penetration and injection in 18.3% and 25.3% of the patients, respectively. This study showed that the majority of children reported no pain or mild pain when anaesthetic was administered by computerized needle rotation and solution deposition. This technique holds promise for use by trained paediatric dentists.

  13. The influence of children's pain memories on subsequent pain experience.

    Science.gov (United States)

    Noel, Melanie; Chambers, Christine T; McGrath, Patrick J; Klein, Raymond M; Stewart, Sherry H

    2012-08-01

    Healthy children are often required to repeatedly undergo painful medical procedures (eg, immunizations). Although memory is often implicated in children's reactions to future pain, there is a dearth of research directly examining the relationship between the 2. The current study investigated the influence of children's memories for a novel pain stimulus on their subsequent pain experience. One hundred ten healthy children (60 boys) between the ages of 8 and 12 years completed a laboratory pain task and provided pain ratings. Two weeks later, children provided pain ratings based on their memories as well as their expectancies about future pain. One month following the initial laboratory visit, children again completed the pain task and provided pain ratings. Results showed that children's memory of pain intensity was a better predictor of subsequent pain reporting than their actual initial reporting of pain intensity, and mediated the relationship between initial and subsequent pain reporting. Children who had negatively estimated pain memories developed expectations of greater pain prior to a subsequent pain experience and showed greater increases in pain ratings over time than children who had accurate or positively estimated pain memories. These findings highlight the influence of pain memories on healthy children's expectations of future pain and subsequent pain experiences and extend predictive models of subsequent pain reporting. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  14. Sensorial saturation for infants' pain.

    Science.gov (United States)

    Bellieni, Carlo Valerio; Tei, Monica; Coccina, Francesca; Buonocore, Giuseppe

    2012-04-01

    Sensorial saturation (SS) is a multisensorial stimulation consisting of delicate tactile, gustative, auditory and visual stimuli. This procedure consists of simultaneously: attracting the infant's attention by massaging the infant's face; speaking to the infant gently, but firmly, and instilling a sweet solution on the infant's tongue. We performed a systematic Medline search of for articles focusing on human neonatal studies related to SS. The search was performed within the last 10 years and was current as of January 2012. We retrieved 8 articles that used a complete form of SS and 2 articles with an incomplete SS. Data show that the use of SS is effective in relieving newborns' pain. Oral solution alone are less effective than SS, but the stimuli without oral sweet solution are ineffective. the partial forms of SS have some effectiveness, but minor than the complete SS. Only one article showed lack of SS as analgesic method, after endotracheal suctioning. SS can be used for all newborns undergoing blood samples or other minor painful procedures. It is more effective than oral sugar alone. SS also promotes interaction between nurse and infant and is a simple effective form of analgesia for the neonatal intensive care unit.

  15. Pain adaptability in individuals with chronic musculoskeletal pain is not associated with conditioned pain modulation

    DEFF Research Database (Denmark)

    Wan, Dawn Wong Lit; Arendt-Nielsen, Lars; Wang, Kelun

    2018-01-01

    (MSK). CPTs at 2°C and 7°C were used to assess the status of pain adaptability in participants with either chronic non-specific low back pain or knee osteoarthritis. The participants' potency of conditioned pain modulation (CPM) and local inhibition were measured. The strengths of pain adaptability...... at both CPTs were highly correlated. PA and PNA did not differ in their demographics, pain thresholds from thermal and pressure stimuli, or potency of local inhibition or CPM. PA reached their maximum pain faster than PNA (t41=-2.76, p... days whereas PNA did not (F (6,246) = 3.01, p = 0.01). The dichotomy of pain adaptability exists in MSK patients. Consistent with the healthy human study, the strength of pain adaptability and potency of CPM are not related. Pain adaptability could be another form of endogenous pain inhibition which...

  16. Pain Control After Surgery: Pain Medicines

    Science.gov (United States)

    ... Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids and Teens ... Bracing: What Works? Home Prevention and Wellness Pain Control After Surgery: Pain Medicines Pain Control After Surgery: ...

  17. Electronic diary assessment of pain-related fear, attention to pain, and pain intensity in chronic low back pain patients.

    NARCIS (Netherlands)

    Roelofs, J.; Peters, M.L.; Patijn, J.; Schouten, E.G.; Vlaeyen, J.W.

    2004-01-01

    The present study investigated the relationships between pain-related fear, attention to pain, and pain intensity in daily life in patients with chronic low back pain. An experience sampling methodology was used in which electronic diary data were collected by means of palmtop computers from 40

  18. La constitución económica y el gobierno de la economía en crisis: reflexiones desde la Unión Europea

    OpenAIRE

    Martínez Sierra, José Manuel

    2010-01-01

    Instrumentos políticos ante la crisis de cara a la ciudadanía, elementos de cambio en el capitalismo y los nuevos retos a los que se enfrenta. Policy tools against the crisis, elements of change in capitalism and the new challenges it faces.

  19. Cross-cultural adaptation of the delphi definitions of low back pain prevalence (German DOLBaPP).

    Science.gov (United States)

    Leonhardt, Marja; Liebers, Falk; Dionne, Clermont E; Latza, Ute

    2014-11-25

    Assessed dimensions of low back pain (LBP) vary in prevalence studies. This may explain the heterogeneity in frequency estimates. To standardize definitions of LBP, an English consensus with 28 experts from 12 countries developed the "Delphi Definitions of Low Back Pain Prevalence" (DOLBaPP). The optimal definition and the shorter minimal definition with the related questionnaires for online, paper, and face-to-face use and telephone surveys are suitable for population-based studies. The definitions have to be adapted to different languages and cultures to provide comparable frequency estimates. The objective was to culturally adapt and pre-test the English definitions and corresponding Delphi DOLBaPP questionnaire forms into German. The German DOLBaPP adaptation was conducted using the systematic approach suggested by Beaton et al. A pre-test of the Delphi DOLBaPP optimal paper questionnaire including an additional evaluation form was conducted in a sample of 121 employees (mainly office workers). In order to evaluate the comprehensibility, usability, applicability, and completeness of the adapted questionnaire, response to the questionnaire and 6 closed evaluation questions were analyzed descriptively. Qualitative methods were used for the 3 open questions of the evaluation form. The cultural adaptation of the DOLBaPP for a German-speaking audience required little linguistic adaptation. Conceptual equivalence was difficult for the expression "low back pain". The expert committee considered the face validity of the pre-final version of the related Delphi DOLBaPP questionnaires as good. In the pre-test, most participants (95%) needed less than 5 minutes to fill in the optimal Delphi DOLBaPP questionnaire. They were generally positive regarding length, wording, diagram, and composition. All subjects with LBP (n=61 out of 121 - 50.4%) answered the questions on functional limitation, sciatic pain, frequency and duration of symptoms as well as pain severity. The

  20. Behavioural typologies of experienced benefit of psychomotor therapy in patients with chronic shoulder pain

    DEFF Research Database (Denmark)

    Stamp, Anne Schinkel; Pedersen, Lise Lang; Ingwersen, Kim Gordon

    2018-01-01

    Abstract In this study we aimed to develop a theoretical account of the experienced benefit of psychomotor therapy in addition to treatment as usual in patients with chronic shoulder pain. The qualitative study design was based on a grounded theory approach. Open-ended face-to-face interviews were...... conducted after treatment was completed. We generated data and performed analyses by constant comparative analysis and theoretical sampling that focused on the patients' behavioural characteristics related to the experienced benefit of psychomotor therapy. We conducted 12 interviews, eight of which were...

  1. Rising prevalence of back pain in Austria: considering regional disparities.

    Science.gov (United States)

    Großschädl, Franziska; Stolz, Erwin; Mayerl, Hannes; Rásky, Éva; Freidl, Wolfgang; Stronegger, Willibald J

    2016-01-01

    Back pain is the most common form of musculoskeletal conditions and leads to high health care costs. Information about geographic variations in highly prevalent diseases/disorders represents important implications for public health planning to face structural challenges. The present study aims to investigate regional trends in the prevalence of back pain and the role of obesity and social inequalities among Austrian adults. A secondary data analysis based on five nationally representative cross-sectional surveys (1973-2007) was carried out (N = 178,818). Back pain was measured as self-reported presence. Obesity (BMI ≥ 30 kg/m²) was adjusted for self-report bias. For the regional analyses, Austria was divided into Western, Central and Eastern Austria. A relative index of inequality (RII) was computed to quantify the extent of social inequality. A continuous rise in back pain prevalence was observed in the three regions and among all investigated subgroups. In 2007 the age-standardised prevalence was similar in Central (36.9 %), Western (35.2 %) and Eastern Austria (34.3 %). The absolute change in back pain prevalence was highest among obese subjects in Central Austria (women: + 29.8 %, men: + 32.5 %). RIIs were unstable during the study period and in 2007 highest in Eastern Austria. Variation and trends in back pain are not attributable to geographic variation in Austria: an assumed East-West gradient in Austria has not been confirmed. Nevertheless our study confirms that back pain dramatically increased in all Austrian regions and investigated subgroups. This worrying trend should be further monitored and public health interventions should be implemented increasingly, especially among obese women and men.

  2. Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

    Science.gov (United States)

    Uthaikhup, Sureeporn; Prasert, Romchat; Paungmali, Aatit; Boontha, Kritsana

    2015-01-01

    Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold heat pain responses. The pain measures were assessed over the cervical spine and at a remote site, the tibialis anterior muscle. Results Elders with chronic neck pain had lower pressure pain threshold over the articular pillar of C5-C6 and decreased cold pain thresholds over the cervical spine and tibialis anterior muscle when compared with controls (p pain thresholds and suprathreshold heat pain responses (p > 0.05). Conclusion The presence of pain hypersensitivity in elderly women with chronic neck pain appears to be dependent on types of painful stimuli. This may reflect changes in the peripheral and central nervous system with age. PMID:26039149

  3. Doubling Your Payoff: Winning Pain Relief Engages Endogenous Pain Inhibition

    Science.gov (United States)

    Becker, Susanne; Gandhi, Wiebke; Kwan, Saskia; Ahmed, Alysha-Karima; Schweinhardt, Petra

    2015-01-01

    When in pain, pain relief is much sought after, particularly for individuals with chronic pain. In analogy to augmentation of the hedonic experience ("liking") of a reward by the motivation to obtain a reward ("wanting"), the seeking of pain relief in a motivated state might increase the experience of pain relief when obtained. We tested this hypothesis in a psychophysical experiment in healthy human subjects, by assessing potential pain-inhibitory effects of pain relief "won" in a wheel of fortune game compared with pain relief without winning, exploiting the fact that the mere chance of winning induces a motivated state. The results show pain-inhibitory effects of pain relief obtained by winning in behaviorally assessed pain perception and ratings of pain intensity. Further, the higher participants scored on the personality trait novelty seeking, the more pain inhibition was induced. These results provide evidence that pain relief, when obtained in a motivated state, engages endogenous pain-inhibitory systems beyond the pain reduction that underlies the relief in the first place. Consequently, such pain relief might be used to improve behavioral pain therapy, inducing a positive, perhaps self-amplifying feedback loop of reduced pain and improved functionality.

  4. Pain Sensitivity and Pain Catastrophizing are Associated with Persistent Pain and Disability after Lumbar Spine Surgery

    Science.gov (United States)

    Coronado, Rogelio A.; George, Steven Z.; Devin, Clinton J.; Wegener, Stephen T.; Archer, Kristin R.

    2015-01-01

    Objective To examine whether pain sensitivity and pain catastrophizing are associated with persistent pain and disability after lumbar spine surgery. Design Prospective observational cohort study. Setting Academic medical center. Participants Patients (N = 68, mean ± SD age = 57.9 ± 13.1 years, N female = 40 (58.8%)) undergoing spine surgery for a degenerative condition from March 1, 2012 to April 30, 2013 were assessed 6 weeks, 3 months, and 6 months after surgery. Interventions Not applicable. Main Outcome Measure(s) The main outcome measures were persistent back pain intensity, pain interference, and disability. Patients with persistent back pain intensity, pain interference, or disability were identified as those patients reporting Brief Pain Inventory scores ≥ 4 and Oswestry Disability Index scores ≥ 21 at all postoperative time points. Results From 6 weeks to 6 months after surgery, approximately 12.9%, 24.2%, and 46.8% of patients reported persistent back pain intensity, pain interference, or disability, respectively. Increased pain sensitivity at 6 weeks was associated with having persistent back pain intensity (OR = 2.0, 95% CI = 1.0; 4.1) after surgery. Increased pain catastrophizing at 6 weeks was associated with having persistent back pain intensity (OR = 1.1, 95% CI = 1.0; 1.2), pain interference (OR = 1.1, 95% CI = 1.0; 1.2), and disability (OR = 1.3, 95% CI = 1.1; 1.4). An interaction effect was not found between pain sensitivity and pain catastrophizing on persistent outcomes (p > 0.05). Conclusion(s) Findings suggest the importance of early postoperative screening for pain sensitivity and pain catastrophizing in order to identify patients at-risk for poor postoperative pain intensity, interference, and/or disability outcomes. Future research should consider the benefit of targeted therapeutic strategies for patients with these postoperative prognostic factors. PMID:26101845

  5. Prevalence of chronic spinal pain and identification of associated factors in a sample of the population of São Paulo, Brazil: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jidiene Dylese Presecatan Depintor

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Chronic spinal pain, especially low-back pain and neck pain, is a leading cause of years of life with disability. The aim of the present study was to estimate the prevalence of chronic spinal pain among individuals aged 15 years or older and to identify the factors associated with it. DESIGN AND SETTING: Cross-sectional epidemiological study on a sample of the population of the city of São Paulo. METHOD: Participants were selected using random probabilistic sampling and data were collected via face-to-face interviews. The Hospital Anxiety and Depression Scale (HADS, EuroQol-5D, Alcohol Use Disorders Identification Test (AUDIT, Fagerström test for nicotine dependence and Brazilian economic classification criteria were used. RESULTS: A total of 826 participants were interviewed. The estimated prevalence of chronic spinal pain was 22% (95% confidence interval, CI: 19.3-25.0%. The factors independently associated with chronic spinal pain were: female sex, age 30 years or older, schooling level of four years or less, symptoms compatible with anxiety and high physical exertion during the main occupation. Quality of life and self-rated health scores were significantly worse among individuals with chronic spinal pain. CONCLUSION: The prevalence of chronic spinal pain in this segment of the population of São Paulo was 22.0%. The factors independently associated with chronic pain were: female sex, age 30 years or older, low education, symptoms compatible with anxiety and physical exertion during the main occupation.

  6. Pain chronification: what should a non-pain medicine specialist know?

    Science.gov (United States)

    Morlion, Bart; Coluzzi, Flaminia; Aldington, Dominic; Kocot-Kepska, Magdalena; Pergolizzi, Joseph; Mangas, Ana Cristina; Ahlbeck, Karsten; Kalso, Eija

    2018-04-12

    Pain is one of the most common reasons for an individual to consult their primary care physician, with most chronic pain being treated in the primary care setting. However, many primary care physicians/non-pain medicine specialists lack enough awareness, education and skills to manage pain patients appropriately, and there is currently no clear, common consensus/formal definition of "pain chronification". This article, based on an international Change Pain Chronic Advisory Board meeting which was held in Wiesbaden, Germany, in October 2016, provides primary care physicians/non-pain medicine specialists with a narrative overview of pain chronification, including underlying physiological and psychosocial processes, predictive factors for pain chronification, a brief summary of preventive strategies, and the role of primary care physicians and non-pain medicine specialists in the holistic management of pain chronification. Based on currently available evidence, we propose the following consensus-based definition of pain chronification which provides a common framework to raise awareness among non-pain medicine specialists: "Pain chronification describes the process of transient pain progressing into persistent pain; pain processing changes as a result of an imbalance between pain amplification and pain inhibition; genetic, environmental and biopsychosocial factors determine the risk, the degree, and time-course of chronification." Early intervention plays an important role in preventing pain chronification and, as key influencers in the management of patients with acute pain, it is critical that primary care physicians are equipped with the necessary awareness, education and skills to manage pain patients appropriately.

  7. Pain as social glue: shared pain increases cooperation.

    Science.gov (United States)

    Bastian, Brock; Jetten, Jolanda; Ferris, Laura J

    2014-11-01

    Even though painful experiences are employed within social rituals across the world, little is known about the social effects of pain. We examined the possibility that painful experiences can promote cooperation within social groups. In Experiments 1 and 2, we induced pain by asking some participants to insert their hands in ice water and to perform leg squats. In Experiment 3, we induced pain by asking some participants to eat a hot chili pepper. Participants performed these tasks in small groups. We found evidence for a causal link: Sharing painful experiences with other people, compared with a no-pain control treatment, promoted trusting interpersonal relationships by increasing perceived bonding among strangers (Experiment 1) and increased cooperation in an economic game (Experiments 2 and 3). Our findings shed light on the social effects of pain, demonstrating that shared pain may be an important trigger for group formation. © The Author(s) 2014.

  8. Pain-related guilt in low back pain.

    Science.gov (United States)

    Serbic, Danijela; Pincus, Tamar

    2014-12-01

    Identifying mechanisms that mediate recovery is imperative to improve outcomes in low back pain (LBP). Qualitative studies suggest that guilt may be such a mechanism, but research on this concept is scarce, and reliable instruments to measure pain-related guilt are not available. We addressed this gap by developing and testing a Pain-related Guilt Scale (PGS) for people with LBP. Two samples of participants with LBP completed the scale and provided data on rates of depression, anxiety, pain intensity, and disability. Three factors were identified using exploratory factor analysis (n=137): "Social guilt," (4 items) relating to letting down family and friends; "Managing condition/pain guilt," (5 items) relating to failing to overcome and control pain; and "Verification of pain guilt," (3 items) relating to the absence of objective evidence and diagnosis. This factor structure was confirmed using confirmatory factor analysis (n=288), demonstrating an adequate to good fit with the data (AGFI=0.913, RMSEA=0.061). The PGS subscales positively correlated with depression, anxiety, pain intensity, and disability. After controlling for depression and anxiety the majority of relationships between the PGS subscales and disability and pain intensity remained significant, suggesting that guilt shared unique variance with disability and pain intensity independent of depression and anxiety. High levels of guilt were reported by over 40% of participants. The findings suggest that pain-related guilt is common and is associated with clinical outcomes. Prospective research is needed to examine the role of guilt as a predictor, moderator, and mediator of patients' outcomes.

  9. Successful decoding of famous faces in the fusiform face area.

    Directory of Open Access Journals (Sweden)

    Vadim Axelrod

    Full Text Available What are the neural mechanisms of face recognition? It is believed that the network of face-selective areas, which spans the occipital, temporal, and frontal cortices, is important in face recognition. A number of previous studies indeed reported that face identity could be discriminated based on patterns of multivoxel activity in the fusiform face area and the anterior temporal lobe. However, given the difficulty in localizing the face-selective area in the anterior temporal lobe, its role in face recognition is still unknown. Furthermore, previous studies limited their analysis to occipito-temporal regions without testing identity decoding in more anterior face-selective regions, such as the amygdala and prefrontal cortex. In the current high-resolution functional Magnetic Resonance Imaging study, we systematically examined the decoding of the identity of famous faces in the temporo-frontal network of face-selective and adjacent non-face-selective regions. A special focus has been put on the face-area in the anterior temporal lobe, which was reliably localized using an optimized scanning protocol. We found that face-identity could be discriminated above chance level only in the fusiform face area. Our results corroborate the role of the fusiform face area in face recognition. Future studies are needed to further explore the role of the more recently discovered anterior face-selective areas in face recognition.

  10. Translation and validation of the German version of the Bournemouth Questionnaire for Neck Pain

    Directory of Open Access Journals (Sweden)

    Soklic Marina

    2012-01-01

    Full Text Available Abstract Background Clinical outcome measures are important tools to monitor patient improvement during treatment as well as to document changes for research purposes. The short-form Bournemouth questionnaire for neck pain patients (BQN was developed from the biopsychosocial model and measures pain, disability, cognitive and affective domains. It has been shown to be a valid and reliable outcome measure in English, French and Dutch and more sensitive to change compared to other questionnaires. The purpose of this study was to translate and validate a German version of the Bournemouth questionnaire for neck pain patients. Methods German translation and back translation into English of the BQN was done independently by four persons and overseen by an expert committee. Face validity of the German BQN was tested on 30 neck pain patients in a single chiropractic practice. Test-retest reliability was evaluated on 31 medical students and chiropractors before and after a lecture. The German BQN was then assessed on 102 first time neck pain patients at two chiropractic practices for internal consistency, external construct validity, external longitudinal construct validity and sensitivity to change compared to the German versions of the Neck Disability Index (NDI and the Neck Pain and Disability Scale (NPAD. Results Face validity testing lead to minor changes to the German BQN. The Intraclass Correlation Coefficient for the test-retest reliability was 0.99. The internal consistency was strong for all 7 items of the BQN with Cronbach α's of .79 and .80 for the pre and post-treatment total scores. External construct validity and external longitudinal construct validity using Pearson's correlation coefficient showed statistically significant correlations for all 7 scales of the BQN with the other questionnaires. The German BQN showed greater responsiveness compared to the other questionnaires for all scales. Conclusions The German BQN is a valid and

  11. Real Time Face Quality Assessment for Face Log Generation

    DEFF Research Database (Denmark)

    Kamal, Nasrollahi; Moeslund, Thomas B.

    2009-01-01

    Summarizing a long surveillance video to just a few best quality face images of each subject, a face-log, is of great importance in surveillance systems. Face quality assessment is the back-bone for face log generation and improving the quality assessment makes the face logs more reliable....... Developing a real time face quality assessment system using the most important facial features and employing it for face logs generation are the concerns of this paper. Extensive tests using four databases are carried out to validate the usability of the system....

  12. Headache attributed to masticatory myofascial pain: impact on facial pain and pressure pain threshold.

    Science.gov (United States)

    Costa, Y M; Porporatti, A L; Stuginski-Barbosa, J; Bonjardim, L R; Speciali, J G; Conti, P C R

    2016-03-01

    There is no clear evidence on how a headache attributed to temporomandibular disorder (TMD) can hinder the improvement of facial pain and masticatory muscle pain. The aim of this study was to measure the impact of a TMD-attributed headache on masticatory myofascial (MMF) pain management. The sample was comprised of adults with MMF pain measured according to the revised research diagnostic criteria for temporomandibular disorders (RDC/TMD) and additionally diagnosed with (Group 1, n = 17) or without (Group 2, n = 20) a TMD-attributed headache. Both groups received instructions on how to implement behavioural changes and use a stabilisation appliance for 5 months. The reported facial pain intensity (visual analogue scale--VAS) and pressure pain threshold (PPT--kgf cm(-2)) of the anterior temporalis, masseter and right forearm were measured at three assessment time points. Two-way anova was applied to the data, considering a 5% significance level. All groups had a reduction in their reported facial pain intensity (P 0·100). A TMD-attributed headache in patients with MMF pain does not negatively impact pain management, but does change the pattern for muscle pain improvement. © 2015 John Wiley & Sons Ltd.

  13. The First National Pain Medicine Summit--final summary report.

    Science.gov (United States)

    Lippe, Philipp M; Brock, Charles; David, Jose; Crossno, Ronald; Gitlow, Stuart

    2010-10-01

    Pain is ubiquitous. At some point in time it affects everyone. For many millions pain becomes chronic, a scourge that impacts every facet of life-work, hobbies, family relations, social fabric, finances, happiness, mood, and even the very essence of identity. According to the National Institutes of Health (NIH), pain is one of our most important national public health problems, a silent epidemic. In 1998, NIH reported that the annual amount spent on health care, compensation, and litigation related to pain had reached one hundred billion dollars ($100,000,000,000). Considering that health care costs have doubled since then, it is not unreasonable to assume that the costs related to pain care have doubled as well. Millions of patients suffer needlessly with acute pain, with cancer pain, and with chronic pain. The ineffective management of pain results in an escalating cascade of health care issues. Acute pain that is not treated adequately and promptly results in persistent pain that eventually causes irreversible changes in the nervous system. This translates into progressive bio-psycho-social epiphenomena resulting in further pain and disability. It creates a vicious cycle transforming a functional human being into an invalid who becomes a burden to family, to society, and to oneself. In the face of adequate medical science, adequate technical skills, and adequate resources the reality of delayed and inadequate pain care is paradoxical. This dilemma deserves close scrutiny and effective remediation. The American Medical Association (AMA), long dedicated to the need to improve pain care in this country, has been faced with this reality. It was from this vision that the idea of holding a Pain Medicine Summit was conceived. Resolution 321 (A-08) set in motion a process that would bring together a diverse group of stakeholders for the purpose of discussing the present and future status of pain care; a process that culminated in a broad-based coalition of physicians

  14. [Pain and Christianity. A symbol for overcoming pain?].

    Science.gov (United States)

    Markschies, C

    2007-08-01

    Pain and Christianity appear to belong together: Christ's pain stands at the centre of God's healing; his pain leads to the salvation of mankind. We can learn from Jesus' example how to bear suffering and pain. In early Christian times, the belief that Jesus Christ suffered pain on the cross was usually not accepted. In line with the "apathy axiom", freedom from emotion was something to strive for at that time. Only after the acceptance of Christianity as the state religion of the Roman Empire in 380 AD did the pain of Christ again stand in the centre of the Christian doctrine of salvation. The memory of the fact that Jesus himself had to undergo the worst pain can still help people to overcome their pain and comfort them.

  15. [Issues and difficulties in the relationship between patients and caregivers in painful sickle cell vaso-occlusive crisis].

    Science.gov (United States)

    Dzierzynski, N; Stankovic Stojanovic, K; Georgin-Lavialle, S; Lionnet, F

    2016-02-01

    Sickle cell patients in acute pain situation experiment cognitive, behavioral and emotional changes that can accentuate their pain and disrupt communication with caregivers. On the other hand, caregivers have to face pain assessment difficulties and their own psychological reactions to their patient's pain. The gap between the patient's experience and caregiver's evaluation can lead to conflict and non-adherence treatment, and have a direct impact on the sickle cell disease prognosis. There is nothing inevitable about these phenomena, whose knowledge allows the action and opens up prospects for improving the management of sickle cell disease pain. This article is a narrative review updating the interactions between acute pain and some configurations, such as the inability to discern emotions, catastrophizing, post-traumatic stress or feeling ostracized. The overestimation of patient's addiction by caregivers also influences the pain itself. Open communication, as well as some treatments, medicated or not, a consistent institutional organization and a multidisciplinary approach altogether have an analgesic role by acting on pain cognitive and emotional components. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  16. Competing effects of pain and fear of pain on postural control in low back pain?

    NARCIS (Netherlands)

    Mazaheri, M.; Heidari, E.; Mostmand, J.; Negahban, H.; van Dieen, J.H.

    2014-01-01

    STUDY DESIGN. A cross-sectional, observational study. OBJECTIVE. To determine whether pain and fear of pain have competing effects on postural sway in patients with low back pain (LBP). SUMMARY OF BACKGROUND DATA. Competing effects of pain and pain-related fear on postural control can be proposed as

  17. Expression of pain and distress in children during dental extractions through drawings as a projective measure: A clinical study.

    Science.gov (United States)

    Pala, Sai Priya; Nuvvula, Sivakumar; Kamatham, Rekhalakshmi

    2016-02-08

    To evaluate the efficacy of drawings as a projective measure of pain and distress in children undergoing dental extractions. Children in the age range of 4-13 years with existence of untreatable caries or over-retained primary teeth, indicated for extractions were included. Pain was assessed using one behavioral [faces, legs, activity, cry and consolability (FLACC)] scale; and a self report measure; faces pain scale-revised (FPS-R), at two points of time, after completion of local anesthetic administration and after extraction. The general behavior of children was assessed with Wright's modification of Frankl rating scale. At the end of the session, children were instructed to represent, themselves along with the dentist and their experiences of the dental treatment through drawing. The drawings were scored utilizing Child drawing: Hospital scale (CD: H) manual and correlated with FLACC, FPS-R and Frankl using Pearson correlation test. A positive correlation, though statistically not significant, was observed between CD: H scores and all other considered parameters (Frankl, FPS-R and FLACC) in the present study. Drawings could not act as surrogate measure of child's pain; however, they acted as a narrative of his/her experiences and reflection of inner emotions. Hence, drawings can be used as an additional dental armamentarium.

  18. Expression of pain and distress in children during dental extractions through drawings as a projective measure: A clinical study

    Science.gov (United States)

    Pala, Sai Priya; Nuvvula, Sivakumar; Kamatham, Rekhalakshmi

    2016-01-01

    AIM: To evaluate the efficacy of drawings as a projective measure of pain and distress in children undergoing dental extractions. METHODS: Children in the age range of 4-13 years with existence of untreatable caries or over-retained primary teeth, indicated for extractions were included. Pain was assessed using one behavioral [faces, legs, activity, cry and consolability (FLACC)] scale; and a self report measure; faces pain scale-revised (FPS-R), at two points of time, after completion of local anesthetic administration and after extraction. The general behavior of children was assessed with Wright’s modification of Frankl rating scale. At the end of the session, children were instructed to represent, themselves along with the dentist and their experiences of the dental treatment through drawing. The drawings were scored utilizing Child drawing: Hospital scale (CD: H) manual and correlated with FLACC, FPS-R and Frankl using Pearson correlation test. RESULTS: A positive correlation, though statistically not significant, was observed between CD: H scores and all other considered parameters (Frankl, FPS-R and FLACC) in the present study. CONCLUSION: Drawings could not act as surrogate measure of child’s pain; however, they acted as a narrative of his/her experiences and reflection of inner emotions. Hence, drawings can be used as an additional dental armamentarium. PMID:26862509

  19. Cross-modal face recognition using multi-matcher face scores

    Science.gov (United States)

    Zheng, Yufeng; Blasch, Erik

    2015-05-01

    The performance of face recognition can be improved using information fusion of multimodal images and/or multiple algorithms. When multimodal face images are available, cross-modal recognition is meaningful for security and surveillance applications. For example, a probe face is a thermal image (especially at nighttime), while only visible face images are available in the gallery database. Matching a thermal probe face onto the visible gallery faces requires crossmodal matching approaches. A few such studies were implemented in facial feature space with medium recognition performance. In this paper, we propose a cross-modal recognition approach, where multimodal faces are cross-matched in feature space and the recognition performance is enhanced with stereo fusion at image, feature and/or score level. In the proposed scenario, there are two cameras for stereo imaging, two face imagers (visible and thermal images) in each camera, and three recognition algorithms (circular Gaussian filter, face pattern byte, linear discriminant analysis). A score vector is formed with three cross-matched face scores from the aforementioned three algorithms. A classifier (e.g., k-nearest neighbor, support vector machine, binomial logical regression [BLR]) is trained then tested with the score vectors by using 10-fold cross validations. The proposed approach was validated with a multispectral stereo face dataset from 105 subjects. Our experiments show very promising results: ACR (accuracy rate) = 97.84%, FAR (false accept rate) = 0.84% when cross-matching the fused thermal faces onto the fused visible faces by using three face scores and the BLR classifier.

  20. Meta-analytic review of the development of face discrimination in infancy: Face race, face gender, infant age, and methodology moderate face discrimination.

    Science.gov (United States)

    Sugden, Nicole A; Marquis, Alexandra R

    2017-11-01

    Infants show facility for discriminating between individual faces within hours of birth. Over the first year of life, infants' face discrimination shows continued improvement with familiar face types, such as own-race faces, but not with unfamiliar face types, like other-race faces. The goal of this meta-analytic review is to provide an effect size for infants' face discrimination ability overall, with own-race faces, and with other-race faces within the first year of life, how this differs with age, and how it is influenced by task methodology. Inclusion criteria were (a) infant participants aged 0 to 12 months, (b) completing a human own- or other-race face discrimination task, (c) with discrimination being determined by infant looking. Our analysis included 30 works (165 samples, 1,926 participants participated in 2,623 tasks). The effect size for infants' face discrimination was small, 6.53% greater than chance (i.e., equal looking to the novel and familiar). There was a significant difference in discrimination by race, overall (own-race, 8.18%; other-race, 3.18%) and between ages (own-race: 0- to 4.5-month-olds, 7.32%; 5- to 7.5-month-olds, 9.17%; and 8- to 12-month-olds, 7.68%; other-race: 0- to 4.5-month-olds, 6.12%; 5- to 7.5-month-olds, 3.70%; and 8- to 12-month-olds, 2.79%). Multilevel linear (mixed-effects) models were used to predict face discrimination; infants' capacity to discriminate faces is sensitive to face characteristics including race, gender, and emotion as well as the methods used, including task timing, coding method, and visual angle. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Guided Internet-based Psycho-educational Intervention Using Cognitive Behavioral Therapy and Self-management for Individuals with Chronic Pain: A Feasibility Study.

    Science.gov (United States)

    Perry, Jennifer; VanDenKerkhof, Elizabeth G; Wilson, Rosemary; Tripp, Dean A

    2017-06-01

    When considering barriers to chronic pain treatment, there is a need to deliver nonpharmacological therapies in a way that is accessible to all individuals who may benefit. To conduct feasibility testing using a guided, Internet-based intervention for individuals with chronic pain, a novel, Internet-based, chronic pain intervention (ICPI) was developed, using concepts proven effective in face-to-face interventions. This study was designed to assess usability of the ICPI and feasibility of conducting larger-scale research, and to collect preliminary data on effectiveness of the intervention. Data were collected at baseline, after each of the six intervention modules, and 12 weeks after intervention completion. Forty-one participants completed baseline questionnaires, and 15 completed the 12-week postintervention questionnaires. At baseline, all participants reported satisfaction with the structure of the intervention and ease of use. Internet-based platforms such as Facebook aided in accrual of participants, making further large-scale study of the ICPI feasible. There is preliminary evidence suggesting that the ICPI improves emotional function but not physical function, with a small but significant decrease in pain intensity and pain interference. Most participants felt they benefited at least minimally as a result of using the ICPI. The ICPI was well received by participants and demonstrated positive outcomes in this preliminary study. Further research with more participants is feasible and necessary to fully assess the effect of this intervention. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  2. Voicing on Virtual and Face to Face Discussion

    Science.gov (United States)

    Yamat, Hamidah

    2013-01-01

    This paper presents and discusses findings of a study conducted on pre-service teachers' experiences in virtual and face to face discussions. Technology has brought learning nowadays beyond the classroom context or time zone. The learning context and process no longer rely solely on face to face communications in the presence of a teacher.…

  3. Menopause affects pain depending on pain type and characteristics.

    Science.gov (United States)

    Meriggiola, Maria Cristina; Nanni, Michela; Bachiocco, Valeria; Vodo, Stellina; Aloisi, Anna M

    2012-05-01

    Women are more affected than men by many chronic pain conditions, suggesting the effect of sex-related mechanisms in their occurrence. The role of gonadal hormones has been studied but with contrasting results depending on the pain syndrome, reproductive status, and hormone considered. The aim of the present study was to evaluate the pain changes related to the menopausal transition period. In this observational study, postmenopausal women were asked to evaluate the presence of pain in their life during the premenopausal and postmenopausal periods and its modification with menopause. One hundred one women were enrolled and completed questionnaires on their sociodemographic status, pain characteristics, and evolution. The most common pain syndromes were headache (38%), osteoarticular pain (31%), and cervical/lumbar pain (21%). Pain was present before menopause in 66 women, ceased with menopause in 17, and started after menopause in 18. Data were used for cluster analysis, which allowed the division of participants into four groups. In the first, all women experienced headaches that disappeared or improved with menopause. The second group included osteoarticular pain; the pain improved in half of these women and remained stable in the other half. The third group had cervical/lumbar pain, which disappeared or improved with menopause in all. The fourth group presented different kinds of moderate pain, which worsened in all. The present study provides preliminary data suggesting that menopause can affect pain depending on the painful condition experienced by the woman. This underlines the different interactions of menopause-related events with body structures involved in pain.

  4. Facing Aggression: Cues Differ for Female versus Male Faces

    OpenAIRE

    Geniole, Shawn N.; Keyes, Amanda E.; Mondloch, Catherine J.; Carr?, Justin M.; McCormick, Cheryl M.

    2012-01-01

    The facial width-to-height ratio (face ratio), is a sexually dimorphic metric associated with actual aggression in men and with observers' judgements of aggression in male faces. Here, we sought to determine if observers' judgements of aggression were associated with the face ratio in female faces. In three studies, participants rated photographs of female and male faces on aggression, femininity, masculinity, attractiveness, and nurturing. In Studies 1 and 2, for female and male faces, judge...

  5. Buzz: Face-to-Face Contact and the Urban Economy

    OpenAIRE

    Michael Storper; Anthony J. Venables

    2003-01-01

    This paper argues that existing models of urban concentrations are incomplete unless grounded in the most fundamental aspect of proximity; face-to-face contact. Face-to-face contact has four main features; it is an efficient communication technology; it can help solve incentive problems; it can facilitate socialization and learning; and it provides psychological motivation. We discuss each of these features in turn, and develop formal economic models of two of them. Face-to-face is particular...

  6. Pain perception and modulation in acute and chronic pain states

    NARCIS (Netherlands)

    Oudejans, L.C.J.

    2016-01-01

    This thesis describes the evaluation of pain perception in acute and chronic pain patients and the strength of the endogenous pain modulation system in chronic pain patients. Additionally, pain phenotypes are determined in patients with chronic pain. The ability of patients with acute pain after

  7. Decision Factors Nurses Use to Assess Pain in Nursing Home Residents With Dementia.

    Science.gov (United States)

    Monroe, Todd B; Parish, Abby; Mion, Lorraine C

    2015-10-01

    Nurses caring for older people with various psychiatric illnesses face many obstacles when treating pain. One setting with a high percentage of psychiatric conditions is long-term care where more than half of residents have some form of dementia, and behavioral symptoms of dementia (BSDs) may mimic behavioral displays of pain. Furthermore, two-thirds of nursing home residents have pain. Thus, many nursing home residents with dementia have pain that may be confounded by BSDs. Since many people with dementia are at risk for poor pain management, determining current methods in which nurses assess and manage pain in nursing home residents will aid in recognizing potential barriers to using current pain management guidelines and help develop strategies to enhance nurses' assessment and management of pain in this vulnerable population. The aim of this study was to explore nursing home nurses' cues and practices to identify and alleviate pain in nursing home residents with dementia. Nurses use the constructs of 'comfort' and 'quality of life' as key components in their overall pain assessment strategy in people with dementia. Indeed, the extensive process they use involving frequent reassessment and application of interventions is geared towards "appearance of comfort." Nurses reported difficulty in ascertaining whether a person with dementia was in pain, and they expressed further difficulty determining the intensity associated with resident pain. Nurses further reported that residents with dementia who are not well know by the staff were are greater risk of poor pain management. It was not unusual for nurses to discuss the importance of conflict resolution among family members as well as allowing for open expression of family's concerns. Nurses had to focus not only on the resident's comfort, but also the families' level of comfort with pain management, especially at the end-of-life. Findings support further use and development of discomfort behavior scales to help

  8. The periodontal pain paradox: Difficulty on pain assesment in dental patients (The periodontal pain paradox hypothesis

    Directory of Open Access Journals (Sweden)

    Haryono Utomo

    2006-12-01

    Full Text Available In daily dental practice, the majority of patients’ main complaints are related to pain. Most patients assume that all pains inside the oral cavity originated from the tooth. One particular case is thermal sensitivity; sometimes patients were being able to point the site of pain, although there is neither visible caries nor secondary caries in dental radiograph. In this case, gingival recession and dentin hypersensitivity are first to be treated to eliminate the pain. If these treatments failed, pain may misdiagnose as pulpal inflammation and lead to unnecessary root canal treatment. Study in pain during periodontal instrumentation of plaque-related periodontitis revealed that the majority of patients feel pain and discomfort during probing and scaling. It seems obvious because an inflammation, either acute or chronic is related to a lowered pain threshold. However, in contrast, in this case report, patient suffered from chronic gingivitis and thermal sensitivity experienced a relative pain-free sensation during probing and scaling. Lowered pain threshold which accompanied by a blunted pain perception upon periodontal instrumentation is proposed to be termed as the periodontal pain paradox. The objective of this study is to reveal the possibility of certain factors in periodontal inflammation which may involved in the periodontal pain paradox hypothesis. Patient with thermal hypersensitivity who was conducted probing and scaling, after the relative pain-free instrumentation, thermal hypersensitivity rapidly disappeared. Based on the successful periodontal treatment, it is concluded that chronic gingivitis may modulate periodontal pain perception which termed as periodontal pain paradox

  9. European cinema: face to face with Hollywood

    NARCIS (Netherlands)

    Elsaesser, T.

    2005-01-01

    In the face of renewed competition from Hollywood since the early 1980s and the challenges posed to Europe's national cinemas by the fall of the Wall in 1989, independent filmmaking in Europe has begun to re-invent itself. European Cinema: Face to Face with Hollywood re-assesses the different

  10. Relationship among perceived stress, anxiety, depression and craniocervical pain in nursing professionals under stress at work

    Directory of Open Access Journals (Sweden)

    Daniela Pozzebon

    Full Text Available Abstract Introduction: The appearance and evolution of some clinical pain conditions may be influenced by stress and other psychosocial factors. Face, head and cervical muscles may increase their activity and tension in the presence of stress, leading to craniocervicomandibular pain in individuals exposed to stress. Objective: To assess the relationship among perceived stress, anxiety, depression and craniocervicomandibular pain in nursing professionals under stress at work. Materials and Methods: Forty-three women under stress at work, according to the Job Stress Scale (JSS, were assessed by the Perceived Stress Scale (PSS, the Hospital Anxiety and Depression Scale (HADS, pressure pain threshold, measured by algometry, and muscle sensitivity to hand palpation of the masticatory and cervical muscles. Results: A low moderate level of perceived stress was found in 62.79% of the sample, anxiety in 11.63% and depression in 9.30%. The psychosocial scales correlated with each other. No correlation was found between pressure pain threshold and perceived stress, anxiety and depression. The level of pain to hand palpation correlated with the perceived stress scores. Conclusion: Pressure pain threshold was not influenced by the psychosocial factors assessed. Pain intensity to hand palpation, however, was higher as the perception of stress increased.

  11. Pain control methods in use and perceived effectiveness by patients with Ehlers-Danlos syndrome: a descriptive study.

    Science.gov (United States)

    Arthur, Karen; Caldwell, Karen; Forehand, Samantha; Davis, Keith

    2016-01-01

    The purpose of this study was to assess the pain control methods in use by patients who have Ehlers-Danlos Syndrome (EDS), a group of connective tissue disorders, and their perceived effectiveness. This descriptive study involved 1179 adults diagnosed with EDS who completed an anonymous on-line survey. The survey consisted of demographics information, the Patient Reported Outcomes Measurement Information System (PROMIS) Pain-Behavior, PROMIS Pain-Interference, and Neuro QOL Satisfaction with Social Roles and Activities scales, as well as a modified version of the Pain Management Strategies Survey. Respondents reported having to seek out confirmation of their EDS diagnosis with multiple healthcare providers, which implies the difficulty many people with EDS face when trying to gain access to appropriate treatment. Patients with EDS experience higher levels of pain interference and lower satisfaction with social roles and activities compared to national norms. Among the treatment modalities in this study, those perceived as most helpful for acute pain control were opioids, surgical interventions, splints and braces, avoidance of potentially dangerous activities and heat therapy. Chronic pain treatments rated as most helpful were opioids, splints or braces and surgical interventions. For methods used for both acute and chronic pain, those perceived as most helpful were opioids, massage therapies, splints or braces, heat therapy and avoiding potentially dangerous activities. EDS is a complex, multi-systemic condition that can be difficult to diagnose and poses challenges for healthcare practitioners who engage with EDS patients in holistic care. Improved healthcare provider knowledge of EDS is needed, and additional research on the co-occurring diagnoses with EDS may assist in comprehensive pain management for EDS patients. Ehlers-Danlos Syndrome (EDS) is a group of connective tissue disorders associated with defective production of collagen, which can dramatically

  12. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial.

    Science.gov (United States)

    Akhtar, Muhammad Waseem; Karimi, Hossein; Gilani, Syed Amir

    2017-01-01

    Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain. This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2 nd , 4 th and 6 th week post treatment. The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2 nd , 4 th and 6 th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively. Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in patients with

  13. Insurance Companies Fighting the Peer Review Empire without any Validity: the Case for Addiction and Pain Modalities in the face of an American Drug Epidemic.

    Science.gov (United States)

    Blum, K; Jacobs, W; Modestino, E J; DiNubile, N; Baron, D; McLaughlin, T; Siwicki, D; Elman, I; Moran, M; Braverman, E R; Thanos, P K; Badgaiyan, R D

    2018-10-04

    The United States are amid an opioid overdose epidemic; we are challenged to provide non-addicting/non-pharmacological alternatives to assist in pain attenuation. There are proven strategies available to manage chronic pain effectively without opioids. Utilization review providers for insurance companies often ignore medicine based scientific peer-reviewed studies that warn against the chronic use of opioid medications, as well as the lack of evidence to support long-term use of opioids for pain. This paradigm must change if we are to indeed change the drug-embracing culture in American chronic pain management. A barrier to treatment is pushback on the part of insurance companies especially as it relates to fighting against pain relief alternatives compared to classical analgesic agents. Pain specialists in the U.S., are compelled to find alternative solutions to help pain victims without promoting unwanted tolerance to analgesics and subsequent biological induction of the "addictive brain." It is noteworthy that reward center of the brain plays a crucial role in the modulation of nociception, and that adaptations in dopaminergic circuitry may affect several sensory and affective components of chronic pain syndromes. Possibly knowing a patient's genetic addiction risk score (GARS™) could eliminate guessing as it relates to becoming addicted.

  14. Multilevel Spondylolysis Repair Using the "Smiley Face" Technique with 3-Dimensional Intraoperative Spinal Navigation.

    Science.gov (United States)

    Voisin, Mathew R; Witiw, Christopher D; Deorajh, Ryan; Guha, Daipayan; Oremakinde, Adetunji; Wang, Shelly; Yang, Victor

    2018-01-01

    Multilevel spondylolysis is a rare cause of progressive lower back pain, and patients who fail conservative management are treated surgically. Direct repair methods can maintain mobility and lead to decreased morbidity compared with spinal fusion in single-level spondylolysis. In this paper, we present a patient with nonadjacent multilevel spondylolysis who underwent the "smiley face" technique of direct multilevel repair without fusion using 3-dimensional intraoperative spinal navigation. Bilateral spondylolysis at L3 and L5 with associated spondylolisthesis in a 50-year-old male was repaired using the "smiley face" technique. Patient-reported outcomes, including the Oswestry Disability Index (ODI) and visual analog scale scores for back and leg pain, were assessed preoperatively along with 6 weeks and 4 months postoperatively. Postoperative computed tomography imaging showed precise screw insertion and rod placement along with stable hardware alignment in follow-up imaging. The patient's ODI and lower back visual analog scale scores decreased from 25 to 8 and 7.5 to 4, respectively, correlating to an excellent outcome on ODI. Direct repair and avoidance of fusion is possible and can provide good functional outcomes in patients with nonadjacent multilevel spondylolysis and associated spondylolisthesis. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. The Caledonian face test: A new test of face discrimination.

    Science.gov (United States)

    Logan, Andrew J; Wilkinson, Frances; Wilson, Hugh R; Gordon, Gael E; Loffler, Gunter

    2016-02-01

    This study aimed to develop a clinical test of face perception which is applicable to a wide range of patients and can capture normal variability. The Caledonian face test utilises synthetic faces which combine simplicity with sufficient realism to permit individual identification. Face discrimination thresholds (i.e. minimum difference between faces required for accurate discrimination) were determined in an "odd-one-out" task. The difference between faces was controlled by an adaptive QUEST procedure. A broad range of face discrimination sensitivity was determined from a group (N=52) of young adults (mean 5.75%; SD 1.18; range 3.33-8.84%). The test is fast (3-4 min), repeatable (test-re-test r(2)=0.795) and demonstrates a significant inversion effect. The potential to identify impairments of face discrimination was evaluated by testing LM who reported a lifelong difficulty with face perception. While LM's impairment for two established face tests was close to the criterion for significance (Z-scores of -2.20 and -2.27) for the Caledonian face test, her Z-score was -7.26, implying a more than threefold higher sensitivity. The new face test provides a quantifiable and repeatable assessment of face discrimination ability. The enhanced sensitivity suggests that the Caledonian face test may be capable of detecting more subtle impairments of face perception than available tests. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Pain Scores Are Not Predictive of Pain Medication Utilization

    Directory of Open Access Journals (Sweden)

    Suzanne Galloway

    2011-01-01

    Full Text Available Objective. To compare Visual Analogue Scale (VAS scores with overall postoperative pain medication requirements including cumulative dose and patterns of medication utilization and to determine whether VAS scores predict pain medication utilization. Methods. VAS scores and pain medication data were collected from participants in a randomized trial of the utility of phenazopyridine for improved pain control following gynecologic surgery. Results. The mean age of the 219 participants was 54 (range19 to 94. We did not detect any association between VAS and pain medication utilization for patient-controlled anesthesia (PCA or RN administered (intravenous or oral medications. We also did not detect any association between the number of VAS scores recorded and mean pain scores. Conclusion. Postoperative VAS scores do not predict pain medication use in catheterized women inpatients following gynecologic surgery. Increased pain severity, as reflected by higher VAS scores, is not associated with an increase in pain assessment. Our findings suggest that VAS scores are of limited utility for optimal pain control. Alternative or complimentary methods may improve pain management.

  17. Face-Lift Satisfaction Using the FACE-Q.

    Science.gov (United States)

    Sinno, Sammy; Schwitzer, Jonathan; Anzai, Lavinia; Thorne, Charles H

    2015-08-01

    Face lifting is one of the most common operative procedures for facial aging and perhaps the procedure most synonymous with plastic surgery in the minds of the lay public, but no verifiable documentation of patient satisfaction exists in the literature. This study is the first to examine face-lift outcomes and patient satisfaction using a validated questionnaire. One hundred five patients undergoing a face lift performed by the senior author (C.H.T.) using a high, extended-superficial musculoaponeurotic system with submental platysma approximation technique were asked to complete anonymously the FACE-Q by e-mail. FACE-Q scores were assessed for each domain (range, 0 to 100), with higher scores indicating greater satisfaction with appearance or superior quality of life. Fifty-three patients completed the FACE-Q (50.5 percent response rate). Patients demonstrated high satisfaction with facial appearance (mean ± SD, 80.7 ± 22.3), and quality of life, including social confidence (90.4 ± 16.6), psychological well-being (92.8 ± 14.3), and early life impact (92.2 ± 16.4). Patients also reported extremely high satisfaction with their decision to undergo face lifting (90.5 ± 15.9). On average, patients felt they appeared 6.9 years younger than their actual age. Patients were most satisfied with the appearance of their nasolabial folds (86.2 ± 18.5), cheeks (86.1 ± 25.4), and lower face/jawline (86.0 ± 20.6), compared with their necks (78.1 ± 25.6) and area under the chin (67.9 ± 32.3). Patients who responded in this study were extremely satisfied with their decision to undergo face lifting and the outcomes and quality of life following the procedure.

  18. A Face Inversion Effect without a Face

    Science.gov (United States)

    Brandman, Talia; Yovel, Galit

    2012-01-01

    Numerous studies have attributed the face inversion effect (FIE) to configural processing of internal facial features in upright but not inverted faces. Recent findings suggest that face mechanisms can be activated by faceless stimuli presented in the context of a body. Here we asked whether faceless stimuli with or without body context may induce…

  19. Oral administration of analgesia and anxiolysis for pain associated with bone marrow biopsy.

    Science.gov (United States)

    Talamo, Giampaolo; Liao, Jason; Bayerl, Michael G; Claxton, David F; Zangari, Maurizio

    2010-03-01

    Medical literature provides only scarce data about the degree of pain experienced by patients undergoing a bone marrow aspiration and biopsy (BMAB), and little is known about the factors that can modify the perception of pain. In this study, we evaluated the effectiveness of a combination of analgesia and anxiolysis in reducing the pain score of patients undergoing BMAB. Eighty-four consecutive adult patients underwent BMAB after local anesthesia with 5 mL of lidocaine hydrochloride 1% aqueous solution in the left posterior superior iliac crest. Analgesia was obtained with acetaminophen 650 mg and oxycodone 10 mg, and anxiolysis was obtained with lorazepam 2 mg, all drugs given once orally 30 min before the procedure. We assessed the pain level with the Wong-Baker Faces Pain Rating Scale, which distinguishes six levels of pain, from 0 to 5. The 34 patients who received an oral administration of analgesia and anxiolysis reported pain at lower levels, i.e., in the range of 0-2, more frequently than the 50 patients who underwent BMAB without analgesia/anxiolysis (78% vs 64%, respectively). Among several predictors analyzed using a multivariate regression model, three were found to be associated with decreased pain level: the use of analgesia/anxiolysis, male sex, and increase in age (all with p values <0.05). Length of the extracted bone specimen, body mass index, and need of a spinal needle for anesthesia in obese patients did not predict for pain level. An oral administration of prophylactic regimen of analgesia and anxiolysis, at the above-mentioned doses, produced a statistically significant reduction of the perception of pain in patients undergoing BMAB, but its effect did not seem to provide a major and clinically significant reduction of pain level.

  20. Characterizing neuropathic pain profiles: enriching interpretation of painDETECT

    Directory of Open Access Journals (Sweden)

    Cappelleri JC

    2016-07-01

    Full Text Available Joseph C Cappelleri,1 Vijaya Koduru,2 E Jay Bienen,3 Alesia Sadosky4 1Pfizer Inc, Groton, CT, USA; 2Eliassen Group, New London, CT, USA; 3Outcomes Research Consultant, New York, NY, USA; 4Pfizer Inc, New York, NY, USA Purpose: To psychometrically evaluate painDETECT, a patient-reported screening questionnaire for neuropathic pain (NeP, for discriminating among sensory pain symptoms (burning, tingling/prickling, light touching, sudden pain attacks/electric shock-type pain, cold/heat, numbness, and slight pressure. Methods: The seven-item version of painDETECT provides an overall score that targets only sensory symptoms, while the nine-item version adds responses on two items to the overall score, covering pain course pattern and pain radiation. Both versions have relevance in terms of characterizing broad NeP. The nine- and seven-item versions of painDETECT were administered to subjects with confirmed NeP across six conditions identified during office visits to US community-based physicians. Responses on the sensory symptom items were dichotomized into “at least moderate” (ie, moderate, strongly, very strongly relative to the combined other responses (never, hardly noticed, slightly. Logistic regression of dichotomized variables on the total painDETECT score provided probabilities of experiencing each symptom across the range of painDETECT scores. Results: Both painDETECT versions discriminated among the symptoms with similar probabilities across the score ranges. Using these data, the probability of moderately experiencing each pain sensory item was estimated for a particular score, providing a pain profile. Additionally, the likelihood of experiencing each sensation was determined for a discrete increase in score, ie, the odds of at least a moderate sensation of burning (versus less than a moderate sensation was 1.29 for a 1-point increase, 3.52 for a 5-point increase, and 12.42 for every 10-point increase in the nine-item painDETECT score

  1. Role for the Ventral Posterior Medial/Posterior Lateral Thalamus and Anterior Cingulate Cortex in Affective/Motivation Pain Induced by Varicella Zoster Virus

    Directory of Open Access Journals (Sweden)

    Phillip R. Kramer

    2017-10-01

    Full Text Available Varicella zoster virus (VZV infects the face and can result in chronic, debilitating pain. The mechanism for this pain is unknown and current treatment is often not effective, thus investigations into the pain pathway become vital. Pain itself is multidimensional, consisting of sensory and affective experiences. One of the primary brain substrates for transmitting sensory signals in the face is the ventral posterior medial/posterior lateral thalamus (VPM/VPL. In addition, the anterior cingulate cortex (ACC has been shown to be vital in the affective experience of pain, so investigating both of these areas in freely behaving animals was completed to address the role of the brain in VZV-induced pain. Our lab has developed a place escape avoidance paradigm (PEAP to measure VZV-induced affective pain in the orofacial region of the rat. Using this assay as a measure of the affective pain experience a significant response was observed after VZV injection into the whisker pad and after VZV infusion into the trigeminal ganglion. Local field potentials (LFPs are the summed electrical current from a group of neurons. LFP in both the VPM/VPL and ACC was attenuated in VZV injected rats after inhibition of neuronal activity. This inhibition of VPM/VPL neurons was accomplished using a designer receptor exclusively activated by a designer drug (DREADD. Immunostaining showed that cells within the VPM/VPL expressed thalamic glutamatergic vesicle transporter-2, NeuN and DREADD suggesting inhibition occurred primarily in excitable neurons. From these results we conclude: (1 that VZV associated pain does not involve a mechanism exclusive to the peripheral nerve terminals, and (2 can be controlled, in part, by excitatory neurons within the VPM/VPL that potentially modulate the affective experience by altering activity in the ACC.

  2. Dysfunctional pain modulation in somatoform pain disorder patients.

    Science.gov (United States)

    Klug, Stefanie; Stefanie, Klug; Anderer, Peter; Peter, Anderer; Saletu-Zyhlarz, Gerda; Gerda, Saletu-Zyhlarz; Freidl, Marion; Marion, Freidl; Saletu, Bernd; Bernd, Saletu; Prause, Wolfgang; Wolfgang, Prause; Aigner, Martin; Martin, Aigner

    2011-06-01

    To date, pain perception is thought to be a creative process of modulation carried out by an interplay of pro- and anti-nociceptive mechanisms. Recent research demonstrates that pain experience constitutes the result of top-down processes represented in cortical descending pain modulation. Cortical, mainly medial and frontal areas, as well as subcortical structures such as the brain stem, medulla and thalamus seem to be key players in pain modulation. An imbalance of pro- and anti-nociceptive mechanisms are assumed to cause chronic pain disorders, which are associated with spontaneous pain perception without physiologic scaffolding or exaggerated cortical activation in response to pain exposure. In contrast to recent investigations, the aim of the present study was to elucidate cortical activation of somatoform pain disorder patients during baseline condition. Scalp EEG, quantitative Fourier-spectral analyses and LORETA were employed to compare patient group (N = 15) to age- and sex-matched controls (N = 15) at rest. SI, SII, ACC, SMA, PFC, PPC, insular, amygdale and hippocampus displayed significant spectral power reductions within the beta band range (12-30 Hz). These results suggest decreased cortical baseline arousal in somatoform pain disorder patients. We finally conclude that obtained results may point to an altered baseline activity, maybe characteristic for chronic somatoform pain disorder.

  3. Spinal pain

    International Nuclear Information System (INIS)

    Izzo, R.; Popolizio, T.; D’Aprile, P.; Muto, M.

    2015-01-01

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  4. Spinal pain

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, R., E-mail: roberto1766@interfree.it [Neuroradiology Department, A. Cardarelli Hospital, Naples (Italy); Popolizio, T., E-mail: t.popolizio1@gmail.com [Radiology Department, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Fg) (Italy); D’Aprile, P., E-mail: paoladaprile@yahoo.it [Neuroradiology Department, San Paolo Hospital, Bari (Italy); Muto, M., E-mail: mutomar@tiscali.it [Neuroradiology Department, A. Cardarelli Hospital, Napoli (Italy)

    2015-05-15

    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  5. Putting Physical Activity While Experiencing Low Back Pain in Context: Balancing the Risks and Benefits.

    Science.gov (United States)

    Darlow, Ben; Perry, Meredith; Dean, Sarah; Mathieson, Fiona; Baxter, G David; Dowell, Anthony

    2016-02-01

    To analyze attitudes and beliefs about movement and physical activity in people with low back pain (LBP) and compare these beliefs between people with acute and chronic LBP. Qualitative inductive analysis of data collected via face-to-face semistructured interviews. Interviews were audio-recorded and transcribed verbatim. Participants were purposively recruited from 1 region of New Zealand. Persons with LBP (N=23), consisting of individuals with acute LBP (3mo; n=11). Not applicable. Themes that emerged from participant interview transcripts using analysis based on Interpretative Description. Participants with acute and chronic LBP made judgments about physical activity and rest using the same conceptual model. Concerns about creating more pain, tissue damage, or impairment influenced the physical activity judgments of most participants with acute and chronic LBP. These perceived risks were balanced against the perceived benefits, the most important of which were psychological or social rather than physical. Judgments made by those with acute and chronic LBP were context dependent and influenced by the nature and duration of pain, the type of physical activity, the importance of the activity, and the participant's previous experience. Participants with acute pain who had not experienced back pain previously often expressed more uncertainty, whereas those with chronic LBP appeared to have developed cognitive rules that determined physical activity decisions. Exploring the perceived risks, benefits, and contextual factors that influence decisions about physical activity and rest may help clinicians to understand the behavior of patients with acute and chronic LBP. Clinicians may best support their patients to engage in physical activity by providing an informed assessment of risks and an explanation about the range of potential benefits. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Impact of Risk Aversion on Price and Quality Decisions under Demand Uncertainty via the CARA Utility Function

    Directory of Open Access Journals (Sweden)

    Qinqin Li

    2014-01-01

    Full Text Available This paper investigates optimal price and quality decisions of a manufacturer-retailer supply chain under demand uncertainty, in which players are both risk-averse decision makers. The manufacturer determines the wholesale price and quality of the product, and the retailer determines the retail price. By means of game theory, we employ the constant absolute risk aversion (CARA function to analyze two different supply chain structures, that is, manufacturer Stackelberg model (MS and retailer Stackelberg model (RS. We then analyze the results to explore the effects of risk aversion of the manufacturer and the retailer upon the equilibrium decisions. Our results imply that both the risk aversion of the manufacturer and the retailer play an important role in the price and quality decisions. We find that, in general, in MS and RS models, the optimal wholesale price and quality decrease with the risk aversion of the manufacturer but increase with the risk aversion of the retailer, while the retail price decreases with the risk aversion of the manufacturer as well as the retailer. We also examine the impact of quality cost coefficient on the optimal decisions. Finally, numerical examples are presented to illustrate the different degree of effects of players’ risk aversion on equilibrium results and to compare results in different models considered.

  7. Long-pulsed dye laser versus intense pulsed light for photodamaged skin: A randomized split-face trial with blinded response evaluation

    DEFF Research Database (Denmark)

    Jorgensen, G.F.; Hedelund, L.; Haedersdal, M.

    2008-01-01

    Objective: In a randomized controlled split-face trial to evaluate efficacy and adverse effects from rejuvenation with long-pulsed dye laser (LPDL) versus intense pulsed light (IPL). Materials and Methods: Twenty female volunteers with Fitzpatrick skin types I-III, classes I-II rhytids......, and symmetrical split-face photodamage were included in the study. Subjects received a series of three treatments at 3-week intervals with half-face LPDL (V-beam Perfecta, 595 nm, Candela Laser Corporation) and half-face IPL (Ellipse Flex, Danish Dermatologic Development); the interventions being randomly...... assigned to left and right sides. Primary end-points were telangiectasias, irregular pigmentation and preferred treatment. Secondary end-points were skin texture, rhytids, pain, and adverse effects. Efficacy was evaluated by patient self-assessments and by blinded clinical on-site and photographic...

  8. ¿Cuál es la supervivencia de los injertos de grasa en la cara? ¿Cómo cuantificarla?: medicina basada en la evidencia

    Directory of Open Access Journals (Sweden)

    E. Serna-Cuéllar

    Full Text Available Muchos de los artículos publicados acerca del éxito de los injertos autólogos de grasa (IAG en humanos son muy subjetivos o, en el mejor de los casos, semicuantitativos Hasta hoy, se necesitan estudios adicionales, tanto clínicos como básicos, antes de que podamos llegar a precisar el valor de esta técnica. Diseñamos un estudio prospectivo y randomizado con el objetivo de cuantificar la supervivencia de los autoinjertos de grasa en cara, en una serie seleccionada de 71 pacientes con defectos subcutáneos de partes blandas faciales que cumplieron criterios de inclusión, en dos grupos, según fueran casos de Cirugía Reconstructiva o de Cirugía Estética. El procedimiento quirúrgico estándar empleado fue la técnica de lipoestructura facial; se tomó biopsia del tejido adiposo injertado a los 14 meses de seguimiento. Empleamos el método estereológico para medir los parámetros volumétricos cuantitativos de la grasa en el momento de la inyección y en el momento de la biopsia. Por medio de simples ecuaciones matemáticas, pudimos extraer las tasas de prendimiento tanto volumétrica como numérica. También se practicaron análisis estadísticos descriptivos y cuantitativos de todos los datos. Los injertos de grasa autólogos en la cara sobreviven en dos tercios del volumen inyectado a los 14 meses de seguimiento. La única prueba confirmatoria de supervivencia de los autoin-jertos de grasa es la evidencia y demostración histológica de tejido adiposo viable en las zonas receptoras y su cuantificación mediante un método de evaluación volumétrico, preciso y objetivo, como el que permite la Estereología.

  9. Reward and motivation in pain and pain relief

    Science.gov (United States)

    Navratilova, Edita; Porreca, Frank

    2015-01-01

    Pain is fundamentally unpleasant, a feature that protects the organism by promoting motivation and learning. Relief of aversive states, including pain, is rewarding. The aversiveness of pain, as well as the reward from relief of pain, is encoded by brain reward/motivational mesocorticolimbic circuitry. In this Review, we describe current knowledge of the impact of acute and chronic pain on reward/motivation circuits gained from preclinical models and from human neuroimaging. We highlight emerging clinical evidence suggesting that anatomical and functional changes in these circuits contribute to the transition from acute to chronic pain. We propose that assessing activity in these conserved circuits can offer new outcome measures for preclinical evaluation of analgesic efficacy to improve translation and speed drug discovery. We further suggest that targeting reward/motivation circuits may provide a path for normalizing the consequences of chronic pain to the brain, surpassing symptomatic management to promote recovery from chronic pain. PMID:25254980

  10. Pain and pain tolerance in professional ballet dancers.

    Science.gov (United States)

    Tajet-Foxell, B; Rose, F D

    1995-01-01

    Pain experience in sport had been the subject of increasing research in recent years. While sports professionals have generally been found to have higher pain thresholds than control subjects the reasons for this are not entirely clear. The present study seeks to investigate one possible explanatory factor, the importance of the popular image of the physical activity and of the self-image of its participants, by examining pain experience in professional ballet dancers. Like sports professionals, dancers were found to have higher pain and pain tolerance thresholds than age matched controls in the Cold Pressor Test. However, they also reported a more acute experience of the sensory aspects of the pain. Explanations of this apparent paradox are discussed both in terms of the neuroticism scores of the two groups and in terms of the dancers' greater experience of pain and its relationship with physical activity. The results illustrated the importance of using multidimensional measures of pain in this type of investigation. PMID:7788215

  11. Pain genes.

    Directory of Open Access Journals (Sweden)

    Tom Foulkes

    2008-07-01

    Full Text Available Pain, which afflicts up to 20% of the population at any time, provides both a massive therapeutic challenge and a route to understanding mechanisms in the nervous system. Specialised sensory neurons (nociceptors signal the existence of tissue damage to the central nervous system (CNS, where pain is represented in a complex matrix involving many CNS structures. Genetic approaches to investigating pain pathways using model organisms have identified the molecular nature of the transducers, regulatory mechanisms involved in changing neuronal activity, as well as the critical role of immune system cells in driving pain pathways. In man, mapping of human pain mutants as well as twin studies and association studies of altered pain behaviour have identified important regulators of the pain system. In turn, new drug targets for chronic pain treatment have been validated in transgenic mouse studies. Thus, genetic studies of pain pathways have complemented the traditional neuroscience approaches of electrophysiology and pharmacology to give us fresh insights into the molecular basis of pain perception.

  12. Cancer pain management: Basic information for the young pain physicians

    Directory of Open Access Journals (Sweden)

    SPS Rana

    2011-01-01

    Full Text Available Cancer pain is multifactorial and complex. The impact of cancer pain is devastating, with increased morbidity and poor quality of life, if not treated adequately. Cancer pain management is a challenging task both due to disease process as well as a consequence of treatment-related side-effects. Optimization of analgesia with oral opioids, adjuvant analgesics, and advanced pain management techniques is the key to success for cancer pain. Early access of oral opioid and interventional pain management techniques can overcome the barriers of cancer pain, with improved quality of life. With timely and proper anticancer therapy, opioids, nerve blocks, and other non-invasive techniques like psychosocial care, satisfactory pain relief can be achieved in most of the patients. Although the WHO Analgesic Ladder is effective for more than 80% cancer pain, addition of appropriate adjuvant drugs along with early intervention is needed for improved Quality of Life. Effective cancer pain treatment requires a holistic approach with timely assessment, measurement of pain, pathophysiology involved in causing particular type of pain, and understanding of drugs to relieve pain with timely inclusion of intervention. Careful evaluation of psychosocial and mental components with good communication is necessary. Barriers to cancer pain management should be overcome with an interdisciplinary approach aiming to provide adequate analgesia with minimal side-effects. Management of cancer pain should comprise not only a physical component but also psychosocial and mental components and social need of the patient. With risk-benefit analysis, interventional techniques should be included in an early stage of pain treatment. This article summarizes the need for early and effective pain management strategies, awareness regarding pain control, and barriers of cancer pain.

  13. The Impact of Virtual Reality Distraction on Pain and Anxiety during Dental Treatment in 4-6 Year-Old Children: a Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Naser Asl Aminabadi

    2013-11-01

    Full Text Available Background and aims. Dental practitioners have numerous methods to control anxiety and pain in children, and distracting the child appears to be the most common technique used for behavior management during dental procedures. The aim of the present study was to evaluate the influence of using virtual reality eyeglasses on severity of pain and anxiety during dental procedures in pediatric patients. Materials and methods. This study included 120 healthy children aged 4-6 years. Children with no previous anxiety disorder were randomly divided into two groups, each consisting of 60 children. The study consisted of 3 consecutive treatment sessions. During the first visit fluoride therapy was carried out in both groups. In the next sessions, the groups received restorative treatment with and without virtual reality eyeglasses in a randomized single-blind-controlled crossover fashion. Then at the end of each session the subjects’ pain severity was assessed using Wong Baker FACES Pain Rating Scale and state anxiety was measured by Faces version of the Modified Child Dental Anxiety Scale [MCDAS (f]. Results. There was a significant decrease in pain perception (P < 0.001 and state anxiety scores (P < 0.001 with the use of virtual reality eyeglasses during dental treatment. Conclusion. Results of this study showed that virtual reality eyeglasses can successfully decrease pain perception and state anxiety during dental treatment. Trial registration number: 201103126036N1.

  14. Construction of a global pain systems network highlights phospholipid signaling as a regulator of heat nociception.

    Directory of Open Access Journals (Sweden)

    G Gregory Neely

    Full Text Available The ability to perceive noxious stimuli is critical for an animal's survival in the face of environmental danger, and thus pain perception is likely to be under stringent evolutionary pressure. Using a neuronal-specific RNAi knock-down strategy in adult Drosophila, we recently completed a genome-wide functional annotation of heat nociception that allowed us to identify α2δ3 as a novel pain gene. Here we report construction of an evolutionary-conserved, system-level, global molecular pain network map. Our systems map is markedly enriched for multiple genes associated with human pain and predicts a plethora of novel candidate pain pathways. One central node of this pain network is phospholipid signaling, which has been implicated before in pain processing. To further investigate the role of phospholipid signaling in mammalian heat pain perception, we analysed the phenotype of PIP5Kα and PI3Kγ mutant mice. Intriguingly, both of these mice exhibit pronounced hypersensitivity to noxious heat and capsaicin-induced pain, which directly mapped through PI3Kγ kinase-dead knock-in mice to PI3Kγ lipid kinase activity. Using single primary sensory neuron recording, PI3Kγ function was mechanistically linked to a negative regulation of TRPV1 channel transduction. Our data provide a systems map for heat nociception and reinforces the extraordinary conservation of molecular mechanisms of nociception across different species.

  15. Construction of a Global Pain Systems Network Highlights Phospholipid Signaling as a Regulator of Heat Nociception

    Science.gov (United States)

    Mair, Norbert; Racz, Ildiko; Milinkeviciute, Giedre; Meixner, Arabella; Nayanala, Swetha; Griffin, Robert S.; Belfer, Inna; Dai, Feng; Smith, Shad; Diatchenko, Luda; Marengo, Stefano; Haubner, Bernhard J.; Novatchkova, Maria; Gibson, Dustin; Maixner, William; Pospisilik, J. Andrew; Hirsch, Emilio; Whishaw, Ian Q.; Zimmer, Andreas; Gupta, Vaijayanti; Sasaki, Junko; Kanaho, Yasunori; Sasaki, Takehiko; Kress, Michaela; Woolf, Clifford J.; Penninger, Josef M.

    2012-01-01

    The ability to perceive noxious stimuli is critical for an animal's survival in the face of environmental danger, and thus pain perception is likely to be under stringent evolutionary pressure. Using a neuronal-specific RNAi knock-down strategy in adult Drosophila, we recently completed a genome-wide functional annotation of heat nociception that allowed us to identify α2δ3 as a novel pain gene. Here we report construction of an evolutionary-conserved, system-level, global molecular pain network map. Our systems map is markedly enriched for multiple genes associated with human pain and predicts a plethora of novel candidate pain pathways. One central node of this pain network is phospholipid signaling, which has been implicated before in pain processing. To further investigate the role of phospholipid signaling in mammalian heat pain perception, we analysed the phenotype of PIP5Kα and PI3Kγ mutant mice. Intriguingly, both of these mice exhibit pronounced hypersensitivity to noxious heat and capsaicin-induced pain, which directly mapped through PI3Kγ kinase-dead knock-in mice to PI3Kγ lipid kinase activity. Using single primary sensory neuron recording, PI3Kγ function was mechanistically linked to a negative regulation of TRPV1 channel transduction. Our data provide a systems map for heat nociception and reinforces the extraordinary conservation of molecular mechanisms of nociception across different species. PMID:23236288

  16. Series 'Facing Radiation'. 2 Facing radiation is facing residents

    International Nuclear Information System (INIS)

    Hanzawa, Takahiro

    2013-01-01

    The series is to report how general people, who are not at all radiological experts, have faced and understood the problems and tasks of radiation given by the Fukushima Daiichi Nuclear Power Plant Accident (Mar. 2011). The section 2 is reported by an officer of Date City, which localizes at 60 km northern west of the Plant, borders on Iitate Village of Fukushima prefecture, and is indicated as the important area of contamination search (IACS), which the reporter has been conducted for as responsible personnel. In July 2011, the ambient dose was as high as 3.0-3.5 mc-Sv/h and the tentative storage place of contaminated materials was decided by own initiative of residents of a small community, from which the real decontamination started in the City. The target dose after decontamination was defined to be 1.0 mc-Sv/h: however, 28/32 IACS municipalities in the prefecture had not defined the target although they had worked for 2 years after the Accident for their areas exceeding the standard 0.23 mc-Sv/h. At the moment of decontamination of the reporter's own house, he noticed that resident's concerns had directed toward its work itself, not toward the target dose, and wondered if these figures had obstructed to correctly face the radiation. At present that about 2.5 years have passed since the Accident, all of Date citizens have personal accumulated glass dosimeters for seeing the effective external dose and it seems that their dose will not exceed 1 mSv/y if the ambient dose estimated is 0.3-5 mc-Sv/h. Media run to popularity not to face radiation, experts tend to hesitate to face media and residents, and radiation dose will be hardly reduced to zero, despite that correct understanding of radiation is a shorter way for residents' own ease: facing radiation is facing residents. (T.T.)

  17. Multidimensional features of pain in patients with chronic neck pain

    Directory of Open Access Journals (Sweden)

    Fabianna Resende de Jesus-Moraleida

    Full Text Available Abstract Introduction: Chronic neck pain is associated with significant health costs and loss of productivity at work. Objective: to assess pain and disability in individuals with chronic neck pain. Methods: 31 volunteers with chronic neck pain, mean age 29, 65 years, were assessed using the McGill Pain Questionnaire in Brazilian version (Br-MPQ and Neck Disability Index (NDI. The Br-MPQ analysis was performed based on the numerical values associated with the words selected to describe the experience of pain (Pain Rating Index - PRI, and present pain intensity (PPI. NDI was used to evaluate the influence of neck pain in performance of everyday tasks. Finally, we investigated the association between PPI and NDI. Results: PRI revealed that the most significant dimension was the sensory pain (70%, and the number of chosen words was 10 (2,62 out of 20 words. Mean PPI value was 1,23 (0,76 in five points; 40% of participants described pain intensity as moderate. NDI score was 9,77 (3,34, indicating mild disability. There was a positive association between disability and pain intensity (r = 0,36; p =0,046. Pain intensity and duration of pain were not associated. Conclusions: Findings of this study identified important information related to neck pain experienced by patients when suffering from chronic neck pain, moreover, the association between disability and pain intensity reinforces the importance of complementary investigation of these aspects to optimize function in them.

  18. Postoperative pain

    DEFF Research Database (Denmark)

    Kehlet, H; Dahl, J B

    1993-01-01

    also modify various aspects of the surgical stress response, and nociceptive blockade by regional anesthetic techniques has been demonstrated to improve various parameters of postoperative outcome. It is therefore stressed that effective control of postoperative pain, combined with a high degree......Treatment of postoperative pain has not received sufficient attention by the surgical profession. Recent developments concerned with acute pain physiology and improved techniques for postoperative pain relief should result in more satisfactory treatment of postoperative pain. Such pain relief may...

  19. Alexithymic trait, painful heat stimulation and everyday pain experience

    Directory of Open Access Journals (Sweden)

    Olga ePollatos

    2015-10-01

    Full Text Available Background: Alexithymia was found to be associated with a variety of somatic complaints including somatoform pain symptoms. This study addressed the question of whether the different facets of alexithymia are related to responses in heat pain stimulation and its interrelations with levels of everyday pain as assessed by self report. Methods: In the study, sensitivity to heat pain was assessed in fifty healthy female participants. Alexithymia facets were assessed by the Toronto Alexithymia Scale. Pain threshold and tolerance were determined using a testing the limits procedure. Participants furthermore rated subjective intensities and unpleasantness of tonic heat stimuli (45.5 C to 47.5 C on visual analogue scales and on a questionnaire. Possible confounding with temperature sensitivity and mood was controlled. Everyday pain was assessed by self-report addressing everyday pain frequency, intensity and impairment experienced over the last two months. Results: Main results were that the facets of alexithymia were differentially associated with pain perception. The affective scale difficulties in describing feelings was associated with hyposensitivity to pain as indicated by higher pain tolerance scores. Furthermore, everyday pain frequency was related to increased alexithymia values on the affective scale difficulties in identifying feelings, whereas higher values on the cognitive alexithymia scale externally oriented thinking were related to lower pain impairment and intensity. Conclusions: We conclude that the different facets of alexithymia are related to alternations in pain processing. Further research on clinical samples is necessary to elucidate whether different aspects of alexithymia act as vulnerability factor for the development of pain symptoms.

  20. Partially hydrolyzed guar gum in pediatric functional abdominal pain.

    Science.gov (United States)

    Romano, Claudio; Comito, Donatella; Famiani, Annalisa; Calamarà, Sabrina; Loddo, Italia

    2013-01-14

    To assess the effects of partially hydrolyzed guar gum (PHGG) diet supplement in pediatric chronic abdominal pain (CAP) and irritable bowel syndrome (IBS). A randomized, double-blind pilot study was performed in sixty children (8-16 years) with functional bowel disorders, such as CAP or IBS, diagnosed according to Rome III criteria. All patients underwent ultrasound, blood and stool examinations to rule out any organic disease. Patients were allocated to receive PHGG at dosage of 5 g/d (n = 30) or placebo (fruit-juice n = 30) for 4 wk. The evaluation of the efficacy of fiber supplement included IBS symptom severity score (Birmingham IBS Questionnaire), severity of abdominal pain (Wong-Baker Face Pain Rating Score) and bowel habit (Bristol Stool Scale). Symptom scores were completed at 2, 4, and 8 wk. The change from baseline in the symptom severity scale at the end of treatment and at 4 wk follow-up after treatment was the primary endpoint. The secondary endpoint was to evaluate compliance to supplementation with the PHGG in the pediatric population. Differences within groups during the treatment period and follow-up were evaluated by the Wilcoxon signed-rank test. The results of the study were assessed considering some variables, such as frequency and intensity of symptoms with modifications of the bowel habit. Both groups were balanced for baseline characteristics and all patients completed the study. Group A (PHGG group) presented a higher level of efficacy compared to group B (control group), (43% vs 5%, P = 0.025) in reducing clinical symptoms with modification of Birmingham IBS score (median 0 ± 1 vs 4 ± 1, P = 0.025), in intensity of CAP assessed with the Wong-Baker Face Pain Rating Score and in normalization of bowel habit evaluated with the Bristol Stool Scale (40% vs 13.3%, P = 0.025). In IBS subgroups, statistical analysis shown a tendency toward normalization of bowel movements, but there was no difference in the prevalence of improvement in two bowel

  1. The evolving clinical picture of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): A look at 1310 patients over 16 years.

    Science.gov (United States)

    Doiron, R Christopher; Tripp, Dean A; Tolls, Victoria; Nickel, J Curtis

    2018-06-01

    Two decades of increasing understanding of etiopathogenesis and clinical phenotyping produces an impression the clinical face of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is changing. We sought to retrospectively analyze trends in CP/CPPS patients presenting to our clinic for evaluation over a 16-year period. Patients with CP/CPPS presenting to a tertiary clinic were evaluated prospectively from 1998-2014 with Chronic Prostatitis Symptom Index (CPSI) and UPOINT (urinary, psychosocial, organ-specific, infection, neurogenic, and tenderness) categorization. Patients were stratified in four cohorts, based on year of presentation, and we retrospectively analyzed variations in symptom scores and patterns, UPOINT categorization, and treatment modalities amongst cohorts. Mean age of the 1310 CP/CPPS patients was 44.7 years, while mean CPSI pain, urination, and total scores were 10.6, 4.8, and 23.3, respectively. The most prevalent UPOINT domain, urinary (U) (71.8%) was associated with a higher CPSI urination score (6.3), more frequent penile tip pain (37%), dysuria (48%), and more treatment with alpha-blockers (70%). Increase in UPOINT domains was associated with higher CPSI pain, quality of life (QoL), and total scores. Trends over time included increased prevalence of psychosocial (P), organ (O), and tenderness (T) domains, as well as increased use of alpha-blockers, neuromodulation, and phytotherapy as treatment modalities. There was little variation in age, CPSI scores, and pain locations over time. The changing clinical face of CP/CPPS reflects the increased recognition of psychosocial (P domain) and pelvic floor pain (T domain), along with the concomitant use of associated therapies. There was little variation of pain/urinary symptom patterns and QoL.

  2. Chronic Pain

    Science.gov (United States)

    ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. × ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. ...

  3. Usage of lidocaine-prilocaine cream in the treatment of postburn pain in pediatric patients.

    Science.gov (United States)

    Kargi, Eksal; Tekerekoğlu, Bülent

    2010-05-01

    Facial burns are quite common among children. Many different wound-covers can be used for dressing burn wounds, which is usually painful for the patients. These covers can also be combined with local anesthetic creams. Lidocaine-prilocaine cream 5% (LPC) is commonly used as a topical anesthetic by physicians performing plastic surgery. In the present study, we investigated the effects of topical LPC on pain cessation in pediatric patients with face burn and compared results with a control group in which LPC was not used in the wound dressing. Thirty pediatric patients (average age 11.3, range 8-15) among those who admitted to our emergency service and plastic surgery outpatient clinic between 2003 and 2006 were included in this study. The patient's burned areas ranged between 1 and 5% percent of their total body surface. The need for analgesic medicine was recorded in the first, second and third 8-hour periods postburn in both groups, and pain level was evaluated at these time points using a verbal rating scale. There was a significant difference between the two groups with respect to values of the first and second 8-hour periods, while in the third 8-hour period, no significant difference was observed. We conclude that topical local anesthetics administered for 16 hours postburn significantly reduce the duration of pain after injury, which suggests a potential use in clinical practice in the treatment of children with face burn. While LPC was found to have an ameliorating effect in the first 16 hours, we recommend oral analgesic co-therapy support since it loses its efficacy in the last 8-hour period.

  4. Face time: educating face transplant candidates.

    Science.gov (United States)

    Lamparello, Brooke M; Bueno, Ericka M; Diaz-Siso, Jesus Rodrigo; Sisk, Geoffroy C; Pomahac, Bohdan

    2013-01-01

    Face transplantation is the innovative application of microsurgery and immunology to restore appearance and function to those with severe facial disfigurements. Our group aims to establish a multidisciplinary education program that can facilitate informed consent and build a strong knowledge base in patients to enhance adherence to medication regimes, recovery, and quality of life. We analyzed handbooks from our institution's solid organ transplant programs to identify topics applicable to face transplant patients. The team identified unique features of face transplantation that warrant comprehensive patient education. We created a 181-page handbook to provide subjects interested in pursuing transplantation with a written source of information on the process and team members and to address concerns they may have. While the handbook covers a wide range of topics, it is easy to understand and visually appealing. Face transplantation has many unique aspects that must be relayed to the patients pursuing this novel therapy. Since candidates lack third-party support groups and programs, the transplant team must provide an extensive educational component to enhance this complex process. As face transplantation continues to develop, programs must create sound education programs that address patients' needs and concerns to facilitate optimal care.

  5. Incidence and characteristics of acute referred orofacial pain caused by a posterior single tooth pulpitis in an Iranian population.

    Science.gov (United States)

    Hashemipour, Maryam Alsadat; Borna, Roya

    2014-02-01

    This study was designed to evaluate incidence and characteristics of acute referred orofacial pain caused by a posterior single tooth pulpitis in an Iranian population. In this cross-sectional study, 3,150 patients (1,400 males and 1,750 females) with pain in the orofacial region were evaluated via clinical and radiographic examination to determine their pain source. Patients completed a standardized clinical questionnaire consisting of a numerical rating scale for pain intensity and chose verbal descriptors from short form McGill questionnaire to describe the quality of their pain. Visual analog scale (VAS) was used to score pain intensity. In addition, patients indicated sites to which pain referred by drawing on an illustration of the head and neck. Data were analyzed using chi-square, fisher exact, and Mann-Whitney tests. Two thousand and hundred twenty patients (67/3%) reported pain in sites that diagnostically differed from the pain source. According to statistical analysis, sex (P = 0.02), intensity of pain (0.04), and quality (P = 0.001) of pain influenced its referral nature, while age of patients and kind of stimulus had no considerable effect on pain referral (P > 0.05). The results of the present study show the prevalence of referred pain in the head, face, and neck region is moderately high. Therefore, in patients with orofacial pain, it is essential to carefully examination before carrying out treatment that could be inappropriate. © 2013 The Authors Pain Practice © 2013 World Institute of Pain.

  6. Effect of pain chronification and chronic pain on an endogenous pain modulation circuit in rats.

    Science.gov (United States)

    Miranda, J; Lamana, S M S; Dias, E V; Athie, M; Parada, C A; Tambeli, C H

    2015-02-12

    We tested the hypothesis that chronic pain development (pain chronification) and ongoing chronic pain (chronic pain) reduce the activity and induce plastic changes in an endogenous analgesia circuit, the ascending nociceptive control. An important mechanism mediating this form of endogenous analgesia, referred to as capsaicin-induced analgesia, is its dependence on nucleus accumbens μ-opioid receptor mechanisms. Therefore, we also investigated whether pain chronification and chronic pain alter the requirement for nucleus accumbens μ-opioid receptor mechanisms in capsaicin-induced analgesia. We used an animal model of pain chronification in which daily subcutaneous prostaglandin E2 (PGE2) injections into the rat's hind paw for 14 days, referred to as the induction period of persistent hyperalgesia, induce a long-lasting state of nociceptor sensitization referred to as the maintenance period of persistent hyperalgesia, that lasts for at least 30 days following the cessation of the PGE2 treatment. The nociceptor hypersensitivity was measured by the shortening of the time interval for the animal to respond to a mechanical stimulation of the hind paw. We found a significant reduction in the duration of capsaicin-induced analgesia during the induction and maintenance period of persistent mechanical hyperalgesia. Intra-accumbens injection of the μ-opioid receptor selective antagonist Cys(2),Tyr(3),Orn(5),Pen(7)amide (CTOP) 10 min before the subcutaneous injection of capsaicin into the rat's fore paw blocked capsaicin-induced analgesia. Taken together, these findings indicate that pain chronification and chronic pain reduce the duration of capsaicin-induced analgesia, without affecting its dependence on nucleus accumbens μ-opioid receptor mechanisms. The attenuation of endogenous analgesia during pain chronification and chronic pain suggests that endogenous pain circuits play an important role in the development and maintenance of chronic pain. Copyright © 2014 IBRO

  7. Sexual pain.

    Science.gov (United States)

    Boardman, Lori A; Stockdale, Colleen K

    2009-12-01

    Sexual pain is an underrecognized and poorly treated constellation of disorders that significantly impact affected women and their partners. Recognized as a form of chronic pain, sexual pain disorders are heterogeneous and include dyspareunia (superficial and deep), vaginismus, vulvodynia, vestibulitis, and noncoital sexual pain disorder. Women too often tolerate pain in the belief that this will meet their partners' needs. This article provides a review of the terminology and definition of the condition, theories on the pathophysiology, diagnostic considerations, and recommendations on the management of female sexual pain.

  8. The Fear of Pain Questionnaire (FOPQ): assessment of pain-related fear among children and adolescents with chronic pain.

    Science.gov (United States)

    Simons, Laura E; Sieberg, Christine B; Carpino, Elizabeth; Logan, Deirdre; Berde, Charles

    2011-06-01

    An important construct in understanding pain-related disability is pain-related fear. Heightened pain-related fear may result in behavioral avoidance leading to disuse, disability, and depression; whereas confrontation of avoided activities may result in a reduction of fear over time and reengagement with activities of daily living. Although there are several measures to assess pain-related fear among adults with chronic pain, none exist for children and adolescents. The aim of the current study was to develop a new tool to assess avoidance and fear of pain with pediatric chronic pain patients: the Fear of Pain Questionnaire, child report (FOPQ-C), and Fear of Pain Questionnaire, parent proxy report (FOPQ-P). After initial pilot testing, the FOPQ-C and FOPQ-P were administered to 299 youth with chronic pain and their parents at an initial multidisciplinary pain treatment evaluation. The FOPQ demonstrated very strong internal consistency of .92 for the child and parent versions. One-month stability estimates were acceptable and suggested responsivity to change. For construct validity, the FOPQ correlated with generalized anxiety, pain catastrophizing, and somatization. Evidence of criterion-related validity was found with significant associations for the FOPQ with pain, healthcare utilization, and functional disability. These results support the FOPQ as a psychometrically sound measure. Pain-related fear plays an important role in relation to emotional distress and pain-related disability among children and adolescents with chronic pain. Identification of patients with high levels of fear avoidance of pain with the FOPQ will inform how to proceed with psychological and physical therapy interventions for chronic pain. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  9. From face processing to face recognition: Comparing three different processing levels.

    Science.gov (United States)

    Besson, G; Barragan-Jason, G; Thorpe, S J; Fabre-Thorpe, M; Puma, S; Ceccaldi, M; Barbeau, E J

    2017-01-01

    Verifying that a face is from a target person (e.g. finding someone in the crowd) is a critical ability of the human face processing system. Yet how fast this can be performed is unknown. The 'entry-level shift due to expertise' hypothesis suggests that - since humans are face experts - processing faces should be as fast - or even faster - at the individual than at superordinate levels. In contrast, the 'superordinate advantage' hypothesis suggests that faces are processed from coarse to fine, so that the opposite pattern should be observed. To clarify this debate, three different face processing levels were compared: (1) a superordinate face categorization level (i.e. detecting human faces among animal faces), (2) a face familiarity level (i.e. recognizing famous faces among unfamiliar ones) and (3) verifying that a face is from a target person, our condition of interest. The minimal speed at which faces can be categorized (∼260ms) or recognized as familiar (∼360ms) has largely been documented in previous studies, and thus provides boundaries to compare our condition of interest to. Twenty-seven participants were included. The recent Speed and Accuracy Boosting procedure paradigm (SAB) was used since it constrains participants to use their fastest strategy. Stimuli were presented either upright or inverted. Results revealed that verifying that a face is from a target person (minimal RT at ∼260ms) was remarkably fast but longer than the face categorization level (∼240ms) and was more sensitive to face inversion. In contrast, it was much faster than recognizing a face as familiar (∼380ms), a level severely affected by face inversion. Face recognition corresponding to finding a specific person in a crowd thus appears achievable in only a quarter of a second. In favor of the 'superordinate advantage' hypothesis or coarse-to-fine account of the face visual hierarchy, these results suggest a graded engagement of the face processing system across processing

  10. Cancer Pain Management Education Rectifies Patients' Misconceptions of Cancer Pain, Reduces Pain, and Improves Quality of Life.

    Science.gov (United States)

    Koh, Su-Jin; Keam, Bhumsuk; Hyun, Min Kyung; Ju Seo, Jeong; Uk Park, Keon; Oh, Sung Yong; Ahn, Jinseok; Lee, Ja Youn; Kim, JinShil

    2018-03-26

    More than half of the patients have reported improper management of breakthrough cancer pain. Empirical evidence is lacking concerning the effectiveness of cancer pain education on breakthrough pain control. This study aimed to examine the effects of individual pain education on pain control, use of short-acting analgesics for breakthrough pain, quality of life outcomes, and rectification of patients' misconceptions regarding cancer pain. A quasi-experimental design was used. In total, 176 (102 inpatients and 74 outpatients) and 163 (93 inpatients and 70 outpatients) cancer patients completed questionnaires on pain intensity, quality of life, use of short-acting medication for breakthrough pain, and misconceptions about cancer pain and opioid use before and immediately and/or seven days after individual pain education. The mean age of the participants was 60.9 years (±11.2), and 56.3% were male. The most common cancers were lung cancer (17.0%), colon cancer (15.9%), and breast cancer (12.5%). The subjects' reasons for attrition were conditional deterioration, death, or voluntary withdrawal (N = 13, 7.4%). Following the education, there was a significant reduction in overall pain intensity over 24 hours (P < 0.001). The outpatients showed more use of short-acting analgesics for breakthrough pain. Sleep quality change was most significantly associated with intervention; other quality of life aspects (e.g., general feelings and life enjoyment) also improved. Pain education also significantly reduced misconceptions regarding cancer pain management. The present educational intervention was effective in encouraging short-acting analgesic use for breakthrough pain, improving quality of life outcomes, and rectifying patients' misconceptions about analgesic use.

  11. Bullous Henoch–Schonlein purpura with involvement of face

    Directory of Open Access Journals (Sweden)

    Devdeep Mukherjee

    2017-01-01

    Full Text Available Henoch–Schonlein purpura (HSP with facial involvement with bullous rashes are extremely rare. A 12-year-old boy presented with abdominal pain and features of arthritis. He also had multiple purpuric rashes over his lower limbs. Gradually, he developed bullous rashes which were seen on his legs and hands and progressed to involve the face. He was confirmed to be suffering from HSP from clinical presentation and skin biopsy. The child responded well to oral steroids. Bullous lesions may be seen in HSP. However, there is neither prognostic significance of this nor does it alter the management. Other causes of bullous lesions should be ruled out. As facial involvement is associated with renal and gastrointestinal involvement, these children should be monitored for sequelae.

  12. Bayesian Face Recognition and Perceptual Narrowing in Face-Space

    Science.gov (United States)

    Balas, Benjamin

    2012-01-01

    During the first year of life, infants' face recognition abilities are subject to "perceptual narrowing", the end result of which is that observers lose the ability to distinguish previously discriminable faces (e.g. other-race faces) from one another. Perceptual narrowing has been reported for faces of different species and different races, in…

  13. A comparison of pain experienced by patients treated with labial and lingual orthodontic appliances.

    Science.gov (United States)

    Wu, Abby K Y; McGrath, Colman; Wong, Ricky W K; Wiechmann, D; Rabie, A Bakr M

    2010-08-01

    The aim of this prospective longitudinal study was to compare pain experiences among Chinese adult patients treated with labial and lingual orthodontic appliances. Sixty patients, 30 with labial appliances (18 females and 12 males, mean age 20.33 years, SD +/- 4.205) and 30 with lingual appliances (22 females and 8 males, mean age 21.63 years, SD +/- 2.236), rated their overall pain experience on a 100 mm visual analogue scale (VAS) at three time points: 1 week (T(1)), 1 month (T(2)), and 3 months (T(3)) after bracket placement. In addition, on a separate 100 mm VAS, they rated their pain experience at the locations of the tongue, lips, cheeks, gums, face, and jaw at T(1), T(2), and T(3). Changes in pain VAS were conducted using Friedman analysis of variance, area under the curve (AUC) analysis and the data were compared using a t-test. There was no significant difference in global ratings of pain among those treated with labial or lingual appliances (P > 0.05). Among both groups, global ratings of pain decreased over the study period (P appliances reported higher ratings of tongue pain (P appliances reported higher ratings of lip (P appliances rate similarly the level of overall pain they experience during treatment. Ratings of overall pain experienced decreased for both treatment groups with time. However, ratings of pain differed at various sites with respect to the type of orthodontic appliance. These findings have implications in informing patients' treatment decision-making processes regarding labial and lingual appliances and in the management of discomfort associated with different treatment modalities.

  14. [SECOT consensus on painful knee replacement].

    Science.gov (United States)

    Vaquero, J; Macule, F; Bello, S; Chana, F; Forriol, F

    2013-01-01

    The opinions of 21 experts in knee surgery were evaluated in this study, using a DELPHI questionnaire method in two successive rounds, on 64 controversial scenarios that covered both the diagnosis and possible treatment of painful knee replacements. The level of consensus was significantly unanimous in 42 items and of the design in 5, with no agreement in 17 of the questions presented. light of the published scientific evidence, the surgeons who took part showed to have a notable level of information on the most effective diagnostic tests, although, it should be pointed out that there was a lack of confidence in the possibility of ruling out an infection when the erythrocyte sedimentation rate and the C-reactive protein were within normal values, which have been demonstrated in the literature to have a high negative predictive value As regards the treatments to employ in the different situations, the responses of the expert panel were mainly in agreement with the data in the literature. The conclusions of this consensus may help other surgeons when they are faced with a painful knee prosthesis. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  15. Pain-related psychological correlates of pediatric acute post-surgical pain

    Directory of Open Access Journals (Sweden)

    Pagé MG

    2012-11-01

    Full Text Available M Gabrielle Pagé,1 Jennifer Stinson,2,3 Fiona Campbell,2,4 Lisa Isaac,2,4 Joel Katz1,4,51Department of Psychology, Faculty of Health, York University, 2Department of Anesthesia and Pain Medicine, Hospital for Sick Children, 3Lawrence S Bloomberg Faculty of Nursing, University of Toronto, 4Department of Anesthesia, Faculty of Medicine, University of Toronto, 5Department of Psychology, Hospital for Sick Children, Toronto, ON, CanadaBackground: Post-surgical pain is prevalent in children, yet is significantly understudied. The goals of this study were to examine gender differences in pain outcomes and pain-related psychological constructs postoperatively and to identify pain-related psychological correlates of acute post-surgical pain (APSP and predictors of functional disability 2 weeks after hospital discharge.Methods: Eighty-three children aged 8–18 (mean 13.8 ± 2.4 years who underwent major orthopedic or general surgery completed pain and pain-related psychological measures 48–72 hours and 2 weeks after surgery.Results: Girls reported higher levels of acute postoperative anxiety and pain unpleasantness compared with boys. In addition, pain anxiety was significantly associated with APSP intensity and functional disability 2 weeks after discharge, whereas pain catastrophizing was associated with APSP unpleasantness.Conclusion: These results highlight the important role played by pain-related psychological factors in the experience of pediatric APSP by children and adolescents.Keywords: acute post-surgical pain, children, adolescents, pain anxiety, pain catastrophizing

  16. The Fear of Movement/Pain in Musculoskeletal Pain-A Review

    Directory of Open Access Journals (Sweden)

    Behnam Akhbari

    2012-07-01

    Full Text Available Objective: To investigate and review psychological influences of pain such as kinesiophobia and pain-related fear on patients with musculoskeletal pain and on rehabilitation outcomes. Materials & Methods: Fear is a universal and powerful emotion and, as a result, it can have a profound impact on human behavior. the fear-motivated behavior has the potential to adversely impact rehabilitation outcomes for patients with musculoskeletal pain. cross-sectional studies consistently documented a positive association between elevated pain-related fear and increased pain intensity and disability. in addition, several longitudinal studies indicated that elevated pain-related fear is a precursor to poor clinical outcomes. existence of catastrophizing in patients effect on the fear of movement/ (reinjury. this fear contributes to avoidance behaviors and subsequent disuse, depression, and disability. it has been established that kinesiophobia plays a negative role in the outcome of the rehabilitation of acute and chronic low back pain, chronic fatigue syndrome and fibromyalgia syndrome. Results: The recent studies suggest that physical therapists should consider the role of pain-related fear and avoidance behaviors in patients' function and they should assess these cognitive and behavioral factors. or (physical therapists should assess pain-related fear when rehabilitating certain individuals with musculoskeletal pain. currently, there is a lot of evidence for the assessment of pain-related fear in patients with musculoskeletal pain. self-report questionnaires are readily available for assessment and investigation of pain-related fear and several studies have found support for their validity and reliability. recent research indicated that besides fear-avoidance responses, endurance-related responses lead to chronic pain via physical overload. the existence of mental kinesiophobia has been established in patients with chronic stress complaints, and this

  17. Attention to internal face features in unfamiliar face matching.

    Science.gov (United States)

    Fletcher, Kingsley I; Butavicius, Marcus A; Lee, Michael D

    2008-08-01

    Accurate matching of unfamiliar faces is vital in security and forensic applications, yet previous research has suggested that humans often perform poorly when matching unfamiliar faces. Hairstyle and facial hair can strongly influence unfamiliar face matching but are potentially unreliable cues. This study investigated whether increased attention to the more stable internal face features of eyes, nose, and mouth was associated with more accurate face-matching performance. Forty-three first-year psychology students decided whether two simultaneously presented faces were of the same person or not. The faces were displayed for either 2 or 6 seconds, and had either similar or dissimilar hairstyles. The level of attention to internal features was measured by the proportion of fixation time spent on the internal face features and the sensitivity of discrimination to changes in external feature similarity. Increased attention to internal features was associated with increased discrimination in the 2-second display-time condition, but no significant relationship was found in the 6-second condition. Individual differences in eye-movements were highly stable across the experimental conditions.

  18. Face recognition : implementation of face recognition on AMIGO

    NARCIS (Netherlands)

    Geelen, M.J.A.J.; Molengraft, van de M.J.G.; Elfring, J.

    2011-01-01

    In this (traineeship)report two possible methods of face recognition were presented. The first method describes how to detect and recognize faces by using the SURF algorithm. This algorithm finally was not used for recognizing faces, with the reason that the Eigenface algorithm was an already tested

  19. Differential pain modulation in patients with peripheral neuropathic pain and fibromyalgia.

    Science.gov (United States)

    Gormsen, Lise; Bach, Flemming W; Rosenberg, Raben; Jensen, Troels S

    2017-12-29

    Background The definition of neuropathic pain has recently been changed by the International Association for the Study of Pain. This means that conditions such as fibromyalgia cannot, as sometimes discussed, be included in the neuropathic pain conditions. However, fibromyalgia and peripheral neuropathic pain share common clinical features such as spontaneous pain and hypersensitivity to external stimuli. Therefore, it is of interest to directly compare the conditions. Material and methods In this study we directly compared the pain modulation in neuropathic pain versus fibromyalgia by recording responses to a cold pressor test in 30 patients with peripheral neuropathic pain, 28 patients with fibromyalgia, and 26 pain-free age-and gender-matched healthy controls. Patients were asked to rate their spontaneous pain on a visual analog scale (VAS (0-100 mm) immediately before and immediately after the cold pressor test. Furthermore the duration (s) of extremity immersion in cold water was used as a measure of the pain tolerance threshold, and the perceived pain intensity at pain tolerance on the VAS was recorded on the extremity in the water after the cold pressor test. In addition, thermal (thermo tester) and mechanical stimuli (pressure algometer) were used to determine sensory detection, pain detection, and pain tolerance thresholds in different body parts. All sensory tests were done by the same examiner, in the same room, and with each subject in a supine position. The sequence of examinations was the following: (1) reaction time, (2) pressure thresholds, (3) thermal thresholds, and (4) cold pressor test. Reaction time was measured to ensure that psychomotoric inhibitions did not influence pain thresholds. Results Pain modulation induced by a cold pressor test reduced spontaneous pain by 40% on average in neuropathic pain patients, but increased spontaneous pain by 2.6% in fibromyalgia patients. This difference between fibromyalgia and neuropathic pain patients was

  20. The complex duration perception of emotional faces: Effects of face direction

    Directory of Open Access Journals (Sweden)

    Katrin Martina Kliegl

    2015-03-01

    Full Text Available The perceived duration of emotional face stimuli strongly depends on the expressed emotion. But, emotional faces also differ regarding a number of other features like gaze, face direction, or sex. Usually, these features have been controlled by only using pictures of female models with straight gaze and face direction. Doi and Shinohara (2009 reported that an overestimation of angry faces could only be found when the model’s gaze was oriented towards the observer. We aimed at replicating this effect for face direction. Moreover, we explored the effect of face direction on the duration perception sad faces. Controlling for the sex of the face model and the participant, female and male participants rated the duration of neutral, angry and sad face stimuli of both sexes photographed from different perspectives in a bisection task. In line with current findings, we report a significant overestimation of angry compared to neutral face stimuli that was modulated by face direction. Moreover, the perceived duration of sad face stimuli did not differ from that of neutral faces and was not influenced by face direction. Furthermore, we found that faces of the opposite sex appeared to last longer than those of the same sex. This outcome is discussed with regards to stimulus parameters like the induced arousal, social relevance and an evolutionary context.

  1. Prevalence and treatment of pain in non-institutionalized very old population: transversal study at national level.

    Science.gov (United States)

    Gálvez-Barrón, César; Narvaiza, Leire; Dapena, María D; Macho, Oscar; Rodríguez-Molinero, Alejandro

    2016-04-01

    In Europe, there is no conclusive data at national level about pain prevalence in non-institutionalized very old population. In USA, it has recently been reported a high prevalence (56 %); however, this data can not be extrapolated to other regions because the known influence of geographical and ethnic differences. Furthermore there are few data on use of treatments for pain in this population. To explore prevalence and considered pharmacological treatments for pain in this population. Transversal study on 551 participants aged 80 or more living in Spain (non-institutionalized). Probabilistic multistage sampling was carried out, stratified by sex and place of residence. All Spanish regions were considered for recruitment process. Pain (last 4 weeks), intensity (Face Pain Scale), localization and pharmacological treatments were evaluated by in-person interviews. Pain's prevalence was 52.5 % (CI 95 % 48.28-56.80) and 38.5 % experienced pain of at least moderate intensity. The most frequently involved body regions were lower limbs (26.6 %) and dorso-lumbar region (21.9 %). Only 40 % of participants with pain and 43.2 % with moderate or severe pain used analgesics, and paracetamol was less frequently used than non-steroidal anti-inflammatory drugs at any pain intensity. Age was not associated with higher prevalence [odds ratios 0.97 (CI 95 % 0.93-1.02) in females and 0.99 (CI 95 % 0.92-1.06) in males]. The prevalence of pain in non-institutionalized very old people is high. Pain is probably being undertreated, even moderate or severe pain. Guideline's recommendations are probably not being considered to select the analgesic therapy.

  2. Enhanced Brain Responses to Pain-Related Words in Chronic Back Pain Patients and Their Modulation by Current Pain.

    Science.gov (United States)

    Ritter, Alexander; Franz, Marcel; Puta, Christian; Dietrich, Caroline; Miltner, Wolfgang H R; Weiss, Thomas

    2016-08-10

    Previous functional magnetic resonance imaging (fMRI) studies in healthy controls (HC) and pain-free migraine patients found activations to pain-related words in brain regions known to be activated while subjects experience pain. The aim of the present study was to identify neural activations induced by pain-related words in a sample of chronic back pain (CBP) patients experiencing current chronic pain compared to HC. In particular, we were interested in how current pain influences brain activations induced by pain-related adjectives. Subjects viewed pain-related, negative, positive, and neutral words; subjects were asked to generate mental images related to these words during fMRI scanning. Brain activation was compared between CBP patients and HC in response to the different word categories and examined in relation to current pain in CBP patients. Pain-related words vs. neutral words activated a network of brain regions including cingulate cortex and insula in subjects and patients. There was stronger activation in medial and dorsolateral prefrontal cortex (DLPFC) and anterior midcingulate cortex in CPB patients than in HC. The magnitude of activation for pain-related vs. negative words showed a negative linear relationship to CBP patients' current pain. Our findings confirm earlier observations showing that pain-related words activate brain networks similar to noxious stimulation. Importantly, CBP patients show even stronger activation of these structures while merely processing pain-related words. Current pain directly influences on this activation.

  3. The Rat Grimace Scale: A partially automated method for quantifying pain in the laboratory rat via facial expressions

    Directory of Open Access Journals (Sweden)

    Zhan Shu

    2011-07-01

    Full Text Available Abstract We recently demonstrated the utility of quantifying spontaneous pain in mice via the blinded coding of facial expressions. As the majority of preclinical pain research is in fact performed in the laboratory rat, we attempted to modify the scale for use in this species. We present herein the Rat Grimace Scale, and show its reliability, accuracy, and ability to quantify the time course of spontaneous pain in the intraplantar complete Freund's adjuvant, intraarticular kaolin-carrageenan, and laparotomy (post-operative pain assays. The scale's ability to demonstrate the dose-dependent analgesic efficacy of morphine is also shown. In addition, we have developed software, Rodent Face Finder®, which successfully automates the most labor-intensive step in the process. Given the known mechanistic dissociations between spontaneous and evoked pain, and the primacy of the former as a clinical problem, we believe that widespread adoption of spontaneous pain measures such as the Rat Grimace Scale might lead to more successful translation of basic science findings into clinical application.

  4. A causal relationship between face-patch activity and face-detection behavior.

    Science.gov (United States)

    Sadagopan, Srivatsun; Zarco, Wilbert; Freiwald, Winrich A

    2017-04-04

    The primate brain contains distinct areas densely populated by face-selective neurons. One of these, face-patch ML, contains neurons selective for contrast relationships between face parts. Such contrast-relationships can serve as powerful heuristics for face detection. However, it is unknown whether neurons with such selectivity actually support face-detection behavior. Here, we devised a naturalistic face-detection task and combined it with fMRI-guided pharmacological inactivation of ML to test whether ML is of critical importance for real-world face detection. We found that inactivation of ML impairs face detection. The effect was anatomically specific, as inactivation of areas outside ML did not affect face detection, and it was categorically specific, as inactivation of ML impaired face detection while sparing body and object detection. These results establish that ML function is crucial for detection of faces in natural scenes, performing a critical first step on which other face processing operations can build.

  5. Evoked potentials after painful cutaneous electrical stimulation depict pain relief during a conditioned pain modulation.

    Science.gov (United States)

    Höffken, Oliver; Özgül, Özüm S; Enax-Krumova, Elena K; Tegenthoff, Martin; Maier, Christoph

    2017-08-29

    Conditioned pain modulation (CPM) evaluates the pain modulating effect of a noxious conditioning stimulus (CS) on another noxious test stimulus (TS), mostly based solely on subjective pain ratings. We used painful cutaneous electrical stimulation (PCES) to induce TS in a novel CPM-model. Additionally, to evaluate a more objective parameter, we recorded the corresponding changes of cortical evoked potentials (PCES-EP). We examined the CPM-effect in 17 healthy subjects in a randomized controlled cross-over design during immersion of the non-dominant hand into 10 °C or 24 °C cold water (CS). Using three custom-built concentric surface electrodes, electrical stimuli were applied on the dominant hand, inducing pain of 40-60 on NRS 0-100 (TS). At baseline, during and after CS we assessed the electrically induced pain intensity and electrically evoked potentials recorded over the central electrode (Cz). Only in the 10 °C-condition, both pain (52.6 ± 4.4 (baseline) vs. 30.3 ± 12.5 (during CS)) and amplitudes of PCES-EP (42.1 ± 13.4 μV (baseline) vs. 28.7 ± 10.5 μV (during CS)) attenuated during CS and recovered there after (all p pain ratings during electrical stimulation and amplitudes of PCES-EP correlated significantly with each other (r = 0.5) and with CS pain intensity (r = 0.5). PCES-EPs are a quantitative measure of pain relief, as changes in the electrophysiological response are paralleled by a consistent decrease in subjective pain ratings. This novel CPM paradigm is a feasible method, which could help to evaluate the function of the endogenous pain modulation processes. German Clinical Trials Register DRKS-ID: DRKS00012779 , retrospectively registered on 24 July 2017.

  6. African Americans' Perceptions of Pain and Pain Management: A Systematic Review.

    Science.gov (United States)

    Booker, Staja Q

    2016-01-01

    The purpose of this systematic review is to explore the perceptions of acute, persistent, and disease-specific pain and treatment options held by adult African Americans. Underassessment and undermanagement of pain in African Americans has been well documented; however, the cultural continuum of pain perceptions and their influence on pain assessment and management has not been synthesized. Electronic database searches of the Cumulative Index for Nursing and Allied Health Literature and PubMed, Web-based searches of the pain-specific journals plus a manual search of reference lists identified 41 relevant articles addressing perceptions of pain and/or pain management. Analysis of the literature revealed six themes: (a) meaning of pain, (b) description of pain, (c) coping with pain, (d) impact of pain, (e) patient-provider relationship, and (f) treatment approaches. These findings warrant further research and indicate the need for more precise evaluation of pain in African Americans, highlighting an imperative to incorporate cultural patterns into pain management practice and education. © The Author(s) 2014.

  7. Food-Derived Natural Compounds for Pain Relief in Neuropathic Pain.

    Science.gov (United States)

    Lim, Eun Yeong; Kim, Yun Tai

    2016-01-01

    Neuropathic pain, defined as pain caused by a lesion or disease of the somatosensory nervous system, is characterized by dysesthesia, hyperalgesia, and allodynia. The number of patients with this type of pain has increased rapidly in recent years. Yet, available neuropathic pain medicines have undesired side effects, such as tolerance and physical dependence, and do not fully alleviate the pain. The mechanisms of neuropathic pain are still not fully understood. Injury causes inflammation and immune responses and changed expression and activity of receptors and ion channels in peripheral nerve terminals. Additionally, neuroinflammation is a known factor in the development and maintenance of neuropathic pain. During neuropathic pain development, the C-C motif chemokine receptor 2 (CCR2) acts as an important signaling mediator. Traditional plant treatments have been used throughout the world for treating diseases. We and others have identified food-derived compounds that alleviate neuropathic pain. Here, we review the natural compounds for neuropathic pain relief, their mechanisms of action, and the potential benefits of natural compounds with antagonistic effects on GPCRs, especially those containing CCR2, for neuropathic pain treatment.

  8. Alternative face models for 3D face registration

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    Salah, Albert Ali; Alyüz, Neşe; Akarun, Lale

    2007-01-01

    3D has become an important modality for face biometrics. The accuracy of a 3D face recognition system depends on a correct registration that aligns the facial surfaces and makes a comparison possible. The best results obtained so far use a one-to-all registration approach, which means each new facial surface is registered to all faces in the gallery, at a great computational cost. We explore the approach of registering the new facial surface to an average face model (AFM), which automatically establishes correspondence to the pre-registered gallery faces. Going one step further, we propose that using a couple of well-selected AFMs can trade-off computation time with accuracy. Drawing on cognitive justifications, we propose to employ category-specific alternative average face models for registration, which is shown to increase the accuracy of the subsequent recognition. We inspect thin-plate spline (TPS) and iterative closest point (ICP) based registration schemes under realistic assumptions on manual or automatic landmark detection prior to registration. We evaluate several approaches for the coarse initialization of ICP. We propose a new algorithm for constructing an AFM, and show that it works better than a recent approach. Finally, we perform simulations with multiple AFMs that correspond to different clusters in the face shape space and compare these with gender and morphology based groupings. We report our results on the FRGC 3D face database.

  9. A synthesis of qualitative research exploring the barriers to staying in work with chronic musculoskeletal pain.

    Science.gov (United States)

    Toye, Francine; Seers, Kate; Allcock, Nick; Briggs, Michelle; Carr, Eloise; Barker, Karen

    2016-01-01

    Qualitative research can help to advance our understanding, management and prevention of work disability. Our aim was to integrate qualitative research findings in order to increase our understanding of barriers to stay in work with chronic pain. We searched five electronic bibliographic databases until September 2012, supplemented by citation tracking and hand-searching. We used meta-ethnography to synthesis our findings. Central to meta-ethnography is identifying “concepts” and developing a conceptual model. Concepts were compared and organised into categories. The following categories can have an impact on the decision to remain in work: struggling to affirm myself as a good worker; balancing life and work in the face of unpredictable symptoms; my work colleagues don't believe me; the system does not facilitate return to work; the battle for legitimacy. Our innovation is to present an internationally relevant model based on a conceptual synthesis. This model highlights the adversarial work experience of people with chronic. The papers span 15 years of qualitative research. A significant finding is that these themes continue to pervade the current work environment for those in pain, and this has clear implications for education, social care and policy. People with chronic pain face an adversarial struggle to maintain their credibility at work. Strategies to maintain personal credibility can have an adverse effect on working lives. Changes at a systems level are needed to facilitate continuance and return to work. Cultural changes in the way that we view people with pain would help to keep people in work.

  10. Withholding response to self-face is faster than to other-face.

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    Zhu, Min; Hu, Yinying; Tang, Xiaochen; Luo, Junlong; Gao, Xiangping

    2015-01-01

    Self-face advantage refers to adults' response to self-face is faster than that to other-face. A stop-signal task was used to explore how self-face advantage interacted with response inhibition. The results showed that reaction times of self-face were faster than that of other-face not in the go task but in the stop response trials. The novelty of the finding was that self-face has shorter stop-signal reaction time compared to other-face in the successful inhibition trials. These results indicated the processing mechanism of self-face may be characterized by a strong response tendency and a corresponding strong inhibition control.

  11. Pain-related anxiety influences pain perception differently in men and women: a quantitative sensory test across thermal pain modalities.

    Science.gov (United States)

    Thibodeau, Michel A; Welch, Patrick G; Katz, Joel; Asmundson, Gordon J G

    2013-03-01

    The sexes differ with respect to perception of experimental pain. Anxiety influences pain perception more in men than in women; however, there lacks research exploring which anxiety constructs influence pain perception differentially between men and women. Furthermore, research examining whether depression is associated with pain perception differently between the sexes remains scant. The present investigation was designed to examine how trait anxiety, pain-related anxiety constructs (ie, fear of pain, pain-related anxiety, anxiety sensitivity), and depression are associated with pain perception between the sexes. A total of 95 nonclinical participants (55% women) completed measures assessing the constructs of interest and participated in quantitative sensory testing using heat and cold stimuli administered by a Medoc Pathway Pain and Sensory Evaluation System. The findings suggest that pain-related anxiety constructs, but not trait anxiety, are associated with pain perception. Furthermore, these constructs are associated with pain intensity ratings in men and pain tolerance levels in women. This contrasts with previous research suggesting that anxiety influences pain perception mostly or uniquely in men. Depression was not systematically associated with pain perception in either sex. Systematic relationships were not identified that allow conclusions regarding how fear of pain, pain-related anxiety, and anxiety sensitivity may contribute to pain perception differentially in men and women; however, anxiety sensitivity was associated with increased pain tolerance, a novel finding needing further examination. The results provide directions for future research and clinical endeavors and support that fear and anxiety are important features associated with hyperalgesia in both men and women. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  12. Suprathreshold Heat Pain Response Predicts Activity-Related Pain, but Not Rest-Related Pain, in an Exercise-Induced Injury Model

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    Coronado, Rogelio A.; Simon, Corey B.; Valencia, Carolina; Parr, Jeffrey J.; Borsa, Paul A.; George, Steven Z.

    2014-01-01

    Exercise-induced injury models are advantageous for studying pain since the onset of pain is controlled and both pre-injury and post-injury factors can be utilized as explanatory variables or predictors. In these studies, rest-related pain is often considered the primary dependent variable or outcome, as opposed to a measure of activity-related pain. Additionally, few studies include pain sensitivity measures as predictors. In this study, we examined the influence of pre-injury and post-injury factors, including pain sensitivity, for induced rest and activity-related pain following exercise induced muscle injury. The overall goal of this investigation was to determine if there were convergent or divergent predictors of rest and activity-related pain. One hundred forty-three participants provided demographic, psychological, and pain sensitivity information and underwent a standard fatigue trial of resistance exercise to induce injury of the dominant shoulder. Pain at rest and during active and resisted shoulder motion were measured at 48- and 96-hours post-injury. Separate hierarchical models were generated for assessing the influence of pre-injury and post-injury factors on 48- and 96-hour rest-related and activity-related pain. Overall, we did not find a universal predictor of pain across all models. However, pre-injury and post-injury suprathreshold heat pain response (SHPR), a pain sensitivity measure, was a consistent predictor of activity-related pain, even after controlling for known psychological factors. These results suggest there is differential prediction of pain. A measure of pain sensitivity such as SHPR appears more influential for activity-related pain, but not rest-related pain, and may reflect different underlying processes involved during pain appraisal. PMID:25265560

  13. The Stress Model of Chronic Pain: Evidence from Basal Cortisol and Hippocampal Structure and Function in Humans

    Science.gov (United States)

    Vachon-Presseau, Etienne; Roy, Mathieu; Martel, Marc-Olivier; Caron, Etienne; Marin, Marie-France; Chen, Jeni; Albouy, Genevieve; Plante, Isabelle; Sullivan, Michael J.; Lupien, Sonia J.; Rainville, Pierre

    2013-01-01

    Recent theories have suggested that chronic pain could be partly maintained by maladaptive physiological responses of the organism facing a recurrent stressor. The present study examined the associations between basal levels of cortisol collected over seven consecutive days, the hippocampal volumes and brain activation to thermal stimulations…

  14. Uncertainty during pain anticipation: the adaptive value of preparatory processes.

    Science.gov (United States)

    Seidel, Eva-Maria; Pfabigan, Daniela M; Hahn, Andreas; Sladky, Ronald; Grahl, Arvina; Paul, Katharina; Kraus, Christoph; Küblböck, Martin; Kranz, Georg S; Hummer, Allan; Lanzenberger, Rupert; Windischberger, Christian; Lamm, Claus

    2015-02-01

    Anticipatory processes prepare the organism for upcoming experiences. The aim of this study was to investigate neural responses related to anticipation and processing of painful stimuli occurring with different levels of uncertainty. Twenty-five participants (13 females) took part in an electroencephalography and functional magnetic resonance imaging (fMRI) experiment at separate times. A visual cue announced the occurrence of an electrical painful or nonpainful stimulus, delivered with certainty or uncertainty (50% chance), at some point during the following 15 s. During the first 2 s of the anticipation phase, a strong effect of uncertainty was reflected in a pronounced frontal stimulus-preceding negativity (SPN) and increased fMRI activation in higher visual processing areas. In the last 2 s before stimulus delivery, we observed stimulus-specific preparatory processes indicated by a centroparietal SPN and posterior insula activation that was most pronounced for the certain pain condition. Uncertain anticipation was associated with attentional control processes. During stimulation, the results revealed that unexpected painful stimuli produced the strongest activation in the affective pain processing network and a more pronounced offset-P2. Our results reflect that during early anticipation uncertainty is strongly associated with affective mechanisms and seems to be a more salient event compared to certain anticipation. During the last 2 s before stimulation, attentional control mechanisms are initiated related to the increased salience of uncertainty. Furthermore, stimulus-specific preparatory mechanisms during certain anticipation also shaped the response to stimulation, underlining the adaptive value of stimulus-targeted preparatory activity which is less likely when facing an uncertain event. © 2014 Wiley Periodicals, Inc.

  15. Enhanced Brain Responses to Pain-Related Words in Chronic Back Pain Patients and Their Modulation by Current Pain

    OpenAIRE

    Ritter, Alexander; Franz, Marcel; Puta, Christian; Dietrich, Caroline; Miltner, Wolfgang H. R.; Weiss, Thomas

    2016-01-01

    Previous functional magnetic resonance imaging (fMRI) studies in healthy controls (HC) and pain-free migraine patients found activations to pain-related words in brain regions known to be activated while subjects experience pain. The aim of the present study was to identify neural activations induced by pain-related words in a sample of chronic back pain (CBP) patients experiencing current chronic pain compared to HC. In particular, we were interested in how current pain influences brain acti...

  16. PAIN INTENSITY AND PAIN INTERFERENCE AMONG TRAUMA PATIENTS: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Deya Prastika

    2016-12-01

    Full Text Available Background: The incidence of trauma has been high and has gained attention worldwide. The energy involved in trauma results in specific tissue damage. Such tissue damage generally leads to pain. The high pain intensity possibly is consequence of trauma due to transfer energy to the body from external force and absorbed in wide area. This pain affected patients’ physical and psychological function, in which well known as pain interference. Objective: The aim of this review is to describe the pain intensity and pain interference among trauma patients. Method: A systematic search of electronic databases (CINHAL, ProQuest, Science Direct, and Google scholar was conducted for quantitative and qualitative studies measuring pain intensity and pain interference. The search limited to hospitalized trauma patients in adult age. Results: The search revealed 678 studies. A total of 10 descriptive studies examined pain intensity and pain interference and met inclusion criteria. The pain intensity and pain interference was assessed using Brief Pain Inventory (BPI. Pain intensity of hospitalized trauma patients were moderate to severe. These including 6 studies in orthopedic trauma, one study in musculoskeletal, two in studies in combinational between orthopedic and musculoskeletal, and two studies in burn injury. Moreover, the patients also reported pain was relentless & unbearable. In accordance, data showed that pain interference was moderate to severe from six studies. These studies result in vary of functional interference. However, those studies examined pain interference on sleep, enjoyment of life, mood, relationship with other, walking, general activity, and walking. Conclusion: The evidence from 10 studies included in this review indicates that hospitalized trauma patients perceived moderate to severe pain intensity and pain interference. Further research is needed to better evaluate the pain of hospitalized trauma patients.

  17. About-face on face recognition ability and holistic processing.

    Science.gov (United States)

    Richler, Jennifer J; Floyd, R Jackie; Gauthier, Isabel

    2015-01-01

    Previous work found a small but significant relationship between holistic processing measured with the composite task and face recognition ability measured by the Cambridge Face Memory Test (CFMT; Duchaine & Nakayama, 2006). Surprisingly, recent work using a different measure of holistic processing (Vanderbilt Holistic Face Processing Test [VHPT-F]; Richler, Floyd, & Gauthier, 2014) and a larger sample found no evidence for such a relationship. In Experiment 1 we replicate this unexpected result, finding no relationship between holistic processing (VHPT-F) and face recognition ability (CFMT). A key difference between the VHPT-F and other holistic processing measures is that unique face parts are used on each trial in the VHPT-F, unlike in other tasks where a small set of face parts repeat across the experiment. In Experiment 2, we test the hypothesis that correlations between the CFMT and holistic processing tasks are driven by stimulus repetition that allows for learning during the composite task. Consistent with our predictions, CFMT performance was correlated with holistic processing in the composite task when a small set of face parts repeated over trials, but not when face parts did not repeat. A meta-analysis confirms that relationships between the CFMT and holistic processing depend on stimulus repetition. These results raise important questions about what is being measured by the CFMT, and challenge current assumptions about why faces are processed holistically.

  18. Adaptability to pain is associated with potency of local pain inhibition, but not conditioned pain modulation: a healthy human study.

    Science.gov (United States)

    Zheng, Zhen; Wang, Kelun; Yao, Dongyuan; Xue, Charlie C L; Arendt-Nielsen, Lars

    2014-05-01

    This study investigated the relationship between pain sensitivity, adaptability, and potency of endogenous pain inhibition, including conditioned pain modulation (CPM) and local pain inhibition. Forty-one healthy volunteers (20 male, 21 female) received conditioning stimulation (CS) over 2 sessions in a random order: tonic heat pain (46 °C) on the right leg for 7 minutes and cold pressor pain (1 °C to 4 °C) on the left hand for 5 minutes. Participants rated the intensity of pain continuously using a 0 to 10 electronic visual analogue scale. The primary outcome measures were pressure pain thresholds (PPT) measured at the heterotopic and homotopic location to the CS sites before, during, and 20 minutes after CS. Two groups of participants, pain adaptive and pain nonadaptive, were identified based on their response to pain in the cold pressor test. Pain-adaptive participants showed a pain reduction between peak pain and pain at end of the test by at least 2 of 10 (n=16); whereas the pain-nonadaptive participants reported unchanged peak pain during 5-minute CS (n=25). Heterotopic PPTs during the CS did not differ between the 2 groups. However, increased homotopic PPTs measured 20 minutes after CS correlated with the amount of pain reduction during CS. These results suggest that individual sensitivity and adaptability to pain does not correlate with the potency of CPM. Adaptability to pain is associated with longer-lasting local pain inhibition. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  19. Development, validation and psychometric properties of a diagnostic/prognostic tool for breakthrough pain in mixed chronic-pain patients.

    Science.gov (United States)

    Samolsky Dekel, Boaz Gedaliahu; Remondini, Francesca; Gori, Alberto; Vasarri, Alessio; Di Nino, GianFranco; Melotti, Rita Maria

    2016-02-01

    Breakthrough pain (BTP) shows variable prevalence in different clinical contexts of cancer and non-cancer patients. BTP diagnostic tools with demonstrated reliability, validation and prognostic capability are lacking. We report the development, psychometric and validation properties of a diagnostic/prognostic tool, the IQ-BTP, for BTP recognition, its likelihood and clinical features among chronic-pain (CP) patients. n=120 consecutive mixed cancer/non-cancer CP in/outpatients. Development, psychometric analyses and formal validation included: Face/Content validity (by 'experts' opinion and assessing the relationship between the IQ-BTP classes and criteria derived from BTP operational-case-definition); Construct validity, by Principle Component Analysis (PCA); and the strength of Spearman correlation between IQ-BTP classes and the Brief Pain Inventory (BPI) items; Reliability, by Cronbach's alpha statistics. Associations with clinical/demographic moderators were assessed applying χ(2) analysis. Potential-BTP was found in 36.7% of patients (38.4% of non-cancer and 32.4% of cancer patients). Among these the likelihood for BTP diagnosis was 'high' in 25%, 'intermediate' in 41% and, 'low' 34% of patients. Analyses showed significant differences between IQ-BTP classes and between the latter BPI pain-item scores. Correlation between IQ-BTP classes and BPI items was moderate. PCA and scree test identified 3 components accounting for 62.3% of the variance. Cronbach's alpha was 0.71. The IQ-BTP showed satisfactory psychometric and validation properties. With adequate feasibility it enabled the allocating of cancer/non-cancer CP patients in three prognostic classes. Results are sufficient to warrant a subsequent impact study of the IQ-BTP as prognostic model and screening tool for BTP in both CP populations. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Biobehavioral pain profile in individuals with chronic spine pain.

    Science.gov (United States)

    Matteliano, Deborah; Scherer, Yvonne Krall; Chang, Yu-Ping

    2014-03-01

    Pain in the spine is the most frequently described pain problem in primary care, afflicting at least 54 million Americans. When spinal pain becomes chronic, the prognosis for recovery is poor, often leading to disability and reduced quality of life. Clinical treatment is inadequate, often focusing on physical pathology alone. To improve treatment outcomes for chronic pain as recommended by current guidelines, the Biobehavioral Pain Profile (BPP), which includes six pain response subscales, was developed to guide cognitive behavioral therapy (CBT). The purpose of this study was to describe the BPP in 100 individuals with chronic spine pain and examine the associations between the BPP and important clinical outcomes, including chronic pain, disability, and quality of life. Participants reported a high level of pain, a low quality of life, and a high level of disability despite receiving treatment with opioids. Scores on BPP subscales including evaluating loss of control, past and current experience, physiologic responsivity, and thoughts of disease progression were elevated, indicating a need for CBT. Five of the six BPP subscales had a significant association with quality of life, chronic pain, and disability with the thought of disease progression being a strong factor for most of the clinical outcome variables. By identifying BPP, clinicians can provide appropriate treatments to improve individuals' quality of life and prevent further disability. Further study using the BPP to guide CBT is needed. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  1. Comparison between Epidural Block vs. High Intensity Laser Therapy for Controlling Chronic Low Back Pain

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    Badiozaman Radpay

    2016-01-01

    Full Text Available Background: Chronic low back pain is among a wide spread musculoskeletal conditions that is related to disability with high economy cost. There are several treatment modalities for controlling chronic low back pain (CLBP, among them high intensity laser therapy (HILT and epidural blocks (EB use more commonly. This study aimed to evaluate the benefits and hazards of each of these two methods.Materials and Methods: We designed a randomized controlled double blind study during 24 months.101 patients divided in 2 groups (52 in EB and 49 in HILT group. Pain intensity was assessed by using faces pain scales (FPS and LINKERT questionaries' before procedure and during one, four, 12, and 24 weeks after beginning the procedures.Results: There were no differences between two groups in FPS lumber tenderness, straight leg rising test (SLRT, paresthesia, deep tendon reflex (DTR, and imaging changes. Motor problems seem was less in HILT group comparing EB.Conclusion: This study showed both EB and HILT approaches can control the pain intensity and motor activities in CLBP patients. Future studies will clarify the precise importance of each these methods.

  2. Postoperative pain assessment using four behavioral scales in Pakistani children undergoing elective surgery

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    Faisal Shamim

    2015-01-01

    Full Text Available Background: Several measurement tools have been used for assessment of postoperative pain in pediatric patients. Self-report methods have limitations in younger children and parent, nurse or physician assessment can be used as a surrogate measure. These tools should be tested in different cultures as pain can be influenced by sociocultural factors. The objective was to assess the inter-rater agreement on four different behavioral pain assessment scales in our local population. Materials and Methods: This prospective, descriptive, observational study was conducted in Pakistan. American Society of Anesthesiologists I and II children, 3-7 years of age, undergoing elective surgery were enrolled. Four pain assessment scales were used, Children′s Hospital of Eastern Ontario Pain Scale (CHEOPS, Toddler Preschool Postoperative Pain Scale (TPPPS, objective pain scale (OPS, and Face, Legs, Activity, Cry, Consolability (FLACC. After 15 and 60 min of arrival in the postanesthesia care unit (PACU, each child evaluated his/her postoperative pain by self-reporting and was also independently assessed by the PACU nurse, PACU anesthetist and the parent. The sensitivity and specificity of the responses of the four pain assessment scales were compared to the response of the child. Results: At 15 min, sensitivity and specificity were >60% for doctors and nurses on FLACC, OPS, and CHEOPS scales and for FLACC and CHEOPS scale for the parents. Parents showed poor agreement on OPS and TPPS. At 60 min, sensitivity was poor on the OPS scale by all three observers. Nurses showed a lower specificity on FLACC tool. Parents had poor specificity on CHEOPS and rate of false negatives was high with TPPS. Conclusions: We recommend the use of FLACC scale for assessment by parents, nurses, and doctors in Pakistani children aged between 3 and 7.

  3. Magnesium sulfate reduces formalin-induced orofacial pain in rats with normal magnesium serum levels.

    Science.gov (United States)

    Srebro, Dragana P; Vučković, Sonja M; Dožić, Ivan S; Dožić, Branko S; Savić Vujović, Katarina R; Milovanović, Aleksandar P; Karadžić, Branislav V; Prostran, Milica Š

    2018-02-01

    In humans, orofacial pain has a high prevalence and is often difficult to treat. Magnesium is an essential element in biological a system which controls the activity of many ion channels, neurotransmitters and enzymes. Magnesium produces an antinociceptive effect in neuropathic pain, while in inflammatory pain results are not consistent. We examined the effects of magnesium sulfate using the rat orofacial formalin test, a model of trigeminal pain. Male Wistar rats were injected with 1.5% formalin into the perinasal area, and the total time spent in pain-related behavior (face rubbing) was quantified. We also spectrophotometrically determined the concentration of magnesium and creatine kinase activity in blood serum. Magnesium sulfate administered subcutaneously (0.005-45mg/kg) produced significant antinociception in the second phase of the orofacial formalin test in rats at physiological serum concentration of magnesium. The effect was not dose-dependent. The maximum antinociceptive effect of magnesium sulfate was about 50% and was achieved at doses of 15 and 45mg/kg. Magnesium did not affect increase the levels of serum creatine kinase activity. Preemptive systemic administration of magnesium sulfate as the only drug can be used to prevent inflammatory pain in the orofacial region. Its analgesic effect is not associated with magnesium deficiency. Copyright © 2017 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier B.V. All rights reserved.

  4. "A life of living death": the experiences of people living with chronic low back pain in rural Nigeria.

    Science.gov (United States)

    Igwesi-Chidobe, Chinonso N; Kitchen, Sheila; Sorinola, Isaac O; Godfrey, Emma L

    2017-04-01

    This study explored the experiences of people living with non-specific chronic low back pain (CLBP) in a rural Nigerian community. Qualitative in-depth semi-structured face-to-face interviews were conducted with purposively sampled participants until data saturation. Questions explored back pain beliefs, coping/management strategies and daily activities. Thematic analysis of transcripts was performed using the Framework approach. Themes showed that back pain beliefs were related to manual labour/deprivation, infection/degeneration, spiritual/cultural beliefs and rural-urban divide. These beliefs impacted on gender roles resulting in adaptive or maladaptive coping. Adaptive coping was facilitated by positive beliefs, such as not regarding CLBP as an illness, whereas viewing CLBP as illness stimulated maladaptive coping strategies. Spirituality was associated with both adaptive and maladaptive coping. Maladaptive coping strategies led to dissatisfaction with health care in this community. CLBP-related disability in rural Nigeria is strongly influenced by beliefs that facilitate coping strategies that either enhance or inhibit recovery. Interventions should therefore target maladaptive beliefs while emphasizing behavioural modification. Implications for Rehabilitation Non-specific chronic low back pain (CLBP) is highly prevalent and responsible for much pain and disability in rural Nigeria. No qualitative study has investigated the experiences of people living with CLBP in rural Nigeria or any other rural African context. Qualitative study of peoples' experiences of living with CLBP in rural Nigeria has the potential of exposing complex socio-cultural and psychological factors associated with CLBP which has potential implications for designing effective interventions. The results of this study may inform the development of complex interventions for reducing the disability associated with CLBP in rural Nigeria and other rural African contexts.

  5. Faces in places: humans and machines make similar face detection errors.

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    Bernard Marius 't Hart

    Full Text Available The human visual system seems to be particularly efficient at detecting faces. This efficiency sometimes comes at the cost of wrongfully seeing faces in arbitrary patterns, including famous examples such as a rock configuration on Mars or a toast's roast patterns. In machine vision, face detection has made considerable progress and has become a standard feature of many digital cameras. The arguably most wide-spread algorithm for such applications ("Viola-Jones" algorithm achieves high detection rates at high computational efficiency. To what extent do the patterns that the algorithm mistakenly classifies as faces also fool humans? We selected three kinds of stimuli from real-life, first-person perspective movies based on the algorithm's output: correct detections ("real faces", false positives ("illusory faces" and correctly rejected locations ("non faces". Observers were shown pairs of these for 20 ms and had to direct their gaze to the location of the face. We found that illusory faces were mistaken for faces more frequently than non faces. In addition, rotation of the real face yielded more errors, while rotation of the illusory face yielded fewer errors. Using colored stimuli increases overall performance, but does not change the pattern of results. When replacing the eye movement by a manual response, however, the preference for illusory faces over non faces disappeared. Taken together, our data show that humans make similar face-detection errors as the Viola-Jones algorithm, when directing their gaze to briefly presented stimuli. In particular, the relative spatial arrangement of oriented filters seems of relevance. This suggests that efficient face detection in humans is likely to be pre-attentive and based on rather simple features as those encoded in the early visual system.

  6. Keeping pain in mind: a motivational account of attention to pain.

    Science.gov (United States)

    Van Damme, Stefaan; Legrain, Valéry; Vogt, Julia; Crombez, Geert

    2010-02-01

    Attention is a key concept in many theories of pain perception. A clinically popular idea is that pain is more intense in persons who are hypervigilant for or bias their attention to pain information. So far, evidence for such bias in pain patients as compared to healthy persons is inconclusive. Furthermore, studies investigating the effects of distracting attention away from pain have shown contradictory results. In this review, we present a motivational perspective on attentional processing of pain that accounts for these inconclusive research findings. We argue that pain always has to be considered within a context of goal pursuit. From this perspective, two largely unexplored theoretical assumptions are introduced. First, when pain occurs during the pursuit of a certain goal, it may unintentionally capture attention although it is not relevant for the goal. Whether such unintentional attentional capture happens is not only dependent upon the characteristics of the pain but also on the characteristics of the focal goal. Second, attention to pain and pain-related information might be driven by a focal goal related to pain. Attentional processing of pain information will be particularly enhanced when the focal goal is related to pain management (e.g., attempting to gain control). Future research should systematically investigate the role of motivation and goal pursuit in the attentional processing of pain-related information. This motivational perspective offers a powerful framework to explain inter- and intra-individual differences in the deployment of attention to pain-related information.

  7. The nature and prevalence of chronic pain in homeless persons: an observational study [v1; ref status: indexed, http://f1000r.es/o6

    Directory of Open Access Journals (Sweden)

    Rebecca Fisher

    2013-07-01

    Full Text Available Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs. Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant’s reasons for homelessness, and whether they slept rough or in shelters. Findings: Of 168 shelter users approached, 150 (89.3% participated: 93 participants (63% reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs. Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable

  8. Antinociceptive Effect of Morphine Microinjections into the Dorsal Hippocampus in the Formalin-Induced Orofacial Pain in Rats

    Directory of Open Access Journals (Sweden)

    Emad Khalilzadeh

    2010-09-01

    Full Text Available In the present study, the effects of intra-hippocampal microinjections of morphine (an opioid agonist and naloxone (an opioid antagonist were investigated in the formalin-induced orofacial pain in rats. Orofacial pain was induced by subcutaneous injection of formalin (1 %, 50 μl in the upper lip region and the time spent of face rubbing was measured in 3-min blocks for 45 min. Formalin induced a biphasic (first phase: 0-3 min; second phase: 15-33 min pain response. Intra-hippocampal microinjections of morphine at doses of 2 and 4 μg significantly (P < 0.05 attenuated the first phase, and at doses of 1, 2 and 4 μg, morphine significantly (P < 0.05 suppressed both phases of formalin-induced orofacial pain response. Intra-hippocampal microinjections of naloxone (1 and 4 μg non-significantly increased pain when used alone, and in pretreatment microinjection, naloxone (4 μg reversed morphine (2 μg-induced antinociception. These results indicate that at the level of hippocampus of the brain, morphine through a naloxone-reversible mechanism produced an antinociceptive effect confronting the pain induced by formalin in the orofacial region in rats.

  9. Bilateral experimental neck pain reorganize axioscapular muscle coordination and pain sensitivity.

    Science.gov (United States)

    Christensen, S W; Hirata, R P; Graven-Nielsen, T

    2017-04-01

    Neck pain is a large clinical problem where reorganized trunk and axioscapular muscle activities have been hypothesised contributing to pain persistence and pain hypersensitivity. This study investigated the effects of bilateral experimental neck pain on trunk and axioscapular muscle function and pain sensitivity. In 25 healthy volunteers, bilateral experimental neck pain was induced in the splenius capitis muscles by hypertonic saline injections. Isotonic saline was used as control. In sitting, subjects performed slow, fast and slow-resisted unilateral arm movements before, during and after injections. Electromyography (EMG) was recorded from eight shoulder and trunk muscles bilaterally. Pressure pain thresholds (PPTs) were assessed bilaterally at the neck, head and arm. Data were normalized to the before-measures. Compared with control and post measurements, experimental neck pain caused (1) decreased EMG activity of the ipsilateral upper trapezius muscles during all but slow-resisted down movements (p neck pain reorganized axioscapular and trunk muscle activity together with local hyperalgesia and widespread hypoalgesia indicating that acute neck pain immediately affects trunk and axioscapular function which may affect both assessment and treatment. Bilateral clinical neck pain alters axioscapular muscle coordination but only effects of unilateral experimental neck pain has been investigated. Bilateral experimental neck pain causes task-dependent reorganized axioscapular and trunk muscle activity in addition to widespread decrease in pressure pain sensitivity. © 2016 European Pain Federation - EFIC®.

  10. Cancer Pain Physiology

    DEFF Research Database (Denmark)

    Falk, Sarah; Bannister, Kirsty; Dickenson, Anthony

    2014-01-01

    Mechanisms of inflammatory and neuropathic pains have been elucidated and translated to patient care by the use of animal models of these pain states. Cancer pain has lagged behind since early animal models of cancer-induced bone pain were based on the systemic injection of carcinoma cells....... This precluded systematic investigation of specific neuronal and pharmacological alterations that occur in cancer-induced bone pain. In 1999, Schwei et al. described a murine model of cancer-induced bone pain that paralleled the clinical condition in terms of pain development and bone destruction, confined...... to the mouse femur. This model prompted related approaches and we can now state that cancer pain may include elements of inflammatory and neuropathic pains but also unique changes in sensory processing. Cancer induced bone pain results in progressive bone destruction, elevated osteoclast activity...

  11. Pain during mammography: Possible risk factors and ways to alleviate pain

    International Nuclear Information System (INIS)

    Davey, Belinda

    2007-01-01

    This article reviews the literature surrounding the issue of pain experienced during mammography. This is an important topic since many women may refuse screening mammograms due to the possibility of a painful examination. It is a difficult area to research since the experience of pain is by nature subjective and the manner by which data have been collected has varied with many different pain assessment instruments being utilised. Accordingly there is wide variation in the degree of pain felt from only slight pain to some women finding it acutely painful. To discover why some women find it so painful certain risk factors that have been associated with painful mammography are explored. There are many of these risk factors but this article concentrates on three main areas: biological, psychological and staff-related. Once the reasons why some women experience such acute pain, ways to ease this may be found. Methods to alleviate painful mammography are suggested and discussed. The article concludes that there is a wide variance in the data collection techniques which could account for the wide variance in the reported pain. More research is required using a validated pain measurement to establish the extent of pain and to establish the effect of this on future compliance

  12. Conditioned pain modulation and situational pain catastrophizing as preoperative predictors of pain following chest wall surgery: a prospective observational cohort study.

    Directory of Open Access Journals (Sweden)

    Kasper Grosen

    Full Text Available Variability in patients' postoperative pain experience and response to treatment challenges effective pain management. Variability in pain reflects individual differences in inhibitory pain modulation and psychological sensitivity, which in turn may be clinically relevant for the disposition to acquire pain. The aim of this study was to investigate the effects of conditioned pain modulation and situational pain catastrophizing on postoperative pain and pain persistency.Preoperatively, 42 healthy males undergoing funnel chest surgery completed the Spielberger's State-Trait Anxiety Inventory and Beck's Depression Inventory before undergoing a sequential conditioned pain modulation paradigm. Subsequently, the Pain Catastrophizing Scale was introduced and patients were instructed to reference the conditioning pain while answering. Ratings of movement-evoked pain and consumption of morphine equivalents were obtained during postoperative days 2-5. Pain was reevaluated at six months postoperatively.Patients reporting persistent pain at six months follow-up (n = 15 were not significantly different from pain-free patients (n = 16 concerning preoperative conditioned pain modulation response (Z = 1.0, P = 0.3 or level of catastrophizing (Z = 0.4, P = 1.0. In the acute postoperative phase, situational pain catastrophizing predicted movement-evoked pain, independently of anxiety and depression (β = 1.0, P = 0.007 whereas conditioned pain modulation predicted morphine consumption (β = -0.005, P = 0.001.Preoperative conditioned pain modulation and situational pain catastrophizing were not associated with the development of persistent postoperative pain following funnel chest repair. Secondary outcome analyses indicated that conditioned pain modulation predicted morphine consumption and situational pain catastrophizing predicted movement-evoked pain intensity in the acute postoperative phase. These findings may have

  13. [The pain-emotion: Advocating pain as an emotion].

    Science.gov (United States)

    Fonseca Das Neves, J; Sule, N; Serra, E

    2017-12-01

    Pain is a common experience, both physical and emotional. However we often feel powerless with our patients suffering pain. This paper aims to give a new heuristic and psychological understanding of pain. According to new theories, recent researches as well as different points of view, we form an analogy between pain and emotion. Throughout historical considerations pain has always been perceived through theories and beliefs, changing its definition. This is also the case for emotion. Could they be two ways of expressing a single phenomenon? First, we must clarify the definition of emotion. In past, emotion was considered as a multiple-conditioned notion. To be considered as an emotion the pain had to fill numerous features, which differ according to the scientific opinions. The emotion may be considered as a physical expression or perceived only as the consequences of a real emotion, i.e., the subjective feeling. We propose as a way of thinking that emotion brings together these two concepts. We support a flexible vision of emotion. To investigate the field of the emotion different mental steps may be thought of: we should conceive of the emotion as a stimulus, as an emotional evaluation and as a tendency to action, which becomes an emotional response. These steps are colored by subjective feelings. It can be summarized in three levels: the situation decoding (1), the response organization (2) and the effectiveness of the response (3). Second pain can be considered as a complex notion involving personal and subjective feelings. We can use multidimensional patterns and consider emotion with its multiple features: the generating mechanisms, the pain perception, the pain behavior and the environment. Each stage can be divided in different ways. Hence pain treatment could be approached as an emotional treatment. Indeed, we can make a link between generating mechanisms and emotion situation decoding, between pain perception and emotion situation decoding and response

  14. Are Pain-Related Fears Mediators for Reducing Disability and Pain in Patients with Complex Regional Pain Syndrome Type 1? An Explorative Analysis on Pain Exposure Physical Therapy

    Science.gov (United States)

    Barnhoorn, Karlijn J.; Staal, J. Bart; van Dongen, Robert T. M.; Frölke, Jan Paul M.; Klomp, Frank P.; van de Meent, Henk; Samwel, Han; Nijhuis-van der Sanden, Maria W. G.

    2015-01-01

    Objective To investigate whether pain-related fears are mediators for reducing disability and pain in patients with Complex Regional Pain Syndrome type 1 when treating with Pain Exposure Physical Therapy. Design An explorative secondary analysis of a randomised controlled trial. Participants Fifty-six patients with Complex Regional Pain Syndrome type 1. Interventions The experimental group received Pain Exposure Physical Therapy in a maximum of five treatment sessions; the control group received conventional treatment following the Dutch multidisciplinary guideline. Outcome measures Levels of disability, pain, and pain-related fears (fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) were measured at baseline and after 3, 6, and 9 months follow-up. Results The experimental group had a significantly larger decrease in disability of 7.77 points (95% CI 1.09 to 14.45) and in pain of 1.83 points (95% CI 0.44 to 3.23) over nine months than the control group. The potential mediators pain-related fears decreased significantly in both groups, but there were no significant differences between groups, which indicated that there was no mediation. Conclusion The reduction of pain-related fears was comparable in both groups. We found no indication that pain-related fears mediate the larger reduction of disability and pain in patients with Complex Regional Pain Syndrome type 1 treated with Pain Exposure Physical Therapy compared to conventional treatment. Trial registration International Clinical Trials Registry NCT00817128 PMID:25919011

  15. Implicit associations between pain and self-schema in patients with chronic pain.

    Science.gov (United States)

    Van Ryckeghem, Dimitri M L; De Houwer, Jan; Van Bockstaele, Bram; Van Damme, Stefaan; De Schryver, Maarten; Crombez, Geert

    2013-12-01

    Chronic pain often interferes with daily functioning, and may become a threat to an individual's sense of self. Despite the development of a recent theoretical account focussing upon the relationship between the presence of chronic pain and a person's self, research investigating this idea is limited. In the present study we aimed to (1) compare the strength of association between self- and pain schema in patients with chronic pain and healthy control subjects and (2) research whether the strength of association between self- and pain-schema is related to particular pain-related outcomes and individual differences of patients with chronic pain. Seventy-three patients with chronic pain (M(age) = 49.95; SD = 9.76) and 53 healthy volunteers (M(age) = 48.53; SD = 10.37) performed an Implicit Association Test (IAT) to assess the strength of association between pain- and self-schema. Patients with chronic pain also filled out self-report measures of pain severity, pain suffering, disability, depression, anxiety, acceptance, and helplessness. Results indicated that the pain- and self-schema were more strongly associated in patients with chronic pain than in healthy control subjects. Second, results indicated that, in patients with chronic pain, a stronger association between self- and pain-schema, as measured with the IAT, is related to a heightened level of pain severity, pain suffering, anxiety, and helplessness. Current findings give first support for the use of an IAT to investigate the strength of association between self- and pain-schema in patients with chronic pain and suggest that pain therapies may incorporate techniques that intervene on the level of self-pain enmeshment. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  16. Women's experiences of pregnancy related pelvic girdle pain: A systematic review.

    Science.gov (United States)

    Mackenzie, Jo; Murray, Esther; Lusher, Joanne

    2018-01-01

    to systematically review the available studies which relay the experience of pregnancy related pelvic girdle pain and how this affects women psychologically and emotionally. a systematic review and meta-synthesis of the experiences of pregnancy related pelvic girdle pain was conducted for qualitative studies dated between 2005 and 2016. Predefined terms were used to search nine central databases and hand searches of two reference lists of identified studies were carried out. 614 records were identified, eight studies met the inclusion criteria for review. Pain from pelvic girdle pain impacted on women's daily lives both at home and the workplace. This had a negative emotional and psychological impact on women as it took away their feeling of independence. Women reported feelings of frustration, guilt, irritability and upset at being unable to carry out their normal roles. Pelvic girdle pain also affected the women's sense of identity and ability to care for their children. Health professionals working with pregnant and postnatal women need to be aware of the anger, frustration and negative emotions resulting from PGP. These women may become socially isolated and there is a risk they could abuse analgesics in attempt to manage the pain especially if they do not have the social support. For women with young children, it is important to be aware of safety issues they face with carrying babies and controlling toddlers. It is therefore important that health professionals recognise PGP as a serious health issue, approach this condition sensitively and refer to appropriate treatment as soon as PGP is suspected. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  17. Prediction of pain in orthodontic patients based on preoperative pain assessment

    Science.gov (United States)

    Zheng, Baoyu; Ren, Manman; Lin, Feiou; Yao, Linjie

    2016-01-01

    Aim To investigate whether pretreatment assessment of experimental pain can predict the level of pain after archwire placement. Methods One hundred and twenty-one general university students seeking orthodontic treatment were enrolled in this study. A cold pressor test was performed to estimate the pain tolerance of subjects before treatment. Self-reported pain intensity was calculated using a 10 cm visual analog scale during the 7 days after treatment. The relationship between pain tolerance and orthodontic pain was analyzed using Spearman’s correlation analysis. Results The maximum mean level of pain intensity occurred at 24 hours after bonding (53.31±16.13) and fell to normal levels at day 7. Spearman’s correlation analysis found a moderate positive association between preoperative pain tolerance and self-reported pain after archwire placement (P0.05). Conclusion A simple and noninvasive preoperative sensory test (the cold pressor test) was useful in predicting the risk of developing unbearable pain in patients after archwire placement. Self-reported pain after archwire placement decreased as individual pain tolerance increased. PMID:27042019

  18. Face-to-face or face-to-screen? Undergraduates' opinions and test performance in classroom vs. online learning

    Science.gov (United States)

    Kemp, Nenagh; Grieve, Rachel

    2014-01-01

    As electronic communication becomes increasingly common, and as students juggle study, work, and family life, many universities are offering their students more flexible learning opportunities. Classes once delivered face-to-face are often replaced by online activities and discussions. However, there is little research comparing students' experience and learning in these two modalities. The aim of this study was to compare undergraduates' preference for, and academic performance on, class material and assessment presented online vs. in traditional classrooms. Psychology students (N = 67) at an Australian university completed written exercises, a class discussion, and a written test on two academic topics. The activities for one topic were conducted face-to-face, and the other online, with topics counterbalanced across two groups. The results showed that students preferred to complete activities face-to-face rather than online, but there was no significant difference in their test performance in the two modalities. In their written responses, students expressed a strong preference for class discussions to be conducted face-to-face, reporting that they felt more engaged, and received more immediate feedback, than in online discussion. A follow-up study with a separate group (N = 37) confirmed that although students appreciated the convenience of completing written activities online in their own time, they also strongly preferred to discuss course content with peers in the classroom rather than online. It is concluded that online and face-to-face activities can lead to similar levels of academic performance, but that students would rather do written activities online but engage in discussion in person. Course developers could aim to structure classes so that students can benefit from both the flexibility of online learning, and the greater engagement experienced in face-to-face discussion. PMID:25429276

  19. Face-to-face or face-to-screen? Undergraduates' opinions and test performance in classroom vs. online learning.

    Science.gov (United States)

    Kemp, Nenagh; Grieve, Rachel

    2014-01-01

    As electronic communication becomes increasingly common, and as students juggle study, work, and family life, many universities are offering their students more flexible learning opportunities. Classes once delivered face-to-face are often replaced by online activities and discussions. However, there is little research comparing students' experience and learning in these two modalities. The aim of this study was to compare undergraduates' preference for, and academic performance on, class material and assessment presented online vs. in traditional classrooms. Psychology students (N = 67) at an Australian university completed written exercises, a class discussion, and a written test on two academic topics. The activities for one topic were conducted face-to-face, and the other online, with topics counterbalanced across two groups. The results showed that students preferred to complete activities face-to-face rather than online, but there was no significant difference in their test performance in the two modalities. In their written responses, students expressed a strong preference for class discussions to be conducted face-to-face, reporting that they felt more engaged, and received more immediate feedback, than in online discussion. A follow-up study with a separate group (N = 37) confirmed that although students appreciated the convenience of completing written activities online in their own time, they also strongly preferred to discuss course content with peers in the classroom rather than online. It is concluded that online and face-to-face activities can lead to similar levels of academic performance, but that students would rather do written activities online but engage in discussion in person. Course developers could aim to structure classes so that students can benefit from both the flexibility of online learning, and the greater engagement experienced in face-to-face discussion.

  20. Translational pain research: evaluating analgesic effect in experimental visceral pain models

    DEFF Research Database (Denmark)

    Olesen, Anne Estrup; Andresen, Trine; Christrup, Lona Louring

    2009-01-01

    Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mechanisms behind the pain and the mode of action of analgesic substances. This can ...... studies and clinical condition in patients suffering from visceral pain, and thus constitute the missing link in translational pain research.......Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mechanisms behind the pain and the mode of action of analgesic substances. This can...... facilitate minimizing the gap between knowledge gained in animal and human clinical studies. Combining experimental pain studies and pharmacokinetic studies can improve understanding of the pharmacokinetic-pharmacodynamic relationship of analgesics and, thus, provide valuable insight into optimal clinical...

  1. First Dutch Consensus of Pain Quality Indicators for Pain Treatment Facilities.

    Science.gov (United States)

    de Meij, Nelleke; van Grotel, Marloes; Patijn, Jacob; van der Weijden, Trudy; van Kleef, Maarten

    2016-01-01

    There is a general consensus about the need to define and improve the quality of pain treatment facilities. Although guidelines and recommendations to improve the quality of pain practice management have been launched, provision of appropriate pain treatment is inconsistent and the quality of facilities varies widely. The aim of the study was to develop an expert-agreed list of quality indicators applicable to pain treatment facilities. The list was also intended to be used as the basis for a set of criteria for registered status of pain treatment facilities. The University Pain Center Maastricht at the Department of Anesthesiology and Pain Management of the Maastricht University Medical Center conducted a 3-round Delphi study in collaboration with the Board of the Pain Section of the Dutch Society of Anesthesiologists (NVA). Twenty-five quality indicators were selected as relevant to 2 types of pain treatment facilities, pain clinics and pain centers. The final expert-agreed list consisted of 22 quality indicators covering 7 quality domains: supervision, availability of care, staffing level and patient load, quality policy, multidisciplinarity, regionalization, and research and education. This set of quality indicators may facilitate organizational evaluation and improve insight into service quality from the perspectives of patients, pain specialists, and other healthcare professionals. Recommendations for improvements to the current set of quality indicators are made. In 2014 the process of registering pain treatment facilities in the Netherlands started; facilities can register as a pain clinic or pain center. © 2015 World Institute of Pain.

  2. Psychosocial work aspects, stress and musculoskeletal pain among musicians. A systematic review in search of correlates and predictors of playing-related pain.

    Science.gov (United States)

    Jacukowicz, Aleksandra

    2016-06-16

    Musicians face numerous psychosocial and physical demands at work resulting in high prevalence of musculoskeletal problems. Unlike physical risks, little is known about psychosocial work factors influencing such health problems in this particular group. The paper aimed to identify psychosocial work demands resulting in musculoskeletal problems among musicians. A systematic review was undertaken to find data linking psychosocial work demands or stress with musculoskeletal disorders among musicians. The exploration of databases resulted in nine research studies linking psychosocial aspects of work or stress with musculoskeletal problems among musicians. The analyzed studies linked psychosocial aspects with musculoskeletal problems in three ways - showing proportions of people indicating particular causes of pain, indicating correlations between these variables or performing regression analysis showing psychosocial predictors of musculoskeletal pain. Only a few studies have undertaken the issue of psychosocial risk factors for musculoskeletal problems among musicians. The results revealed that some psychosocial aspects of work, e.g. long hours at work, work content, high job demands, low control/influence, lack of social support, were related to musculoskeletal pain, however, the methods and results were inconsistent. The extant studies employed variety of definitions of psychosocial aspects that hindered the possibility for consistent conclusions. Basing on those conclusions, future directions were offered.

  3. Primary motor cortex changes after amputation correlate with phantom limb pain and the ability to move the phantom limb

    DEFF Research Database (Denmark)

    Raffin, Estelle; Richard, Nathalie; Giraux, Pascal

    2016-01-01

    A substantial body of evidence documents massive reorganization of primary sensory and motor cortices following hand amputation, the extent of which is correlated with phantom limb pain. Many therapies for phantom limb pain are based upon the idea that plastic changes after amputation...... for the maladaptative plasticity model, we demonstrate for the first time that motor capacities of the phantom limb correlate with post-amputation reorganization, and that this reorganization is not limited to the face and hand representations but also includes the proximal upper-limb....

  4. Differences in Pain Processing Between Patients with Chronic Low Back Pain, Recurrent Low Back Pain, and Fibromyalgia.

    Science.gov (United States)

    Goubert, Dorien; Danneels, Lieven; Graven-Nielsen, Thomas; Descheemaeker, Filip; Meeus, Mira

    2017-05-01

    The impairment in musculoskeletal structures in patients with low back pain (LBP) is often disproportionate to their complaint. Therefore, the need arises for exploration of alternative mechanisms contributing to the origin and maintenance of non-specific LBP. The recent focus has been on central nervous system phenomena in LBP and the pathophysiological mechanisms underlying the various symptoms and characteristics of chronic pain. Knowledge concerning changes in pain processing in LBP remains ambiguous, partly due to the diversity in the LBP population. The purpose of this study is to compare quantitative sensory assessment in different groups of LBP patients with regard to chronicity. Recurrent low back pain (RLBP), mild chronic low back pain (CLBP), and severe CLBP are compared on the one hand with healthy controls (HC), and on the other hand with fibromyalgia (FM) patients, in which abnormal pain processing has previously been reported. Cross-sectional study. Department of Rehabilitation Sciences, Ghent University, Belgium. Twenty-three RLBP, 15 mild CLBP, 16 severe CLBP, 26 FM, and 21 HC participated in this study. Quantitative sensory testing was conducted by manual pressure algometry and computer-controlled cuff algometry. A manual algometer was used to evaluate hyperalgesia as well as temporal summation of pain and a cuff algometer was used to evaluate deep tissue hyperalgesia, the efficacy of the conditioned pain modulation and spatial summation of pain. Pressure pain thresholds by manual algometry were significantly lower in FM compared to HC, RLBP, and severe CLBP. Temporal summation of pain was significantly higher in FM compared to HC and RLBP. Pain tolerance thresholds assessed by cuff algometry were significantly lower in FM compared to HC and RLBP and also in severe CLBP compared to RLBP. No significant differences between groups were found for spatial summation or conditioned pain modulation. No psychosocial issues were taken into account for this

  5. The differences of brain cortical activation between superficial pain and deep pain

    International Nuclear Information System (INIS)

    Ikemoto, Tatsunori; Ushida, Takahiro; Taniguchi, Shinichirou; Tani, Toshikazu; Morio, Kazuo; Sasaki, Toshikazu; Tanaka, Shigeki

    2006-01-01

    Using functional magnetic resonance imaging (FMRI) technology, we investigated the difference of pain related brain cortical activation derived from noxious stimulation to the skin and muscular tissue. Ten healthy volunteers who have no history of brain vascular disease were enrolled in this study. A cutaneous pain was provoked by isotonic (0.9%) saline injection into intra-dermal space on right lower leg through 24G plastic catheter, and a muscle pain was provoked by hypertonic (3%) saline injection into right tibialis anterior muscle. We used event-related FMRI to measure brain activity during each injection. Visual analogue scale (VAS) was used to quantify pain intensity and unpleasantness, and pain quality was assessed with several verbal descriptions. Pain unpleasantness rating was higher in the muscle pain compared to the cutaneous pain, despite the same pain intensity rating. The cutaneous pain had more acute pain onset than the muscle pain. Pain duration after stimulation was short in the cutaneous pain, but long in the muscle pain. The extent of the painful region tended to be larger with the muscle pain, but there was no statistical significance. Evoked FMRI response from the cutaneous pain showed distinct brain activation in the inferior and superior parietal cortex (BA: Brodmann area 5/7/40), primary and secondary somatosensory cortex (S1 and S2), insula, supplementary motor area (SMA, BA6), posterior cingulate cortex and cerebellum. On the other hand, FMRI response from muscle pain showed distinct brain activation mainly in the contralateral insula. These results suggest that the parietal lobe including the S1 is the essential area for cognition of sharp and well-localized pain conditions such as cutaneous pain, and may not be essential for cognition of diffuse pain derived from muscular tissue. (author)

  6. Effectiveness of link prediction for face-to-face behavioral networks.

    Science.gov (United States)

    Tsugawa, Sho; Ohsaki, Hiroyuki

    2013-01-01

    Research on link prediction for social networks has been actively pursued. In link prediction for a given social network obtained from time-windowed observation, new link formation in the network is predicted from the topology of the obtained network. In contrast, recent advances in sensing technology have made it possible to obtain face-to-face behavioral networks, which are social networks representing face-to-face interactions among people. However, the effectiveness of link prediction techniques for face-to-face behavioral networks has not yet been explored in depth. To clarify this point, here we investigate the accuracy of conventional link prediction techniques for networks obtained from the history of face-to-face interactions among participants at an academic conference. Our findings were (1) that conventional link prediction techniques predict new link formation with a precision of 0.30-0.45 and a recall of 0.10-0.20, (2) that prolonged observation of social networks often degrades the prediction accuracy, (3) that the proposed decaying weight method leads to higher prediction accuracy than can be achieved by observing all records of communication and simply using them unmodified, and (4) that the prediction accuracy for face-to-face behavioral networks is relatively high compared to that for non-social networks, but not as high as for other types of social networks.

  7. Characterizing the Pain Narratives of Parents of Youth with Chronic Pain

    Science.gov (United States)

    Noel, Melanie; Beals-Erickson, Sarah E.; Law, Emily F.; Alberts, Nicole; Palermo, Tonya M.

    2015-01-01

    Objectives Questionnaire-based research has shown that parents exert a powerful influence on and are profoundly influenced by living with a child with chronic pain. Examination of parents' pain narratives through an observational lens offers an alternative approach to understanding the complexity of pediatric chronic pain; however, the narratives of parents of youth with chronic pain have been largely overlooked. The present study aimed to characterize the vulnerability- and resilience-based aspects of the pain narratives of parents of youth with chronic pain. Methods Pain narratives of 46 parents were recorded during the baseline session as part of two clinical trials evaluating a behavioral intervention for parents of youth with chronic pain. The narratives were coded for aspects of pain-related vulnerability and resilience. Results Using exploratory cluster analysis, two styles of parents’ pain narratives were identified. Distress narratives were characterized by more negative affect and an exclusively unresolved orientation towards the child’s diagnosis of chronic pain whereas resilience narratives were characterized by positive affect and a predominantly resolved orientation towards the child’s diagnosis. Preliminary support for the validity of these clusters was provided through our finding of differences between clusters in parental pain catastrophizing about child pain (helplessness). Discussion Findings highlight the multidimensional nature of parents’ experience of their child’s pain problem. Clinical implications in terms of assessment and treatment are discussed. PMID:26736026

  8. Making Sense of Low Back Pain and Pain-Related Fear.

    Science.gov (United States)

    Bunzli, Samantha; Smith, Anne; Schütze, Robert; Lin, Ivan; O'Sullivan, Peter

    2017-09-01

    Synopsis Pain-related fear is implicated in the transition from acute to chronic low back pain and the persistence of disabling low back pain, making it a key target for physical therapy intervention. The current understanding of pain-related fear is that it is a psychopathological problem, whereby people who catastrophize about the meaning of pain become trapped in a vicious cycle of avoidance behavior, pain, and disability, as recognized in the fear-avoidance model. However, there is evidence that pain-related fear can also be seen as a common-sense response to deal with low back pain, for example, when one is told that one's back is vulnerable, degenerating, or damaged. In this instance, avoidance is a common-sense response to protect a "damaged" back. While the fear-avoidance model proposes that when someone first develops low back pain, the confrontation of normal activity in the absence of catastrophizing leads to recovery, the pathway to recovery for individuals trapped in the fear-avoidance cycle is less clear. Understanding pain-related fear from a common-sense perspective enables physical therapists to offer individuals with low back pain and high fear a pathway to recovery by altering how they make sense of their pain. Drawing on a body of published work exploring the lived experience of pain-related fear in people with low back pain, this clinical commentary illustrates how Leventhal's common-sense model may assist physical therapists to understand the broader sense-making processes involved in the fear-avoidance cycle, and how they can be altered to facilitate fear reduction by applying strategies established in the behavioral medicine literature. J Orthop Sports Phys Ther 2017;47(9):628-636. Epub 13 Jul 2017. doi:10.2519/jospt.2017.7434.

  9. Pronociceptive pain modulation in patients with painful chemotherapy-induced polyneuropathy.

    Science.gov (United States)

    Nahman-Averbuch, Hadas; Yarnitsky, David; Granovsky, Yelena; Sprecher, Elliot; Steiner, Mariana; Tzuk-Shina, Tzahala; Pud, Dorit

    2011-08-01

    Several chemotherapy agents induce polyneuropathy that is painful for some patients, but not for others. We assumed that these differences might be attributable to varying patterns of pain modulation. The aim of the present study was to evaluate pain modulation in such patients. Twenty-seven patients with chemotherapy-induced polyneuropathy were tested for detection thresholds (cold, warm, and mechanical) in both the forearm and foot, as well as for heat pain threshold, mechanical temporal summation (TS), and conditioned pain modulation (CPM; also known as the diffuse noxious inhibitory control-like effect), which were tested in the upper limbs. Positive correlations were found between clinical pain levels and both TS (r=0.52, P=0.005) and CPM (r=0.40, P=0.050) for all patients. In addition, higher TS was associated with less efficient CPM (r=0.56, P=0.004). The group of patients with painful polyneuropathy (n=12) showed a significantly higher warm detection threshold in the foot (P=0.03), higher TS (P<0.01), and less efficient CPM (P=0.03) in comparison to the group with nonpainful polyneuropathy. The painfulness of polyneuropathy is associated with a "pronociceptive" modulation pattern, which may be primary to the development of pain. The higher warm sensory thresholds in the painful polyneuropathy group suggest that the severity of polyneuropathy may be another factor in determining its painfulness. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  10. Chronic abdominal wall pain misdiagnosed as functional abdominal pain.

    Science.gov (United States)

    van Assen, Tijmen; de Jager-Kievit, Jenneke W A J; Scheltinga, Marc R; Roumen, Rudi M H

    2013-01-01

    The abdominal wall is often neglected as a cause of chronic abdominal pain. The aim of this study was to identify chronic abdominal wall pain syndromes, such as anterior cutaneous nerve entrapment syndrome (ACNES), in a patient population diagnosed with functional abdominal pain, including irritable bowel syndrome, using a validated 18-item questionnaire as an identification tool. In this cross-sectional analysis, 4 Dutch primary care practices employing physicians who were unaware of the existence of ACNES were selected. A total of 535 patients ≥18 years old who were registered with a functional abdominal pain diagnosis were approached when they were symptomatic to complete the questionnaire (maximum 18 points). Responders who scored at least the 10-point cutoff value (sensitivity, 0.94; specificity, 0.92) underwent a diagnostic evaluation to establish their final diagnosis. The main outcome was the presence and prevalence of ACNES in a group of symptomatic patients diagnosed with functional abdominal pain. Of 535 patients, 304 (57%) responded; 167 subjects (31%) recently reporting symptoms completed the questionnaire. Of 23 patients who scored above the 10-point cutoff value, 18 were available for a diagnostic evaluation. In half of these subjects (n = 9) functional abdominal pain (including IBS) was confirmed. However, the other 9 patients were suffering from abdominal wall pain syndrome, 6 of whom were diagnosed with ACNES (3.6% prevalence rate of symptomatic subjects; 95% confidence interval, 1.7-7.6), whereas the remaining 3 harbored a painful lipoma, an abdominal herniation, and a painful scar. A clinically relevant portion of patients previously diagnosed with functional abdominal pain syndrome in a primary care environment suffers from an abdominal wall pain syndrome such as ACNES.

  11. Pain and Nociception

    DEFF Research Database (Denmark)

    Falk, Sarah; Dickenson, Anthony H

    2014-01-01

    Cancer pain, especially pain caused by metastasis to bone, is a severe type of pain, and unless the cause and consequences can be resolved, the pain will become chronic. As detection and survival among patients with cancer have improved, pain has become an increasing challenge, because traditiona...

  12. Chronic Widespread Back Pain is Distinct From Chronic Local Back Pain: Evidence From Quantitative Sensory Testing, Pain Drawings, and Psychometrics.

    Science.gov (United States)

    Gerhardt, Andreas; Eich, Wolfgang; Janke, Susanne; Leisner, Sabine; Treede, Rolf-Detlef; Tesarz, Jonas

    2016-07-01

    Whether chronic localized pain (CLP) and chronic widespread pain (CWP) have different mechanisms or to what extent they overlap in their pathophysiology is controversial. The study compared quantitative sensory testing profiles of nonspecific chronic back pain patients with CLP (n=48) and CWP (n=29) with and fibromyalgia syndrome (FMS) patients (n=90) and pain-free controls (n = 40). The quantitative sensory testing protocol of the "German-Research-Network-on-Neuropathic-Pain" was used to measure evoked pain on the painful area in the lower back and the pain-free hand (thermal and mechanical detection and pain thresholds, vibration threshold, pain sensitivity to sharp and blunt mechanical stimuli). Ongoing pain and psychometrics were captured with pain drawings and questionnaires. CLP patients did not differ from pain-free controls, except for lower pressure pain threshold (PPT) on the back. CWP and FMS patients showed lower heat pain threshold and higher wind-up ratio on the back and lower heat pain threshold and cold pain threshold on the hand. FMS showed lower PPT on back and hand, and higher comorbidity of anxiety and depression and more functional impairment than all other groups. Even after long duration CLP presents with a local hypersensitivity for PPT, suggesting a somatotopically specific sensitization of nociceptive processing. However, CWP patients show widespread ongoing pain and hyperalgesia for different stimuli that is generalized in space, suggesting the involvement of descending control systems, as also suggested for FMS patients. Because mechanisms in nonspecific chronic back pain with CLP and CWP differ, these patients should be distinguished in future research and allocated to different treatments.

  13. Bone pain

    DEFF Research Database (Denmark)

    Frost, Charlotte Ørsted; Hansen, Rikke Rie; Heegaard, Anne-Marie

    2016-01-01

    Skeletal conditions are common causes of chronic pain and there is an unmet medical need for improved treatment options. Bone pain is currently managed with disease modifying agents and/or analgesics depending on the condition. Disease modifying agents affect the underlying pathophysiology...... of the disease and reduce as a secondary effect bone pain. Antiresorptive and anabolic agents, such as bisphosphonates and intermittent parathyroid hormone (1-34), respectively, have proven effective as pain relieving agents. Cathepsin K inhibitors and anti-sclerostin antibodies hold, due to their disease...... modifying effects, promise of a pain relieving effect. NSAIDs and opioids are widely employed in the treatment of bone pain. However, recent preclinical findings demonstrating a unique neuronal innervation of bone tissue and sprouting of sensory nerve fibers open for new treatment possibilities....

  14. Pain patterns and descriptions in patients with radicular pain: Does the pain necessarily follow a specific dermatome?

    Directory of Open Access Journals (Sweden)

    Hurwitz Eric L

    2009-09-01

    Full Text Available Abstract Background It is commonly stated that nerve root pain should be expected to follow a specific dermatome and that this information is useful to make the diagnosis of radiculopathy. There is little evidence in the literature that confirms or denies this statement. The purpose of this study is to describe and discuss the diagnostic utility of the distribution of pain in patients with cervical and lumbar radicular pain. Methods Pain drawings and descriptions were assessed in consecutive patients diagnosed with cervical or lumbar nerve root pain. These findings were compared with accepted dermatome maps to determine whether they tended to follow along the involved nerve root's dermatome. Results Two hundred twenty-six nerve roots in 169 patients were assessed. Overall, pain related to cervical nerve roots was non-dermatomal in over two-thirds (69.7% of cases. In the lumbar spine, the pain was non-dermatomal in just under two-thirds (64.1% of cases. The majority of nerve root levels involved non-dermatomal pain patterns except C4 (60.0% dermatomal and S1 (64.9% dermatomal. The sensitivity (SE and specificity (SP for dermatomal pattern of pain are low for all nerve root levels with the exception of the C4 level (Se 0.60, Sp 0.72 and S1 level (Se 0.65, Sp 0.80, although in the case of the C4 level, the number of subjects was small (n = 5. Conclusion In most cases nerve root pain should not be expected to follow along a specific dermatome, and a dermatomal distribution of pain is not a useful historical factor in the diagnosis of radicular pain. The possible exception to this is the S1 nerve root, in which the pain does commonly follow the S1 dermatome.

  15. Atypical electrophysiological activity during pain observation in amputees who experience synaesthetic pain.

    Science.gov (United States)

    Fitzgibbon, Bernadette M; Enticott, Peter G; Giummarra, Melita J; Thomson, Richard H; Georgiou-Karistianis, Nellie; Bradshaw, John L

    2012-03-01

    There are increasing reports of people experiencing pain when observing pain in another. This describes the phenomenon of synaesthetic pain which, until recently, had been primarily reported in amputees with phantom pain. In the current study, we used electroencephalography (EEG) to investigate how amputees who experience synaesthetic pain process pain observed in another. Participants were grouped according to amputees who experience phantom and synaesthetic pain (n=8), amputees who experience phantom pain but not synaesthetic pain (n=10) and healthy controls (n=10). Participants underwent EEG as they observed still images of hands and feet in potentially painful and non-painful situations. We found that pain synaesthetes showed some reduced event-related potential (ERP) components at certain electrode sites, and reduced theta- and alpha band power amplitude at a central electrode. The finding of reduced ERP amplitude and theta band power may reflect inhibition of the processing of observed pain (e.g. avoidance/guarding as a protective strategy), and reduced alpha band power may indicate a disinhibition in control processes that may result in synaesthetic pain. These results provide the first documentation of atypical neurophysiological activity in amputees who experience synaesthetic pain when processing pain in another. © The Author (2011). Published by Oxford University Press.

  16. Fear of pain in children and adolescents with neuropathic pain and CRPS

    Science.gov (United States)

    Simons, Laura E.

    2015-01-01

    A significant proportion of children and adolescents with chronic pain endorse elevated pain-related fear. Pain-related fear is associated with high levels of disability, depressive symptoms, and school impairment. Due to faulty nerve signaling, individuals with neuropathic pain and CRPS may be more prone to develop pain-related fear as they avoid use of and neglect the affected body area(s), resulting in exacerbated symptoms, muscle atrophy, maintenance of pain signaling, and ongoing pain-related disability. Not surprisingly, effective treatments for elevated pain-related fears involve exposure to previously avoided activities to down-regulate incorrect pain signaling. In the context of intensive interdisciplinary pain treatment of youth with neuropathic pain, decreasing pain-related fear is associated with improved physical and psychological functioning, while high initial pain-related fear is a risk factor for less treatment responsiveness. An innovative approach to targeting pain-related fear as well as evidence of a neural response to treatment involving decoupling of the amygdala with key fear circuits in youth with CRPS suggest breakthroughs in our ability to ameliorate these issues. PMID:26785161

  17. Face to Face or E-Learning in Turkish EFL Context

    Science.gov (United States)

    Solak, Ekrem; Cakir, Recep

    2014-01-01

    This purpose of this study was to understand e-learners and face to face learners' views towards learning English through e-learning in vocational higher school context and to determine the role of academic achievement and gender in e-learning and face to face learning. This study was conducted at a state-run university in 2012-2013 academic year…

  18. The construction FACE database - Codifying the NIOSH FACE reports.

    Science.gov (United States)

    Dong, Xiuwen Sue; Largay, Julie A; Wang, Xuanwen; Cain, Chris Trahan; Romano, Nancy

    2017-09-01

    The National Institute for Occupational Safety and Health (NIOSH) has published reports detailing the results of investigations on selected work-related fatalities through the Fatality Assessment and Control Evaluation (FACE) program since 1982. Information from construction-related FACE reports was coded into the Construction FACE Database (CFD). Use of the CFD was illustrated by analyzing major CFD variables. A total of 768 construction fatalities were included in the CFD. Information on decedents, safety training, use of PPE, and FACE recommendations were coded. Analysis shows that one in five decedents in the CFD died within the first two months on the job; 75% and 43% of reports recommended having safety training or installing protection equipment, respectively. Comprehensive research using FACE reports may improve understanding of work-related fatalities and provide much-needed information on injury prevention. The CFD allows researchers to analyze the FACE reports quantitatively and efficiently. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

  19. The effects of three different distraction methods on pain and anxiety in children.

    Science.gov (United States)

    Sahiner, Nejla Canbulat; Bal, Meltem Demirgoz

    2016-09-01

    This study aims to investigate of three different distraction methods (distraction cards, listening to the music of cartoon and balloon inflation) on pain and anxiety relief of children during phlebotomy. This study is a prospective, randomized, and controlled trial. The sample consisted of 6 to 12 years old children who require blood tests. Children were randomized into four groups as the distraction cards, the music, the balloon inflation, and the control. Data were obtained by conducting interviews with the children, their parents, and the observer before and after the procedure. The pain levels of the children were assessed by the parent and observer reports as well as self-report using the Wong-Baker FACES. The anxiety levels of children were assessed by parent and observer reports using Children Fear Scale. One hundred and twenty children (mean age: 9.1 ± 1.6 years) were included. The self-reported procedural pain levels showed significant differences among the study groups (p = .040). The distraction card group (2.33 ± 3.24) had significantly lower pain levels (p = .057) than the control group (4.53 ± 3.23). The procedural child anxiety levels reported by the observer showed a significant difference among the study groups (p = .032). All the forms of distraction significantly reduced pain and anxiety perception. © The Author(s) 2015.

  20. Future Directions for Pain Management: Lessons from the Institute of Medicine Pain Report and the National Pain Strategy.

    Science.gov (United States)

    Mackey, Sean

    2016-02-01

    According to the Institute of Medicine Relieving Pain in America Report and the soon to be released National Pain Strategy, pain affects over 100 million Americans and costs our country in over $500 billion per year. We have a greater appreciation for the complex nature of pain and that it can develop into a disease in itself. As such, we need more efforts on prevention of chronic pain and for interdisciplinary approaches. For precision pain medicine to be successful, we need to link learning health systems with pain biomarkers (eg, genomics, proteomics, patient reported outcomes, brain markers) and its treatment. Copyright © 2016 Elsevier Inc. All rights reserved.