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Sample records for pain complaints prevalence

  1. Prevalence of somatoform pain complaints in the German population

    PubMed Central

    Hessel, Aike; Beutel, Manfred; Geyer, Michael; Schumacher, Jrg; Brhler, Elmar

    2005-01-01

    The prevalence of somatoform pain complaints was assessed in a representative sample of 2050 persons in Germany in the age range from 18 to 92 years by the Screening for Somatoform Symptoms questionnaire [57]. A high percentage of the study participants turned out to complain of serious somatoform pains. Most frequently, back pain (30.5%), joint pain, pain in the arms and/or legs (19.9%) and headache or facial pain (19.5%) were reported. Women complained of more somatoform pain symptoms than men. Pain was higher with an increasing age, lower education, lower income, rural residency, and residency in Eastern Germany. While the prevalence of somatoform pain is high, the majority of patients does not receive adequate psychotherapeutic care but is inadequately treated by somatic treatments. PMID:19742064

  2. Prevalence of Self-Reported Pain, Joint Complaints and Knee or Hip Complaints in Adults Aged ? 40 Years: A Cross-Sectional Survey in Herne, Germany

    PubMed Central

    Thiem, Ulrich; Lamsfu, Rainer; Gnther, Sven; Schumacher, Jochen; Bker, Christian; Endres, Heinz G.; Zacher, Josef; Burmester, Gerd R.; Pientka, Ludger

    2013-01-01

    Background Pain and musculoskeletal complaints are among the most common symptoms in the general population. Despite their epidemiological, clinical and health economic importance, prevalence data on pain and musculoskeletal complaints for Germany are scarce. Methods A cross-sectional survey of a random sample of citizens of Herne, Germany, aged ? 40 years was performed. A detailed self-complete postal questionnaire was used, followed by a short reminder questionnaire and telephone contacts for those not responding. The questionnaire contained 66 items, mainly addressing pain of any site, musculoskeletal complaints of any site and of knee and hip, pain intensities, the Western Ontario MacMaster Universities (WOMAC) index, medication, health care utilization, comorbidities, and quality of life. Results The response rate was 57.8% (4,527 of 7,828 individuals). Survey participants were on average 1.3 years older, and the proportion of women among responders tended to be greater than in the population sample. There was no age difference between the population sample and 2,221 participants filling out the detailed questionnaire. The following standardized prevalences were assessed: current pain: 59.7%, pain within the past four weeks: 74.5%, current joint complaints: 49.3%, joint complaints within the past four weeks and twelve month: 62.8% and 67.4%, respectively, knee as the site predominantly affected: 30.9%, knee bilateral: 9.7%, hip: 15.2%, hip bilateral: 3.5%, knee and hip: 5.5%. Pain and musculoskeletal complaints were significantly more often reported by women. A typical relationship of pain and joint complaints to age could be found, i.e. increasing prevalences with increasing age categories, with a drop in the highest age groups. In general, pain and joint pain were associated with comorbidity and body mass index as well as quality of life. Conclusions Our data confirm findings of other recent national as well as European surveys. The high site specific prevalences of knee and hip complaints underline the necessity to further investigate characteristics and consequences of pain and symptomatic osteoarthritis of these joints in adults in Germany. PMID:23646102

  3. Peripheral Nerve Blocks and Incidence of Post-operative Neurogenic Complaints and Pain Scores

    PubMed Central

    Mellecker, Chloe; Albright, John; Clark, Randy

    2012-01-01

    Background Peripheral nerve blocks (PNB) are a common adjuvant for anesthesia. There is little orthopedic literature regarding the incidence of neurogenic complaints and quality of pain control. Methods We instituted a questionnaire to post-operative patients who would have potentially received a PNB at a single institution between 2008 and 2009 and asked them to rate their pain on a standardized pain scale at several points in the post-operative period. The survey queried whether patients experienced severe pain, went to the ER, or experienced neurogenic complaints. comparative data was also collected on patients who did not receive a PNB. We instituted a follow up survey several months later to investigate the persistence of these complaints. Results 268 patients completed the survey, 215 patients with PNb and 53 control patients. There was a 38.14% incidence of neurogenic complaints in patients who received PNB as compared to 9.43% incidence in patients who did not receive a PNB, p <0.001. There was 27.9% (PNB) versus 15.1% (control) incidence of severe pain (p 0.05). 24 patients that received PNB versus five control patients visited the ER or called the house officer (p = 0.71). Patients who received PNB had significantly better pain control immediately after surgery (p = 0.02) and improved pain control the same night (p = 0.04), but there was no difference in pain control the morning after surgery, 24 hours after surgery and at the one week post-operative period (p values 0.77, 0.28 and 0.69). At the several month follow-up, we found that 41 of the 80 (51%) patients had persistent complaints. Conclusions Patients who receive PNBs have more neurogenic complaints and severe pain. They have improved initial pain control, but the profile shows no difference after less than 24 hours. If patients experience initial neurogenic complaints, a significant percentage of these patients have persistent complaints several months after surgery. the relative benefit of PNBs must be weighed against the possibility of persistent neurogenic complaints. Level of Evidence Cohort study type III PMID:23576926

  4. Prevalence of cold-related complaints, symptoms and injuries in the general population: the FINRISK 2002 cold substudy

    NASA Astrophysics Data System (ADS)

    Raatikka, Veli-Pekka; Rytkönen, Mika; Näyhä, Simo; Hassi, Juhani

    2007-05-01

    The prevalence of cold-related complaints and symptoms in the general population has remained unknown. As part of the nationwide FINRISK 2002 health survey performed in Finland, 8,723 people aged 25 64 years filled in a questionnaire asking about the number of hours spent weekly in cold air, their sensations during cold exposure, cold-related complaints, symptoms of diseases, and degradation of performance. Cold thermal sensations at +5°C to -5°C were reported by 35% of men and 46% of women. Almost all subjects reported at least some cold-related complaints, most commonly musculoskeletal pain (men 30%, women 27%), followed by respiratory (25% / 29%), white finger (15% / 18%) and episodic peripheral circulation symptoms (12% / 15%). Decreased mental or physical performance in cold was reported by 75% of men and 70% of women, most commonly impairing manual dexterity and tactile sense. With declining temperature, the first symptom to emerge was pain in the elbow or the forearm (at -3°C), followed by increased excretion of mucus from the lungs (-5°C), while most other symptoms appeared only at lower temperatures of -15°C to -20°C. Most symptoms showed little or no association with the weekly duration of exposure, with the exception of cold-induced pain at most sites. Although, in general, Finns are well adapted to the cold climate, the high prevalence of cold-related complaints poses a challenge to the health care system in terms of decreased performance and the possibility that such symptoms predict more serious health effects, such as increased mortality.

  5. Bullying Victimization Prevalence and Its Effects on Psychosomatic Complaints: Can Sense of Coherence Make a Difference?

    ERIC Educational Resources Information Center

    García-Moya, Irene; Suominen, Sakari; Moreno, Carmen

    2014-01-01

    Background: The aim of this study was to examine the prevalence of bullying victimization and its impact on physical and psychological complaints in a representative sample of adolescents and to explore the role of sense of coherence (SOC) in victimization prevalence and consequences. Methods: A representative sample of Spanish adolescents (N =…

  6. Bullying Victimization Prevalence and Its Effects on Psychosomatic Complaints: Can Sense of Coherence Make a Difference?

    ERIC Educational Resources Information Center

    Garca-Moya, Irene; Suominen, Sakari; Moreno, Carmen

    2014-01-01

    Background: The aim of this study was to examine the prevalence of bullying victimization and its impact on physical and psychological complaints in a representative sample of adolescents and to explore the role of sense of coherence (SOC) in victimization prevalence and consequences. Methods: A representative sample of Spanish adolescents (N =

  7. A comparative study on the prevalence of musculoskeletal complaints among musicians and non-musicians

    PubMed Central

    2013-01-01

    Background Research comparing the frequency of musculoskeletal complaints between musicians and non-musicians is scarce. The aim of this study was to compare the prevalence of musculoskeletal complaints between musicians and non-musicians. Methods A cross-sectional study in 3215 students from three music academies (n?=?345) and one medical school (n?=?2870) in The Netherlands was performed, using an electronic questionnaire. The questionnaire included socio-demographic characteristics, use of music instruments and the occurrence of musculoskeletal complaints in six body regions. Questions were related to musculoskeletal complaints over the last twelve months and at the time of the questionnaire. Chi-square, t-tests and Kruskal-Wallis tests were used for comparison between the two groups. The association between musculoskeletal complaints and possible predictors was analyzed using a logistic and Poisson regression. Results Eighty-seven music academy students and 503 medical students returned the questionnaire, of which respectively eighty-three and 494 were included in the study. Seventy-four music academy students (89.2%) reported one or more musculoskeletal complaints during the last twelve months, compared to 384 (77.9%) medical students (p?=?0.019). Moreover 52 music academy students (62.7%) and 211 medical students (42.7%) reported current musculoskeletal complaints (p?=?0.001). The Odds ratio (OR) for the development of musculoskeletal complaints during the last twelve months in music academy students versus medical students is 2.33 (95% CI 1.613.05, p?=?0.022). The OR at the time of the questionnaire is 2.25 (95% CI 1.772.73, p?=?0.001). The total number of complaints have been modeled by employing a Poisson regression; the results show that non-musicians have on average less complaints than musicians (p?=?0.01). The adjusted means are 2.90 (95% CI 2.183.63) and 1.83 (95% CI 1.632.04) respectively for musicians and non-musicians. Regarding the localization of complaints, music academy students reported more complaints concerning the right hand, wrists, left elbow, shoulders, neck, jaw and mouth in contrast to medical students. Conclusions Musculoskeletal complaints are significantly more common among musicians compared to non-musicians, mainly due to a higher number of upper extremity complaints. PMID:23289849

  8. Pain-only complaint about cochlear implant device: A five-patient pediatric experience.

    PubMed

    Todd, Norman Wendell; Fainberg, Jolie C; Ukatu, CeIsha Chinwe; Venable, Claudia Y; Segel, Phil

    2015-09-01

    Objectives To present the case histories and management of five pediatric patients who experienced pain at the receiver-stimulator site, but no other indication that the device was failing. Patients were from a sole-surgeon pediatric practice (600+implant surgeries before June 2013; about even proportions of Advanced Bionics, Cochlear Corporation, and MED-EL devices). Methods The University Institutional Review Board-approved review of sole-surgeon pediatric case series. Results The onset of pain ranged from 2 to 16years post implantation. Pain, not amenable to conventional medical therapy, was present regardless of whether or not the external appliance was 'on', or even being worn on the head. Four of the five patients were bilaterally implanted, but pain was only at one receiver-stimulator package. Clinical management ultimately included revision surgery in all five cases, with immediate resolution of the pain in four. For those four, the replacement cochlear implant (CI) performed well; the other patient fears pain if her replacement device is used, but continues enjoying her contralateral implant. At analysis by the company, two of five explanted devices exhibited problems: loss of hermeticity; insulation failure. Discussion Though infrequently reported, pain-only complaint by a CI user is a challenging dilemma. Conclusion Pain may be the sole clinical manifestation of cochlear implant device failure. We offer a flowchart for the care of CI patients with pain, encourage a worldwide registry of such cases, and offer ideas to try to understand better the problem. PMID:25563523

  9. Cervical Spine pain as a presenting complaint in metastatic pancreatic cancer: a case report.

    PubMed

    Rosenberg, Emily; Buchtel, Lindsey

    2016-04-01

    A 48 year-old female presented to her primary care physician with a two-month history of neck pain with negative cervical spine x-rays. During that office visit, the patient was noted to be tachycardic with EKG revealing ST depressions, which led to hospital admission. Acute coronary syndrome was ruled out, however, persistent neck pain warranted inpatient MRI of the cervical spine, which revealed a cervical spine lesion. Extensive investigation and biopsy ultimately confirmed stage IV pancreatic adenocarcinoma with metastases to the bone, liver, and likely lung. In the literature, the findings of a primary metastatic site being bone is rare with only a few case reports showing vertebral or sternal metastasis as the first clinical manifestation of pancreatic cancer. The uniqueness of this case lies in the only presenting complaint being cervical spine pain in the setting of extensive metastases to the liver, bone, and likely lung. PMID:26890294

  10. Prevalence of chronic low back pain: systematic review

    PubMed Central

    Meucci, Rodrigo Dalke; Fassa, Anaclaudia Gastal; Faria, Neice Muller Xavier

    2015-01-01

    OBJECTIVE To estimate worldwide prevalence of chronic low back pain according to age and sex. METHODS We consulted Medline (PubMed), LILACS and EMBASE electronic databases. The search strategy used the following descriptors and combinations: back pain, prevalence, musculoskeletal diseases, chronic musculoskeletal pain, rheumatic, low back pain, musculoskeletal disorders and chronic low back pain. We selected cross-sectional population-based or cohort studies that assessed chronic low back pain as an outcome. We also assessed the quality of the selected studies as well as the chronic low back pain prevalence according to age and sex. RESULTS The review included 28 studies. Based on our qualitative evaluation, around one third of the studies had low scores, mainly due to high non-response rates. Chronic low back pain prevalence was 4.2% in individuals aged between 24 and 39 years old and 19.6% in those aged between 20 and 59. Of nine studies with individuals aged 18 and above, six reported chronic low back pain between 3.9% and 10.2% and three, prevalence between 13.1% and 20.3%. In the Brazilian older population, chronic low back pain prevalence was 25.4%. CONCLUSIONS Chronic low back pain prevalence increases linearly from the third decade of life on, until the 60 years of age, being more prevalent in women. Methodological approaches aiming to reduce high heterogeneity in case definitions of chronic low back pain are essential to consistency and comparative analysis between studies. A standard chronic low back pain definition should include the precise description of the anatomical area, pain duration and limitation level. PMID:26487293

  11. Prevalence and Cognitive Bases of Subjective Memory Complaints in Older Adults: Evidence from a Community Sample.

    PubMed

    Fritsch, Thomas; McClendon, McKee J; Wallendal, Maggie S; Hyde, Trevor F; Larsen, Janet D

    2014-01-01

    Objectives. To estimate the prevalence of subjective memory complaints (SMCs) in a sample of community-dwelling, older adults and to examine cognitive bases of these complaints. Participants. 499 community-dwelling adults, 65 and older. Measurements. A telephone survey consisting of cognitive tests and clinical and sociodemographic variables. SMCs were based on subjects' evaluations and subjects' perceptions of others' evaluations. Analysis. Logistic regression was used to model the risk for SMCs as a function of the cognitive, clinical, and sociodemographic variables. We tested for interactions of the cognitive variables with age, education, and gender. Results. 27.1% reported memory complaints. Among the younger age, better objective memory performance predicted lower risk for SMCs, while among the older age, better memory had no effect on risk. Among the better-educated people, better global cognitive functioning predicted lower risk for SMCs, while among the less-educated people, better global cognitive functioning had no effect on SMC risk. When predicting others' perceptions, better objective memory was associated with lower risk for SMCs. Conclusion. Objective memory performance and global cognitive functioning are associated with lower risk for SMCs, but these relationships are the strongest for the younger age and those with more education, respectively. Age and education may affect the ability to accurately appraise cognitive functioning. PMID:26317004

  12. Ocular pain and discomfort after advanced surface ablation: an ignored complaint

    PubMed Central

    Sobas, Eva M; Videla, Sebastin; Maldonado, Miguel J; Pastor, Jose C

    2015-01-01

    Purpose Laser vision correction is one of the most commonly performed elective surgical procedures in ophthalmology. Generally, discomfort besides pain (photophobia, burning sensation, tearing, and foreign body sensation) after these procedures is not taken into consideration in the clinical practice. The objective is to provide data on these symptoms and their relevance after advanced surface ablation (ASA). Methods Single-center survey study based on a structured questionnaire relative to the patients perceived symptoms after ASA. Inclusion criteria were: ?18 years old, no ocular disease, with myopia (0.75 to 9 D) or hyperopia (0.25 to 5 D) with or without astigmatism, receiving ASA on at least one eye. All procedures were performed by the same surgeon. A descriptive analysis was performed. Results Seventy-three consecutive patients (34 men and 39 women) were included in the study. The median (range) of age was 33 (1964) years. Sixty-nine patients had surgery done on both eyes. Postoperative pain was the most frequent comorbidity (97% [95% confidence interval {CI}: 90100]) with a median (range) of intensity (verbal numerical rating scale) score of 7 (210). Photophobia: 85% (95% CI: 7592); burning sensation: 62% (95% CI: 5073); tearing: 59% (95% CI: 4770); and foreign body sensation: 48% (95% CI: 3660) were also prevalent postoperative symptoms. Pain during ASA was reported for 44% (95% CI: 3256) of patients. Conclusion Comorbidities such as pain, photophobia, burning sensation, tearing, and foreign body sensation are prevalent after ASA procedure. Postoperative pain should be taken into consideration due to its prevalence and intensity. A new and more efficient postoperative analgesic protocol should be established. PMID:26379419

  13. Trends in Clinically Significant Pain Prevalence Among Hospitalized Cancer Patients at an Academic Hospital in Taiwan

    PubMed Central

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

    2016-01-01

    Abstract Clinically significant pain (CSP) is one of the most common complaints among cancer patients during repeated hospitalizations, and the prevalence ranges from 24% to 86%. This study aimed to characterize the trends in CSP among cancer patients and examine the differences in the prevalence of CSP across repeated hospitalizations. A hospital-based, retrospective cohort study was conducted at an academic hospital. Patient-reported pain intensity was assessed and recorded in a nursing information system. We examined the differences in the prevalence of worst pain intensity (WPI) and last evaluated pain intensity (LPI) of ≥4 or ≥7 points among cancer inpatients from the 1st to the 18th hospitalization. Linear mixed models were used to determine the significant difference in the WPI and LPI (≥4 or ≥7 points) at each hospitalization. We examined 88,133 pain scores from the 1st to the 18th hospitalization among cancer patients. The prevalence of the 4 CSP types showed a trend toward a reduction from the 1st to the 18th hospitalization. There was a robust reduction in the CSP prevalence from the 1st to the 5th hospitalization, except in the case of LPI ≥ 7 points. The prevalence of a WPI ≥ 4 points was significantly higher (0.240-fold increase) during the 1st hospitalization than during the 5th hospitalization. For the 2nd, 3rd, and 4th hospitalizations, there was a significantly higher prevalence of a WPI ≥ 4 points compared with the 5th hospitalization. We also observed significant reductions in the prevalence of a WPI ≥ 7 points during the 1st to the 4th hospitalizations, an LPI ≥ 4 points during the 1st to the 3rd hospitalizations, and an LPI ≥ 7 points during the 1st to the 2nd hospitalization. Although the prevalence of the 4 CSP types decreased gradually, it is impossible to state the causative factors on the basis of this observational and descriptive study. The next step will examine the factors that determine the CSP prevalence among cancer patients. However, based on these positive findings, we can provide feedback to nurses, physicians, and pharmacists to empower them to be more committed to pain management. PMID:26735526

  14. Pressure ulcer related pain in community populations: a prevalence survey

    PubMed Central

    2014-01-01

    Background Pressure ulcers are costly to the healthcare provider and can have a major impact on patients quality of life. One of the most distressing symptoms reported is pain. There is very little published data on the prevalence and details of pain experienced by patients with pressure ulcers, particularly in community populations. The study was conducted in two community NHS sites in the North of England. Methods The aim was to estimate the prevalence of pressure area related pain within a community population. We also explored the type and severity of the pain and its association with pressure ulcer classification. A cross-sectional survey was performed of community nurses caseloads to identify adult patients with pressure ulcers and associated pain. Consenting patients then had a full pain assessment and verification of pressure ulcer grade. Results A total of 287 patients were identified with pressure ulcers (0.51 per 1000 adult population). Of the 176 patients who were asked, 133 (75.6%) reported pain. 37 patients consented to a detailed pain assessment. Painful pressure ulcers of all grades and on nearly all body sites were identified. Pain intensity was not related to number or severity of pressure ulcer. Both inflammatory and neuropathic pain were reported at all body sites however the proportion of neuropathic pain was greater in pressure ulcers on lower limbs. Conclusions This study has identified the extent and type of pain suffered by community patients with pressure ulcers and indicates the need for systematic and regular pain assessment and treatment. PMID:25024642

  15. Prevalence of complaints of arm, neck and shoulder among computer office workers and psychometric evaluation of a risk factor questionnaire

    PubMed Central

    Eltayeb, Shahla; Staal, J Bart; Kennes, Janneke; Lamberts, Petra HG; de Bie, Rob A

    2007-01-01

    Background Complaints of Arm Neck and Shoulder (CANS) represent a wide range of complaints, which can differ in severity from mild, periodic symptoms to severe, chronic and debilitating conditions. They are thought to be associated with both physical and psychosocial risk factors. The measurement and identification of the various risk factors for these complaints is an important step towards recognizing (a) high risk subgroups that are relevant in profiling CANS; and (b) also for developing targeted and effective intervention plans for treatment. The purpose of the present study was to investigate the prevalence of CANS in a Dutch population of computer workers and to develop a questionnaire aimed at measuring workplace physical and psychosocial risk factors for the presence of these complaints. Methods To examine potential workplace risk factors for the presence of CANS, the Maastricht Upper Extremity Questionnaire (MUEQ), a structured questionnaire, was developed and tested among 264 computer office workers of a branch office of the national social security institution in the Netherlands. The MUEQ holds 95 items covering demographic characteristics, in addition to seven main domains assessing potential risk factors with regard to (1) work station, (2) posture during work, (3) quality of break time, (4) job demands, (5) job control, and (6) social support. The MUEQ further contained some additional questions about the quality of the work environment and the presence of complaints in the neck, shoulder, upper and lower arm, elbow, hand and wrist. The prevalence rates of CANS in the past year were computed. Further, we investigated the psychometric properties of the MUEQ (i.e. factor structure and reliability). Results The one-year prevalence rate of CANS indicated that 54% of the respondents reported at least one complaint in the arm, neck and/or shoulder. The highest prevalence rates were found for neck and shoulder symptoms (33% and 31% respectively), followed by hand and upper arm complaints (11% to 12%) and elbow, lower arm and wrist complaints (6% to 7%). The psychometric properties of the MUEQ were assessed using exploratory factor analysis which resulted in the identification of 12 factors. The calculation of internal consistency and cross validation provided evidence of reliability and lack of redundancy of items. Conclusion Neck and shoulder complaints are more frequently reported among Dutch computer workers than arm, elbow and hand complaints. The results further indicate that the MUEQ has satisfactory reliability and internal consistency when used to document CANS among computer workers in the Netherlands. PMID:17629925

  16. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions

    PubMed Central

    Manchikanti, Laxmaiah; Boswell, Mark V; Singh, Vijay; Pampati, Vidyasagar; Damron, Kim S; Beyer, Carla D

    2004-01-01

    Background Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. Methods Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The prevalence of facet joint pain was determined using controlled comparative local anesthetic blocks (1% lidocaine or 1% lidocaine followed by 0.25% bupivacaine), in accordance with the criteria established by the International Association for the Study of Pain (IASP). The study was performed in the United States in a non-university based ambulatory interventional pain management setting. Results The prevalence of facet joint pain in patients with chronic cervical spine pain was 55% 5(95% CI, 49% 61%), with thoracic spine pain was 42% (95% CI, 30% 53%), and in with lumbar spine pain was 31% (95% CI, 27% 36%). The false-positive rate with single blocks with lidocaine was 63% (95% CI, 54% 72%) in the cervical spine, 55% (95% CI, 39% 78%) in the thoracic spine, and 27% (95% CI, 22% 32%) in the lumbar spine. Conclusion This study demonstrated that in an interventional pain management setting, facet joints are clinically important spinal pain generators in a significant proportion of patients with chronic spinal pain. Because these patients typically have failed conservative management, including physical therapy, chiropractic treatment and analgesics, they may benefit from specific interventions designed to manage facet joint pain. PMID:15169547

  17. Prevalence and Characteristics of Musculoskeletal Pain in Korean Farmers

    PubMed Central

    Min, David; Baek, Sora; Park, Hee-won; Lee, Sang-Ah; Moon, Jiyoung; Yang, Jae E.; Kim, Ki Sung; Kim, Jee Yong

    2016-01-01

    Objective To investigate the prevalence and characteristics of musculoskeletal pain (MSK) pain in Korean farmers using initial survey data of Farmers' Cohort for Agricultural Work-Related MSK pain (FARM) study. Methods Farmers (534 females and 479 males; mean age 57.2±7.5 years) who owned or rented a farm and belonged to an agricultural cooperative unit were recruited. Presence of pain for each body part (neck, shoulder, arm/elbow, wrist/hand/finger, low back, leg/foot), and characteristics of MSK pain (prevalence, location, duration, severity, and frequency) during the last year was assessed. Additionally, demographic data such as farming duration, history of prior injury, and workload (low, moderate, somewhat hard, or hard) were collected using structured questionnaires. Results Almost all subjects (n=925; 91.3%) complained of pain in more than one body part. The frequency order was low back (63.8%), leg/foot (43.3%), shoulder (42.9%), wrist/hand/finger (26.6%), arm/elbow (25.3%), and neck (21.8%). Low back pain was more frequent in those with over 30 years of farming experience (odds ratio [OR], 1.40; 95% confidence interval, 1.08–1.81). MSK pain was related to history of prior injury (OR, 2.18–5.24; p<0.05) in all body parts except for leg/foot, and very hard workload was associated with low back, leg/foot, neck, shoulder, and wrist/hand/finger pain (OR, 2.88–10.83; p<0.05). Conclusion Most Korean farmers experience MSK pain; furthermore, there is a significant association between pain, history of prior injury, and workload, suggestive of the necessity of coping and preventive strategies to reduce injury or workload. PMID:26949663

  18. Prevalence of Dementia and Cognitive Complaints in the Context of High Cognitive Reserve: A Population-Based Study

    PubMed Central

    Perquin, Magali; Diederich, Nico; Pastore, Jessica; Lair, Marie-Lise; Stranges, Saverio; Vaillant, Michel

    2015-01-01

    Objectives This study aimed to assess the prevalence of dementia and cognitive complaints in a cross-sectional sample of Luxembourg seniors, and to discuss the results in the societal context of high cognitive reserve resulting from multilingualism. Methods A population sample of 1,377 people representative of Luxembourg residents aged over 64 years was initially identified via the national social insurance register. There were three different levels of contribution: full participation in the study, partial participation, and non-participation. We examined the profiles of these three different samples so that we could infer the prevalence estimates in the Luxembourgish senior population as a whole using the prevalence estimates obtained in this study. Results After careful attention to the potential bias and of the possibility of underestimation, we considered the obtained prevalence estimates of 3.8% for dementia (with corresponding 95% confidence limits (CL) of 2.8% and 4.8%) and 26.1% for cognitive complaints (CL = [17.8–34.3]) as trustworthy. Conclusion Based on these findings, we postulate that high cognitive reserve may result in surprisingly low prevalence estimates of cognitive complaints and dementia in adults over the age of 64 years, which thereby corroborates the longer disability-free life expectancy observed in the Luxembourg population. To the best of our knowledge, this study is the first to report such Luxembourgish public health data. PMID:26390288

  19. Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation

    ERIC Educational Resources Information Center

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

    This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence

  20. The prevalence of fibromyalgia in other chronic pain conditions.

    PubMed

    Yunus, Muhammad B

    2012-01-01

    Central sensitivity syndromes (CSS) include fibromyalgia syndrome (FMS), irritable bowel syndrome, temporomandibular disorder, restless legs syndrome, chronic fatigue syndrome, and other similar chronic painful conditions that are based on central sensitization (CS). CSS are mutually associated. In this paper, prevalence of FMS among other members of CSS has been described. An important recent recognition is an increased prevalence of FMS in other chronic pain conditions with structural pathology, for example, rheumatoid arthritis, systemic lupus, ankylosing spondylitis, osteoarthritis, diabetes mellitus, and inflammatory bowel disease. Diagnosis and proper management of FMS among these diseases are of crucial importance so that unwarranted use of such medications as corticosteroids can be avoided, since FMS often occurs when RA or SLE is relatively mild. PMID:22191024

  1. The Prevalence of Fibromyalgia in Other Chronic Pain Conditions

    PubMed Central

    Yunus, Muhammad B.

    2012-01-01

    Central sensitivity syndromes (CSS) include fibromyalgia syndrome (FMS), irritable bowel syndrome, temporomandibular disorder, restless legs syndrome, chronic fatigue syndrome, and other similar chronic painful conditions that are based on central sensitization (CS). CSS are mutually associated. In this paper, prevalence of FMS among other members of CSS has been described. An important recent recognition is an increased prevalence of FMS in other chronic pain conditions with structural pathology, for example, rheumatoid arthritis, systemic lupus, ankylosing spondylitis, osteoarthritis, diabetes mellitus, and inflammatory bowel disease. Diagnosis and proper management of FMS among these diseases are of crucial importance so that unwarranted use of such medications as corticosteroids can be avoided, since FMS often occurs when RA or SLE is relatively mild. PMID:22191024

  2. Prevalence of Neuropathic Pain in Radiotherapy Oncology Units

    SciTech Connect

    Manas, Ana; Monroy, Jose Luis; Ramos, Avelino Alia; Cano, Carmen; Lopez-Gomez, Vanessa; Masramon, Xavier; Perez, Maria

    2011-10-01

    Purpose: Neuropathic pain (NP) in cancer patients severely impacts quality of life. Radiotherapy (RT) may cause NP, and at the same time, cancer patients visit RT units for pain relief. NP prevalence at these sites and current analgesic treatment should be assessed to improve management. Methods and Materials: This epidemiological, prospective, multicenter study was undertaken to assess NP prevalence, according to Douleur Neuropathique 4 questions questtionaire (DN4) test results, and analgesic management in cancer pain patients visiting RT oncologic units. Secondary analyses assessed NP etiology and pain intensity (using the Brief Pain Inventory-Short Form) and impact (using the Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study [MOS] for Sleep, and the Health Survey Short Form-12). Results: A total of 1,098 patients with any kind of pain were registered. NP prevalence was 31.1% (95% confidence interval, 28.4%--33.9%); 291 NP patients (mean age, 62.2 {+-}12.5 years and 57.7% men) were eligible for study; 49% of patients were overweight. The most frequent tumors were those of breast and lung, and stage IIIB was the most common cancer stage. The tumors caused 75% of NP cases. Anxiety, sleepiness, and depression were common. At 8 weeks, pain intensity and interference with daily activities decreased significantly for 50.8% of responders. Depression and anxiety (p < 0.0001) scores on the Physical Component Summary and Mental Component Summary measures (p < 0.0001) and all MOS-Sleep subscales, except for snoring, improved significantly. The percentage of satisfied patients increased from 13.8% to 87.4% (p < 0.0001) with the current analgesic treatment, which meant a 1.2- and 6-fold increase (p < 0.0001) in narcotic analgesics and anticonvulsants, respectively, compared to previous treatment. Conclusions: NP is highly prevalent at RT oncology units, with sleepiness, anxiety, and depression as frequent comorbidities. There is a need to improve management of NP with increased use of more specific NP-targeting drugs.

  3. Dating Violence Perpetration and Victimization among US Adolescents: Prevalence, Patterns, and Associations with Health Complaints and Substance Use

    PubMed Central

    Farhat, Tilda; Brooks-Russell, Ashley; Wang, Jing; Barbieri, Brittney; Iannotti, Ronald J.

    2013-01-01

    Purpose This research identified conceptually cohesive latent classes of youth dating violence (DV) and examined associations between covariates and classes by gender. Methods A nationally representative sample of 2,203 tenth-grade students completed assessments of physical and verbal DV victimization and perpetration, depressive symptoms, health complaints, and substance use. A Factor Mixture Model was used to identify patterns of DV. Gender differences among classes were examined for depressive symptoms, health complaints, and substance use. Results Prevalence of DV victimization was 35% and perpetration was 31%. A three-class model fit adequately and provided conceptual cohesion: Class 1) non-involved (65%); Class 2) victims/perpetrators of verbal DV (30%); and Class 3) victims/perpetrators of verbal and physical DV (5%). Compared to Class 1 adolescents, those in Classes 2 and 3 were more likely to report depressive symptoms, psychological complaints, and alcohol use. Females in Classes 2 and 3 were also more likely to report physical complaints, cigarette use, and marijuana use. Among females involved in DV, those in Class 3 compared to Class 2 reported more depressive symptoms, physical and psychological complaints, and cigarette and marijuana use. Conclusions The three-class model distinguished involvement in verbal acts from involvement in verbal and physical acts. Adolescents involved in DV had similar probabilities of reporting perpetration and victimization suggesting violence within relationships may be mutual. Involvement in DV was associated with more health issues and concurrent problem behaviors. For females in particular, the increased involvement in DV was associated with other health indicators. PMID:23664626

  4. Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adults with a history of pediatric recurrent abdominal pain

    PubMed Central

    Pace, Fabio; Zuin, Giovanna; Giacomo, Stefania Di; Molteni, Paola; Casini, Valentina; Fontana, Massimo; Porro, Gabriele Bianchi

    2006-01-01

    AIM: To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain (RAP) or irritable bowel syndrome (IBS). METHODS: A group of 67 children with RAP referred to the department from January 1986 to December 1995 was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview. We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history of IBS in comparison with adults with no persistent abdominal complaint. RESULTS: Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up (29%) whereas the majority (37 subjects) did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining (40.0% vs 16.0%), respectively (P < 0.05 at Student t test). Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances. CONCLUSION: The study confirms previous obser-vations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms, possibly through the learning of a specific illness behavior. PMID:16804973

  5. Trends in Clinically Significant Pain Prevalence Among Hospitalized Cancer Patients at an Academic Hospital in Taiwan: A Retrospective Cohort Study.

    PubMed

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

    2016-01-01

    Clinically significant pain (CSP) is one of the most common complaints among cancer patients during repeated hospitalizations, and the prevalence ranges from 24% to 86%. This study aimed to characterize the trends in CSP among cancer patients and examine the differences in the prevalence of CSP across repeated hospitalizations.A hospital-based, retrospective cohort study was conducted at an academic hospital. Patient-reported pain intensity was assessed and recorded in a nursing information system. We examined the differences in the prevalence of worst pain intensity (WPI) and last evaluated pain intensity (LPI) of ≥4 or ≥7 points among cancer inpatients from the 1st to the 18th hospitalization. Linear mixed models were used to determine the significant difference in the WPI and LPI (≥4 or ≥7 points) at each hospitalization.We examined 88,133 pain scores from the 1st to the 18th hospitalization among cancer patients. The prevalence of the 4 CSP types showed a trend toward a reduction from the 1st to the 18th hospitalization. There was a robust reduction in the CSP prevalence from the 1st to the 5th hospitalization, except in the case of LPI ≥ 7 points. The prevalence of a WPI ≥ 4 points was significantly higher (0.240-fold increase) during the 1st hospitalization than during the 5th hospitalization. For the 2nd, 3rd, and 4th hospitalizations, there was a significantly higher prevalence of a WPI ≥ 4 points compared with the 5th hospitalization. We also observed significant reductions in the prevalence of a WPI ≥ 7 points during the 1st to the 4th hospitalizations, an LPI ≥ 4 points during the 1st to the 3rd hospitalizations, and an LPI ≥ 7 points during the 1st to the 2nd hospitalization.Although the prevalence of the 4 CSP types decreased gradually, it is impossible to state the causative factors on the basis of this observational and descriptive study. The next step will examine the factors that determine the CSP prevalence among cancer patients. However, based on these positive findings, we can provide feedback to nurses, physicians, and pharmacists to empower them to be more committed to pain management. PMID:26735526

  6. Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation

    ERIC Educational Resources Information Center

    Desmond, Deirdre M.; MacLachlan, Malcolm

    2010-01-01

    This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…

  7. Prevalence of pain in institutionalized adults with intellectual disabilities: a cross-sectional approach.

    PubMed

    Boerlage, Anneke A; Valkenburg, Abraham J; Scherder, Erik J A; Steenhof, Gertrud; Effing, Peter; Tibboel, Dick; van Dijk, Monique

    2013-08-01

    Information about pain prevalence in institutionalized individuals with intellectual disabilities is scarce, most likely because communication problems impede pain assessment. We aimed to inventory pain prevalence and actual pain management in intellectually disabled individuals living in a representative special care facility in the Netherlands. Caregivers rated the residents' present pain and overall pain during the preceding week on an 11-point numerical rating scale (NRS-11). In addition, behavioral pain assessment was performed with validated pain scales; the Rotterdam Elderly Pain Observation Scale (REPOS) or Checklist Pain Behavior (CPG). Ratings suggested that 47 of the 255 included residents (18%) suffered from pain either at present or during the preceding week, 14 of whom (30%) experienced pain on both occasions. Most of these 47 (85%) residents with pain had no analgesic prescription, not even in the case of severe pain (NRS 7 or higher). Ratings for nearly one out of every five residents suggested they suffered pain. This proportion is lower than in other studies and could imply that caregivers probably underestimate residents' prevalence of pain. Pain treatment might be inadequate in light of the low percentage of analgesic prescriptions. To prevent unnecessary suffering in institutes for residents with an intellectual disability (ID) we recommend use of a pain protocol including a validated pain measurement instrument. PMID:23714716

  8. Prevalence of heroin markers in urine for pain management patients.

    PubMed

    Knight, Julie; Puet, Brandi L; DePriest, Anne; Heltsley, Rebecca; Hild, Cheryl; Black, David L; Robert, Timothy; Caplan, Yale H; Cone, Edward J

    2014-10-01

    Surveys of current trends indicate heroin abuse is associated with nonmedical use of pain relievers. Consequently, there is an interest in evaluating the presence of heroin-specific markers in chronic pain patients who are prescribed controlled substances. A total of 926,084 urine specimens from chronic pain patients were tested for heroin/diacetylmorphine (DAM), 6-acetylmorphine (6AM), 6-acetylcodeine (6AC), codeine (COD), and morphine (MOR). Heroin and markers were analyzed using liquid chromatography tandem mass spectrometry (LC-MS-MS). Opiates were analyzed following hydrolysis using LC-MS-MS. The prevalence of heroin use was 0.31%, as 2871 were positive for one or more heroin-specific markers including DAM, 6AM, or 6AC (a known contaminant of illicit heroin). Of these, 1884 were additionally tested for the following markers of illicit drug use: 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), methamphetamine (MAMP), 11-nor-9-carboxy-?(9)-tetracannabinol (THCCOOH), and benzoylecgonine (BZE); 654 (34.7%) had positive findings for one or more of these analytes. The overall prevalence of heroin markers were as follows: DAM 1203 (41.9%), 6AM 2570 (89.5%), 6AC 1082 (37.7%). MOR was present in 2194 (76.4%) and absent (Prevalence of combinations for specimens containing MOR were as follows: DAM only 13 (0.59%), 6AM only 1140 (52.0%), 6AC only 24 (1.1%), DAM/6AM/6AC 710 (32.4%), 6AM/6AC 188 (8.6%), DAM/6AM 113 (5.2%), DAM/6AC 6 (0.27%). Importantly, the prevalence of combinations for specimens without MOR were as follows: DAM only 161 (23.8%), 6AM only 217 (32.1%), 6AC only 92 (13.6%), DAM/6AM/6AC 50 (7.4%), 6AM/6AC 7 (1.0%), DAM/6AM 145 (21.4%), DAM/6AC 5 (0.74%). Unexpected patterns of excretion were observed, such as the presence of DAM and 6AC in the absence of 6AM and MOR; therefore, multiple heroin markers may be useful to assess for heroin use. PMID:24858136

  9. Prevalence and Pharmacologic Treatment of Patients with Low Back Pain Treated at Kosovo Energetic Corporation

    PubMed Central

    Ibraimi, Zana; Murtezani, Ardiana; Haxhiu, Bekim; Mustafa, Aziz; Martinaj, Merita

    2013-01-01

    ABSTRACT Introduction: Low back pain (LBP) is a common complaint among the general population with a subgroup developing chronic and disabling symptoms generating large societal costs. Recurrences and functional limitations can be minimized with appropriate conservative management, including medications, physical therapy modalities, exercise and patient education. Objectives: The purpose of this study was to determine the prevalence of low back complaints in industrial workers, to investigate whether individual risk factors involved in the occurrence of LBP, and to determine the most frequent used drug in LBP treatment. Materials and Methods: Data for this study were provided from Kosovo Energetic Corporation. A cross-sectional study design was utilized. Self-administered questionnaires were distributed among 228 industrial workers. Patient with LBP underwent a comprehensive clinical, radiological and biochemical evaluation. Results: showed that LBP occurred in 63.5% of workers. Individual factors did not show significant associations with LBP. Age (OR=0.99/95% Cl 0.95-1.03), weight (OR=1.13/95% Cl 0.99-1.06), height (OR=0.97/95% Cl 0.91-1.02), and work experience (OR=1.01/95% Cl 0.97-1.05) increase odds for LBP but not significantly. The most frequently used drugs in patients included in this study are NSAIDs. In 33 (55.0%) patients for the treatment of LBP two types of drugs are administered. Conclusion: Increased physical activity, health promotion and reduced body weight can prevent morbidity from LBP. A continuous consultation with the Clinical Pharmacist demonstrates effective way of dosage and drug re-evaluation for the patients with LBP. PMID:25568510

  10. [Prevalence and evolution of sleep complaints recorded upon medical check-ups in healthcare centers in Bordeaux and Cenon, France, between 1988 and 1998].

    PubMed

    Cugy, D; Penide, D; Paty, J; Balan, J; Vinclair, J; Cugy, S; Lenain, J-L; Giordanella, J-P

    2004-01-01

    Primary healthcare checkups are regularly performed by French healthcare centers. We report analysis of sleep disorders complaint registered from 1988 to 1998 in Bordeaux-Cauderan and Cenon CPAM welfare centers. The prevalence of sleep disorders is estimated from a total of 205 347 checkups. The population is segmented by age (18-24: 19 332, 25-34:46 694, 35-44:51 072, 45-54:46 886, 55-64:32 658, 65 +:7 705), gender (male: 101 801; female: 103 546) and population category (general: 147 188, underprivileged: 22 785, prioritized: 35 374). Datas shows a relationship between sex and age. Surprisingly we found a relation between Buying Power for Net Wages and Prevalence of Sleep Complaint. There is a significant correlation (R(2)=0,718, p<0,0079). These data are in relationship with M. Ohayon findings relatively to low income and sleep complaint. PMID:15235520

  11. Education and the Prevalence of Pain. NBER Working Paper No. 14964

    ERIC Educational Resources Information Center

    Atlas, Steven J.; Skinner, Jonathan S.

    2009-01-01

    Many Americans report chronic and disabling pain, even in the absence of identifiable clinical disorders. We first examine the prevalence of pain in the older U.S. population using the Health and Retirement Study (HRS). Among 50-59 year females, for example, pain rates ranged from 26 percent for college graduates to 55 percent for those without a…

  12. Education and the Prevalence of Pain. NBER Working Paper No. 14964

    ERIC Educational Resources Information Center

    Atlas, Steven J.; Skinner, Jonathan S.

    2009-01-01

    Many Americans report chronic and disabling pain, even in the absence of identifiable clinical disorders. We first examine the prevalence of pain in the older U.S. population using the Health and Retirement Study (HRS). Among 50-59 year females, for example, pain rates ranged from 26 percent for college graduates to 55 percent for those without a

  13. FDG PET/CT Findings of the Recurrent Posttransplantation Lymphoproliferative Disorder in a Pediatric Liver Transplant Recipient With Right Leg Pain as the Only Complaint.

    PubMed

    Bai, Xia; Yang, Hua; Zhuang, Hongming

    2015-10-01

    The most commonly observed symptoms of posttransplantation lymphoproliferative disorder (PTLD) after a liver transplantation were diarrhea and fever. Although PTLD can involve bones, bone pain is a rare manifestation of PTLD, much less to say a sole presentation. We report a case of a pediatric patient with recurrent PTLD after liver transplantation, whose only complaint was right tibial pain. FDG PET/CT revealed not only hypermetabolic activity in the right proximal tibia but also in many other parts of the body. Recurrent PTLD was confirmed after bone biopsy. PMID:26098286

  14. The prevalence, severity, and impact of breast pain in the general population.

    PubMed

    Scurr, Joanna; Hedger, Wendy; Morris, Paul; Brown, Nicola

    2014-01-01

    Breast pain has been investigated in clinical populations; however we have yet to understand the prevalence and severity of this condition in the general population to determine whether more should be done to minimize the impact of this condition on women's quality of life. Therefore, this study investigated the prevalence, severity, and impact of breast pain on quality of life and factors associated with breast pain in a normal population sample. 1,659 females (34.1 13.2 years) completed the Breast Pain Questionnaire online, providing information on demographics, duration, frequency, and severity of breast pain, its association with the menstrual cycle, relieving, and aggravating factors and the impact on quality of life. Over half the sample (51.5%) experienced breast pain, with a severity similar to that reported in clinical populations. There was a higher prevalence of breast pain in older participants, larger breasted participants and those who were less fit and active. Of symptomatic participants, 41% and 35% reported breast pain affecting quality of life measures of sex and sleep and 10% of symptomatic participants had sufferer for over half their lives. The results of this study suggest that breast pain is a significant issue within the general population and yet this is the first study to investigate it. It is concluded that this condition warrants increased investigation, awareness, and treatment. The reported relationship between breast pain and fitness/activity levels may offer an alternative treatment in the form of exercise intervention strategies to reduce breast pain. PMID:25041468

  15. Racial/Ethnic and Gender Prevalences in Reported Common Pains in a National Sample

    PubMed Central

    Plesh, O; Adams, SH; Gansky, SA

    2011-01-01

    Aims To compare prevalences of self reported temporomandibular joint and muscle disorders (TMJMD)-type pain, headaches, neck and back pains in the 2000-2005 US National Health Interview Survey (NHIS) by gender and age for non-Hispanic Whites (Whites), Hispanics and non-Hispanic Blacks (Blacks). Methods Data from the 2000-2005 NHIS included information on gender, age, race, ethnicity, and different common types of pain specifically: TMJMD-type pain, severe headaches/migraine, neck, and low back pains. Results A total of 189,992 people were included: 52% female and 48% male, 73% White, 12% Hispanic, 11% Black and 4% Other. The overall prevalence of TMJMD-type pain was 4.6%; severe headaches/migraine was 15.4%, neck 14.9%, and low back 28%. Survey logistic regression models estimating race-specific, age-adjusted curves revealed race by age pain differences. For TMJMD-type pain, White females presented the highest prevalence at younger ages, decreasing after age 40. Prevalences for Hispanic and Black females, although lower at younger ages, increased up to age 60 and remained higher than Whites. Males showed less racial/ethnic and age variation. Severe headaches/migraines presented an age pattern similar to TMJMD-type pain for White females and little overall variation for males, but without racial differences. Neck pain showed some similarities to TMJMD-type pain: higher in Whites at younger ages, lower at older ages, with Hispanics having the highest rates after 60s. For low back pain the rates peaked around 60s for all racial/ethnic groups. Conclusions The patterns of TMJMD-type pain varied greatly within and across racial/ethnic groups by gender and across the adult lifespan. Similarities and differences with regard to the other pains were noted. PMID:21359234

  16. Agreement between 2 pain visual analogue scales, by age and area of complaint in neck and low back pain subjects: the standard pen and paper VAS versus plastic mechanical sliderule VAS

    PubMed Central

    Hagino, Carol; Thompson, Marylee; Advent, Jolayne; Rivet, Lyne

    1996-01-01

    Objective: This study endeavoured to determine the agreement between the standard pencil and paper pain VAS (pVAS) and a relatively newly designed plastic mechanical (slide-rule) VAS (mVAS) in assessing cervical and lumbar pain intensity in cervical pain vs low back pain (LBP) patients stratified by age (< 65 years of age (yoa) and ? 65 yoa). Design Architecture: This was a concurrent validity study assessing the agreement between the gold standard pVAS and the experimental mVAS. Sample Size: A sample size estimate revealed that a minimum of 9 subjects for each of 4 age-complaint subgroups (< 65 yoa) neck pain, ? 65 yoa neck pain, <65 yoa low back pain, ? 65 yoa low back pain) would be necessary. Sample Profile: All adults (? 18 yrs of age) presenting to the Canadian Memorial Chiropractic Colleges Herbert K. Lee Outpatient Clinic with low back (LBP) pain or neck pain were considered eligible for the study. Three (3) essentially asymptomatic subjects were also recruited in order to provide a complete spectrum of pain severities. Outcome Measure: Pain intensity was measured in centimetres (to nearest one tenth) on the pVAS and in ten units on the mVAS (to the nearest one tenth unit). Method: The pVAS was administered by including it with either the standard intake forms which all new patients are required to complete, or by presenting it to patients visiting the Clinic for a subsequent treatment. The subject made a visual estimation of his/her pain intensity and marked it on the pVAS accordingly. The response was then measured in centimetres. One of the investigators presented the mVAS to the subject after arrival in the examination room. The mVAS instrument was presented to the subject with instructions as to how to indicate his/her level of present pain intensity. Every attempt was made to ensure that no less than five minutes and no more than 15 minutes elapsed between the completion of the two forms of Visual Analogue Scale. The data were categorized according to the subjects ages (? 65 years of age (yoa) or < 65 yoa) and their areas of complaint (neck pain or low back pain). Statistical Analysis Strategy: Intraclass Correlation Coefficient (ICC) analyses were performed to determine the index of agreement between the mVAS and pVAS for each of the age and complaint categories. 95% Confidence Intervals (95% CI) were calculated for each ICC value. A clinically acceptable level of agreement was judged by the investigators to be ICC ? 0.85; a 95% CI no wider than 0.25 was considered to provide statistical significance. Results: The Intraclass Correlation Coefficient (ICC) analysis revealed an ICC of 0.86 with a 95% CI of 0.25 for the group under 65 yoa with neck pain, and an ICC of 0.87 with a 95% CI of 0.13 for the group under 65 yoa with low back pain. ICCs ( 95 CI) of 0.60 ( 0.64) and 0.93 ( 0.2) were calculated for the ? 65 yoa neck pain group and ? 65 yoa LBP group, respectively. Conclusion: The results of this study suggest that for the most part, there is statistically significant and clinically acceptable agreement between the pencil and paper VAS (pVAS) and a mechanical VAS (mVAS). The areas of complaint assessed (neck versus low back), did not appear to affect the level of agreement within each age category; only the older male neck pain and younger female LBP groups, however, yielded clinically unacceptable levels of agreement.

  17. Prevalence and Correlates of Pain and Pain Treatment in a Western Kenya Referral Hospital

    PubMed Central

    Owino, Claudio; Gramelspacher, Gregory P.; Monahan, Patrick O.; Tabbey, Rebeka; Hagembe, Mildred; Strother, Robert M.; Njuguna, Festus; Vreeman, Rachel C.

    2013-01-01

    Abstract Background Pain is often inadequately evaluated and treated in sub-Saharan Africa (SSA). Objective We sought to assess pain levels and pain treatment in 400 hospitalized patients at a national referral hospital in western Kenya, and to identify factors associated with pain and pain treatment. Design Using face-validated Kiswahili versions of two single-item pain assessment tools, the Numerical Rating Scale (NRS) and the Faces Pain ScaleRevised (FPS-R), we determined patients' pain levels. Additional data collected included patient demographics, prescribed analgesics, and administered analgesics. We calculated mean pain ratings and pain management index (PMI) scores. Results Averaged between the NRS and FPS-R, 80.5% of patients endorsed a nonzero level of pain and 30% of patients reported moderate to severe pain. Older patients, patients with HIV, and cancer patients had higher pain ratings. Sixty-six percent of patients had been prescribed analgesics at some point during their hospitalization, the majority of which were nonopioids. A majority of patients (66%) had undertreated pain (negative scores on the PMI). Conclusion This study shows that hospitalized patients in Kenya are experiencing pain and that this pain is often undertreated. PMID:24032753

  18. [Prevalence and characteristics of chronic pain with neuropathic component at Parakou in northern Benin in 2012].

    PubMed

    Adoukonou, T; Gnonlonfoun, D; Kpozehouen, A; Adjien, C; Tchaou, B; Tognon-Tchegnonsi, F; Adechina, H; Covi, R; Houinato, D

    2014-11-01

    The burden of chronic and neuropathic pain is high making it an important public health problem. The epidemiology is not well known in the general population in sub-Saharan Africa. We aimed to determine the prevalence of chronic pain with a neuropathic component at Tititou in Parakou in northeastern Benin. A cross-sectional study was conducted from 1st April to 31 May 2012 and included 2314 people in a door-to-door survey. Chronic pain was defined as pain occurring for more than three months. Neuropathic pain was assessed with the DN4 score. A neurological exam was performed by a young physician for all people with chronic pain. During the interview, sociodemographic data, past medical history, weight and height were recorded. Multivariate logistic regression was performed to analyze the main associated factors. Among the 2314 people included in this survey, 49.7% were male. The mean age was 32.3 ± 13.1 years. Nine hundred seven reported pain occurring for more than 3 months. The prevalence of chronic pain was 39.2% (CI95%: 29.3-34.7). It was more frequent in females, older people, among diabetics, people with a history of any surgery, stroke, brain trauma, and alcoholism. The prevalence of chronic pain with a neuropathic component was 6.3% (CI95%: 5.0-7.9). The main associated factors were age, matrimonial status, professional occupation, body mass index, diabetes, history of zoster, history of any surgery, brain trauma. People with neuropathic pain often reported pain with burning (87.6%), prickling (82.8%), numbness (66.9%), tingling (63.4%), and lightning pain (48.3%). The main locations were the lower limbs and low back pain. This study suggested the high frequency of chronic neuropathic pain in the general population in Parakou compared with rates reported in western countries. PMID:25444451

  19. [Prevalence of mental disorders in multimodal therapy of chronic back pain].

    PubMed

    Artner, J; Lattig, F; Cakir, B; Gndel, H; Reichel, H; Spiekermann, J A

    2012-12-01

    Because of its biopsychosocial factors chronic back pain is often resistant to unimodal therapy regimes. Multimodal pain programs are a promising therapy option in the management of chronic pain as they focus on functional restoration. The aim of the study was to evaluate the prevalence of psychopathology in patients with chronic back pain. The study included 127 patients suffering from chronic back pain in multimodal inpatient pain therapy who were assessed by a psychologist. A retrospective analysis was performed focusing on the psychological diagnoses. Further factors investigated were age, gender, numeric rating scale (NRS) pain intensity at the beginning and end of the program, hospital anxiety and depression scale (HADS), further psychological treatment recommendations and migration background. Fisher's exact test was performed to calculate the significance in the different subgroups. The results showed that there was a high prevalence of depression, anxiety disorders and adjustment disorders in patients with chronic back pain. In this cohort the prevalence of depression and anxiety disorders was significantly higher than the estimated prevalence of the normal German population. PMID:23149491

  20. Prevalence of temporomandibular disorder pain in Chinese adolescents compared to an age-matched Swedish population.

    PubMed

    Hongxing, L; Astrøm, A N; List, T; Nilsson, I-M; Johansson, A

    2016-04-01

    This study aimed to (i) assess the prevalence and perceived need for treatment of TMD pain, and its association with socio-economic factors and gender, in adolescents in Xi᾽an, Shaanxi Province, China, and (ii) compare the prevalence and association with gender of TMD pain in Xi᾽an to an age-matched Swedish population. We surveyed Chinese adolescents aged 15 to 19 years in Xi'an, China (n = 5524), using a questionnaire with two-stage stratified sampling and the school as the sampling unit. The study included second-year students at selected high schools. It also included an age-matched Swedish population (n = 17 015) surveyed using the same diagnostic criteria for TMD pain as that used in the Chinese sample. The survey found TMD pain in 14·8% (n = 817) of the Chinese sample and 5·1% (n = 871) of the Swedish sample (P < 0·0001). Girls had significantly more TMD pain than boys in both the Chinese (P < 0·05) and Swedish (P < 0·001) samples. TMD pain increased with age in the Chinese population. Of the Chinese adolescents with TMD pain, 47% reported that they felt a need for treatment. Rural schools, low paternal education levels, poverty, living outside the home, poor general and oral health, and dissatisfaction with teeth all showed significant positive correlations with TMD pain. Prevalence of TMD pain in Chinese adolescents was significantly higher than in the Swedish sample. PMID:26538188

  1. The nature and prevalence of chronic pain in homeless persons: an observational study

    PubMed Central

    Wheeler, Daniel W

    2013-01-01

    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 people’s lives. PMID:24555079

  2. Prevalence of low back pain and associated factors among farmers during the rice transplanting process

    PubMed Central

    Keawduangdee, Petcharat; Puntumetakul, Rungthip; Swangnetr, Manida; Laohasiriwong, Wongsa; Settheetham, Dariwan; Yamauchi, Junichiro; Boucaut, Rose

    2015-01-01

    [Purpose] The aim of this study was to investigate the prevalence of low back pain and associated factors in Thai rice farmers during the rice transplanting process. [Subjects and Methods] Three hundred and forty-four farmers, aged 20–59 years old, were asked to answer a questionnaire modified from the Standard Nordic Questionnaire (Thai version). The questionnaire sought demographic, back-related, and psychosocial data. [Results] The results showed that the prevalence of low back pain was 83.1%. Farmers younger than 45 years old who worked in the field fewer than six days were more likely to experience low back pain than those who worked for at least six days. Farmers with high stress levels were more likely to have low back pain. [Conclusion] In the rice transplanting process, the low back pain experienced by the farmers was associated with the weekly work duration and stress. PMID:26311961

  3. A clinical comparison of internal joint disorders in patients presenting disk-attachment pain: prevalence, characterization, and severity of bruxing behavior.

    PubMed

    Molina, Omar Franklin; dos Santos, Jos; Nelson, Stanley; Nowlin, Thomas; Mazzetto, Marcelo

    2003-01-01

    This study clinically documents the presence of disk-attachment pain (DAP) related to the severity of bruxism and to the prevalence of internal joint disorders in patients and controls. The sample consisted of 394 temporomandibular disorder (TMD) and bruxing behavior patients and 104 nonbruxer control subjects. The TMD group was subdivided in a group of 109 disk-attachment pain patients and 285 bruxing behavior-nonDAP groups. The second reference group was a sample of 104 nonbruxing behavior subjects. Comprehensive evaluations (including history of signs and symptoms), use of questionnaires, clinical examination, palpation of muscles and joints, classification of bruxing behavior by the degree of severity, and diagnostic tests were performed in patients and controls. There was a prevalence of disk-attachment pain in the group of TMD and bruxing behavior patients. The degree of jaw opening was lower in the DAP group as compared to the TMD/bruxism-nonDAP group and controls. The mean Visual Analog Scale (VAS) value for the joint pain complaints was slightly elevated in the DAP group as compared to the TMD/bruxism-nonDAP group. Specific masticatory disorders including difficulties to open, pain on opening, chewing pain, fatigue on chewing, jaw deviation to opening, and change to a soft diet, were significantly more prevalent in the DAP group as compared to the other reference groups. Our conclusions are based upon a review of the literature and on the results of this study: a. DAP is a relatively well defined stage of internal joint derangement (IJD); and b. compared to other groups, DAP patients as a subgroup are relatively more impaired by their masticatory and other functional disorders. This study provides strong support to other studies and demonstrates that DAP is a well-differentiated and severe internal joint disorder. PMID:12555927

  4. Subjective health complaints in patients with lumbar radicular pain and disc herniation are associated with a sex - OPRM1 A118G polymorphism interaction: a prospective 1-year observational study

    PubMed Central

    2014-01-01

    Background Earlier observations show that development of persistent pain may be associated with the genetic variability in the gene encoding for the ?-opioid receptor 1, the OPRM1 A118G (rs1799971). The aim of this study was to investigate the association between OPRM1 genotype and subjective health complaints in patients with radicular pain and disc herniation. Methods A prospective, 1-year observational study was conducted at a hospital back clinic, including 118 Caucasian patients with lumbar radicular pain and MRI confirmed disc herniation. Single nucleotide polymorphism genotyping regarding the OPRM1 A118G was performed. The data of individuals with AA versus AG or GG were analysed separately by linear mixed models. The Subjective Health Complaints Inventory (0-81) including 27 common complaints experienced the previous month on a scale from not at all (0) to severe (3) was used as outcome. Pain, prior duration of leg pain, age, smoking status, and lumbar disc surgery were considered as covariates. Results In total 23 of 118 patients were carriers of the OPRM1 G-allele. All patients except female carriers of the G-allele reported a decrease in pain from baseline to 1year. Female carriers of the G-allele reported significantly higher subjective health complaints score during the study time span than male carriers of the G-allele when controlling for pain and pain duration. Conclusion The present data indicate that, when controlling for pain intensity and duration, subjective health complaints are associated with a sex - OPRM1 A118G polymorphism interaction in patients with radicular pain. PMID:24884878

  5. Prevalence of peripheral neuropathy and painful peripheral neuropathy in Turkish diabetic patients.

    PubMed

    Erbas, Tomris; Ertas, Mustafa; Yucel, Aysen; Keskinaslan, Abdulkadir; Senocak, Mustafa

    2011-02-01

    The aim of this study was to determine the prevalence of diabetic peripheral neuropathy (DPN) and neuropathic pain in diabetic patients attending university outpatient clinics in Turkey. In this multicenter cross-sectional study, neurologic examinations and nerve conduction studies along with clinical diabetic neuropathy score, and Leeds Assessment of Neuropathic Symptoms and Signs pain scale were performed on 1,113 patients (46.2% male) from 14 centers. Prevalence of DPN determined only by clinical examination was 40.4% and increased to 62.2%, by combining nerve conduction studies with clinical examination. According to Leeds Assessment of Neuropathic Symptoms and Signs scores, neuropathic pain prevalence was 16.0% in those who reported pain. Poor glycemic control, retinopathy, microalbuminuria, hyperlipidemia, diabetic foot, and foot amputation were more commonly observed in patients with DPN. Clinical DPN affected 40.4% of diabetic patients, and neuropathic pain prevalence in diabetic patient population was 14.0%. Clinical examinations and nerve conduction studies are important components for early detection and accurate diagnosis of DPN and painful DPN. PMID:21221008

  6. Factors associated with self-reported back-pain prevalence: a population-based study.

    PubMed

    Reisbord, L S; Greenland, S

    1985-01-01

    We present a study of demographic factors associated with self-reported back pain prevalence in a population-based study. Study variables were age, gender, occupation, physical demand of occupation, income, education and marital status. Crude associations of the independent variables and reported back pain were in general agreement with other cross-sectional studies. Multiway contingency tables and multivariate models were employed for further analyses. When we controlled each of the other variables, only gender, education and marital status remained strongly associated with reported back pain. Using these three variables plus age, we developed regression models for the prediction of back pain and identified a steep gradient of prevalence: the highest prevalence (44-46%) was in no-longer-married women aged 50-64, regardless of education, while the lowest prevalence (9-11%) was in men who were married and had greater than a high school education. Because the models employ only census-type variables, they should be easy to validate or use to predict back pain prevalence in other populations. PMID:3160720

  7. Chronic Pain in the Japanese Community—Prevalence, Characteristics and Impact on Quality of Life

    PubMed Central

    Inoue, Shinsuke; Kobayashi, Fumio; Nishihara, Makoto; Arai, Young-Chang P.; Ikemoto, Tatsunori; Kawai, Takashi; Inoue, Masayuki; Hasegawa, Tomomi; Ushida, Takahiro

    2015-01-01

    Background Chronic pain is recognized as a public health problem that affects the general population physically, psychologically, and socially. However, there is little knowledge about the associated factors of chronic pain, such as the influence of weather, family structure, daily exercise, and work status. Objectives This survey had three aims: 1) to estimate the prevalence of chronic pain in Japan, 2) to analyze these associated factors, and 3) to evaluate the social burden due to chronic pain. Methods We conducted a cross-sectional postal survey in a sample of 6000 adults aged ≥20 years. The response rate was 43.8%. Results The mean age of the respondents was 57.7 years (range 20–99 years); 39.3% met the criteria for chronic pain (lasting ≥3 months). Approximately a quarter of the respondents reported that their chronic pain was adversely influenced by bad weather and also oncoming bad weather. Risk factors for chronic pain, as determined by a logistic regression model, included being an older female, being unemployed, living alone, and no daily exercise. Individuals with chronic pain showed significantly lower quality of life and significantly higher psychological distress scores than those without chronic pain. The mean annual duration of absence from work of working-age respondents was 9.6 days (range 1–365 days). Conclusions Our findings revealed that high prevalence and severity of chronic pain, associated factors, and significant impact on quality of life in the adult Japanese population. A detailed understanding of factors associated with chronic pain is essential for establishing a management strategy for primary care. PMID:26076135

  8. Facts and Figures on Pain

    MedlinePLUS

    ... adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting ... Institute of Health Statistics survey indicated that low back pain was the most common (27%), followed by severe ...

  9. Back pain prevalence in US industry and estimates of lost workdays.

    PubMed Central

    Guo, H R; Tanaka, S; Halperin, W E; Cameron, L L

    1999-01-01

    OBJECTIVES: Back pain is the most common reason for filing workers' compensation claims and often causes lost workdays. Data from the 1988 National Health Interview Survey were analyzed to identify high-risk industries and to estimate the prevalence of work-related back pain and number of workdays lost. METHODS: Analyses included 30074 respondents who worked during the 12 months before the interview. A case patient was defined as a respondent who had back pain every day for a week or more during that period. RESULTS: The prevalence of lost-workday back pain was 4.6%, and individuals with work-related cases lost 101.8 million workdays owing to back pain. Male and female case patients lost about the same number of workdays. Industries in high-risk categories were also identified for future research and intervention, including those seldom studied. CONCLUSIONS: This study provides statistically reliable national estimates of the prevalence of back pain among workers and the enormous effect of this condition on American industry in terms of lost workdays. PMID:10394311

  10. Neck/shoulder pain and low back pain among school teachers in China, prevalence and risk factors

    PubMed Central

    2012-01-01

    Background School teachers represent an occupational group among which there appears to be a high prevalence of neck and/or shoulder pain (NSP) and low back pain (LBP). Epidemiological data on NSP and LBP in Chinese teachers are limited. The aim of this study was to investigate the prevalence of and risk factors for NSP and LBP among primary, secondary and high school teachers. Methods In a cross-sectional study of teachers from 7 schools, information on participant demographics, work characteristics, occupational factors and musculoskeletal symptoms and pain were collected. Results Among 893 teachers, the prevalence of NSP and LBP was 48.7% and 45.6% respectively. There was significant association between the level and prevalence of NSP and LBP among teachers in different schools. The prevalence of NSP among female teachers was much higher than that for males. Self-reported NSP was associated with physical exercise (OR 0.55, 95% CI 0.35 to 0.86), prolonged standing (1.74, 1.03 to 2.95), sitting (1.76, 1.23 to 2.52) and static posture (2.25, 1.56 to 3.24), and uncomfortable back support (1.77, 1.23 to 2.55). LBP was more consistently associated with twisting posture (1.93, 1.30 to 2.87), uncomfortable back support (1.62, 1.13 to 2.32) and prolonged sitting (1.42, 1.00 to 2.02) and static posture (1.60, 1.11 to 2.31). Conclusions NSP and LBP are common among teachers. There were strong associations with different individual, ergonomic, and occupational factors. PMID:22978655

  11. High prevalence of shoulder pain among elite Norwegian female handball players.

    PubMed

    Myklebust, G; Hasslan, L; Bahr, R; Steffen, K

    2013-06-01

    Clinical experience indicates that a substantial number of handball players may suffer from shoulder pain, but they continue to play despite having shoulder pain problems. The aim of this study was to evaluate the prevalence and consequences of shoulder pain problems among Norwegian female elite handball players. In the preseason of the 2007-2008 season, 179 players from all 12 teams of the Norwegian elite league went through the following tests: internal and external shoulder range of motion, apprehension, relocation test, and shooting velocity. All players completed the Fahlström questionnaire and, for players with current pain, the Western Ontario shoulder instability index questionnaire. Sixty-five (36%) players reported shoulder pain on the test day, and 40 (22%) players reported previous shoulder pain. Two thirds of the players with pain reported a gradual onset. For players with current or previous pain, 22 (36%) and 14 (36%) had missed match play, and 43 (68%) and 28 (76%) reported changing their training habits. A positive apprehension and relocation test was found among 51 (29%) of the players. In conclusion, a high proportion of female elite handball players experience shoulder pain and problems and have an unstable shoulder. PMID:22092886

  12. Prevalence and natural history of pain in adults with multiple sclerosis: systematic review and meta-analysis.

    PubMed

    Foley, Peter L; Vesterinen, Hanna M; Laird, Barry J; Sena, Emily S; Colvin, Lesley A; Chandran, Siddharthan; MacLeod, Malcolm R; Fallon, Marie T

    2013-05-01

    The prevalence, associations, and natural history of pain in multiple sclerosis (MS) are poorly understood. The objective of this work was to study the prevalence of pain syndromes in MS both cross-sectionally, and longitudinally during the MS disease course. We systematically identified prospective studies detailing pain prevalence in definite MS. We used pooled prevalence estimates, explored heterogeneity using meta-regression, and analysed prevalence during the disease course using both estimates at disease milestones and longitudinal studies. Twenty-eight articles (7101 subjects) describing overall pain, or pain syndromes, met inclusion criteria. Pooled overall pain prevalence (17 studies, 5319 subjects) was 63% (95% confidence interval [CI] 55-70%). Marked heterogeneity in this estimate was not significantly explained by selected study design variables (use of outpatient sample, timeframe prior to study over which pain was assessed) or sample demographic variables (mean Expanded Disability Status Scale, mean disease duration, proportion of female sex, and proportion with progressive MS). We quantified prevalence of headache (43%; 95% CI 33-52%), neuropathic extremity pain (26%; 95% CI 7-53%), back pain (20%; 95% CI 13-28%), painful spasms (15%; 95% CI 8.5-23%), Lhermitte sign (16%; 95% CI 10-25%), and trigeminal neuralgia (3.8%; 95% CI 2-6%) in included studies. Prevalence of pain at MS disease milestones (prior to onset, at onset, and at relapse) and during longitudinal follow-up was poorly described. Pain is common in MS, as are specific pain syndromes. The clinical associations and natural history of pain in MS require clarification. Future study could be enhanced by standardised study design. PMID:23318126

  13. Prevalence of and risk factors for low back pain among dentists

    PubMed Central

    Gaowgzeh, Riziq Allah; Chevidikunnan, Mohamed Faisal; Al Saif, Amer; El-Gendy, Salwa; Karrouf, Gamal; Al Senany, Samira

    2015-01-01

    [Purpose] The purpose of this study was to determine the prevalence, symptoms of, and risk factors for low back pain among dentists as well as to discover the possible correlation of these factors with working posture and how to reduce their prevalence. [Subjects and Methods] The study was conducted among 60 dentists (28 male and 32 female) with a mean age of 25.7?years. Dentists were evaluated with the self-administered Nordic musculoskeletal evaluation chart, postural discomfort chart, and a self-prepared questionnaire. [Results] The data showed a 70% incidence of back pain among dentists, with low back pain predominating in 47.6% of cases. Most of the subjects (90.5%) had a mild-to-moderate level of severity, and only 9.5% had a severe level of low back pain. The majority of the dentists (57%) treated 13 patients per day. Only a few dentists (17%) exercised during their rest period even though 57% of them reported taking a break during their working hours. Although 63% of the dentists were aware of the advantages of assistive tools, only 40% of them used any kind of assistive devices. [Conclusion] Dental professionals demonstrate a high prevalence of low back pain. PMID:26504297

  14. Prevalence and Psychiatric Correlates of Pain Interference Among Men and Women in the General Population1

    PubMed Central

    Barry, Declan T.; Pilver, Corey; Potenza, Marc N.; Desai, Rani A.

    2011-01-01

    Objective To examine gender differences in the associations of levels of pain interference and psychiatric disorders among a nationally representative sample of adult men and women. Method Chi-square tests and multinomial logistic regression analyses were performed on data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions from 42,750 adult respondents (48% men; 52% women), who were categorized according to three levels of pain interference (i.e., no or low pain interference [NPI], moderate pain interference [MPI], severe pain interference [SPI]). Results Female respondents in comparison to male respondents were more likely to exhibit moderate (p < 0.001) or severe pain interference (p < 0.001). Levels of pain interference were associated with past-year Axis I and lifetime Axis II psychiatric disorders in both male and female respondents (p < 0.05), with the largest odds typically observed in association with moderate or severe pain interference. A stronger relationship between MPI and alcohol abuse or dependence (OR = 1.61, p < 0.05) was observed in male participants as compared to female ones, while a stronger relationship between SPI and drug abuse or dependence (OR = 0.57, p < 0.05) was observed in female respondents as compared to male ones. Conclusions Levels of pain interference are associated with the prevalence of Axis I and Axis II psychiatric disorders in both men and women. Differences in the patterns of co-occurring substance-related disorders between levels of pain interference in male and female respondents indicate the importance of considering gender-related factors associated with levels of pain interference in developing improved mental health prevention and treatment strategies. PMID:21944430

  15. Prevalence of low back pain among handloom weavers in West Bengal, India

    PubMed Central

    Durlov, Santu; Chakrabarty, Sabarni; Chatterjee, Arijit; Das, Tamal; Dev, Samrat; Gangopadhyay, Somnath; Haldar, Prasun; Maity, Santi Gopal; Sarkar, Krishnendu; Sahu, Subhashis

    2014-01-01

    Background: Handloom is one of the oldest industries in India, particularly in West Bengal, where a considerable number of rural people are engaged in weaving. Objectives: The purpose of this study was to evaluate the prevalence of low back pain among the handloom weavers in India. Methods: A modified Nordic Musculoskeletal Disorder Questionnaire and Oswestry Low Back Pain Disability Questionnaire along with a body part discomfort scale were administered to handloom weavers (n = 175). Working posture of the participants was assessed using the Ovako Working Posture Analysis System (OWAS). Results: Sixty eight per cent of the participants reported suffering from low back pain, making it the most prevalent disorder in our sample. Analysis of the Oswestry Low Back Pain Disability Questionnaire data revealed that among those with low back pain (n = 119), 2% had severe disabilities, 46% had moderate disabilities, and 52% had minimal disabilities. Statistical analyses revealed a positive significant association between the intensity of pain in the lower back and an increased number of years of work experience (P<0.05). Conclusions: The study underlines the need for further research regarding the postural strain of weavers and also suggests the implementation of ergonomic design into weaver workstations to minimize the adverse effect of their current working postures. Improving upon the weaver’s work-posture could improve their quality of life. PMID:25224808

  16. The immediate effects of thoracic transverse mobilization in patients with the primary complaint of mechanical neck pain: a pilot study

    PubMed Central

    McGregor, CIndy; Boyles, Robert; Murahashi, Laura; Sena, Tanya; Yarnall, Robert

    2014-01-01

    Objective: Posterior-to-anterior (PA) vertebral mobilization to the thoracic spine has been studied as an intervention for neck pain. Our purpose was to explore effects of a different mobilization technique, transverse vertebral pressure, on cervical range of motion (ROM) and pain when applied to the thoracic spine among participants with neck pain. Methods: A single-blinded quasi-experimental study with a one-group pretestposttest design. A transverse group consisted of 21 participants whose neck pain increased with active movements. A non-intervention group of 20 asymptomatic participants was included simply to ensure rater blinding. The treatment group received Grades IV to IV+ transverse mobilizations at T1 through T4 bilaterally. Measurements taken immediately after intervention included pre/post cervical ROM, distant pressure pain threshold (PPT), and a numerical pain rating scale (NPRS). Analysis utilized t-tests and ordinal counterparts. Results: The transverse group demonstrated significant gains in extension and bilateral rotation (P?0.005) but not flexion or side-bend. A total of 57% of mobilized participants reported clinically meaningful decreased pain (P<0.001). Seven participants exceeded the PPT MDC95 of 0.36 kg/cm2. The non-intervention group had no significant changes in ROM or NPRS scores. Discussion: After 8 minutes of transverse mobilization to the upper thoracic spine, significant gains in cervical extension and bilateral rotation, and decreased pain scores were found. There were no adverse effects. Unlike other mobilization studies, PPT changes at a remote site were statistically but not clinically meaningful. Findings suggest that transverse mobilization would be a productive topic for controlled clinical trials. PMID:25395827

  17. Cervical Spinal Canal Stenosis and Central Disc Herniation C3/4 in a Man with Primary Complaint of Thigh Pain

    PubMed Central

    Akhavan-Sigari, R.; Rohde, V.; Alaid, A.

    2013-01-01

    Purpose?The purpose of this report is to describe the clinical course of a patient who had a primary complaint of isolated right lateral thigh pain 3 years prior that was nonresponsive to conservative measures. Hypoesthesia in the lateral side of the right forearm, deltoid and biceps, as well as triceps paresis, was also diagnosed. Results?Immediately after surgery, the patient reported substantial improvement in his right thigh symptoms. The signs and symptoms associated with the right C6 and C7 radiculopathy did improve. Conclusion?Although the presentation described in this case is somewhat unique, the eventual myelopathic signs and symptoms were not. It was these myelopathic signs and symptoms that led to cervical magnetic resonance imaging, the diagnosis of cervical cord compressive myelopathy, and surgical management. PMID:24303344

  18. The prevalence of back pain, hand discomfort, and dermatitis in the US working population.

    PubMed Central

    Behrens, V; Seligman, P; Cameron, L; Mathias, C G; Fine, L

    1994-01-01

    OBJECTIVES. The purpose of the study was to provide the health care and public health communities with national prevalence estimates of selected conditions in the US working population. METHODS. National prevalence estimates of self-reported conditions among working people were calculated from data collected for the 1988 Occupational Health Supplement to the National Health Interview Survey. RESULTS. The highest prevalence estimates were found among occupational groups. For example, the prevalence of back pain due to an injury at work among truck drivers was 6.7%; back pain due to repeated activities at work among mechanics and repairers of heavy equipment and machinery was 10.5%; hand discomfort among operators of machines that process metal, plastic, stone, and glass was 23.5%; and dermatitis due to contact with substances at work among physicians, dentists, nurses, pharmacists, and dietitians was 5.6%. CONCLUSIONS. A substantial proportion of these conditions among occupational groups with the highest prevalence estimates are occupational in origin. These prevalence estimates identify occupations in which efforts are needed to prevent these conditions. PMID:7977917

  19. Prevalence and management of back pain in adolescent idiopathic scoliosis patients: A retrospective study

    PubMed Central

    Théroux, Jean; Le May, Sylvie; Fortin, Carole; Labelle, Hubert

    2015-01-01

    BACKGROUND: Back pain (BP) has often been associated with adolescent idiopathic scoliosis (AIS), which is a three-dimensional deviation of the vertebral column. In adolescents, chronic pain appears to be a predictor of health care utilization and has a negative impact on physical, psychological and family well-being. In this population, BP tends to be persistent and may be a predictor of BP in adulthood. OBJECTIVE: To document the prevalence and management of BP in AIS patients. METHODS: A retrospective chart review of AIS patients who were referred to Sainte-Justine University Teaching Hospital (Montreal, Quebec) from 2006 to 2011 was conducted. RESULTS: A total of 310 randomly selected charts were reviewed. Nearly one-half of the patients (47.3%) mentioned that they experienced BP, most commonly in the lumbar (19.7%) and thoracic regions (7.7%). The type of BP was documented in only 36% (n=112) of the charts. Pain intensity was specified in only 21% (n=65) of the charts. In approximately 80% (n=248) of the charts, no pain management treatment plan was documented. CONCLUSIONS: The prevalence of BP was moderately high among the present sample of adolescents with AIS. An improved system for documenting BP assessment, type, treatment plan and treatment effectiveness would improve pain management for these patients. PMID:25831076

  20. Prevalence of Radiographic Osteoarthritis of the Knee and Its Relationship to Self-Reported Pain

    PubMed Central

    Ho-Pham, Lan T.; Lai, Thai Q.; Mai, Linh D.; Doan, Minh C.; Pham, Hoa N.; Nguyen, Tuan V.

    2014-01-01

    Background and Aim Osteoarthritis (OA) of the knee is one of the most common skeletal disorders, yet little data are available in Asian populations. We sought to assess the prevalence and pattern of radiographic OA of the knee, and its relationship to self-reported pain in a Vietnamese population. Methods The study was based on a sample of 170 men and 488 women aged ?40 years who were randomly sampled from the Ho Chi Minh City (Vietnam). Radiographs of the knee were graded from 0 to 4 according to the Kellgren and Lawrence scale. Osteoarthritis was defined as being present in a knee if radiographic grades of 2 or higher were detected. Knee pain and symptoms were ascertained by direct interview using a structured questionnaire. Results The point prevalence of radiographic OA of the knee was 34.2%, with women having higher rate than men (35.3% vs 31.2%). The prevalence of knee OA increased with advancing age: 8% among those aged 4049 years, 30% in those aged 5059 years, and 61.1% in those aged ?60 years. Greater BMI was associated with higher risk of knee OA. Self-reported knee pain was found in 35% of men and 62% of women. There was a statistically significant association between self-reported knee pain and knee OA (prevalence ratio 3.1; 95% CI 2.0 to 4.6). Conclusions These data indicate that approximately a third of Vietnamese men and women have radiographic OA in the knee, and that self-reported knee pain may be used as an indicator of knee osteoarthritis. PMID:24722559

  1. A cross-sectional survey to investigate the prevalence of pain in Japanese patients with major depressive disorder and schizophrenia.

    PubMed

    Kishi, Taro; Matsuda, Yuki; Mukai, Tomohiko; Matsunaga, Shinji; Yasue, Ichiro; Fujita, Kiyoshi; Okochi, Tomo; Hirano, Shigeki; Kajio, Yusuke; Funahashi, Toshihiko; Akamatsu, Kaku; Ino, Kei; Okuda, Momoko; Tabuse, Hideaki; Iwata, Nakao

    2015-05-01

    We conducted a cross-sectional survey to assess the prevalence of physical pain in Japanese major depressive disorder (MDD) and schizophrenia (SZ) patients as well as in healthy controls (HCs). We also examined the association between their psychopathology and characteristics of pain according to a face-to-face survey by an experienced psychiatrist and psychologist. We analyzed 233 HCs, 94 MDD patients, and 75 SZ patients using the McGill Pain Questionnaire (MPQ) and SF-8 (all participants), the Hamilton Depression Rating Scale 21 items (MDD patients), and the Positive and Negative Symptom Scale (SZ patients). Although MDD patients experienced more pain than HCs, there was no difference in the prevalence of pain between SZ patients and HCs. Moreover, HCs with pain did not have higher SF-8 total scores than those without pain, whereas both MDD and SZ patients with pain had higher SF-8 total scores than those without pain. The severity of psychopathology in MDD and SZ patients was also positively associated with both the prevalence of pain and MPQ scores. MPQ scores were also associated with positive symptoms in SZ patients. Considering these results, physicians need to query MDD patients about physical pain during examination if they are to ensure a favorable and quick response to treatment. The severity of positive symptoms (i.e., clinical status) in SZ patients might also be associated with pain sensitivity, and warrants further investigation. PMID:25724075

  2. Assessment and Treatment of Recurrent Abdominal Pain: Guidelines for the School Psychologist.

    ERIC Educational Resources Information Center

    McMahon, Colleen; And Others

    1990-01-01

    Notes that somatic complaints without clear organic origin are also primary indicators for both anxiety and depression in childhood and adolescence. Review of literature provides school psychologists with basic information regarding prevalence, assessment, and treatment of one of most common types of somatic complaints: recurrent abdominal pain.

  3. Complaints of the arm, neck and shoulder among computer office workers in Sudan: a prevalence study with validation of an Arabic risk factors questionnaire

    PubMed Central

    Eltayeb, Shahla M; Staal, J Bart; Hassan, Amar A; Awad, Salwa S; de Bie, Rob A

    2008-01-01

    Background Complaints of the arm, neck and/or shoulders (CANS) in general and computer-related disorders in particular affect millions of computer office workers in Western developed countries. However, with the widespread use of computer systems in developing countries, the associated musculoskeletal complaints are yet to be investigated. Aim To study the prevalence of work-related CANS, among computer office workers in Sudan, and to test the psychometric properties of a translated Dutch questionnaire in Arabic language. Methods In 2005 282 computer office workers at a mobile telecommunication company and three banks in Khartoum, Sudan, received an Arabic language version of the validated Maastricht upper extremity questionnaire (MUEQ). The questionnaire holds 109 items covering demographic characteristics, in addition to six main domains (i.e. work station, body posture, break time, job control, job demands and social support) assessing potential physical and psychosocial risk factors. Forward/backward translation of the MUQE was done independently by two different translators. Prevalence over the past year were computed for CANS. Further, the psychometric properties of the Arabic questionnaire were investigated (i.e. factor structure and reliability) and cross-validation was carried out. Results The response rate of the questionnaire was 88% (n = 250). The one-year prevalence of CANS showed that 53% of the respondents could be classified as mild cases. The highest incidences were found for neck and shoulder symptoms (64% and 41% respectively). The analysis of the psychometric properties of the scale resulted in the identification of 2 factors for each of the 6 domains (i.e. office equipment, computer position, head and body posture, awkward body posture, autonomy, quality of break time, skill discretion, decision authority, time pressure, task complexity, social support, and work flow). The calculation of internal consistency and cross validation provided evidence of reliability and lack of redundancy of items. Conclusion The prevalence of CANS among the targeted population seems to correspond strongly with prevalence of CANS in Western developed countries. The Arabic translation of the MUEQ has satisfactory psychometric properties to be used to assess work-related risk factors for the development of CANS among computer office workers in Sudan. PMID:18588691

  4. Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: a 2-year prospective multicentre study

    PubMed Central

    Choinire, Manon; Watt-Watson, Judy; Victor, J. Charles; Baskett, Roger J.F.; Bussires, Jean S.; Carrier, Michel; Cogan, Jennifer; Costello, Judy; Feindel, Christopher; Guertin, Marie-Claude; Racine, Mlanie; Taillefer, Marie-Christine

    2014-01-01

    Background: Persistent postoperative pain continues to be an underrecognized complication. We examined the prevalence of and risk factors for this type of pain after cardiac surgery. Methods: We enrolled patients scheduled for coronary artery bypass grafting or valve replacement, or both, from Feb. 8, 2005, to Sept. 1, 2009. Validated measures were used to assess (a) preoperative anxiety and depression, tendency to catastrophize in the face of pain, health-related quality of life and presence of persistent pain; (b) pain intensity and interference in the first postoperative week; and (c) presence and intensity of persistent postoperative pain at 3, 6, 12 and 24 months after surgery. The primary outcome was the presence of persistent postoperative pain during 24 months of follow-up. Results: A total of 1247 patients completed the preoperative assessment. Follow-up retention rates at 3 and 24 months were 84% and 78%, respectively. The prevalence of persistent postoperative pain decreased significantly over time, from 40.1% at 3 months to 22.1% at 6 months, 16.5% at 12 months and 9.5% at 24 months; the pain was rated as moderate to severe in 3.6% at 24 months. Acute postoperative pain predicted both the presence and severity of persistent postoperative pain. The more intense the pain during the first week after surgery and the more it interfered with functioning, the more likely the patients were to report persistent postoperative pain. Pre-existing persistent pain and increased preoperative anxiety also predicted the presence of persistent postoperative pain. Interpretation: Persistent postoperative pain of nonanginal origin after cardiac surgery affected a substantial proportion of the study population. Future research is needed to determine whether interventions to modify certain risk factors, such as preoperative anxiety and the severity of pain before and immediately after surgery, may help to minimize or prevent persistent postoperative pain. PMID:24566643

  5. Prevalence of low back pain and associated occupational factors among Chinese coal miners

    PubMed Central

    2012-01-01

    Background Very few studies have evaluated the association between occupational factors and low back pain (LBP) among miners. The epidemiological data on LBP in Chinese miners are limited. The aim of this study was to measure the prevalence of low back pain in Chinese coal miners and to investigate the role of occupational factors. Methods A cross-sectional survey was conducted to examine 1573 coal miners in northern China. The prevalence of LBP over a 12-month period was assessed using the Nordic Musculoskeletal Questionnaire. Odds ratios were calculated to examine the association between the prevalence of LBP over a 12-month period and occupational factors using logistic regression. Results Among the coal miners, 64.9% self-reported LBP in a 12-month period. Occupational factors associated with LBP were identified, including tasks with a high degree of repetitiveness (OR 1.3, 95%CI 1.0-1.6), tasks characterized by a high level of physical demand (OR 1.4, 95% CI 1.1-1.8), posture requiring extreme bending (OR 1.6, 95% CI 1.2-1.7) and insufficient recovery time (OR 1.4, 95% CI 1.0-1.8). Conclusion Low back pain is common among Chinese miners. There were strong associations with occupational factors. PMID:22375934

  6. Work related complaints of neck, shoulder and arm among computer office workers: a cross-sectional evaluation of prevalence and risk factors in a developing country

    PubMed Central

    2011-01-01

    Background Complaints of arms, neck and shoulders (CANS) is common among computer office workers. We evaluated an aetiological model with physical/psychosocial risk-factors. Methods We invited 2,500 computer office workers for the study. Data on prevalence and risk-factors of CANS were collected by validated Maastricht-Upper-extremity-Questionnaire. Workstations were evaluated by Occupational Safety and Health Administration (OSHA) Visual-Display-Terminal workstation-checklist. Participants' knowledge and awareness was evaluated by a set of expert-validated questions. A binary logistic regression analysis investigated relationships/correlations between risk-factors and symptoms. Results Sample size was 2,210. Mean age 30.8 ± 8.1 years, 50.8% were males. The 1-year prevalence of CANS was 56.9%, commonest region of complaint was forearm/hand (42.6%), followed by neck (36.7%) and shoulder/arm (32.0%). In those with CANS, 22.7% had taken treatment from a health care professional, only in 1.1% seeking medical advice an occupation-related injury had been suspected/diagnosed. In addition 9.3% reported CANS-related absenteeism from work, while 15.4% reported CANS causing disruption of normal activities. A majority of evaluated workstations in all participants (88.4%,) and in those with CANS (91.9%) had OSHA non-compliant workstations. In the binary logistic regression analyses female gender, daily computer usage, incorrect body posture, bad work-habits, work overload, poor social support and poor ergonomic knowledge were associated with CANS and its' severity In a multiple logistic regression analysis controlling for age, gender and duration of occupation, incorrect body posture, bad work-habits and daily computer usage were significant independent predictors of CANS Conclusions The prevalence of work-related CANS among computer office workers in Sri Lanka, a developing, South Asian country is high and comparable to prevalence in developed countries. Work-related physical factors, psychosocial factors and lack of awareness were all important associations of CANS and effective preventive strategies need to address all three areas. PMID:21816073

  7. Back Pain Prevalence and Its Associated Factors in Brazilian Athletes from Public High Schools: A Cross-Sectional Study.

    PubMed

    Noll, Matias; de Avelar, Ivan Silveira; Lehnen, Georgia Cristina; Vieira, Marcus Fraga

    2016-01-01

    Most studies on the prevalence of back pain have evaluated it in developed countries (Human Development Index-HDI > 0.808), and their conclusions may not hold for developing countries. The aim of this study was to identify the prevalence of back pain in representative Brazilian athletes from public high schools. This cross-sectional study was performed during the state phase of the 2015 Jogos dos Institutos Federais (JIF), or Federal Institutes Games, in Brazil (HDI = 0.744), and it enrolled 251 athletes, 173 males and 78 females (14-20 years old). The dependent variable was back pain, and the independent variables were demographic, socioeconomic, psychosocial, hereditary, exercise-level, anthropometric, strength, behavioral, and postural factors. The prevalence ratio (PR) was calculated using multivariable analysis according to the Poisson regression model (α = 0.05). The prevalence of back pain in the three months prior to the study was 43.7% (n = 104), and 26% of the athletes reported feeling back pain only once. Multivariable analysis showed that back pain was associated with demographic (sex), psychosocial (loneliness and loss of sleep in the previous year), hereditary (ethnicity, parental back pain), strength (lumbar and hand forces), anthropometric (body mass index), behavioral (sleeping time per night, reading and studying in bed, smoking habits in the previous month), and postural (sitting posture while writing, while on a bench, and while using a computer) variables. Participants who recorded higher levels of lumbar and manual forces reported a lower prevalence of back pain (PR < 0.79), whereas feeling lonely in the previous year, obesity, and ethnicity exhibited the highest prevalence ratio (PR > 1.30). In conclusion, there is no association between exercise levels and back pain but there is an association between back pain and non-exercise related variables. PMID:26938456

  8. Back Pain Prevalence and Its Associated Factors in Brazilian Athletes from Public High Schools: A Cross-Sectional Study

    PubMed Central

    Noll, Matias; de Avelar, Ivan Silveira; Lehnen, Georgia Cristina; Vieira, Marcus Fraga

    2016-01-01

    Most studies on the prevalence of back pain have evaluated it in developed countries (Human Development Index—HDI > 0.808), and their conclusions may not hold for developing countries. The aim of this study was to identify the prevalence of back pain in representative Brazilian athletes from public high schools. This cross-sectional study was performed during the state phase of the 2015 Jogos dos Institutos Federais (JIF), or Federal Institutes Games, in Brazil (HDI = 0.744), and it enrolled 251 athletes, 173 males and 78 females (14–20 years old). The dependent variable was back pain, and the independent variables were demographic, socioeconomic, psychosocial, hereditary, exercise-level, anthropometric, strength, behavioral, and postural factors. The prevalence ratio (PR) was calculated using multivariable analysis according to the Poisson regression model (α = 0.05). The prevalence of back pain in the three months prior to the study was 43.7% (n = 104), and 26% of the athletes reported feeling back pain only once. Multivariable analysis showed that back pain was associated with demographic (sex), psychosocial (loneliness and loss of sleep in the previous year), hereditary (ethnicity, parental back pain), strength (lumbar and hand forces), anthropometric (body mass index), behavioral (sleeping time per night, reading and studying in bed, smoking habits in the previous month), and postural (sitting posture while writing, while on a bench, and while using a computer) variables. Participants who recorded higher levels of lumbar and manual forces reported a lower prevalence of back pain (PR < 0.79), whereas feeling lonely in the previous year, obesity, and ethnicity exhibited the highest prevalence ratio (PR > 1.30). In conclusion, there is no association between exercise levels and back pain but there is an association between back pain and non-exercise related variables. PMID:26938456

  9. Prevalence of Vitamin D Deficiency in Korean Children Presenting with Nonspecific Lower-Extremity Pain

    PubMed Central

    Park, Min Jung; Lee, Juyeob; Lee, Jun Ku

    2015-01-01

    Purpose Although interest in the role played by vitamin D in bone health is increasing, little is known about the role of this vitamin in musculoskeletal pain in children. This study aimed to assess the prevalence of vitamin D deficiency in children presenting with nonspecific lower extremity pains. Materials and Methods From 2011 to 2012, 183 children underwent evaluation for nonspecific lower-extremity pains. Patients with valid causes, such as fractures or transient synovitis, were excluded, as were those with underlying medical conditions, such as cerebral palsy and metabolic disease. Ultimately, 140 patients met the inclusion criteria. Levels of serum 25-hydroxy vitamin D [25-(OH)D], the ideal indicator of vitamin D status, were measured in these children. Results Eighty-seven boys (62.1%) and 53 girls (37.9%) were included. The mean age at presentation was 5.2 years (range, 2-15). Serum 25-(OH)D levels were <10 ng/mL in 5.7% of patients, 10 to <20 ng/mL in 51.4%, 20 to <30 ng/mL in 37.9%, and ?30 ng/mL in only 5.0%. Most patients visited the hospital in the winter (41.4%) (summer, 12.9%), and serum 25-(OH)D levels were also lowest in the winter (17.25.5 ng/mL). Conclusion This study found a high prevalence of vitamin D deficiency or insufficiency in Korean children with nonspecific lower-extremity pains, indicating a positive association between vitamin D deficiency and growing pains. More attention should be directed toward vitamin D and its role in the optimization of bone health. PMID:26256984

  10. Prevalence of neuropathic pain after radical sacral chordoma resection: an observational cohort study with 10-year follow-up.

    PubMed

    Phimolsarnti, Rapin; Waikakul, Saranatra

    2015-07-01

    This study was carried out to discover the prevalence, characteristics and severity of neuropathic pain after wide resection of chordoma of the sacrum by the use of posterior approach. Patients who had chordoma of their sacrums and underwent wide resection via posterior approach, during 1990-2002, were followed up as a prospective cohort. Pain assessment was carried out in terms of onset, characteristics, intensity (numerical rating scale), response to pain medication and associated symptoms. The correlation between patients' biographic data, preoperative neuropathic pain, type and levels of surgery and pain were analyzed. There were 21 patients; 14 male and 7 female patients. Their ages ranged between 29 and 75 years. Subtotal sacrectomy was carried out in 9 patients and total sacrectomy was carried out in 12 patients. All patients survived the operation. Neuropathic pain was found in 11 patients (52.4%). Male patients and presentation of preoperative neuropathic pain were significantly related to postoperative neuropathic pain. The other factors were not related to the postoperative pain. Recurrent of severe pain with different characteristics after the operation might indicate tumor recurrent. Early detection of the pain and proper treatment could minimize pain intensity and improved pain management satisfaction. PMID:25200317

  11. National Breakthrough Pain Study: prevalence, characteristics, and associations with health outcomes.

    PubMed

    Narayana, Arvind; Katz, Nathaniel; Shillington, Alicia C; Stephenson, Judith J; Harshaw, Qing; Frye, Carla B; Portenoy, Russell K

    2015-02-01

    The National Breakthrough Pain Study is a large observational study that assessed breakthrough pain (BTP) in a population of commercially insured community-dwelling patients with opioid-treated chronic pain. Eligible patients were identified from an administrative claims database, and consenting patients were asked to complete a structured telephone interview and several validated questionnaires. Questionnaires assessed pain interference with function (Brief Pain Inventory-Short Form), health status (Short Form 12 [SF-12] Health Survey), disability (Sheehan Disability Scale), work performance (World Health Organization Health and Work Performance Questionnaire), and mood (Generalized Anxiety Disorder-7 Screener [GAD-7] and Patient Health Questionnaire-2 [PHQ-2]). Of 2198 patients interviewed, 1278 patients had persistent pain controlled with opioid therapy; 1023 (80%) of these patients reported BTP. Patients had a median of 2.0 episodes of BTP per day (range, 1-50) and a median duration of BTP of 45 minutes (range, 1-720). Compared with patients without BTP, patients with BTP had more pain-related interference in function (Brief Pain Inventory, mean ± SD: 34.2 ± 15.6 vs 25.0 ± 15.7 [P < 0.001]), worse physical health (SF-12 physical component score: 29.9 ± 9.6 vs 35.1 ± 10.4 [P < 0.001]) and mental health (SF-12 mental component score: 47.4 ± 11.3 vs 49.3 ± 10.4 [P < 0.001]), more disability (Sheehan Disability Scale global impairment score: 15.1 ± 9.1 vs 10.6 ± 8.5; World Health Organization Health and Work Performance Questionnaire absolute absenteeism: 12.4 ± 59.9 vs 7.7 ± 44.9 hours [both P < 0.001]), and worse mood (GAD-7 score: 7.4 ± 5.9 vs 5.9 ± 5.4; PHQ-2 anhedonia score: 1.2 ± 1.1 vs 0.9 ± 1.0 [both P < 0.001]). In this population of community-dwelling patients with opioid-treated chronic pain, BTP was highly prevalent and associated with negative outcomes. This burden of illness suggests the need for specific treatment plans. PMID:25599446

  12. Prevalence of chronic non-cancer pain in a UK prison environment

    PubMed Central

    Mayhew, Rachel

    2015-01-01

    Chronic non-cancer pain (CNCP) is significant global health issue, accounting for a substantial increase in prescription analgesics worldwide, in recent decades. This clinical burden is evident in the UK prison population, where the prevalence of CNCP has never previously been determined. This study, conducted in June/July 2013, used prescribing data and a systematic review of clinical records from two UK prison establishments to derive a figure for point-prevalence of CNCP. Results showed that 20% of the total aggregated prisoner rolls (N = 1944) described CNCP and had been in receipt of treatment with daily analgesia, for a period of at least 3 months prior to observation date. This prevalence of CNCP was related to increasing age group (Spearman’s rank correlation 0.94). Of those on continuous analgesic therapy (CAT), 44% were taking continuous opioid therapy (COT) of any sort. Prisoners with a diagnosis of opioid-type drug dependence (OTDD) were more than twice as likely to complain of CNCP and be on continuous medication for it (odds ratio 2.3). The issues relating to CNCP in prisons are discussed. Further research is recommended, identifying factors influencing CNCP prevalence in prisons, and enabling comparisons to CNCP prevalence in the UK general population. PMID:26516564

  13. Neuropathic Pain and Psychological Morbidity in Patients with Treated Leprosy: A Cross-Sectional Prevalence Study in Mumbai

    PubMed Central

    Lasry-Levy, Estrella; Hietaharju, Aki; Pai, Vivek; Ganapati, Ramaswamy; Rice, Andrew S. C.; Haanp, Maija; Lockwood, Diana N. J.

    2011-01-01

    Background Neuropathic pain has been little studied in leprosy. We assessed the prevalence and clinical characteristics of neuropathic pain and the validity of the Douleur Neuropathique 4 questionnaire as a screening tool for neuropathic pain in patients with treated leprosy. The association of neuropathic pain with psychological morbidity was also evaluated. Methodology/Principal Findings Adult patients who had completed multi-drug therapy for leprosy were recruited from several Bombay Leprosy Project clinics. Clinical neurological examination, assessment of leprosy affected skin and nerves and pain evaluation were performed for all patients. Patients completed the Douleur Neuropathique 4 and the 12-item General Health Questionnaire to identify neuropathic pain and psychological morbidity. Conclusions/Significance One hundred and one patients were recruited, and 22 (21.8%) had neuropathic pain. The main sensory symptoms were numbness (86.4%), tingling (68.2%), hypoesthesia to touch (81.2%) and pinprick (72.7%). Neuropathic pain was associated with nerve enlargement and tenderness, painful skin lesions and with psychological morbidity. The Douleur Neuropathique 4 had a sensitivity of 100% and specificity of 92% in diagnosing neuropathic pain. The Douleur Neuropathique 4 is a simple tool for the screening of neuropathic pain in leprosy patients. Psychological morbidity was detected in 15% of the patients and 41% of the patients with neuropathic pain had psychological morbidity. PMID:21408111

  14. Untying chronic pain: prevalence and societal burden of chronic pain stages in the general population - a cross-sectional survey

    PubMed Central

    2014-01-01

    Background Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods A cross-sectional survey with 4360 people aged???14years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load, were tested by Poisson and logistic regression analyses. Results 2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and 6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]). Conclusion Chronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load. PMID:24725286

  15. Urine drug testing of chronic pain patients. II. Prevalence patterns of prescription opiates and metabolites.

    PubMed

    Heltsley, Rebecca; Zichterman, Anne; Black, David L; Cawthon, Beverly; Robert, Tim; Moser, Frank; Caplan, Yale H; Cone, Edward J

    2010-01-01

    This study of 20,089 urine specimens from chronic pain patients provided a unique opportunity to evaluate the prevalence of prescription opiates and metabolites, assess the usefulness of inclusion of normetabolites in the test panel, and compare opiate and oxycodone screening results to liquid chromatography with tandem mass spectrometry (LC-MS-MS) results. All specimens were screened by an opiate [enzyme-linked immunosorbent assay (ELISA), 100 ng/mL] and oxycodone assay [ELISA, 100 ng/mL or enzyme immunoassay (EIA), 50 ng/mL] and simultaneously tested by LC-MS-MS [limit of quantitation (LOQ) = 50 ng/mL] for 10 opiate analytes (codeine, norcodeine, morphine, hydrocodone, dihydrocodeine, norhydrocodone, hydromorphone, oxycodone, noroxycodone, and oxymorphone). Approximately two-thirds of the specimens were positive for one or more opiate analytes. The number of analytes detected in each specimen varied from 1 to 8 with 3 (34.8%) being most prevalent. Hydrocodone and oxycodone (in combination with metabolites) were most prevalent followed by morphine. Norcodeine was only infrequently detected whereas the prevalence of norhydrocodone and noroxycodone was approximately equal to the prevalence of the parent drug. A substantial number of specimens were identified that contained norhydrocodone (n = 943) or noroxycodone (n = 702) but not the parent drug, thereby establishing their interpretative value as biomarkers of parent drug use. Comparison of the two oxycodone screening assays revealed that the oxycodone ELISA had broader cross-reactivity with opiate analytes, and the oxycodone EIA was more specific for oxycodone. Specimens containing only norhydrocodone were best detected with the opiate ELISA whereas noroxycodone (only) specimens were best detected by the oxycodone EIA. PMID:20109300

  16. Prevalence of restless legs syndrome in somatoform pain disorder and its effect on quality of life

    PubMed Central

    Chatterjee, Seshadri Sekhar; Mitra, Sayantanava; Guha, Prathama; Chakraborty, Kaustav

    2015-01-01

    Background: Persistent somatoform pain disorder (SPD) is a condition in which the patient suffers from persistent, severe and distressing pain; and from associated physical and psychological distress. While presence of restless leg syndrome (RLS) in SPD is understudied, their association might have an impact on general well-being and quality of life (QoL) in SPD. Aims and Objectives: Present study aimed at evaluating the prevalence of RLS in SPD patients attending outpatient department services at a tertiary care institute in eastern India. Materials and Methods: Two hundred and forty consecutive patients with SPD were screened initially and after applying appropriate inclusion and exclusion criteria, 192 subjects (male = 85, female = 107) were included in the study. Severity of RLS was assessed using a questionnaire of the International Restless Legs Syndrome Study Group and QoL was measured on QoL Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). Results: Revealed a 28% prevalence of RLS is in patients with SPD, which is much higher than its estimated population prevalence. A larger proportion of those with RLS had continuous course of SPD, longer duration of SPD, and higher daytime sleepiness. They also had poorer scores on Q-LES-Q-SF, indicating a poorer QoL overall. Discussion and Conclusion: This is the first report, to the best of our knowledge, on this aspect from India. While this association between RLS and SPD may have biological explanation based on abnormal monoaminergic neurotransmission system, the findings call for more vigilant approach to SPD patients in order to improve their QoL and add to their well-being. PMID:25883472

  17. Pain in Parkinson's Disease: A Cross-Sectional Study of Its Prevalence, Types, and Relationship to Depression and Quality of Life.

    PubMed

    Valkovic, Peter; Minar, Michal; Singliarova, Helena; Harsany, Jan; Hanakova, Marta; Martinkova, Jana; Benetin, Jan

    2015-01-01

    Pain is an important and distressing symptom in Parkinson's disease (PD). Our aim was to determine the prevalence of pain, its various types and characteristics, as well as its impact on depression and quality of life (QoL) in patients with PD. How pain differs in early- and advanced-stage PD and male and female PD patients was of special interest. One hundred PD patients on dopaminergic medications had a neurological examination and participated in a structured interview on pain characteristics and completed standardized questionnaires. A total of 76% of the patients had pain. The following types of pain were present: musculoskeletal pain accounted for 41% of the total pain, dystonic pain for 17%, central neuropathic pain for 22%, radicular pain for 27%, and other pains (non-radicular low back pain, arthritic, and visceral pain) made up 24%. One type of pain affected 29% of all the subjects, two types 35%, three types 10%, and four types of pain were reported by 2%. All types of pain were more prevalent in advanced-stage PD subjects than in early-stage PD subjects, except for arthritic pain (subclassified under"other pain"). The frequency and intensity of actual, average, and worst experienced pain were significantly more severe in advanced-stage subjects. PD subjects with general pain and in advanced stages were more depressed and had poorer QoL. Depression correlated with worst pain in the last 24 hours and with pain periodicity (the worst depression score in patients with constant pain). QoL correlated with average pain in the last 7 days. Pain is a frequent problem in PD patients, and it worsens during the course of the disease. PMID:26309254

  18. Pain in Parkinson´s Disease: A Cross-Sectional Study of Its Prevalence, Types, and Relationship to Depression and Quality of Life

    PubMed Central

    Singliarova, Helena; Harsany, Jan; Hanakova, Marta; Martinkova, Jana; Benetin, Jan

    2015-01-01

    Pain is an important and distressing symptom in Parkinson’s disease (PD). Our aim was to determine the prevalence of pain, its various types and characteristics, as well as its impact on depression and quality of life (QoL) in patients with PD. How pain differs in early- and advanced-stage PD and male and female PD patients was of special interest. One hundred PD patients on dopaminergic medications had a neurological examination and participated in a structured interview on pain characteristics and completed standardized questionnaires. A total of 76% of the patients had pain. The following types of pain were present: musculoskeletal pain accounted for 41% of the total pain, dystonic pain for 17%, central neuropathic pain for 22%, radicular pain for 27%, and other pains (non-radicular low back pain, arthritic, and visceral pain) made up 24%. One type of pain affected 29% of all the subjects, two types 35%, three types 10%, and four types of pain were reported by 2%. All types of pain were more prevalent in advanced-stage PD subjects than in early-stage PD subjects, except for arthritic pain (subclassified under”other pain”). The frequency and intensity of actual, average, and worst experienced pain were significantly more severe in advanced-stage subjects. PD subjects with general pain and in advanced stages were more depressed and had poorer QoL. Depression correlated with worst pain in the last 24 hours and with pain periodicity (the worst depression score in patients with constant pain). QoL correlated with average pain in the last 7 days. Pain is a frequent problem in PD patients, and it worsens during the course of the disease. PMID:26309254

  19. Prevalence and correlates of foot pain in a population-based study: the North West Adelaide health study

    PubMed Central

    Hill, Catherine L; Gill, Tiffany K; Menz, Hylton B; Taylor, Anne W

    2008-01-01

    Background Few population-based studies have examined the prevalence of foot pain in the general community. The aims of this study were therefore to determine the prevalence, correlates and impact of foot pain in a population-based sample of people aged 18 years and over living in the northwest region of Adelaide, South Australia. Methods The North West Adelaide Health Study is a representative longitudinal cohort study of n = 4,060 people randomly selected and recruited by telephone interview. The second stage of data collection on this cohort was undertaken between mid 2004 and early 2006. In this phase, information regarding the prevalence of musculoskeletal conditions was included. Overall, n = 3,206 participants returned to the clinic during the second visit, and as part of the assessment were asked to report whether they had pain, aching or stiffness on most days in either of their feet. Data were also collected on body mass index (BMI); major medical conditions; other joint symptoms and health-related quality of life (the Medical Outcomes Study Short Form 36 [SF-36]). Results Overall, 17.4% (95% confidence interval 16.2 18.8) of participants indicated that they had foot pain, aching or stiffness in either of their feet. Females, those aged 50 years and over, classified as obese and who reported knee, hip and back pain were all significantly more likely to report foot pain. Respondents with foot pain scored lower on all domains of the SF-36 after adjustment for age, sex and BMI. Conclusion Foot pain affects nearly one in five of people in the community, is associated with increased age, female sex, obesity and pain in other body regions, and has a significant detrimental impact on health-related quality of life. PMID:18822153

  20. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity

    PubMed Central

    Latthe, Pallavi; Latthe, Manish; Say, Lale; Glmezoglu, Metin; Khan, Khalid S

    2006-01-01

    Background Health care planning for chronic pelvic pain (CPP), an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates. Methods We identified data available from Medline (1966 to 2004), Embase (1980 to 2004), PsycINFO (1887 to 2003), LILACS (1982 to 2004), Science Citation index, CINAHL (January 1980 to 2004) and hand searching of reference lists. Two reviewers extracted data independently, using a piloted form, on participants' characteristics, study quality and rates of CPP. We considered a study to be of high quality (valid) if had at least three of the following features: prospective design, validated measurement tool, adequate sampling method, sample size estimation and response rate >80%. We performed both univariate and multivariate meta-regression analysis to explore heterogeneity of results across studies. Results There were 178 studies (459975 participants) in 148 articles. Of these, 106 studies were (124259 participants) on dysmenorrhoea, 54 (35973 participants) on dyspareunia and 18 (301756 participants) on noncyclical pain. There were only 19/95 (20%) less developed and 1/45 (2.2%) least developed countries with relevant data in contrast to 22/43 (51.2%) developed countries. Meta-regression analysis showed that rates of pain varied according to study quality features. There were 40 (22.5%) high quality studies with representative samples. Amongst them, the rate of dysmenorrhoea was 16.8 to 81%, that of dyspareunia was 8 to 21.8%, and that for noncyclical pain was 2.1 to 24%. Conclusion There were few valid population based estimates of disease burden due to CPP from less developed countries. The variation in rates of CPP worldwide was due to variable study quality. Where valid data were available, a high disease burden of all types of pelvic pain was found. PMID:16824213

  1. A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population

    PubMed Central

    Mansfield, Kathryn E.; Sim, Julius; Jordan, Joanne L.; Jordan, Kelvin P.

    2016-01-01

    Abstract Chronic widespread pain (CWP) is common and associated with poor general health. There has been no attempt to derive a robust prevalence estimate of CWP or assess how this is influenced by sociodemographic factors. This study therefore aimed to determine, through a systematic review and meta-analysis, the prevalence of CWP in the adult general population and explore variation in prevalence by age, sex, geographical location, and criteria used to define CWP. MEDLINE, Embase, CINAHL, and AMED were searched using a search strategy combining key words and related database-specific subject terms to identify relevant cohort or cross-sectional studies published since 1990. Included articles were assessed for risk of bias. Prevalence figures for CWP (American College of Rheumatology criteria) were stratified according to geographical location, age, and sex. Potential sources of variation were investigated using subgroup analyses and meta-regression. Twenty-five articles met the eligibility criteria. Estimates for CWP prevalence ranged from 0% to 24%, with most estimates between 10% and 15%. The random-effects pooled prevalence was 10.6% (95% confidence intervals: 8.6-12.9). When only studies at low risk of bias were considered pooled, prevalence increased to 11.8% (95% confidence intervals: 10.3-13.3), with reduced but still high heterogeneity. Prevalence was higher in women and in those aged more than 40 years. There was some limited evidence of geographic variation and cultural differences. One in 10 adults in the general population report chronic widespread pain with possible sociocultural variation. The possibility of cultural differences in pain reporting should be considered in future research and the clinical assessment of painful conditions. PMID:26270591

  2. A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population.

    PubMed

    Mansfield, Kathryn E; Sim, Julius; Jordan, Joanne L; Jordan, Kelvin P

    2016-01-01

    Chronic widespread pain (CWP) is common and associated with poor general health. There has been no attempt to derive a robust prevalence estimate of CWP or assess how this is influenced by sociodemographic factors. This study therefore aimed to determine, through a systematic review and meta-analysis, the prevalence of CWP in the adult general population and explore variation in prevalence by age, sex, geographical location, and criteria used to define CWP. MEDLINE, Embase, CINAHL, and AMED were searched using a search strategy combining key words and related database-specific subject terms to identify relevant cohort or cross-sectional studies published since 1990. Included articles were assessed for risk of bias. Prevalence figures for CWP (American College of Rheumatology criteria) were stratified according to geographical location, age, and sex. Potential sources of variation were investigated using subgroup analyses and meta-regression. Twenty-five articles met the eligibility criteria. Estimates for CWP prevalence ranged from 0% to 24%, with most estimates between 10% and 15%. The random-effects pooled prevalence was 10.6% (95% confidence intervals: 8.6-12.9). When only studies at low risk of bias were considered pooled, prevalence increased to 11.8% (95% confidence intervals: 10.3-13.3), with reduced but still high heterogeneity. Prevalence was higher in women and in those aged more than 40 years. There was some limited evidence of geographic variation and cultural differences. One in 10 adults in the general population report chronic widespread pain with possible sociocultural variation. The possibility of cultural differences in pain reporting should be considered in future research and the clinical assessment of painful conditions. PMID:26270591

  3. Prevalence of Gastrointestinal Diseases and Treatment Status in Noncardiac Chest Pain Patients

    PubMed Central

    Park, Sung-Hun; Choi, Ja Yeon; Park, Eun Jin; Lee, Jae Joong; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Jin Won; Kim, Eung Ju; Rha, Seung-Woon; Seo, Hong Seog; Oh, Dong Joo

    2015-01-01

    Background and Objectives We evaluated the prevalence of gastroesophageal reflux diseases (GERD) in noncardiac chest pain (NCCP) patients, risk factors for GERD, and status of prescriptions for GERD in Korean population. Subjects and Methods This was a retrospective non-interventional observational nation-wide 45-center study. Patients with a normal coronary angiogram (CAG) and upper gastroendoscopy within 2 years after CAG were enrolled. The prevalence of GERD was examined. Other gastrointestinal diseases including peptic ulcer diseases or gastritis were also examined. Risk factors for GERD were compared between the GERD group and non-GERD group. The ratio of patients medicated for gastrointestinal diseases (antacids or proton-pump inhibitor) was also examined. Results Nine hundred four patients were enrolled. Among the NCCP patients, GERD was present in 436 (48.2%), peptic ulcer disease in 154 patients (17.0%), and gastritis in 659 (72.9%). There was no difference in risk factors for GERD between the GERD and non-GERD patients. Medications for GERD and other gastrointestinal diseases were prescribed in 742 (82.1%) patients. Conclusion GERD was common (42.8%) in Korean NCCP patients and most (82.1%) received the prescription of gastrointestinal medications. No differences were evident in risk factors between GERD and non-GERD patients. PMID:26617648

  4. Musculoskeletal pain and limitations in work ability in Swedish marines: a cross-sectional survey of prevalence and associated factors

    PubMed Central

    Monnier, Andreas; Larsson, Helena; Djupsjöbacka, Mats; Brodin, Lars-Åke; Äng, Björn O

    2015-01-01

    Objectives To estimate the prevalence of self-rated musculoskeletal pain and pain limiting work ability in Swedish Armed Forces (SAF) marines, and to study factors potentially associated with pain limiting work ability for the most prevalent pain regions reported. Design Population-based, cross-sectional survey. Participants There were 272 SAF marines from the main marine battalion in Sweden included in the study. Outcomes Self-assessed musculoskeletal pain and pain limiting the marines' work ability within a 6-month period, as obtained from structured questionnaires. The association of individual, health and work-related factors with musculoskeletal pain limiting work ability was systematically regressed with multiple logistic models, estimating OR and 95% CI. Results Musculoskeletal pain and pain limiting work ability were most common in the back, at 46% and 20%, and lower extremities at 51% and 29%, respectively. Physical training ≤1 day/week (OR 5.3, 95% CI 1.7 to 16.8); body height ≤1.80 m (OR 5.0, 95% CI 1.6 to 15.1) and ≥1.86 m (OR 4.4, 95% CI 1.4 to 14.1); computer work 1/4 of the working day (OR 3.2, 95% CI 1.0 to 10.0) and ≥1/2 (OR 3.3, 95% CI 1.1 to 10.1) of the working day were independently associated with back pain limiting work ability. None of the studied variables emerged significantly associated with such pain for the lower extremities. Conclusions Our findings show that musculoskeletal pain and resultant limitations in work ability are common in SAF marines. Low frequency of physical training emerged independently associated with back pain limiting work ability. This suggests that marines performing physical training 1 day per week or less are suitable candidates for further medical evaluation and secondary preventive actions. While also associated, body height and computer work need further exploration as underlying mechanisms for back pain limiting work ability. Further prospective studies are necessary to clarify the direction of causality. PMID:26443649

  5. Prevalence of nonspecific lumbar pain and associated factors among adolescents in Uruguaiana, state of Rio Grande do Sul???

    PubMed Central

    Graup, Susane; de Arajo Bergmann, Mauren Lcia; Bergmann, Gabriel Gustavo

    2014-01-01

    Objective To identify the prevalence of nonspecific lumbar pain and associated factors among adolescents in Uruguaiana, state of Rio Grande do Sul. Methods This was a cross-sectional school-based study conducted among adolescents aged 1017 years who were enrolled in the day shift of the municipal and state educational systems of Uruguaiana. This study evaluated 1455 adolescents. The data-gathering procedures involved two stages. Firstly, a questionnaire on sociodemographic indicators, behavioral patterns and habits of the daily routine and history of nonspecific lumbar pain was applied. Subsequently, height, body mass, flexibility and abdominal strength/resistance measurements were evaluated. To analyze the data, univariate, bivariate and multivariable methods were used and the significance level was taken to be 5% for all the tests. Results The prevalence of lumbar pain among the adolescents evaluated was 16.1%. Grouped according to sex, the prevalence among males was 10.5% and among females, 21.6%. The variables of sex, body mass index, abdominal strength/resistance and physical activity level presented statistically significant associations with nonspecific lumbar pain. In the adjusted analysis, sex (OR=2.36; p<0.001), age (OR=1.14; p<0.001) and body mass index (OR=1.44; p=0.029) maintained significance in the final model. Conclusions Female adolescents of older age and who presented overweight or obesity had higher chances of developing nonspecific lumbar pain. PMID:26229878

  6. A School-Based Survey of Recurrent Non-Specific Low-Back Pain Prevalence and Consequences in Children

    ERIC Educational Resources Information Center

    Jones, M. A.; Stratton, G.; Reilly, T.; Unnithan, V. B.

    2004-01-01

    The aim of this investigation was to provide evidence of the prevalence and consequences of recurrent low-back pain in children from Northwest England. A cross-sectional survey was conducted involving a standardized questionnaire with established reliability and validity. A cross-sectional sample of 500 boys (n = 249) and girls (n = 251) aged

  7. A School-Based Survey of Recurrent Non-Specific Low-Back Pain Prevalence and Consequences in Children

    ERIC Educational Resources Information Center

    Jones, M. A.; Stratton, G.; Reilly, T.; Unnithan, V. B.

    2004-01-01

    The aim of this investigation was to provide evidence of the prevalence and consequences of recurrent low-back pain in children from Northwest England. A cross-sectional survey was conducted involving a standardized questionnaire with established reliability and validity. A cross-sectional sample of 500 boys (n = 249) and girls (n = 251) aged…

  8. Ethnic differences in pain and pain management.

    PubMed

    Campbell, Claudia M; Edwards, Robert R

    2012-05-01

    Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of the healthcare system, that may contribute to shaping individual differences in pain. For example, the experience of pain differentially activates stress-related physiological responses across various ethnic groups, members of different ethnic groups appear to use differing coping strategies in managing pain complaints, providers' treatment decisions vary as a function of patient ethnicity and pharmacies in predominantly minority neighborhoods are far less likely to stock potent analgesics. These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes. PMID:23687518

  9. Ethnic differences in pain and pain management

    PubMed Central

    Campbell, Claudia M; Edwards, Robert R

    2012-01-01

    SUMMARY Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of the healthcare system, that may contribute to shaping individual differences in pain. For example, the experience of pain differentially activates stress-related physiological responses across various ethnic groups, members of different ethnic groups appear to use differing coping strategies in managing pain complaints, providers’ treatment decisions vary as a function of patient ethnicity and pharmacies in predominantly minority neighborhoods are far less likely to stock potent analgesics. These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes. PMID:23687518

  10. Gender differences in pain levels before and after treatment: a prospective outcomes study on 3,900 Swiss patients with musculoskeletal complaints

    PubMed Central

    2012-01-01

    Background Current studies comparing musculoskeletal pain levels between the genders focus on a single point in time rather than measuring change over time. The purpose of this study is to compare pain levels between males and females before and after treatment. Methods Eleven different patient cohorts (3,900 patients) included in two prospective outcome databases collected pain data at baseline and 1?month after treatment. Treatments were either imaging-guided therapeutic injections or chiropractic therapy. The MannWhitney U test was used to calculate differences in numerical rating scale (NRS) median scores between the genders for both time points in all 11 cohorts. Results Females reported significantly higher baseline pain scores at 4 of the 11 sites evaluated (glenohumeral (p = 0.015), subacromial (p = 0.002), knee (p = 0.023) injections sites and chiropractic low back pain (LBP) patients (p = 0.041)). However, at 1?month after treatment there were no significant gender differences in pain scores at any of the extremity sites. Only the chiropractic LBP patients continued to show higher pain levels in females at 1?month. Conclusions In these 11 musculoskeletal sites evaluated before and after treatment, only 3 extremity sites and the chiropractic LBP patients showed significantly higher baseline pain levels in females. At 1?month after treatment only the LBP patients had significant gender differences in pain levels. Gender evaluation of change in pain over time is likely to be more clinically important than an isolated pain measurement for certain anatomical sites. PMID:23217116

  11. Association between Hypertension and the Prevalence of Low Back Pain and Osteoarthritis in Koreans: A Cross-Sectional Study

    PubMed Central

    Bae, Young-Hyeon; Shin, Joon-Shik; Lee, Jinho; Kim, Me-riong; Park, Ki Byung; Cho, Jae-Heung; Ha, In-Hyuk

    2015-01-01

    Background Hypertension and musculoskeletal disorders are highly prevalent in adult populations. The objective of this study was to investigate the association between hypertension and prevalence of low back pain (LBP) and osteoarthritis in Koreans. Methods A total 17,128 participants (age ?20 years) who answered low back pain and osteoarthritis items in the 4th Korean National Health and Nutrition Examination Survey (20072009) were analyzed. Odds ratios were calculated using logistic regression and were adjusted for age, sex, income level, education, occupation, BMI, smoking status, alcohol consumption, and physical activity. Results Lifetime prevalence of LBP in hypertensive subjects was 34.4%, and that of osteoarthritis 26.2%. LBP prevalence was significantly lower in hypertensives (fully adjusted OR 0.79; 95% CI 0.700.90), and both LBP and osteoarthritis prevalence was significantly lower in participants with systolic blood pressure ?140mmHg than those with <120mmHg (fully adjusted OR 0.81; 95% CI 0.700.94, and 0.81; 95% CI 0.680.96, respectively). Prevalence of LBP in subjects with diastolic blood pressure ?90mmHg was also significantly lower than those with <80mmHg (fully adjusted OR 0.73; 95% CI 0.630.85). LBP and osteoarthritis prevalence did not differ by systolic or diastolic blood pressure interval in respondents taking antihypertensive medication. LBP and osteoarthritis prevalence increased with longer hypertension duration (fully adjusted p for trend 0.028, and 0.0008, respectively). Conclusions Hypertension showed an inverse relationship with LBP and osteoarthritis prevalence, which may be ascribed to hypertension-associated hypalgesia, and antihypertensive medication intake and longer hypertension duration attenuated this association. PMID:26393797

  12. Prevalence and individual risk factors associated with clinical lumbar instability in rice farmers with low back pain

    PubMed Central

    Puntumetakul, Rungthip; Yodchaisarn, Wantanee; Emasithi, Alongkot; Keawduangdee, Petcharat; Chatchawan, Uraiwan; Yamauchi, Junichiro

    2015-01-01

    Introduction Clinical lumbar instability (CLI) is one of the subgroups of chronic non-specific low back pain. Thai rice farmers often have poor sustained postures during a rice planting process and start their farming at an early age. However, individual associated factors of CLI are not known and have rarely been diagnosed in low back pain. This study aimed to determine the prevalence and individual associated factors of CLI in Thai rice farmers. Methods A cross-sectional survey was conducted among 323 Thai rice farmers in a rural area of Khon Kaen province, Thailand. Face-to-face interviews were conducted using the 13-item Delphi criteria questionnaire, after which an objective examination was performed using aberrant movement sign, painful catch sign, and prone instability test to obtain information. Individual factors such as sex, body mass index, waist-hip ratio, smoking, and number of years of farming experience, were recorded during the face-to-face interview. Results The prevalence of CLI in Thai rice farmers calculated by the method described in this study was 13% (age 44±10 years). Number of years of farming experience was found to be significantly correlated with the prevalence of CLI (adjusted odds ratio =2.02, 95% confidence interval =1.03–3.98, P<0.05). Conclusion This study provides prevalence of CLI in Thai rice farmers. Those with long-term farming experience of at least 30 years have a greater risk of CLI. PMID:25565778

  13. Self-Reported Hindering Health Complaints of Community-Dwelling Older Persons: A Cross-Sectional Study

    PubMed Central

    van Blijswijk, Sophie C. E.; Chan, On Ying A.; van Houwelingen, Anne H.; Gussekloo, Jacobijn; den Elzen, Wendy P. J.; Blom, Jeanet W.

    2015-01-01

    Purpose Proactive care for community-dwelling older persons targeting self-reported hindering health complaints might prevent a decline in function. We investigated the spectrum of self-reported hindering complaints of community-dwelling older persons, the association with functional outcomes, and help-seeking behavior for these complaints. Methods Within the ISCOPE trial, participants (aged ?75 years) received the ISCOPE screening questionnaire, including the open-ended question At the moment, which health complaints limit you the most in your day-to-day life?. After coding the answers with the ICPC-1-NL, we examined the prevalence and the association between the number and type of complaints and functional outcomes (Groningen Activities Restriction Scale, quality of life measured on Cantrils Ladder, Mini-Mental State Examination, Geriatric Depression Scale-15, and De Jong Gierveld Loneliness Scale). Electronic patient registers were searched for the most reported complaints. Results 7285 participants (median age: 81.0 years [IQR 77.885.3], 38.6% males) reported 13,524 hindering complaints (median 1, range 018); 32.7% reported no complaints. Participants mostly reported problems with walking/standing (22.1%), pain (20.8%) or weakness/tiredness (8.5%). These complaints were mentioned in the electronic patient registers in 28.3%, 91.3% and 55.5%, respectively. Higher numbers of hindering complaints were related to poorer scores on the number of domains with problems, Cantrils Ladder for quality of life, Groningen Activities Restriction Scale, Geriatric Depression Scale, and De Jong Gierveld Loneliness Scale. Self-reported weakness, problems with walking/standing, visual limitations, cognitive problems, dyspnea and back complaints were associated with poorer scores on the number of domains with problems, Groningen Activities Restriction Scale, MMSE or Geriatric Depression Scale. Conclusion One third of the participants reported no hindering complaints. Problems with walking/standing, pain, and weakness/tiredness were most reported, but not always found in electronic patient registers. A higher number of, and specific self-reported hindering complaints, were associated with poorer scores on functional outcomes. It may be helpful for general practitioners to ask about these complaints and their influence on daily life. PMID:26571233

  14. Work-Related Health Complaints and Injuries, and Health and Safety Perceptions of Latino Day Laborers.

    PubMed

    Burgel, Barbara J; Nelson, Ronald W; White, Mary C

    2015-08-01

    This study describes socio-demographic, health, and work factors as well as health and safety perceptions of day laborers who reported work-related health complaints and injuries. The researchers completed a secondary data analysis of 217 interviews conducted in 2009 with day laborers in a large city. The participants reported 83 health complaints or injuries (38%) that had occurred during the prior 12 months, with 57 of these complaints or injuries resulting in lost work time. Pain and soreness of the back were the most prevalent health complaints or injuries; 66% of participants did not report their injuries, 62% reported no health and safety training, 96% reported they needed personal protective equipment (PPE), and 63% were provided with PPE. Latino day laborers reported a high 12-month prevalence of work-related health complaints and injuries. Ongoing policy work is needed to encourage injury reporting by day laborers and the provision of health and safety training and PPE to this group of workers. PMID:26240118

  15. Oral fluid drug testing of chronic pain patients. I. Positive prevalence rates of licit and illicit drugs.

    PubMed

    Heltsley, Rebecca; DePriest, Anne; Black, David L; Robert, Tim; Marshall, Lucas; Meadors, Viola M; Caplan, Yale H; Cone, Edward J

    2011-10-01

    Oral fluid compliance monitoring of chronic pain patients is an analytical challenge because of the limited specimen volume and the number of drugs that require detection. This study evaluated oral fluid for monitoring pain patients and compared results to urine studies of similar populations. Oral fluid specimens were analyzed from 6441 pain patients from 231 pain clinics in 20 states. Specimens were screened with 14 ELISA assays and non-negative specimens were confirmed by LC-MS-MS for 40 licit and illicit drugs and metabolites. There was an 83.9% positive screening rate (n=5401) of which 98.7% (n=5329) were confirmed at ? LOQ concentrations for at least one analyte. The prevalence of confirmed positive drug groups was as follows: opiates > oxycodone > benzodiazepines > methadone ? carisoprodol > fentanyl > cannabinoids ? tramadol > cocaine > amphetamines ? propoxyphene ? buprenorphine > barbiturates > methamphetamine. Approximately 11.5% of the study population of pain patients apparently used one or more illicit drugs (cannabis, cocaine, methamphetamine and/or MDMA). Overall, the pattern of licit and illicit drugs and metabolites observed in oral fluid paralleled results reported earlier for urine, indicating that oral fluid is a viable option for use in compliance monitoring programs of chronic pain patients. PMID:22004671

  16. Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study1

    PubMed Central

    Pereira, Lilian Varanda; de Vasconcelos, Patrícia Pereira; Souza, Layz Alves Ferreira; Pereira, Gilberto de Araújo; Nakatani, Adélia Yaeko Kyosen; Bachion, Maria Márcia

    2014-01-01

    OBJECTIVE: to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status. METHOD: cross-sectional study with a populational sample (n=934), conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more) was measured using a numerical scale (0-10) and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor). For the statistical analysis, the absolute frequency and percentage, CI (95%), Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%. RESULTS: The prevalence of chronic pain was 52.8% [CI (95%):49.4-56.1]; most frequently located in the lower limbs (34.5%) and lumbar region (29.5%); with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001) a worse self-perception of health (OR=4.2:2.5-7.0), a greater number of chronic diseases (OR=1.8:1.2-2.7), joint disease (OR=3.5:2.4-5.1) and the female gender (OR=2.3:1.7-3.0). A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001). CONCLUSION: the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population. PMID:25296151

  17. Prevalence of pain-free weeks in chiropractic subjects with low back pain - a longitudinal study using data gathered with text messages

    PubMed Central

    2011-01-01

    Introduction The use of automated text messages has made it possible to identify different courses of low back pain (LBP), and it has been observed that pain often fluctuates and that absolute recovery is rather rare. The purpose of this study was to describe the prevalence of pain-free weeks and pain-free periods in subjects with non-specific LBP treated by chiropractors, and to compare subjects from two different countries in these aspects. Methods Data were obtained from two practice-based multicentre prospective outcome studies, one Danish and one Swedish, involving subjects being treated by chiropractors for non-specific LBP. Over 18 weeks, subjects answered a weekly automated text message question on the number of days in the past week that they had experienced bothersome LBP, i.e. a number between 0 and 7. The number of weeks in a row without any LBP at all ("zero weeks") as well as the maximum number of zero weeks in a row was determined for each individual. Comparisons were made between the two study samples. Estimates are presented as percentages with 95% confidence intervals. Results In the Danish and the Swedish populations respectively, 93/110 (85%) and 233/262 (89%) of the subjects were eligible for analysis. In both groups, zero weeks were rather rare and were most commonly (in 40% of the zero weeks) reported as a single isolated week. The prevalence of pain free periods, i.e. reporting a maximum of 0, 1 or 2, or 3-6 zero weeks in a row, were similar in the two populations (20-31%). Smaller percentages were reported for ? 7 zero weeks in a row. There were no significant differences between the two study groups. Conclusion It was uncommon that chiropractic subjects treated for non-specific LBP experienced an entire week without any LBP at all over 18 weeks. When this occurred, it was most commonly reported for brief periods only. Hence, recovery in the sense that patients become absolutely pain free is rare, even in a primary care population. PMID:22168838

  18. The prevalence of musculoskeletal pain and use of painkillers among adolescent male ice hockey players in Finland

    PubMed Central

    Selanne, Harri; Ryba, Tatiana V.; Siekkinen, Kirsti; Kyrlinen, Heikki; Kautiainen, Hannu; Hakonen, Harto; Mikkelsson, Marja; Kujala, Urho M.

    2014-01-01

    Participating in competitive sport increases the risk for injuries and musculoskeletal pain among adolescent athletes. There is also evidence that the use of prescription drugs has increased among sport club athletes. The purpose of this study was to evaluate the use of painkillers among young male ice hockey players (IHP) in comparison to schoolboys (controls) and its relation to the prevalence of musculoskeletal pain and problems during activities and sleeping. Information was gathered through a questionnaire, completed by 121 IHP and compared to the responses of 618 age-matched controls. Results showed that monthly existing pain was at 82% for IHP, and 72% for controls, though IHP had statistically more musculoskeletal pain in their lower limbs (56% vs. 44%), lower back (54% vs. 35%), and buttocks (26% vs. 11%). There were no group differences in the neck, upper back, upper limb, or chest areas. The disability index was statistically similar for both groups, as musculoskeletal pain causing difficulties in daily activities and sleeping was reported by a minority of subjects. Despite this similarity, IHP used more painkillers than controls (18% vs. 10%). Further nuanced research is encouraged to compare athletes and non-athletes in relation to painkillers. PMID:25750794

  19. [Pain and cognition].

    PubMed

    Moroni, Christine; Laurent, Bernard

    2006-03-01

    Pain is a multidimensional subjective experience mediated by emotion, attitudes and other perceptual influences. The functional deficit of patients suffering from pain could be expressed by a cognitive complaint. In this paper, cognitive repercussions of pain, associated factors and iatrogenic factors are presented. According to all the relation between pain and cognition seems complex and involves factors such as depression, anxiety, and medical treatment among others. All these factors interact together and produce a specific cognitive complaint for each patient. PMID:16556515

  20. Is undergraduate physiotherapy study a risk factor for low back pain? A prevalence study of LBP in physiotherapy students

    PubMed Central

    Nyland, Leah Jane; Grimmer, Karen Anne

    2003-01-01

    Background Following reports of high prevalence of low back pain (LBP) in young physiotherapists [17-22], we investigated whether LBP was a problem for undergraduate physiotherapy students. Method Physiotherapy students enrolled in one Australian tertiary institution completed a validated self-administered questionnaire in April 2001, seeking information on LBP prevalence (lifetime, 12 month, one-month, one-week), and its risk factors. The survey incorporated the Nordic back questionnaire, questions on common risks for LBP, and purpose-built questions regarding educational exposures. Univariate logistic regression models were applied to test associations. Results and Discussion 72% students responded. LBP prevalence was 69% (lifetime), 63% (12-month), 44% (one-month), 28% (one-week). The risk of LBP increased significantly for students once they completed first year. Being aged 20 or 21 years (final year students) was significantly associated with all measures of LBP, compared with the youngest students. Exposure to tertiary study of greater than two years was associated with lifetime, 12 month and one-month LBP prevalence. Spending more than 20 hours in the past month 'sitting looking down' was significantly associated with one-month LBP prevalence. Similar exposure to 'treating patients' was significantly associated with one-month and one-week LBP prevalence. Conclusions Physiotherapy students should be alerted to the likelihood of LBP and is potential causes during their training, so that they enter the workforce with reduced risk of LBP. The potential for other undergraduate students to suffer LBP should also be considered. PMID:14536021

  1. Characteristics of visual disturbances reported by subjects with neck pain.

    PubMed

    Treleaven, Julia; Takasaki, Hiroshi

    2014-06-01

    Visual symptoms are often reported by patients with neck pain. The aim of the study was to report on the prevalence and most troublesome visual disturbances in subjects with neck pain. Seventy subjects with neck pain and seventy healthy control subjects answered questions about the presence and magnitude (/12) - product of frequency (0-4) and intensity (0-3) of each of 16 visual symptoms noted to be associated with neck pain and other possible causes. A visual complaint index (VCI) (/168) was generated from the sum of the magnitude rating of 14 significant symptoms. The neck pain group had significantly (P > 0.05) greater prevalence and magnitude of 14/16 visual complaints and VCI (mean 27.4) compared to control subjects (mean 6.2). The most prevalent symptoms were 'need to concentrate to read' (70%) and 'sensitivity to light' (58.6%). The least prevalent were 'double vision' (28.6%) and 'dizzy reading' (38.6%). The most troublesome symptoms (greatest magnitude) were 'need to concentrate to read' (3.4/12), 'visual fatigue' (3/12), 'difficulty judging distances' (2.1/12) and 'sensitivity to light' (2.1/12) while the least troublesome complaints were 'double vision' (0.5/12), 'red eyes' (1/12) and 'spots and words moving' (1/12). The characteristics of the visual symptoms were mostly consistent for those previously associated with neck pain. Subjects with traumatic neck pain had a significantly higher VCI compared to those with idiopathic neck pain. The results could help with differential diagnosis. The visual symptoms might be related to eye movement control disturbances in neck pain, however further research is required. PMID:24521926

  2. Spinal pain in adolescents: prevalence, incidence, and course: a school-based two-year prospective cohort study in 1,300 Danes aged 1113

    PubMed Central

    2014-01-01

    Background The severity and course of spinal pain is poorly understood in adolescents. The study aimed to determine the prevalence and two-year incidence, as well as the course, frequency, and intensity of pain in the neck, mid back, and low back (spinal pain). Methods This study was a school-based prospective cohort study. All 5th and 6th grade students (1113 years) at 14 schools in the Region of Southern Denmark were invited to participate (N?=?1,348). Data were collected in 2010 and again two years later, using an e-survey completed during school time. Results The lifetime prevalence of spinal pain was 86% and 89% at baseline and follow-up, respectively. A group of 13.6% (95% CI: 11.8, 15.6) at baseline and 19.5% (95% CI: 17.1, 22.0) at follow-up reported that they had pain frequently. The frequency of pain was strongly associated with the intensity of pain, i.e., the majority of the participants reported their pain as relatively infrequent and of low intensity, whereas the participants with frequent pain also experienced pain of higher intensity. The two-year incidence of spinal pain varied between 40% and 60% across the physical locations. Progression of pain from one to more locations and from infrequent to more frequent was common over the two-year period. Conclusions Spinal pain is common at the age of 1115 years, but some have more pain than others. The pain is likely to progress, i.e., to more locations, higher frequency, and higher pain intensity over a two-year period. PMID:24885549

  3. Population based study of noncardiac chest pain in southern Chinese: Prevalence, psychosocial factors and health care utilization

    PubMed Central

    Wong, Wai Man; Lam, Kwok Fai; Cheng, Cecilia; Hui, Wai Mo; Xia, Harry Hua-Xiang; Lai, Kam Chuen; Hu, Wayne H.C.; Huang, Jia Qing; Lam, Cindy L.K.; Chan, Chi Kuen; Chan, Annie O.O.; Lam, Shiu Kum; Wong, Benjamin Chun-Yu

    2004-01-01

    AIM: Population-based assessment of noncardiac chest pain (NCCP) is lacking. The aim of this study was to evaluate the prevalence, psychosocial factors and health seeking behaviour of NCCP in southern Chinese. METHODS: A total of 2209 ethnic Hong Kong Chinese households were recruited to participate in a telephone survey to study the epidemiology of NCCP using the Rose angina questionnaire, a validated gastroesophageal reflux disease (GERD) questionnaire and the hospital anxiety-depression scale. NCCP was defined as non-exertional chest pain according to the Rose angina questionnaire and had not been diagnosed as ischaemic heart diseases by a physician. RESULTS: Chest pain over the past year was present in 454 subjects (20.6%, 95%CI 19-22), while NCCP was present in 307 subjects (13.9%, 95%CI 13-15). GERD was present in 51% of subjects with NCCP and 34% had consulted a physician for chest pain. Subjects with NCCP had a significantly higher anxiety (P < 0.001) and depression score (P = 0.007), and required more days off (P = 0.021) than subjects with no chest pain. By multiple logistic regression analysis, female gender (OR 1.9, 95%CI 1.1-3.2), presence of GERD (OR 2.8, 95%CI 1.6-4.8), and social life being affected by NCCP (OR 6.9, 95%CI 3.3-15.9) were independent factors associated with health seeking behaviour in southern Chinese with NCCP. CONCLUSION: NCCP is a common problem in southern Chinese and associated with anxiety and depression. Female gender, GERD and social life affected by chest pain were associated with health care utilization in subjects with NCCP. PMID:14991943

  4. Urine drug testing of chronic pain patients. V. Prevalence of propoxyphene following its withdrawal from the United States market.

    PubMed

    Puet, Brandi; DePriest, Anne; Knight, Julie; Heltsley, Rebecca; Black, David L; Caplan, Yale H; Cone, Edward J

    2013-01-01

    Propoxyphene is an opioid analgesic that was surrounded by controversy concerning its safety and efficacy during its lifespan in the US market. Propoxyphene was withdrawn in November of 2010 from the US market and is still being detected one year post-withdrawal in urine specimens from the pain management population. In this study, the prevalence of propoxyphene was determined in a total of 417,914 urine specimens collected from 630 clinics involved in pain management located in 24 states during the period of January 1, 2010, through December 31, 2011. Propoxyphene and norpropoxyphene were measured in urine by a validated liquid chromatography-tandem mass spectrometry procedure with a lower limit of quantitation of 50 ng/mL. The positivity rate for propoxyphene prevalence declined sharply between November and December of 2010 and further declined at a gradual rate, ending in a prevalence of 0.27% (one out of every 370 specimens, n = 25,658) for the month of December 2011. The presented data provide evidence of the dramatic decline in the use of propoxyphene products since their removal from the medical market, and may be beneficial to US urine drug testing programs determining the need for continual monitoring of propoxyphene levels. PMID:23129731

  5. Prevalence of occupation-related pain among baristas and an examination of low back and shoulder demand during the preparation of espresso-based beverages.

    PubMed

    Dainty, R Scott; Alcorn, Eric; Ferguson, Chantelle A; Gregory, Diane E

    2014-01-01

    Many baristas complain of low back pain (LBP) and upper extremity discomfort while at work. This study documented the prevalence of LBP and shoulder pain, via questionnaire, among a population of baristas to determine whether cumulative low back loads and shoulder moments are associated with pain reporting. Fifty-nine baristas completed the questionnaire; ten were also video-recorded for biomechanical analysis while making espresso beverages and cumulative and peak low back loads and shoulder moments were calculated. Seventy-three percent of those who completed the questionnaire reported having experienced LBP, and half attributed this pain to their job as a barista. Furthermore, 68% reported having experienced shoulder pain and half also attributed this pain to their job. Those who suffered from LBP had higher peak low back compression and those with shoulder pain had, in general, higher moments about their dominant shoulder. PMID:24837283

  6. Prevalence, characteristics, and management of childhood functional abdominal pain in general practice

    PubMed Central

    2013-01-01

    Abstract Objective To (i) describe the proportion of children presenting with abdominal pain diagnosed by the GP as functional abdominal pain (GPFAP); (ii) evaluate the association between patient and disease characteristics and GPFAP; (iii) describe diagnostic management by the GP in children presenting with abdominal pain, and (iv) evaluate whether children with GPFAP fulfill diagnostic criteria for functional abdominal pain (FAP) as described in current literature: chronic abdominal pain (CAP) and the Rome III criteria (PRC-III) for abdominal pain-related functional gastrointestinal disorders (FGID). Design Cross-sectional study. Setting General practices in the Netherlands. Subjects 305 children aged 417 years consulting for abdominal pain. Main outcome measures GPFAP, CAP, FGIDs. Results 89.2% of children were diagnosed with GPFAP. Headaches and bloating were positively associated with GPFAP whereas fever and > 3 red flag symptoms were inversely associated. Additional diagnostic tests were performed in 26.8% of children. Less than 50% of all children with GPFAP fulfilled criteria for CAP and FGIDs; in 47.9% of patients the duration of symptoms at presentation was less than three months. Conclusions In almost 90% of children included in this study the GP suspected no organic cause for the abdominal pain. GPs diagnose FAP in children without alarm symptoms and order diagnostic testing in one out of four children presenting with abdominal pain. No difference was found in GPs management between children with a diagnosis of GPFAP and other diagnoses. Only about half of the children with a GP diagnosis of FAP fulfilled time-criteria of FAP as defined in the literature. PMID:24106821

  7. Pain.

    PubMed

    Lefaucheur, Jean-Pascal

    2013-01-01

    Invasive stimulation of the motor (precentral) cortex using surgically implanted epidural electrodes is indicated for the treatment of neuropathic pain that is refractory to medical treatment. Controlled trials have demonstrated the efficacy of epidural motor cortex stimulation (MCS), but MCS outcome remains variable and validated criteria for selecting good candidates for implantation are lacking. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive approach that could be used as a preoperative tool to predict MCS outcome and also could serve as a therapeutic procedure in itself to treat pain disorders. This requires repeated rTMS sessions and a maintenance protocol. Other studies have also demonstrated the efficacy of transcranial direct current stimulation (tDCS) in relieving chronic pain syndromes. The most studied target is the precentral cortex, but other targets, such as the prefrontal and parietal cortices, could be of interest. The analgesic effects of cortical stimulation relate to the activation of various circuits modulating neural activities in remote structures, such as the thalamus, limbic cortex, insula, or descending inhibitory controls. In addition to the treatment of refractory neuropathic pain by epidural MCS, new developments of this type of strategy are ongoing, for other types of pain syndrome and stimulation techniques. PMID:24112914

  8. Pain Prevalence and Management in an Internal Medicine Setting in Italy

    PubMed Central

    De Giorgi, Alfredo; Pala, Marco; Mallozzi Menegatti, Alessandra; Gallerani, Massimo

    2014-01-01

    Background. Since data on pain evaluation and management in patients admitted to internal medicine wards (IMWs) are limited, we aimed to evaluate these aspects in a cohort of internistic patients. Methods. We considered all patients consecutively admitted from June to December 2011 to our unit. Age, gender, and length-of-hospital-stay (LOS) were recorded. Comorbidities were arbitrarily defined, and pain severity was evaluated by Numeric Rating Scale (NRS) on admission and discharge. Results. The final sample consisted of 526 patients (mean age 74 14 years; 308 women). Significant pain (NRS ? 3) was detected in 63% of cases, and severe (NRS ? 7) in 7.6%. Pain was successfully treated, and NRS decreased from 4.65 2.05 to 0.89 1.3 (P < 0.001). Compared with subjects with NRS < 3, those with significant pain were older (75.5 13.9 versus 72.9 14.5 years, P = 0.038), and had a higher LOS (7.9 6.1 versus 7.3 6.8, P = 0.048). Significant pain was independently associated with age (OR 0.984, P = 0.018), cancer (OR 3.347, P < 0.001), musculoskeletal disease (OR 3.054, P < 0.0001), biliary disease (OR 3.100, P < 0.01), and bowel disease (OR 3.100, P < 0.003). Conclusion. In an internal medicine setting, multiple diseases represent significant cause of pain. Prompt pain evaluation and management should be performed as soon as possible, in order to avoid patients' suffering and reduce the need of hospital stay. PMID:24579045

  9. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome.

    PubMed

    Kirchhoff, Gertrud; Kirchhoff, Chlodwig; Buhmann, Sonja; Kanz, Karl-Georg; Lenz, Miriam; Vogel, Tobias; Kichhoff, Rainer Maria

    2006-01-01

    Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain. PMID:16800878

  10. [Pain on mandibular movements].

    PubMed

    Huddleston Slater, J J R; Stegenga, B

    2006-11-01

    Pain or fatigue in the masticatory muscles or pain in the temporomandibular joints are well-known complaints. Diagnosing these complaints, that have a relation with mandibular movements, can be challenging since they can arise from the teeth and surrounding tissues, the temporomandibular joints or other musculoskeletal structures. Also referred pains are a common finding in this area. Pain history and clinical examination are crucial for a comprehensive diagnosis. Besides the disorders underlying the pain (so called axis I), the impact of the pain on the patient's physical and psychosocial functioning can play an important role in the diagnosis (axis II). PMID:17147030

  11. A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks

    PubMed Central

    2011-01-01

    Background The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB), acromioclavicular joint (ACJ) and glenohumeral joint (GHJ). Methods Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance arthrogram (MRA) and GHJ diagnostic block. Differences in proportions of positive and negative imaging findings in the anaesthetic response groups were assessed using Fishers test and odds ratios were calculated a for positive anaesthetic response (PAR) to diagnostic blocks. Results In the 208 subjects recruited, the rotator cuff and SAB displayed the highest prevalence of pathology on both ultrasound (50% and 31% respectively) and MRA (65% and 76% respectively). The prevalence of PAR following SAB injection was 34% and ACJ injection 14%. Of the 59% reporting a negative anaesthetic response (NAR) for both of these injections, 16% demonstrated a PAR to GHJ injection. A full thickness tear of supraspinatus on ultrasound was associated with PAR to SAB injection (OR 5.02; p < 0.05). Ultrasound evidence of a biceps tendon sheath effusion (OR 8.0; p < 0.01) and an intact rotator cuff (OR 1.3; p < 0.05) were associated with PAR to GHJ injection. No imaging findings were strongly associated with PAR to ACJ injection (p ? 0.05). Conclusions Rotator cuff and SAB pathology were the most common findings on ultrasound and MRA. Evidence of a full thickness supraspinatus tear was associated with symptoms arising from the subacromial region, and a biceps tendon sheath effusion and an intact rotator cuff were associated with an intra-articular GHJ pain source. When combined with clinical information, these results may help guide diagnostic decision making in primary care. PMID:21619663

  12. Prevalence of Low Back Pain Among Nurses: Predisposing Factors and Role of Work Place Violence

    PubMed Central

    Rezaee, Maryam; Ghasemi, Mohammad

    2014-01-01

    Background: Ergonomic factors predispose nurses to low back pain (LBP). Few studies have clarified the role of workplace violence in LBP occurrence. Objectives: The present study was designed to investigate acute and chronic LBP in Iranian nurses and its association with exposure to physical violence as well as its personal and ergonomic risk factors. Materials and Methods: In this analytic cross sectional study, the rate of acute and chronic LBP and contributing factors were investigated among 1246 nurses using a validated questionnaire. Statistical analysis was performed by chi square, student t-test, and logistic regression, to determine the association between independent variables and LBP. Results: In total, 1246 nurses, consisting of 576 (46.23%) males and 670 (53.77%) females, were included. The mean age and the mean years of employment were 31.23 5.33 and 16.18 7.05, respectively. Both acute low back pain (ALBP) and chronic low back pain (CLBP) were associated with physical violence experience. Moreover, acute and chronic LBP were predicted by positive past history of LBP as well as two ergonomic factors, frequent bending and frequent carrying of patients. Conclusions: Besides a history of low back pain and ergonomic factors, physical violence may be considered a contributing factor for acute low back injuries. Special attention to all personal, occupational, and psychological risk factors is recommended. PMID:25717449

  13. Prevalence and risk factors of low back pain among undergraduate students of a sports and physical education institute in Tunisia.

    PubMed

    Triki, Moez; Koubaa, Abdessalem; Masmoudi, Liwa; Fellmann, Nicole; Tabka, Zouhair

    2015-01-01

    Introduction : For obvious reasons, athletes are at greater risk of sustaining a lumber (lower) spine injury due to physical activity. To our knowledge, no previous studies have examined the prevalence of low back pain (LBP) in a Tunisian sports and physical education institute. Aim : To assess the prevalence of LBP in different sports among students studying in a sports and physical education institute in Tunisia, to determine the causes of the injuries, and to propose solutions. Methods : A total of 3,379 boys and 2,579 girls were studied. A retrospective cross-sectional survey was conducted on a group of students aged 18.5-24.5 years at the Higher Institute of Sport and Physical Education of Sfax to estimate the prevalence of LBP and its relation to the type of sports. Data on age, weight, height, smoking, and the sport in which the student was injured in the low back were collected from the institute health service records from 2005 until 2013. Results : LBP was reported by 879 of the 5,958 study participants (14.8%). The prevalence of LBP was significantly higher (p<0.001) in females (17.6%) than in males (12.5%). LBP prevalence did not differ by body mass index or smoking habit (p>0.05). The sports associated with the higher rates of LBP were gymnastics, judo, handball, and volleyball, followed by basketball and athletics. Conclusion : LBP is frequent among undergraduate students of a sports and physical education institute in Tunisia. It is strongly associated with fatigue after the long periods of training in different sports. Gymnastics, judo, handball, and volleyball were identified as high-risk sports for causing LBP. PMID:25758252

  14. Prevalence and risk factors of low back pain among undergraduate students of a sports and physical education institute in Tunisia

    PubMed Central

    Triki, Moez; Koubaa, Abdessalem; Masmoudi, Liwa; Fellmann, Nicole; Tabka, Zouhair

    2015-01-01

    Introduction For obvious reasons, athletes are at greater risk of sustaining a lumber (lower) spine injury due to physical activity. To our knowledge, no previous studies have examined the prevalence of low back pain (LBP) in a Tunisian sports and physical education institute. Aim To assess the prevalence of LBP in different sports among students studying in a sports and physical education institute in Tunisia, to determine the causes of the injuries, and to propose solutions. Methods A total of 3,379 boys and 2,579 girls were studied. A retrospective cross-sectional survey was conducted on a group of students aged 18.5–24.5 years at the Higher Institute of Sport and Physical Education of Sfax to estimate the prevalence of LBP and its relation to the type of sports. Data on age, weight, height, smoking, and the sport in which the student was injured in the low back were collected from the institute health service records from 2005 until 2013. Results LBP was reported by 879 of the 5,958 study participants (14.8%). The prevalence of LBP was significantly higher (p<0.001) in females (17.6%) than in males (12.5%). LBP prevalence did not differ by body mass index or smoking habit (p>0.05). The sports associated with the higher rates of LBP were gymnastics, judo, handball, and volleyball, followed by basketball and athletics. Conclusion LBP is frequent among undergraduate students of a sports and physical education institute in Tunisia. It is strongly associated with fatigue after the long periods of training in different sports. Gymnastics, judo, handball, and volleyball were identified as high-risk sports for causing LBP. PMID:25758252

  15. Restless legs syndrome and pain disorders: what's in common?

    PubMed

    Goulart, Leonardo Ierardi; Delgado Rodrigues, Raimundo Nonato; Prieto Peres, Mario Fernando

    2014-11-01

    Between 10 % and 30 % of the population report chronic pain. More than half of these also have sleep complaints. From considering these data, it can be inferred there is a significant overlapping between these conditions. Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is characterized by complaints of an "urge to move" frequently associated with dysesthesias. From that perspective, these sensations can also have painful characteristics. By the same token, the presence of comorbid diseases as predicted by a higher prevalence RLS/WED, have many of them with pain as an important complaint. Pain is a multidimensional response involving several levels of expression ranging from somatosensory to emotional. The potential shared mechanisms between RLS/WED and pain may involve sleep deprivation/fragmentation effect, inducing an increase in markers of inflammation and reduction in pain thresholds. These are modulated by several different settings of neurotransmitters with a huge participation of monoaminergic dysfunctional circuits. A thorough comprehension of these mechanisms is of utmost importance for the correct approach and treatment choices. PMID:25249423

  16. Prevalence and social burden of active chronic low back pain in the adult Portuguese population: results from a national survey.

    PubMed

    Gouveia, Nélia; Rodrigues, Ana; Eusébio, Mónica; Ramiro, Sofia; Machado, Pedro; Canhão, Helena; Branco, Jaime C

    2016-02-01

    To determine the prevalence of active chronic low back pain (CLBP) in the adult Portuguese population; to compare the active CLBP population with the population without CLBP; and to explore factors associated with active CLBP. The present study was conducted under the scope of EpiReumaPt a population-based study. Active CLBP was self-reported and considered if present on the day of the interview and for ≥90 days. Prevalence estimates were calculated. Association of active CLBP with quality of life, functional ability and healthcare consumption were evaluated. Factors associated with active CLBP were identified through logistic regression. Among 10.661 EpiReumaPt subjects, 1487 self-reported active CLBP. The prevalence of active CLBP was 10.4 % (95 % CI 9.6; 11.9 %). After adjustment, active CLBP subjects had a higher likelihood for anxiety symptoms (OR 2.77), early retirement due to disease (OR 1.88) and more physician visits (β = 2.65). Factors significantly and independently associated with the presence of active CLBP were: female gender (OR 1.34), overweight/obesity (OR 1.27), presence of self-reported rheumatic musculoskeletal disease (RMD) (OR 2.93), anxiety symptoms (OR 2.67), age (OR 1.02) and higher number of self-reported comorbidities (OR 1.12). Active CLBP is highly prevalent in the Portuguese population and is associated with disability and with a high consumption of healthcare resources. Female gender, older age, anxiety symptoms, overweight/obesity, the presence of other RMD and the number of comorbidities were independently associated with the presence of active CLBP. These factors should be taken into account when new cohort prospective studies will be developed. PMID:26661091

  17. Prevalence of shoulder pain in Swedish flatwater kayakers and its relation to range of motion and scapula stability of the shoulder joint.

    PubMed

    Johansson, Anette; Svantesson, Ulla; Tannerstedt, Jörgen; Alricsson, Marie

    2016-05-01

    Few studies have investigated the incidence of injuries in kayakers. The aim was to study the prevalence of shoulder pain in competitive flatwater kayakers and to evaluate any differences in range of motion or scapula stability of the shoulder joint among kayakers with or without the history of shoulder pain. Thirty-one kayakers were participated in the study, and a questionnaire including background data was used. Shoulder range of motion was measured with a goniometer, and the participants were observed for scapula dyskinesis in flexion and abduction. Of the participating kayakers, 54.8% (n = 17) had experienced shoulder pain. Kayakers who had experienced shoulder pain showed a significantly lower degree of internal rotational range of motion versus kayakers with no reported shoulder pain, with a mean degree of internal rotation in the right shoulder 49.3 vs 60.0 (P = 0.017) and the left shoulder 51.9 vs 66.0 (P = 0.000). Kayakers who had experienced shoulder pain were also observed with a scapular dyskinesis (n = 15 of 17 kayakers) to a significantly higher degree (P = 0.001) than kayakers with no reported shoulder pain. Findings suggest that screening for scapular dyskinesis and testing for rotational range of motion in the shoulder joint is essential in order to treat and maybe prevent shoulder pain in kayakers. PMID:26301322

  18. Determining zolpidem compliance: urinary metabolite detection and prevalence in chronic pain patients.

    PubMed

    Schwope, David M; DePriest, Anne; Black, David L; Caplan, Yale H; Cone, Edward J; Heltsley, Rebecca

    2014-10-01

    Zolpidem (Ambien(®)) is the most prescribed insomnia treatment in the USA; however, little is known about zolpidem metabolite excretion in chronic pain patients. As zolpidem is extensively metabolized in vivo to zolpidem 4-phenyl carboxylic acid (ZCA), metabolite detection may provide improved accuracy for compliance determinations, thereby improving clinical decisions. Zolpidem and ZCA were extracted from 1 mL human urine by mixed-mode solid-phase extraction. Samples were analyzed by LC-MS-MS using positive electrospray ionization with multiple reaction monitoring mode employed for detection and quantification. Gradient chromatographic separation was achieved with a reversed-phase column in a rapid 1.8 min analysis. The assay was linear from 4 to 1,000 µg/L for zolpidem and 4 to 10,000 µg/L for ZCA. Interday recovery (bias) and imprecision (n = 20) were 100-107% of target and 2.4-3.7% relative standard deviation, respectively. Extraction efficiencies were 78-90%. Pain compliance samples (n = 3,142) were de-identified and analyzed for zolpidem and ZCA. Zolpidem was detected greater than limit of quantification in 720 specimens (22.9%), while ZCA was detected in 1,579 specimens (50.3%). Only five specimens contained zolpidem alone. ZCA was observed without parent zolpidem in 864 specimens, thereby increasing population detection rates by 27.5%. Addition of a zolpidem metabolite to compliance determinations substantially improved detection for zolpidem intake and also should prove useful in clinical and forensic settings. PMID:25217539

  19. The role of ergonomic training interventions on decreasing neck and shoulders pain among workers of an Iranian automobile factory: a randomized trial study

    PubMed Central

    Aghilinejad, Mashallah; Kabir-Mokamelkhah, Elahe; Labbafinejad, Yasser; Bahrami-Ahmadi, Amir; Hosseini, Hamid Reza

    2015-01-01

    Background: Ergonomic training had been implemented for prevention or reduction of neck and shoulder complaints among workers. The purpose of the present study was to assess the role of ergonomic training intervention on decreasing the prevalence of neck and shoulder complaints among workers of an automobile factory. Methods: Within the present randomized clinical trial, the role of three ergonomic training methods on the prevalence of neck and shoulders pain among 503 workers of an automobile factory (Response rate: 94.23%) was assessed. The eligible workers were randomly allocated into the following three interventional (pamphlet, lecture, workshop) groups and one control group. The Nordic questionnaire was used to assess the prevalence of neck and shoulder complaints. We followed and assessed the prevalence of neck and shoulders complaints among the study employees before and one year after the intervention. We used chi-square and Mann-Whitney tests to compare the prevalence of neck and shoulder complaints between the trial and control groups. A two-tailed P-value less than or equal to 0.05 was considered statistically significant. Results: The prevalence of neck and shoulders complaints among the study employees at the recent week (p= 0.002) and year (p= 0.02) had been significantly decreased in the study employees after participating in the study workshop. The prevalence of neck and shoulders complaints at the recent week and year did not significantly changed in the study employees after receiving the pamphlet and lecture as ergonomic trainings. Conclusion: Workshop as an ergonomic training method had an effective and powerful role on decreasing the prevalence of neck and shoulders complaints among workers. PMID:26034743

  20. PSYCHOLOGICAL AND PSYCHOSOCIAL DETERMINANTS OF MUSCULOSKELETAL PAIN AND ASSOCIATED DISABILITY

    PubMed Central

    Vargas-Prada, Sergio; Coggon, David

    2015-01-01

    Although much attention has been given to the physical determinants of common musculoskeletal complaints such as back and arm pain, research points to a stronger influence of psychological factors. Multiple studies have implicated poor mental health and somatisation (a tendency to worry about common somatic symptoms) in the incidence and chronicity of musculoskeletal pain and associated disability. Also important are adverse beliefs about the prognosis of such disorders, and about the role of physical activity in their development and persistence. Differences in societal beliefs may have contributed to major variation in the prevalence of disabling musculoskeletal pain that has been observed between countries and in the same countries over time. Psychosocial aspects of work have also been linked with musculoskeletal pain, although relative risks have generally been smaller. There is a need to take account of psychological factors in the clinical management of patients with back, neck and arm pain. PMID:26612236

  1. Prevalence of the Fibromyalgia Phenotype in Spine Pain Patients Presenting to a Tertiary Care Pain Clinic and the Potential Treatment Implications

    PubMed Central

    Brummett, Chad M.; Goesling, Jenna; Tsodikov, Alex; Meraj, Taha S.; Wasserman, Ronald A.; Clauw, Daniel J.; Hassett, Afton L.

    2014-01-01

    Objective Injections for spinal pain have high failure rates, emphasizing the importance of patient selection. It is possible that detecting the presence of a fibromyalgia-like phenotype could aid in prediction, because in these individuals a peripheral injection would not address pain due to alterations in central neurotransmission. We hypothesized that spine pain patients meeting survey criteria for fibromyalgia would be phenotypically distinct from those who do not meet criteria. Methods 548 patients with a primary spine pain diagnosis were studied. All patients completed validated self-report questionnaires, including the Brief Pain Inventory, PainDETECT, Hospital Anxiety and Depression Scale, measures of physical function, and the American College of Rheumatology survey criteria for fibromyalgia. Results 42% met survey criteria for fibromyalgia (FM+). When compared with criteria negative patients, FM+ patients were more likely to be younger, unemployed, receiving compensation, have greater pain intensity, pain interference and neuropathic pain descriptors, as well as higher levels of depression and anxiety, and lower level of physical function (p < 0.0001 for each comparison). Gender, neuropathic pain, pain interference, physical function, and anxiety were independently predictive of fibromyalgia status in a multivariate analysis (p < 0.01, all variables). ROC analysis showed the strength of association of 0.81 as measured by the cross-validated C-statistic. Conclusion Using the survey criteria for fibromyalgia, we demonstrated profound phenotypic differences in a spine pain population. Although centralized pain cannot be confirmed with a survey alone, the pathophysiology of fibromyalgia may help explain a portion of the variability of responses to spine interventions. PMID:24022710

  2. Spinal alignment, mobility of the hip and thoracic spine and prevalence of low back pain in young elite cross-country skiers

    PubMed Central

    Alricsson, Marie; Björklund, Glenn; Cronholm, Martin; Olsson, Oscar; Viklund, Peter; Svantesson, Ulla

    2016-01-01

    This study investigated the association between spinal alignment, mobility of the hips and the thoracic spine and low back pain in adolescent cross-country skiers. Cohort of 51 elite cross-country skiers from a cross-country skiing high school in Sweden participated in the study. Sagittal spinal alignment, active range of motion in flexion, extension and rotation of the thoracic spine as well as passive and active extension of the hips were measured. The participants also completed a questionnaire regarding training, competition, skiing technique and occurrence of low back pain. A simple linear regression was calculated to predict pain score based on thoraco-lumbar relation, with a significant (P<0.05) regression equation of y=−0.069x+2.280 (standard error of estimate, 0.034). Participants with greater lordosis than kyphosis were more likely to suffer from low back pain than subjects without this offset. Thoracic mobility and passive or active hip extension showed no correlation with low back pain. Sagittal spinal alignment seems to be related with low back pain among young elite cross-country skiers. This study shows that range of motion of the thoracic spine and hips do not have an effect on the prevalence of low back pain in this population. PMID:26933656

  3. The prevalence, impact and cost of chronic non-cancer pain in Irish primary schoolchildren (PRIME-C): protocol for a longitudinal school-based survey

    PubMed Central

    O'Higgins, Siobhn; Doherty, Edel; NicGabhainn, Saoirse; Murphy, Andrew; Hogan, Michael; O'Neill, Ciaran; McGuire, Brian E

    2015-01-01

    Introduction Previous research has indicated that pain influences children's daily lives, resulting in absence from school, sleep problems, poor school performance and problems with social activities. Our study aims to characterise the nature, extent, impact and cost of chronic pain among Irish children. Methods and analysis Using cluster-systematic random sampling, primary schools will be invited to participate and 6000 512-year-olds asked to complete questionnaires in school classrooms, at time points 1?year apart. Questionnaires will use internationally valid psychometric measures to assess a range of quality of life factors and chronic pain indicators among children, with corresponding parental/primary caregiver questions, which will be completed at home. Data will also be gathered on the cost of chronic pain. Space will be given for comments on how pain impacts on participants lives and possible coping mechanisms. Ethics and dissemination Ethical approval has been granted by the Research Ethics Committee, National University of Ireland, Galway. Dissemination of results will be via journal articles and conference presentations on the various aspects of the study (ie, prevalence, impact and economic cost of chronic pain among 512-year-olds living in Ireland). PMID:25976764

  4. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain.

    PubMed

    Fernandes da Mota, Patrcia Gonalves; Pascoal, Augusto Gil Brites Andrade; Carita, Ana Isabel Andrade Dinis; B, Kari

    2015-02-01

    Diastasis recti abdominis (DRA) is an impairment characterized by a midline separation of the rectus abdominis muscles along the linea alba. It has its onset during pregnancy and the first weeks following childbirth. There is scant knowledge on both prevalence and risk factors for development of the condition. The aim of this study was to investigate the prevalence of DRA at gestational week 35 and three timepoints postpartum, possible risk factors, and the relationship between DRA and lumbo-pelvic pain. Ultrasound images of inter rectus distance (IRD) were recorded in 84 healthy primiparous women, at three locations on the linea alba. The IRD was measured at: gestational week 35 and 6-8, 12-14, and 24-26 weeks postpartum. Diagnosis of DRA was defined as 16 mm at 2 cm below the umbilicus. Independent sample t-test and binary logistic regression was used to assess differences and risk factors in women with and without DRA and women with and without lumbo-pelvic pain. P < 0.05 was considered statistically significant. The prevalence of DRA decreased from 100% at gestational week 35-39% at 6 months postpartum. No statistically significant differences were found in prepregnancy body mass index (BMI), weight gain, baby's birth weight or abdominal circumference between women with and without DRA at 6 months postpartum. Women with DRA at 6 months postpartum were not more likely to report lumbo-pelvic pain than women without DRA. DRA is prevalent at 6 months postpartum, but is not linked with lumbo-pelvic pain. PMID:25282439

  5. Prevalence and factors associated with neck, shoulder and low back pains among medical students in a Malaysian Medical College

    PubMed Central

    2013-01-01

    Background The main purpose of the study was to assess the prevalence, body distributions and factors associated with musculoskeletal pain (MSP) among medical students in a private Malaysian medical college. Method This cross-sectional study was conducted among 232 medical students in a private medical college using an online questionnaire. The questionnaire was a modified Standardized Nordic Questionnaire focused on neck, shoulder and low back pain in the past week and the past year. Results Two hundred and thirty two medical students responded to the questionnaire out of 642. Mean age was 20.7??2.1years. The majority were female (62.9%), Malay (80.6%) and in the preclinical years (72%). One hundred and six (45.7%) of all students had at least one site of MSP in the past week and 151 (65.1%) had at least one site of MSP in the past year. MSP in the past week was associated significantly with the academic year, (OR 2.0, 95% CI 1.15-3.67, P?=?0.015), history of trauma (OR 2.6, 95% CI 1.2-5.3, P?=?0.011), family history of MSP (OR 2.1, 95% CI 1.1-3.9, P?=?0.023) and Body Mass Index (BMI) (P?=?0.028). MSP in the past year was significantly associated with computer use (P?=?0.027), daily hours of computer use (median??IQR (5.0 3.0), history of trauma (OR 7.5, 95% CI 2.24-2.56, P?

  6. Complaints against Nursing Homes: Comparing Two Sources of Complaint Information and Predictors of Complaints

    ERIC Educational Resources Information Center

    Troyer, Jennifer L.; Sause, Wendy L.

    2011-01-01

    Purpose of the Study: Two consumer-derived measures of nursing home quality that have been underutilized by researchers are consumer complaints to the state certification agency between inspections and complaints to the Long-Term Care Ombudsman Program. This article describes these complaints, considers facility-level predictors of complaints, and

  7. Complaints and Diagnoses of Emergency Department Patients in the Netherlands: A Comparative Study of Integrated Primary and Emergency Care

    PubMed Central

    Thijssen, Wendy A. M. H.; van Miero, Elske; Willekens, Maartje; Rebel, Jasper; Sandel, Maro H.; Giesen, Paul; Wensing, Michel

    2015-01-01

    Objective In the Netherlands, an increasing number of emergency departments (EDs) and general practitioner cooperatives collaborate by creating one Emergency-Care-Access-Point (ECAP). This has resulted in fewer patients at ECAP EDs. The objective of this study was to explore differences in patient characteristics, presented complaints and ED discharge diagnoses between EDs with an ECAP and EDs without an ECAP. Methods A retrospective observational study was performed with 1800 consecutive patient records sampled from six EDs spread over the Netherlands in 2013. We extracted data on time and date of presentation, sex, age, presenting complaint, discharge diagnosis, origin and follow up. Results At ECAP EDs, the mean age was 47.8 years (95%CI 46.1-49.4) compared to 41.3 (95%CI 39.7-42.9). Compared to non-ECAP EDs, more patients were referred by medical professionals (74.7% versus 46.8%), more patients received hospital admission (45.2% versus 29.0%) and fewer patients received GP follow-up (4.1% versus 16.9%). There was no significant difference in presenting complaints between ECAP and non-ECAP EDs. Most prevalent complaints were trauma (25.7% versus 29.7%), abdominal pain (12.1% versus 10.9%) and general symptoms (7.8% versus 4.8%). The most prevalent ED diagnoses significantly differed with fractures and dislocations (10.8%), sprains and strains (10.4%) and respiratory infections (6.8%) at ECAP EDs versus fractures and dislocations (10.7%), wounds (9.3%) and sprains and strains (8.9%) at non-ECAP EDs. Conclusion Compared to non-ECAP EDs, patients at ECAP EDs were older, medical professionals referred more patients and more patients received a hospital admission. We found some small differences in discharge diagnoses between ECAP EDs compared to non-ECAP EDs, but no difference in presented complaints. PMID:26131564

  8. Relationship between complaints presented by emergency patients and the final outcome 1

    PubMed Central

    Guedes, Helisamara Mota; Souza, Kesia Meiriele; Lima, Patrcia de Oliveira; Martins, Jos Carlos Amado; Chianca, Tnia Couto Machado

    2015-01-01

    Abstract Objective: to relate complaints presented by emergency room patients, classified using the Manchester Triage System, with the final outcome (discharge/death/transfer). Methods: prospective cohort study, involving 509 patients who were admitted to the emergency room and remained there for more than 24 hours after admission, being monitored to the final outcome. Data were analyzed with a statistical program using descriptive and analytical statistics. Results: the mean age of the patients was 59.1 years and 59.3% were male. The main complaints were unwell adult (130 - 22.5%), shortness of breath in adults (81 - 14.0%), abdominal pain in adults (58 - 10.0%) and behaving strangely (34 - 5.9%), with 87% of the patients being discharged. More deaths were found in the patients classified in the severe colors, with 42.8% classified as red, 17.0% as orange and 8.9% as yellow. Among the patients classified as green, 9.6% died. Conclusion: in the various colors of the Manchester Triage System, death prevailed in patients that presented the complaints of unwell adult, shortness of breath, head injury, major trauma, diarrhea and vomiting. The higher the clinical priority the greater the prevalence of death. PMID:26444159

  9. Pain-related and Psychological Symptoms in Adolescents With Musculoskeletal and Sleep Problems

    PubMed Central

    Wilson, Sue; Munafò, Marcus R.

    2016-01-01

    Objectives: Two-thirds of adolescents with chronic musculoskeletal pain report a concurrent sleep problem. Both musculoskeletal pain and sleep problems can have deleterious effects on physiological and psychological well-being. We explored the prevalence of sleep problems and musculoskeletal pain, using data on 3568 adolescents from the Avon Longitudinal Study of Children. Materials and Methods: A comprehensive battery of questionnaires was administered to derive clinical phenotypes of musculoskeletal pain. Adolescents with single symptoms were compared with those reporting both musculoskeletal pain and sleep problems. Linear and logistic regression analyses were used to compare groups on pain-related variables and psychological complaints. The association between sociodemographic variables and comorbid musculoskeletal pain and sleep problems was assessed using logistic regression. Results: Over half the sample was female (n=2076, 58.2%) and the majority of European ancestry (n=3174, 97.7%). Only 5.5% (n=196) of participants were identified as having a pain condition, while 21.2% (n=749) reported a significant sleep problem, and 2.8% (n=99) reported comorbid musculoskeletal pain and sleep problems. Adolescents with comorbid problems experienced greater pain intensity and pain-related anxiety. Other psychological complaints were also higher in those who experienced concurrent problems, including depression, fatigue, concentration, and overall severity of psychological symptoms. Discussion: Comorbid sleep and pain problems were associated with a higher incidence of pain-related and psychological symptoms. Sleep problems may therefore be an important modifiable risk factor for alleviating distress in adolescents with musculoskeletal pain. PMID:25974623

  10. Scrotal pain: Evaluation and management

    PubMed Central

    Gordhan, Chirag G

    2015-01-01

    Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete history and physical examination. This article discusses the evaluation and management of several entities of scrotal pain, including testicular torsion, epididymitis, postvasectomy pain, varicocele, and chronic orchialgia. PMID:25598931

  11. [Pain management in subarachnoid haemorrhages].

    PubMed

    Martin, Carole; Garbacz, Michle; Bracard, Serge

    2015-12-01

    Pain and anxiety are among the recurring complaints in patients with a subarachnoid haemorrhage. A team assessed the efficacy and quality of pain management in a clinical neuroradiology unit. A global pain management procedure, including antalgic drug protocols and recommendations, was then put in place. PMID:26675097

  12. Neuropathic Pain Components in Patients with Lumbar Spinal Stenosis

    PubMed Central

    An, Howard S; Moon, Seong Hwan; Lee, Hwan Mo; Suh, Seung Woo; Chen, Ding; Jeon, Jin Ho

    2015-01-01

    Purpose To determine the prevalence and characteristics of neuropathic pain (NP) in patients with lumbar spinal stenosis (LSS) according to subgroup analysis of symptoms. Materials and Methods We prospectively enrolled subjects with LSS (n=86) who were scheduled to undergo spinal surgery. The patients were divided into two groups according to a chief complaint of radicular pain or neurogenic claudication. We measured patient's pain score using the visual analog scale (VAS), Oswestry Disability Index (ODI) and Leads Assessment of Neuropathic Symptoms and Signs (LANSS). According to LANSS value, the prevalence of NP component pain in patients with LSS was assessed. Statistical analysis was performed to find the relationship between LANSS scores and the other scores. Results From our sample of 86 patients, 31 (36.0%) had a NP component, with 24 (63.4%) in the radicular pain group having NP. However, only seven patients (15.6%) in the neurogenic claudication group had NP. The LANSS pain score was not significantly correlated with VAS scores for back pain, but did correlate with VAS scores for leg pain (R=0.73, p<0.001) and with ODI back pain scores (R=0.54, p<0.01). Conclusion One-third of the patients with LSS had a NP component. The presence of radicular pain correlated strongly with NP. The severity of leg pain and ODI score were also closely related to a NP component. This data may prove useful to understanding the pain characteristics of LSS and in better designing clinical trials for NP treatment in patients with LSS. PMID:26069129

  13. Prevalence and correlates of pain interference in older adults: why treating the whole body and mind is necessary.

    PubMed

    Przekop, Peter; Haviland, Mark G; Oda, Keiji; Morton, Kelly R

    2015-04-01

    Our study presents pain-related interference rates in a sample of community-dwelling, older adults and determines factors associated with these restrictions. Participants were 9506 respondents to the Biopsychosocial Religion and Health Study (66.8% female and 33.2% male; average age = 62.3 years). In this sample, 48.2% reported no pain-related interference, whereas 37.7% reported moderate and 14.1% reported severe interference. As hypothesized, older age, female gender, lower education, financial strain, traumatic experiences, worse health, increased body mass index, poor sleep, and depressive symptoms all were associated with higher pain interference ratings (ordered logistic regression/three-level pain criterion; odds ratios p < 0.05). Our findings are similar to those from younger adults, and they suggest enduring effects of trauma on health and reveal the complexity of chronic pain in community-dwelling, older adults. PMID:25892375

  14. Psychophysiology of pain.

    PubMed

    Sternbach, R A

    1975-01-01

    The recent literature on pain states shows: pain thresholds are relatively constant for an individual, but pain tolerance is influenced by psychological state; the expression of pain is a function partly of ethnic membership and degree of extroversion; pain complaints are determined as well by cultural and extroversive factors, and also degree of neuroticism. Studies of pain patients reveals that those with acute pain tend to show normal personality profiles, but the degree of pain experienced is related to the degree of anxiety present. Most chronic pain patients, like those with psychogenic pain, show somatic preoccupations and reactive depression. The treatment and/or rehabilitation of pain patients has developed in three areas. In cases of peripheral neuropathy and some spinal cord lesions, electrical stimulation with "neural pacemakers" can often "close the gate" to pain signals and provide significant reduction or abolition of pain. Psychotropic medications, particularly the tricyclic antidepressants, sometimes in combination with phenothiazines and antihistamines, are effective in many instances of central pain, and help increase the pain tolerance and decrease the need for narcotics in other pain states. Operant conditioning, including the use of biofeedback, extinguishes pain behavior and increases pain-incompatible behaviors, with good long-term results. PMID:5384

  15. Musicians' illness perceptions of musculoskeletal complaints.

    PubMed

    Kok, Laura M; Vliet Vlieland, Theodora P M; Fiocco, Marta; Kaptein, Ad A; Nelissen, Rob G H H

    2013-04-01

    The purpose of this study is to know the views of people about their illness, i.e., illness perceptions, determine coping strategies, and outcome. Previous research suggests a higher prevalence and a different perception of musculoskeletal complaints between musicians and nonmusicians. The aim of this study is to compare illness perceptions related to musculoskeletal complaints between musicians and nonmusicians. In this cross-sectional study, students from three music academies (n?=?345) and one university medical center (n?=?2,870) in the Netherlands received an electronic questionnaire concerning questions on sociodemographic characteristics, use of musical instruments, occurrence and characteristics of musculoskeletal complaints in the past year, and the Brief Illness Perception Questionnaire (B-IPQ). Baseline and B-IPQ scores were compared between the samples by means of t tests, chi-square tests, and regression models to adjust for differences in sociodemographic characteristics. Eighty-three music academy students and 494 medical students completed the questionnaire (response rates, 25.5 and 17.6 %, respectively). Seventy-four (89 %) persons in the musician group and 382 (78 %) persons in the nonmusician group reported occurrence of musculoskeletal complaints during the last 12 months. Adjusted for sociodemographic characteristics, the B-IPQ scores of the domains consequences (my illness is a serious condition), concern (I am extremely concerned about my illness), and emotions (my illness makes me scared) were significantly higher among musicians, whereas personal control (there is little I can do to improve my illness), identity (number of symptoms patient sees as part of illness) were not significantly different. Music academy students had a significant more positive score on treatment control. Music academy students report more negative perceptions of their musculoskeletal complaints compared to medical students. Although some selection bias is present, this is supposed to have a minor effect on the outcomes of this study. Addressing illness perceptions in musicians with musculoskeletal complaints could have beneficial effects on physical and functional outcomes. PMID:23417426

  16. Sleep complaints in the Brazilian population: Impact of socioeconomic factors

    PubMed Central

    Hirotsu, Camila; Bittencourt, Lia; Garbuio, Silverio; Andersen, Monica Levy; Tufik, Sergio

    2014-01-01

    National surveys are relevant for the study of sleep epidemiology since they can provide specific data about sleep in large dimension with important implications for the health system. Thus, the aim of this study was to investigate the prevalence of sleep complaints among the Brazilian population using a randomized cluster sample according to region and socioeconomic class. For this, a 3-stage sampling technique was used to randomly select Brazilian subjects of both genders older than 16 years. A total of 2017 subjects, from 132 different cities, were selected to estimate prevalence in the Brazilian population with a sampling error of ±2%. Questions about sleep complaints were administered face-to-face by Instituto Datafolha interviewers on April 10 and 16, 2012. Data were expanded using a weighted variable. The results showed that 76% of the study population suffers from at least 1 sleep complaint, indicating that approximately 108 million Brazilians may be affected by sleep disorders. On average, each subject had 1.9 sleep problems with the most common complaints being light and insufficient sleep, snoring, moving a lot during sleep, and insomnia, which usually occurred more than 3 times per week. Low income was associated with higher number of sleep complaints only in Northeast and Southeast regions. In conclusion, this study showed a high prevalence of sleep complaints in a sample of the Brazilian population, suggesting that sleep disorders may be markedly frequent in the Brazilian population with a possible correlation with the socioeconomic situation of the interviewed subjects. PMID:26483918

  17. SUBJECTIVE COMPLAINTS IN INDUSTRIAL INJURIES

    PubMed Central

    Barritt, J. L.

    1957-01-01

    Subjective complaints that are actually disabling are ratable factors in industrial injury cases in California. The responsibility of evaluating these complaints with fairness to the patient and employer rests with the examining physician. Full confidence in the physician's integrity minimizes the subjective complaint problem. The importance of good physician-patient relationship is not always recognized. PMID:13446750

  18. School-Related Stress, School Support, and Somatic Complaints: A General Population Study.

    ERIC Educational Resources Information Center

    Torsheim, Torbjorn; Wold, Bente

    2001-01-01

    Examined relationship between school-related stress, social support, and somatic complaints among Norwegian adolescents. Found that students with high levels of school-related stress had a higher odds ratio for weekly headache, abdominal pain, backache, dizziness, and coexisting somatic complaints. For social support, associations were weaker, but

  19. Epidemiology of Back Pain in Children and Youth Aged 1019 from the Area of the Southeast of Poland

    PubMed Central

    K?dra, Agnieszka; Czaprowski, Dariusz

    2013-01-01

    Objective. The aim of this work was to define the prevalence of back pain in children and youth aged 1019 from the southeast of Poland. Material and Methods. The cross-sectional study included 1089 students (547 girls and 542 boys) aged 1019. The prevalence of back pain, its intensity, location, and situations in which it occurred were assessed with a questionnaire. Results. Among 1089 respondents, 830 (76.2%) admitted that they had experienced back pain at various frequencies within the year preceding the study. Back pain was located mainly in the lumbar segment (74.8%). Mild pains were dominant, which was declared by 44.7% of the respondents. Girls experienced back pain significantly more frequently than boys (52.2% versus 47.8%, P < 0.05). Conclusions. The research revealed that back pain is a common phenomenon. The prevalence of back pain in children and youth living in southeast Poland is similar to the frequency of occurrence of such complaints occurring in peers in other countries. It seems significant to monitor the remaining regions of Poland in order to define the scale of the problem and to look for the risk factors of back pain in children and youth to undertake efficient prophylactic actions. PMID:23984375

  20. Prevalence of the different Axis I clinical subtypes in a sample of patients with orofacial pain and temporomandibular disorders in the Andalusian Healthcare Service

    PubMed Central

    Blanco-Aguilera, Antonio; Blanco-Aguilera, Elena; Serrano-del-Rosal, Rafael; Biedma-Velázquez, Lourdes; Rodríguez-Torronteras, Alejandro; Segura-Saint-Gerons, Rafael

    2016-01-01

    Background The main objective of this paper is to analyze the prevalence of each of the different clinical subtypes of temporomandibular disorders (TMD) in a sample of patients with this pathology. In addition, a second objective was to analyze their distribution according to gender. Material and Methods To this end, the results of 1603 patients who went to the Unit of Temporomandibular Disorders in the Córdoba Healthcare District because they suffered from this pathology were analyzed. In order to diagnose them, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were applied, analyzing the different Axis I subtypes (myopathy, discopathy and arthropathy) and obtaining the combined Axis I for each patient and the relation of all these variables according to gender. The null-hypothesis test confirmed the lack of connection between the gender variable and the different subtypes in the clinical analysis, and between the former and the combined Axis I of the RDC/TMD. Results The prevalence was high for the muscle disorders subtype in general, showing an 88.7% prevalence, while the presence of discopathies or arthropathies was much lower. Among discopathies, the most frequent ones were disc displacements with reduction, with 39.7% and 42.8% for the left and right temporomandibular joints (TMJ), respectively, while the prevalence of arthropathies was 26.3% for the right TMJ and 32.9% for the left TMJ. The bivariate analysis on the connection with gender reveals a p≥ 0.05 value for the muscle and arthralgia subtypes. Conclusions The patients seen at the TMD Unit where mostly middle-aged women whose main clinical axis subtype was the muscle disorder subtype. For their part, both discopathies and arthropathies, although present, are much less prevalent. Key words:RDCTMD, axis I, orofacial pain, temporomandibular disorders, gender. PMID:26615508

  1. A Retrospective Study of Chronic Post-Surgical Pain following Thoracic Surgery: Prevalence, Risk Factors, Incidence of Neuropathic Component, and Impact on Qualify of Life

    PubMed Central

    Peng, Zhiyou; Li, Huiling; Zhang, Chong; Qian, Xiang; Feng, Zhiying; Zhu, Shengmei

    2014-01-01

    Background Thoracic surgeries including thoracotomy and VATS are some of the highest risk procedures that often lead to CPSP, with or without a neuropathic component. This retrospective study aims to determine retrospectively the prevalence of CPSP following thoracic surgery, its predicting risk factors, the incidence of neuropathic component, and its impact on quality of life. Methods Patients who underwent thoracic surgeries including thoracotomy and VATS between 01/2010 and 12/2011 at the First Affiliated Hospital, School of Medicine, Zhejiang University were first contacted and screened for CPSP following thoracic surgery via phone interview. Patients who developed CPSP were then mailed with a battery of questionnaires, including a questionnaire referenced to Maguire's research, a validated Chinese version of the ID pain questionnaire, and a SF-36 Health Survey. Logistic regression analyses were subsequently performed to identify risk factors for CPSP following thoracic surgery and its neuropathic component. Results The point prevalence of CPSP following thoracic surgery was 24.9% (320/1284 patients), and the point prevalence of neuropathic component of CPSP was 32.5% (86/265 patients). CPSP following thoracic surgery did not improve significantly with time. Multiple predictive factors were identified for CPSP following thoracic surgery, including age<60 years old, female gender, prolonged duration of post-operative chest tube drainage (≥4 days), options of post-operative pain management, and pre-existing hypertension. Furthermore, patients who experienced CPSP following thoracic surgery were found to have significantly decreased physical function and worse quality of life, especially those with neuropathic component. Conclusions Our study demonstrated that nearly 1 out of 4 patients underwent thoracic surgery might develop CPSP, and one third of them accompanied with a neuropathic component. Early prevention as well as aggressive treatment is important for patients with CPSP following thoracic surgery to achieve a high quality of life. PMID:24587187

  2. Effects of bariatric surgery for knee complaints in (morbidly) obese adult patients: a systematic review.

    PubMed

    Groen, V A; van de Graaf, V A; Scholtes, V A B; Sprague, S; van Wagensveld, B A; Poolman, R W

    2015-02-01

    Obesity is a major risk factor for the development of knee osteoarthritis, and over the past 30 years the prevalence of obesity has more than doubled. In an advanced-stage knee osteoarthritis is treated with total knee arthroplasty, and the demand for primary total knee arthroplasties is expected to grow exponentially. However, total knee arthroplasty in obese patients is associated with more complications, longer hospital stay and higher costs. We aimed to determine the effects of bariatric surgery on knee complaints in (morbidly) obese (body mass index >30?kg?m(-2) ) adult patients. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, TRIP, BIOSIS-Previews and reference lists of retrieved publications were systematically searched from earliest available up to 20 April?2014 for any English, German, French and Dutch studies. There was no restriction on study design. We included studies on the effect of surgically induced weight reduction on knee complaints in (morbidly) obese adult patients, with a minimal follow-up of 3 months. Studies on the effects of lipectomy or liposuction and studies in which patients had already received a total knee arthroplasty were excluded. Thirteen studies were included in this systematic review with a total of 3,837 patients. Although different assessment tools were used, an overall significant improvement in knee pain was seen in 73% out of the used assessments. All studies measuring intensity of knee pain, knee physical function and knee stiffness showed a significant improvement after bariatric surgery. The quality of evidence was very low or too low for most of the included studies and moderate for one study. Bariatric surgery with subsequent marked weight loss is likely to improve knee pain, physical function and stiffness in (morbidly) obese adult patients. However, with the current available evidence, there is need for high-quality studies. PMID:25487972

  3. Prevalence of low back pain and associated risk factors amongst adult patients presenting to a Nigerian family practice clinic, a hospital-based study

    PubMed Central

    Adebusoye, Lawrence A.; Alonge, Temitope O.

    2013-01-01

    Abstract Background Low back pain (LBP) is a common health problem with concomitant disability which has assumed a public health importance in our setting. Objectives The aim of this study was to determine the prevalence of LBP and associated risk factors amongst adult patients attending the General Outpatients Clinic of the University College Hospital in Ibadan, Nigeria. Method This was a cross-sectional study of 485 respondents. A semi-structured questionnaire was used to obtain information on socio-demography, lifestyle, occupation and other risk factors associated with LBP. Results There were 288 (59.4%) female and 197 (40.6%) male respondents. The point prevalence of LBP was 46.8%. Occupational activities, previous back injury and tobacco smoking were significant associated factors for the total population. For the female respondents, logistic regression analysis showed that a waist circumference of 88 cm or more, dysmenorrhea, previous back injury and being engaged in an occupation were the most significant factors associated with LBP. However, previous back injury was the most significant factor associated with LBP for the male respondents. Conclusion The prevalence of LBP amongst adult patients in our setting is high, with preventable and treatable predisposing factors. Public health efforts should be directed at educating people on occupational activities and lifestyle habits.

  4. Physical inactivity is associated with chronic musculoskeletal complaints 11 years later: results from the Nord-Trndelag Health Study

    PubMed Central

    Holth, Helene Sulutvedt; Werpen, Hanne Kine Buchardt; Zwart, John-Anker; Hagen, Knut

    2008-01-01

    Background Physical inactivity is associated with several diseases, but studies evaluating the association between chronic musculoskeletal complaints (MSCs) and physical exercise have shown conflicting results. The aim of this large-scale prospective population-based study was to investigate the association between self-reported physical exercise at baseline and the prevalence of chronic musculoskeletal complaints (MSCs) 11 years later. Methods The results are based upon two consecutive public health studies conducted within the county of Nord-Trndelag, Norway (The HUNT studies). A total of 39,520 (83%) out of 47,556 adults who participated in HUNT 1 and HUNT 2 responded to questions about physical exercise at baseline in 198486, and to questions about musculoskeletal complaints 11 years later (199597). Chronic MSCs was defined as MSCs ? 3 months during the past year, and chronic widespread MSCs such as pain ? 15 days during the last month from the axial region, above the waist, and below the waist. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR) with 95% confidence intervals (CIs). All the final analyses were adjusted for age, gender, body mass index, smoking and education level. Results At follow-up 20,223 (51%) reported chronic MSCs, and among these 2,318 (5.9%) reported chronic widespread MSCs. Individuals who exercised at baseline were less likely to report chronic MSCs 11 years later (OR 0.91, 95% CI 0.850.97) than inactive persons. Among individuals who exercised more than three times per week, chronic widespread MSCs were 28% less common (OR 0.72, 95% CI 0.590.88) compared to inactive individuals. Conclusion In this large-scale population-based study, physical exercise was associated with lower prevalence of chronic MSCs, in particular chronic widespread MSCs. Future studies should try to clarify whether chronic MSCs are a cause or a consequence of inactivity. PMID:19046448

  5. Depression, Health, and Somatic Complaints in Older Adults.

    ERIC Educational Resources Information Center

    Mahurin, Kathleen A.; Gatz, Margaret

    Although depression is considered to be common in the elderly, reliable rates of prevalence are lacking. Studies have shown that age differences on measures of depressive symptomatology can be attributed to higher levels of somatic complaints. In order to examine whether the association between somatic and depressive symptoms varies as a function…

  6. Trail the state board's complaints.

    PubMed

    Sheehan, J P

    2000-09-01

    If your state board of nursing receives a complaint about one of your nurses, the complaint triggers a structured disciplinary process. Follow the process from start to finish and test your knowledge, then check your answers at http://www.nursingmanagement.com. PMID:15127471

  7. Changes in functional connectivity of pain modulatory systems in women with primary dysmenorrhea.

    PubMed

    Wei, Shyh-Yuh; Chao, Hsiang-Tai; Tu, Cheng-Hao; Li, Wei-Chi; Low, Intan; Chuang, Chih-Ying; Chen, Li-Fen; Hsieh, Jen-Chuen

    2016-01-01

    Menstrual pain is the most prevalent gynecological complaint, and is usually without organic cause (termed primary dysmenorrhea, PDM). The high comorbidity in the later life of PDM with many functional pain disorders (associated with central dysfunction of pain inhibition, eg, fibromyalgia) suggests possible maladaptive functionality of pain modulatory systems already occurred in young PDM women, making them vulnerable to functional pain disorders. Periaqueductal gray (PAG) matter functions as a critical hub in the neuraxis of pain modulatory systems; therefore, we investigated the functional connectivity of PAG in PDM. Forty-six PDM subjects and 49 controls received resting-state functional magnetic resonance imaging during menstruation and periovulatory phases. The PAG of PDM subjects exhibited adaptive/reactive hyperconnectivity with the sensorimotor cortex during painful menstruation, whereas it exhibited maladaptive hypoconnectivity with the dorsolateral prefrontal cortex and default mode network (involving the ventromedial prefrontal cortex, posterior cingulate cortex, or posterior parietal cortex) during menstruation or periovulatory phase. We propose that the maladaptive descending pain modulatory systems in PDM may underpin the central susceptibility to subsequent development of various functional disorders later in life. This hypothesis is corroborated by the growing body of evidence that hypoconnectivity between PAG and default mode network is a coterminal to many functional pain disorders. PMID:26307856

  8. Work–Family Conflict, Task Interruptions, and Influence at Work Predict Musculoskeletal Pain in Operating Room Nurses

    PubMed Central

    Nützi, Marina; Koch, Patricia; Baur, Heiner; Elfering, Achim

    2015-01-01

    Background The aim of this study is to examine the prevalence of musculoskeletal complaints in Swiss operating room (OR) nurses, and to investigate how work–family conflict, work interruptions, and influence at work are related to lumbar and cervical back pain. Methods Participants in this correlational questionnaire study included 116 OR nurses from eight different hospitals in Switzerland. Results We found that 66% of the OR staff suffered from musculoskeletal problems. The most prevalent musculoskeletal complaints were lumbar (52.7%) and cervical pain (38.4%). Furthermore, 20.5% reported pain in the mid spine region, 20.5% in the knees and legs, and 9.8% in the hands and feet. Multiple linear regression analyses showed that work–family conflict (p < 0.05) and interruptions (p < 0.05) significantly predicted lumbar and cervical pain in OR nurses, while influence at work (p < 0.05) only predicted lumbar pain. Conclusion These results suggest that reducing the work–family conflict and interruptions at work, as well as offering opportunities to influence one's workplace, help to promote OR nurses' health. PMID:26929846

  9. Use of analgesics for exercise-associated pain: prevalence and predictors of use in recreationally trained college-aged students.

    PubMed

    Brewer, Christi B; Bentley, John P; Hallam, Jeffrey S; Woodyard, Catherine D; Waddell, Dwight E

    2014-01-01

    The objectives of this study were to examine the use of the analgesics for the relief of exercise-associated pain (EAP) and to examine personal and/or exercise characteristics that might potentially predict such use in recreationally trained college-aged individuals. Recreationally trained college-aged students (N = 263) were invited to complete a self-administered 16-item questionnaire concerning personal exercise habits and analgesic use for EAP. The primary dependent variable was analgesic use for EAP, and additional items sought to characterize patterns and behaviors related to the use. Descriptive statistics and frequencies were calculated for all items, and logistic regression was used to evaluate the ability of 4 variables to predict analgesic use for EAP: gender, length of time performing regular exercise, weekly frequency of aerobic exercise, and weekly frequency of resistance exercise. Approximately 36% of respondents reported analgesic use for EAP, with data indicating acute use for what is generally acute pain. With predictors considered individually, gender was a significant predictor, with female respondents being more likely to use analgesics for EAP (p = 0.04). With all predictors considered concurrently, the model did not significantly contribute to the prediction of use in this sample. Potential for misuse was highlighted by a large percentage of users who described themselves as very unlikely to follow label directions and more likely to take a dose exceeding recommendations. In light of research that reports a potential detriment to muscular regeneration when analgesics are consumed with exercise, it is important to be cognizant of the use of these drugs in individuals striving to improve muscular fitness. Coaches and trainers should educate athletes about the associated risks and caution those who may unnecessarily take analgesics. PMID:23542880

  10. 48 CFR 422.1308 - Complaint procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Vietnam Era, and Other Eligible Veterans 422.1308 Complaint procedures. The contracting officer shall forward complaints received about the administration of the Vietnam Era Veterans Readjustment...

  11. 48 CFR 422.1308 - Complaint procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Vietnam Era, and Other Eligible Veterans 422.1308 Complaint procedures. The contracting officer shall forward complaints received about the administration of the Vietnam Era Veterans Readjustment...

  12. 48 CFR 422.1308 - Complaint procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Vietnam Era, and Other Eligible Veterans 422.1308 Complaint procedures. The contracting officer shall forward complaints received about the administration of the Vietnam Era Veterans Readjustment...

  13. 48 CFR 422.1308 - Complaint procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Vietnam Era, and Other Eligible Veterans 422.1308 Complaint procedures. The contracting officer shall forward complaints received about the administration of the Vietnam Era Veterans Readjustment...

  14. Use of Airport Noise Complaint Files to Improve Understanding of Community Response to Aircraft Noise

    NASA Technical Reports Server (NTRS)

    Fidell, Sanford; Howe, Richard

    1998-01-01

    This study assessed the feasibility of using complaint information archived by modem airport monitoring systems to conduct quantitative analyses of the causes of aircraft noise complaints and their relationship to noise- induced annoyance. It was found that all computer-based airport monitoring systems provide at least rudimentary tools for performing data base searches by complainant name, address, date, time of day, and types of aircraft and complaints. Analyses of such information can provide useful information about longstanding concerns, such as the extent to which complaint rates are driven by objectively measurable aspects of aircraft operations; the degree to which changes in complaint rates can be predicted prior to implementation of noise mitigation measures; and the degree to which aircraft complaint information can be used to simplify and otherwise improve prediction of the prevalence of noise-induced annoyance in communities.

  15. [Pathophysiology of abdominal pain].

    PubMed

    Curatolo, Michele

    2011-08-01

    Abdominal pain can be induced by stimulation of visceral nociceptors. Activation of nociceptors usually requires previous sensitization by pathological events, such as inflammation, ischemia or acidosis. Although abdominal pain can obviously be caused by pathology of a visceral structure, clinicians frequently observe that such a pathology explains only part of the pain complaints. Occasionally, there is lack of objective signs of visceral lesions. There is clear evidence that pain states are associated with profound changes of the central processing of the sensory input. The main consequences of such alterations for patients are twofold: 1) a central sensitization, i.e. an increased excitability of the central nervous system; 2) an alteration of the endogenous pain modulation, which under normal conditions inhibits the processing of nociceptive signals in the central nervous system. Both phenomena lead to a spread of pain to other body regions and an amplification of the pain perception. The interactions between visceral pathology and alterations of the central pain processes represent an at least partial explanation for the discrepancy between objective signs of peripheral lesions and severity of the symptoms. Today, both central hypersensitivity and alteration in endogenous pain modulation can be measured in clinical practice. This information can be used to provide the patients with an explanatory model for their pain. Furthermore, first data suggest that alterations in central pain processing may represent negative prognostic factors. A better understanding of the individual pathophysiology may allow in the future the development of individual therapeutic strategies. PMID:21796591

  16. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the investigation of complaints as appropriate. (b) Complaint file. You must maintain a record of... complaint relating to core CGTP requirements to determine if the complaint is related to an HCT/P deviation... reported to determine whether an investigation is necessary; an investigation may include referring a...

  17. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... the investigation of complaints as appropriate. (b) Complaint file. You must maintain a record of... complaint relating to core CGTP requirements to determine if the complaint is related to an HCT/P deviation... reported to determine whether an investigation is necessary; an investigation may include referring a...

  18. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the investigation of complaints as appropriate. (b) Complaint file. You must maintain a record of... complaint relating to core CGTP requirements to determine if the complaint is related to an HCT/P deviation... reported to determine whether an investigation is necessary; an investigation may include referring a...

  19. 45 CFR 98.93 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Complaints. 98.93 Section 98.93 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Monitoring, Non-compliance and Complaints 98.93 Complaints. (a) This section applies to any complaint...

  20. 39 CFR 3030.10 - Complaint contents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts...

  1. 39 CFR 3030.10 - Complaint contents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts...

  2. 39 CFR 3030.10 - Complaint contents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts...

  3. 39 CFR 3030.10 - Complaint contents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts...

  4. 39 CFR 3030.10 - Complaint contents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Complaint contents. 3030.10 Section 3030.10 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS Form and Manner Requirements of Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts...

  5. 20 CFR 658.401 - Types of complaints handled by the JS complaint system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... agency shall handle such complaints under the Department's regulations at 41 CFR part 60-250. (c... complaints). These complaint procedures are not applicable to UI, or WIA complaints. Complaints alleging violations of UI, or WIA regulations should be handled within the procedures set forth in the...

  6. 20 CFR 658.401 - Types of complaints handled by the JS complaint system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... agency shall handle such complaints under the Department's regulations at 41 CFR part 60-250. (c... complaints). These complaint procedures are not applicable to UI, or WIA complaints. Complaints alleging violations of UI, or WIA regulations should be handled within the procedures set forth in the...

  7. Pain Assessment

    MedlinePLUS

    Introduction Types of Pain Pain Assessment Pain Treatments Integrative Pain Therapy Pain Management Recommendations References March 30, 2016 Pain Assessment Effective pain management begins with a comprehensive assessment. This ...

  8. [Groin pain in athletes].

    PubMed

    Sanders, Rick J M; Kokshoorn, Arjan P J; Kolkman, Karel A; van der Wal, Wybren A; van Loon, Corn J M

    2014-01-01

    Groin pain in young athletes is a common problem, accounting for significant downtime in sports participation. It can be difficult to make the correct diagnosis as groin pain has a wide differential diagnosis, which encompasses acute as well as chronic causative factors. In this article this is illustrated by presenting three cases of patients who attended our hospital. In all three cases the main complaint was sports-related groin pain, and the patients presented with very similar symptoms. However, after further investigation the patients were diagnosed with three very different types of injury: sportsman's hernia; hip labral tear; and pubic osteitis. This emphasises the need for every general practitioner and medical specialist to understand that there is a wide differential diagnosis for groin pain in athletes, in order to be able to implement specific therapy targeting the actual cause of groin pain. PMID:25315329

  9. Prevalence of Narcotic Bowel Syndrome in Opioid Abusers in Iran

    PubMed Central

    Ahmadi, Bizhan; Arab, Peyman; Zahedi, Mohammad Javad; Shafieipour, Sara; Drossman, Douglas A.; Banivaheb, Ghodseyeh

    2014-01-01

    BACKGROUND In spite of the increasing trend in opioid abusers worldwide, the prevalence of narcotic bowel syndrome (NBS) is undetermined. We aimed to estimate the prevalence of NBS and other opioid bowel dysfunction (OBD) in opioid abusers in Kerman, southeast Iran. According to the best of our knowledge, this is the first study to assess the prevalence of NBS in opioid abusers. METHODS By referring to addiction treatment centers in Kerman city and in a cross-sectional study, 577 subjects with opium or opioid subtracts abuse were included in our study. A validated questionnaire was used for OBD assessment and diagnosis of NBS was made according to both the presence of chronic abdominal pain despite increasing the opioid dose and ruling out other causes of abdominal pain. SPSS software version 16 was used for data analysis. p value<0.05 was considered as statistically significant. RESULTS Constipation, regurgitation, and heartburn were the most gastrointestinal complaints that were found in 132(22.9%), 123(21.3%) and 91(15.8%) subjects, respectively. Only 16(2.8%) participants fulfilled all the NBS criteria. Simultaneous use of non-narcotic sedative drugs increased the risk of NBS significantly (the odds ratio 3:1 and p=0.049). CONCLUSION NBS is not rare among opioid abusers and should be considered as a cause of chronic abdominal pain in this group. PMID:25349684

  10. Association of neck pain with symptoms of temporomandibular dysfunction in the general adult population.

    PubMed

    Ciancaglini, R; Testa, M; Radaelli, G

    1999-03-01

    The association of neck pain with symptoms of temporomandibular dysfunction in the general adult population was evaluated in a sample of 483 subjects selected from the population living in the municipality of Segrate, northern Italy. Subjects were interviewed by a standard questionnaire about oral conditions, temporomandibular symptomatology and neck pain. Symptoms related to the Helkimo Anamnestic Index were the indicators of temporomandibular dysfunction, and the evaluation also included history of trauma of the masticatory system. Troublesome neck pain was experienced within the last year in 38.9% of the total series, and the prevalence of complaints was higher in women than in men (41.7 vs 34.4%). Prevalence increased with age (p < 0.005) and was significantly higher in subjects with than without temporomandibular symptomatology (47.4 vs 28.6%, p < 0.0001). At univariate analysis, facial and jaw pain (p < 0.001) and feeling of stiffness or fatigue of the jaws (p < 0.01) were significantly related to neck pain. Age- and sex-adjusted multiple logistic analysis showed that neck pain is associated with the temporomandibular symptomatology as a whole (p < 0.001), and in particular with facial and jaw pain (p < 0.01). These findings confirm that there is a significant association between neck pain and the temporomandibular symptomatology. Moreover, they suggest that the most relevant relationship is with facial and jaw pain, according to recent neurophysiologic studies on pain mechanism. Further clinical and longitudinal studies are desirable in order to give a better clarification of mutual specific roles of craniocervical and temporomandibular disorders in the aetiology of these pathologies. PMID:10229999

  11. Overtreating chronic back pain: time to back off?

    PubMed

    Deyo, Richard A; Mirza, Sohail K; Turner, Judith A; Martin, Brook I

    2009-01-01

    Chronic back pain is among the most common patient complaints. Its prevalence and impact have spawned a rapidly expanding range of tests and treatments. Some of these have become widely used for indications that are not well validated, leading to uncertainty about efficacy and safety, increasing complication rates, and marketing abuses. Recent studies document a 629% increase in Medicare expenditures for epidural steroid injections; a 423% increase in expenditures for opioids for back pain; a 307% increase in the number of lumbar magnetic resonance images among Medicare beneficiaries; and a 220% increase in spinal fusion surgery rates. The limited studies available suggest that these increases have not been accompanied by population-level improvements in patient outcomes or disability rates. We suggest a need for a better understanding of the basic science of pain mechanisms, more rigorous and independent trials of many treatments, a stronger regulatory stance toward approval and post-marketing surveillance of new drugs and devices for chronic pain, and a chronic disease model for managing chronic back pain. PMID:19124635

  12. Calcium, Parathyroid Hormone, and Vitamin D: Major Determinants of Chronic Pain in Hemodialysis Patients

    PubMed Central

    Haggiag, Isabelle; Os, Pnina; Bernheim, Jacques

    2009-01-01

    Background and objectives: Pain is a frequent complaint of hemodialysis (HD) patients, yet information regarding its causes and frequency is relatively scarce. The aim of this study was to evaluate the frequency and possible causes of chronic pain in patients who are on long-term HD. Design, setting, participants, & measurements: We prospectively enrolled 100 patients who were undergoing maintenance HD for at least 3 mo. Pain was evaluated using the Brief Pain Inventory. Data collected on each participant included age, gender, ethnic origin, body mass index, smoking habits, time on dialysis, type of blood access, comorbidities, and biochemical and hematologic parameters. Results: The average age was 64.5 yr; the average time on dialysis 40.4 mo. Forty-five patients were male. Thirty-one participants were of Arabic origin. Fifty-three patients had diabetes, 36 of whom had diabetic retinopathy. Although 51 patients experienced chronic pain, only 19.6% described the pain as severe. Musculoskeletal pain, neuropathic pain, and headache were the most prevalent forms of pain. The presence of diabetic retinopathy and neuropathy (but not diabetes per se) and levels of intact parathyroid hormone, calcium, and calcitriol (but not 25-hydroxyvitamin D3) differed significantly between those who experienced chronic pain and those who did not. On a logistic regression model, higher serum calcium levels and intact parathyroid hormone levels >250 pg/ml were independently associated with chronic pain, as well as the presence of diabetic retinopathy. Calcitriol had a marginal effect. Conclusions: Disturbed mineral metabolism is strongly associated with chronic pain in long-term HD patients, along with microangiopathy. PMID:19578003

  13. Prevalence and determinants of cannabinoid prescription for the management of chronic noncancer pain: a postal survey of physicians in the Abitibi-Témiscamingue region of Quebec

    PubMed Central

    St-Amant, Huguette; Ware, Mark A.; Julien, Nancy

    2015-01-01

    Background Few studies have been conducted to explore physicians’ prescription practices and attitudes toward the use of cannabinoids in Canada.We measured the prevalence and identified determinants of cannabinoid prescription for the management of chronic noncancer pain among physicians in southwestern Quebec. Methods In February 2013, we conducted a postal survey using a modified Dillman method that involved physicians practising in the Abitibi-Témiscamingue region of Quebec. We used multivariate logistic regression models to identify determinants of cannabinoid prescription. Results A total of 166 physicians of 318 practising in the region participated in the survey (response rate 52.2%). The prevalence of cannabinoid prescription was 27.3% (45/165) for any indication and 23.0% (38/165) for the management of chronic noncancer pain; 91.1% (41/45) of the physicians prescribed cannabinoids to 5 or fewer patients. Of the 38 physicians who prescribed cannabinoids for chronic noncancer pain, 35 (92.1%) prescribed nabilone, 7 (18.4%) medical marijuana and 2 (5.3%) nabiximols. The principal determinant of cannabinoid prescription was the physician’s level of comfort with prescribing cannabinoids (adjusted odds ratio 1.25, 95% confidence interval 1.01–1.55, per 1-point increase in comfort level measured on 10-point scale). Respondents reported that continuing medical education (CME) activities could increase their comfort level. They also indicated a need for guidelines or algorithms that included cannabinoid use as well as more studies about the efficacy and safety of cannabinoids for the management of chronic noncancer pain. Interpretation We found that cannabinoids were not often prescribed for the management of chronic noncancer pain and that survey respondents were not comfortable with prescribing this drug class. This degree of discomfort could be addressed by CME activities, more effective dissemination of guidelines and more evidence regarding cannabinoid use for the management of chronic noncancer pain. PMID:26389104

  14. Pain after earthquake

    PubMed Central

    2012-01-01

    Introduction On 6 April 2009, at 03:32 local time, an Mw 6.3 earthquake hit the Abruzzi region of central Italy causing widespread damage in the City of L Aquila and its nearby villages. The earthquake caused 308 casualties and over 1,500 injuries, displaced more than 25,000 people and induced significant damage to more than 10,000 buildings in the L'Aquila region. Objectives This observational retrospective study evaluated the prevalence and drug treatment of pain in the five weeks following the L'Aquila earthquake (April 6, 2009). Methods 958 triage documents were analysed for patients pain severity, pain type, and treatment efficacy. Results A third of pain patients reported pain with a prevalence of 34.6%. More than half of pain patients reported severe pain (58.8%). Analgesic agents were limited to available drugs: anti-inflammatory agents, paracetamol, and weak opioids. Reduction in verbal numerical pain scores within the first 24 hours after treatment was achieved with the medications at hand. Pain prevalence and characterization exhibited a biphasic pattern with acute pain syndromes owing to trauma occurring in the first 15 days after the earthquake; traumatic pain then decreased and re-surged at around week five, owing to rebuilding efforts. In the second through fourth week, reports of pain occurred mainly owing to relapses of chronic conditions. Conclusions This study indicates that pain is prevalent during natural disasters, may exhibit a discernible pattern over the weeks following the event, and current drug treatments in this region may be adequate for emergency situations. PMID:22747796

  15. Mental and somatic health complaints associated with school bullying between 10th and 12th grade students; results from cross sectional studies in Oslo, Norway

    PubMed Central

    2009-01-01

    Background Bullying is a widespread and serious problem that might influence both mental and psychical well being as well as school performance and social life. The aim of this study was to describe the prevalence of bullying, mental health problems and psychical complaints among 10th and 12th grade students and to analyze the association between bullying, mental health problems and muscle and skeletal complaints. Methods Two cross sectional studies of adolescents living in Oslo, Norway the first conducted in 2001 among 10th grade students (15/16 years old) and the second in 2004 among 12th grade students (18/19 years old). Both surveys were based on self report, were mostly school based and had almost identical questionnaires. There were around 3700 participants in both surveys, but the participation rate was lower in the latter survey (88 versus 80%). The Hopkins Symptoms Check List (HSCL-10) and the Strength and Difficulties Questionnaire (SDQ) were used to measure mental health problems. Results Bullying is decreasing both among boys and girls while the prevalence of internalized mental health problems are increasing from 10th to 12th grade. For muscle and skeletal pain there is a diverging trend between boys and girls, with an increase among girls and a decrease among boys. The highest Odds Ratios, as a measure for the association between bullying, mental health problems and pain, were found for internalized mental health problems at both 10th and 12th grade both for boys and girls. Conclusion Both internalized and externalized mental health problems together with pain seem to be associated with bullying irrespective of school type and gender. PMID:19309497

  16. Responding to concerns about complaints.

    PubMed

    Bishop, Luke

    2014-08-16

    When the RCVS asked members of the profession and public about its complaints and disciplinary system, it received a great deal of feedback - some positive, but much of it critical. Here, Luke Bishop, RCVS communications officer, describes how the process has now been overhauled with the aim of making it quicker, more efficient and a more satisfactory experience for all involved. PMID:25125415

  17. Chronic Low Back Pain in Young Korean Urban Males: The Life-Time Prevalence and Its Impact on Health Related Quality of Life

    PubMed Central

    Shim, Jae-Hyun; Yoon, Sang-Young; Lee, Chang-Hoon; Doh, Jae-Won; Bae, Hack-Gun

    2014-01-01

    Objective We assessed the life-time prevalence (LTP) of chronic low back pain (LBP) in young Korean males. We also evaluated the relationship between lumbar spinal lesions and their health related quality-of-life (HRQOL). Methods A cross-sectional, self-reported survey was conducted in Korean males (aged 19-year-old) who underwent physical examinations for the conscript. We examined 3331 examinees in November 2014. We included 2411 subjects, who accepted to participate this study without any comorbidities. We interviewed using simple binary questions for their LBP experience and chronicity. HRQOL was assessed by Short-Form Health-Survey-36 (SF-36) in chronic LBP and healthy control groups. Radiological assessment was performed in chronic LBP group to determine whether there were any pathological causes of their symptoms. Results The LTP of chronic LBP was 13.4%. Most (71.7%) of them didn't have any lumbar spinal lesions (i.e., non-specific chronic LBP). The SF-36 subscale and summary scores were significantly lower in subjects with chronic LBP. Between specific and non-specific chronic LBP group, all physical and mental subscale scores were significantly lower in specific chronic LBP group, except mental health (MH) subscale score. In MH subscale and mental component summary score, statistical significant differences didn't appear between two groups (p=0.154, 0.126). Conclusion In Korean males 19 years of age, the LTP of chronic LBP was 13.4%, and more than two-thirds were non-specific chronic LBP. Chronic LBP had a significant impact on HRQOL. The presence of lumbar spinal pathoanatomical lesions affected mainly on the physical aspect of HRQOL. It influenced little on the mental health. PMID:25628807

  18. Botlhoko, botlhoko! How people talk about their musculoskeletal complaints in rural Botswana: a focused ethnography

    PubMed Central

    Hondras, Maria; Myburgh, Corrie; Hartvigsen, Jan; Johannessen, Helle

    2015-01-01

    Background Conflicting interpretations about the structure and function of the body contribute to discordance in communication between healthcare professionals and lay people. Understanding musculoskeletal (MSK) complaints presents additional complexities when discussed in more than one language or in cross-cultural settings. In low- and middle-income countries (LMICs), few healthcare professionals have specialist MSK training and not all practitioners speak the primary language of patients. Objective Our goal was to understand how people in rural Botswana perceive and express MSK complaints. Design Ethnographic fieldwork for 8 months in the Botswana Central District included participant observations and interviews with 34 community members with MSK complaints. Audio-recorded interviews were typically conducted in Setswana with an interpreter, transcribed verbatim, and contextually translated into English. Abductive qualitative analysis was used as the interpretive methodology. Results Whereas initial responses about MSK troubles yielded the exclamation botlhoko, botlhoko! combined with animated non-verbal gestures and facial expressions indicating widespread body pains, in-depth interviews revealed the complexities of pain expression among respondents. MSK pains were described as ‘bursting, exploding, aching, numbness, hot, pricking, stabbing, swollen, and pain in the heart’. Language subtleties manifested during interviews, where ‘meat’ or ‘flesh’ implied soft tissue pains; waist pains were voiced yet portrayed as low back or sacroiliac pain; and ‘veins’ variously referred to structural and functional types of pain. Psychological and social stressors accompanied many accounts of MSK troubles. Conclusions Respondents offered diverse MSK symptom descriptions consistent with biopsychosocial illness models, yet few communicated complaints using the biomedical language of healthcare providers. Although research interview and transcription processes may not be practical for clinicians, working with interpreters who communicate detailed patient accounts for MSK troubles will complement patient–provider encounters. Community member perceptions of their MSK pain and associated conditions should be explored and incorporated into healthcare interventions and innovations for rural communities in LMICs. PMID:26689457

  19. [Greater trochanteric pain syndrome].

    PubMed

    Gollwitzer, H; Opitz, G; Gerdesmeyer, L; Hauschild, M

    2014-01-01

    Greater trochanteric pain is one of the common complaints in orthopedics. Frequent diagnoses include myofascial pain, trochanteric bursitis, tendinosis and rupture of the gluteus medius and minimus tendon, and external snapping hip. Furthermore, nerve entrapment like the piriformis syndrome must be considered in the differential diagnosis. This article summarizes essential diagnostic and therapeutic steps in greater trochanteric pain syndrome. Careful clinical evaluation, complemented with specific imaging studies and diagnostic infiltrations allows determination of the underlying pathology in most cases. Thereafter, specific nonsurgical treatment is indicated, with success rates of more than 90 %. Resistant cases and tendon ruptures may require surgical intervention, which can provide significant pain relief and functional improvement in most cases. PMID:24414233

  20. 19 CFR 210.12 - The complaint.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false The complaint. 210.12 Section 210.12 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Pleadings § 210.12 The complaint. (a) Contents of the complaint. In addition to conforming with the requirements of §...

  1. 20 CFR 658.412 - Complaint resolution.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Complaint resolution. 658.412 Section 658.412 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADMINISTRATIVE PROVISIONS... Complaint resolution. (a) A JS-related complaint is resolved when: (1) The complainant...

  2. 20 CFR 658.412 - Complaint resolution.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Complaint resolution. 658.412 Section 658.412 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADMINISTRATIVE PROVISIONS... Complaint resolution. (a) A JS-related complaint is resolved when: (1) The complainant...

  3. 20 CFR 658.412 - Complaint resolution.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Complaint resolution. 658.412 Section 658.412 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADMINISTRATIVE... 658.412 Complaint resolution. (a) A JS-related complaint is resolved when: (1) The...

  4. 20 CFR 658.412 - Complaint resolution.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Complaint resolution. 658.412 Section 658.412 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADMINISTRATIVE... 658.412 Complaint resolution. (a) A JS-related complaint is resolved when: (1) The...

  5. 20 CFR 658.412 - Complaint resolution.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Complaint resolution. 658.412 Section 658.412 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) ADMINISTRATIVE... 658.412 Complaint resolution. (a) A JS-related complaint is resolved when: (1) The...

  6. 29 CFR 1614.204 - Class complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... hearing shall be conducted in accordance with 29 CFR 1614.109 (a) through (f). (i) Report of findings and..., age, disability, or genetic information. (2) A class complaint is a written complaint of... and such other material as may be requested. (g) Opportunity for resolution of the complaint. (1)...

  7. 12 CFR 268.204 - Class complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... hearing shall be conducted in accordance with 12 CFR 268.108(a) through (f). (i) Report of findings and... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Class complaints. 268.204 Section 268.204 Banks... REGARDING EQUAL OPPORTUNITY Provisions Applicable to Particular Complaints 268.204 Class complaints....

  8. 47 CFR 8.12 - Formal complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Formal complaints. 8.12 Section 8.12 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.12 Formal complaints. Any person may file a formal complaint alleging a violation of the rules in this part....

  9. 47 CFR 8.12 - Formal complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Formal complaints. 8.12 Section 8.12 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.12 Formal complaints. Any person may file a formal complaint alleging a violation of the rules in this part....

  10. 47 CFR 8.12 - Formal Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Formal Complaints. 8.12 Section 8.12 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.12 Formal Complaints. Any person may file a formal complaint alleging a violation of the rules in this part....

  11. 47 CFR 8.12 - Formal complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Formal complaints. 8.12 Section 8.12 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.12 Formal complaints. Any person may file a formal complaint alleging a violation of the rules in this part....

  12. 47 CFR 1.1404 - Complaint.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Pole Attachment Complaint... for pole attachments. The complaint shall include a statement that the utility is not owned by any... State. (d) The complaint shall be accompanied by a copy of the pole attachment agreement, if...

  13. 47 CFR 1.1404 - Complaint.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Pole Attachment Complaint... for pole attachments. The complaint shall include a statement that the utility is not owned by any... State. (d) The complaint shall be accompanied by a copy of the pole attachment agreement, if...

  14. 12 CFR 268.204 - Class complaints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... hearing shall be conducted in accordance with 12 CFR 268.108(a) through (f). (i) Report of findings and... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Class complaints. 268.204 Section 268.204 Banks... REGARDING EQUAL OPPORTUNITY Provisions Applicable to Particular Complaints § 268.204 Class complaints....

  15. 28 CFR 71.7 - Complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Administration DEPARTMENT OF JUSTICE (CONTINUED) IMPLEMENTATION OF THE PROVISIONS OF THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 Implementation for Actions Initiated by the Department of Justice 71.7 Complaint. (a... complaint in accordance with 31 U.S.C. 3803(b)(1), the reviewing official may serve a complaint on...

  16. 45 CFR 1618.3 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Complaints. 1618.3 Section 1618.3 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION ENFORCEMENT PROCEDURES § 1618.3 Complaints. A complaint of a violation of the Act by a recipient or an employee may be made to the...

  17. 10 CFR 13.7 - Complaint.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Complaint. 13.7 Section 13.7 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.7 Complaint. (a) On or after the date the Department of Justice approves the issuance of a complaint in accordance with 31 U.S.C. 3803(b)(1), the reviewing official...

  18. 21 CFR 225.115 - Complaint files.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Complaint files. 225.115 Section 225.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a) Complaints and reports of experiences...

  19. 21 CFR 225.115 - Complaint files.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Complaint files. 225.115 Section 225.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a) Complaints and reports of experiences...

  20. 45 CFR 1618.3 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Complaints. 1618.3 Section 1618.3 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION ENFORCEMENT PROCEDURES § 1618.3 Complaints. A complaint of a violation by a recipient or an employee of a recipient may be made to...

  1. 45 CFR 1618.3 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Complaints. 1618.3 Section 1618.3 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION ENFORCEMENT PROCEDURES § 1618.3 Complaints. A complaint of a violation of the Act by a recipient or an employee may be made to the...

  2. 45 CFR 1618.3 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Complaints. 1618.3 Section 1618.3 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION ENFORCEMENT PROCEDURES § 1618.3 Complaints. A complaint of a violation of the Act by a recipient or an employee may be made to the...

  3. 45 CFR 1618.3 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Complaints. 1618.3 Section 1618.3 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION ENFORCEMENT PROCEDURES § 1618.3 Complaints. A complaint of a violation by a recipient or an employee of a recipient may be made to...

  4. 48 CFR 408.711 - Quality complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Quality complaints. 408... People Who Are Blind or Severely Disabled 408.711 Quality complaints. Prior to attempting to resolve a complaint regarding the quality of goods or services provided by participating nonprofit agency with...

  5. 48 CFR 408.711 - Quality complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Quality complaints. 408... People Who Are Blind or Severely Disabled 408.711 Quality complaints. Prior to attempting to resolve a complaint regarding the quality of goods or services provided by participating nonprofit agency with...

  6. 48 CFR 408.711 - Quality complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Quality complaints. 408... People Who Are Blind or Severely Disabled 408.711 Quality complaints. Prior to attempting to resolve a complaint regarding the quality of goods or services provided by participating nonprofit agency with...

  7. 48 CFR 408.711 - Quality complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Quality complaints. 408... People Who Are Blind or Severely Disabled 408.711 Quality complaints. Prior to attempting to resolve a complaint regarding the quality of goods or services provided by participating nonprofit agency with...

  8. 48 CFR 408.711 - Quality complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Quality complaints. 408... People Who Are Blind or Severely Disabled 408.711 Quality complaints. Prior to attempting to resolve a complaint regarding the quality of goods or services provided by participating nonprofit agency with...

  9. 21 CFR 820.198 - Complaint files.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... QUALITY SYSTEM REGULATION Records § 820.198 Complaint files. (a) Each manufacturer shall maintain... device; (2) The date the complaint was received; (3) Any device identification(s) and control number(s... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Complaint files. 820.198 Section 820.198 Food...

  10. 21 CFR 820.198 - Complaint files.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... QUALITY SYSTEM REGULATION Records § 820.198 Complaint files. (a) Each manufacturer shall maintain... device; (2) The date the complaint was received; (3) Any device identification(s) and control number(s... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Complaint files. 820.198 Section 820.198 Food...

  11. 46 CFR 502.64 - Answer to complaint; counter-complaint.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 9 2011-10-01 2011-10-01 false Answer to complaint; counter-complaint. 502.64 Section 502.64 Shipping FEDERAL MARITIME COMMISSION GENERAL AND ADMINISTRATIVE PROVISIONS RULES OF PRACTICE AND PROCEDURE Proceedings; Pleadings; Motions; Replies § 502.64 Answer to complaint; counter-complaint. (a) Respondent shall file with the...

  12. Public Complaints and Complaint Responses in Calls to a Jordanian Radio Phone-In Program

    ERIC Educational Resources Information Center

    Migdadi, Fathi; Badarneh, Muhammad A.; Momani, Kawakib

    2012-01-01

    This study investigates complaints and complaint responses in interactions between local citizens and the hosts of a live two-hour radio phone-in in Jordan devoted to receiving and handling complaints of a public nature. Using Brown and Levinson's (1987) politeness model, the study examines the functions and patterns of complaints and the types of…

  13. Public Complaints and Complaint Responses in Calls to a Jordanian Radio Phone-In Program

    ERIC Educational Resources Information Center

    Migdadi, Fathi; Badarneh, Muhammad A.; Momani, Kawakib

    2012-01-01

    This study investigates complaints and complaint responses in interactions between local citizens and the hosts of a live two-hour radio phone-in in Jordan devoted to receiving and handling complaints of a public nature. Using Brown and Levinson's (1987) politeness model, the study examines the functions and patterns of complaints and the types of

  14. Primary hyperparathyroidism: an uncommon cause of hip pain.

    PubMed

    Waseem, Muhammad; Erickson, Evelyn; Agyare, Samuel; Godil, Mushtaq A

    2015-04-01

    Hip pain is a common complaint in a pediatric emergency department. The causes of hip pain are diverse and generally include traumatic and infectious causes. We report a case of hip pain caused by deep soft tissue infection associated with hypercalcemia and primary hyperparathyroidism. Atypical presentation of primary hyperparathyroidism may result in a delay in diagnosis. PMID:25831028

  15. Chronic pain management in the active-duty military

    NASA Astrophysics Data System (ADS)

    Jamison, David; Cohen, Steven P.

    2012-06-01

    As in the general population, chronic pain is a prevalent and burdensome affliction in active-duty military personnel. Painful conditions in military members can be categorized broadly in terms of whether they arise directly from combat injuries (gunshot, fragmentation wound, blast impact) or whether they result from non-combat injuries (sprains, herniated discs, motor vehicle accidents). Both combat-related and non-combat-related causes of pain can further be classified as either acute or chronic. Here we discuss the state of pain management as it relates to the military population in both deployed and non-deployed settings. The term non-battle injury (NBI) is commonly used to refer to those conditions not directly associated with the combat actions of war. In the history of warfare, NBI have far outstripped battle-related injuries in terms not only of morbidity, but also mortality. It was not until improvements in health care and field medicine were applied in World War I that battle-related deaths finally outnumbered those attributed to disease and pestilence. However, NBI have been the leading cause of morbidity and hospital admission in every major conflict since the Korean War. Pain remains a leading cause of presentation to military medical facilities, both in and out of theater. The absence of pain services is associated with a low return-to-duty rate among the deployed population. The most common pain complaints involve the low-back and neck, and studies have suggested that earlier treatment is associated with more significant improvement and a higher return to duty rate. It is recognized that military medicine is often at the forefront of medical innovation, and that many fields of medicine have reaped benefit from the conduct of war.

  16. Characteristics of temporomandibular joint in patients with temporomandibular joint complaint

    PubMed Central

    Li, Yanfeng; Guo, Xiaoqian; Sun, Xiaoxue; Wang, Ning; Xie, Min; Zhang, Jianqiang; Lv, Yuan; Han, Weili; Hu, Min; Liu, Hongchen

    2015-01-01

    Introduction: This study was to investigate whether there was statistical difference between the bilateral temporomandibular joint (TMJ) in patients with unilateral TMJ pain or joint sounds, using cone beam computed tomography (CBCT). Methods: TMJ CBCT images of 123 cases were used to preliminarily determine the indicators suitable for the measuring method. TMJ CBCT image reconstruction was performed and 19 indicators were measured. Thirty-six cases without TMJ complaint served as controls. The comparison of bilateral TMJs was analyzed by paired t-test to find out the indicators without statistical significance. Twenty-nine patients with unilateral TMJ pain or joint sounds who underwent CBCT at the hospital were enrolled for the comparative study. The measured values were analyzed by paired t-test to determine the indicators with statistical difference. Results: In the control group, only radius value of bilateral TMJ was different statistically (P < 0.05). In the TMJ complaint group, the vertical 60 joint space of the bilateral TMJ was statistically different (P < 0.05) and the rest of the measured values showed no statistical difference. Conclusions: In the patients with unilateral TMJ pain or joint sounds, the vertical 60 joint space of the symptomatic side was significantly increased comparing with the asymptomatic side. PMID:26629112

  17. Groin pain

    MedlinePLUS

    Pain - groin; Lower abdominal pain; Genital pain; Perineal pain ... Common causes of groin pain include: Pulled muscle, tendon, or ligaments in the leg. This problem often occurs in people who play sports such as ...

  18. Acute and Chronic Low Back Pain.

    PubMed

    Patrick, Nathan; Emanski, Eric; Knaub, Mark A

    2016-01-01

    Low back pain is an extremely common presenting complaint that occurs in upward of 80% of persons. Treatment of an acute episode of back pain includes relative rest, activity modification, nonsteroidal anti-inflammatories, and physical therapy. Patient education is also imperative, as these patients are at risk for further future episodes of back pain. Chronic back pain (>6months' duration) develops in a small percentage of patients. Clinicians' ability to diagnose the exact pathologic source of these symptoms is severely limited, making a cure unlikely. Treatment of these patients should be supportive, the goal being to improve pain and function. PMID:26614726

  19. Spinal cord injury pain.

    PubMed

    Saulino, Michael

    2014-05-01

    Chronic pain associated with traumatic spinal cord injury (SCI) can be quite challenging to the physiatrist. This highly prevalent condition within the SCI population requires an appropriate evaluative approach including a thorough history, a targeted physical examination, and appropriate use of diagnostic testing. The International Spinal Cord Injury Pain Classification allows for a reasonable categorization of the various pain syndromes and may assist in selecting a reasoned treatment strategy. A multitude of management approaches exist including nonpharmacologic, pharmacologic, and interventional approaches. This article provides an overview of the epidemiology, classification, evaluation, and management of SCI-associated pain. PMID:24787340

  20. High prevalence of neck, shoulder and back pain among nursing graduates warrants preventive strategies during the degree and into working life.

    PubMed

    Yassi, Annalee

    2015-04-01

    Implications for practice and research: Physical, organisational and social aspects of work significantly contribute to musculoskeletal pain in nurses, along with nonoccupational contextual and personal factors. Measures to prevent neck, shoulder and back pain in nurses should be implemented for nurses from the very beginning of their training programmes, while modifications to overtime work and physical loads should be seriously considered. Preventive measures targeting overtime work, physical workload and psychosocial factors need investigating further. PMID:25121936

  1. [Repetitive work and psychosomatic complaints].

    PubMed

    Liebrich, J; Geiger, L; Rupp, M

    1978-08-01

    200 workers of the Swiss watch industry were examined in an interdisciplinary study on the effect of repetitive work on the wellbeing of the worker. Women doing repetitive work with little autonomy complained more often about psychosomatic problems than the male workers doing non-repetitive work. This difference is interpreted as a difference of sexe rather than one of the work situation. However, there is a significant difference in the complaint about nervosity between women being paid monthly and women who were paid by piece or by hour with a premium. PMID:706840

  2. Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia

    PubMed Central

    Bismark, Marie M; Spittal, Matthew J; Gurrin, Lyle C; Ward, Michael; Studdert, David M

    2013-01-01

    Objectives (1) To determine the distribution of formal patient complaints across Australia's medical workforce and (2) to identify characteristics of doctors at high risk of incurring recurrent complaints. Methods We assembled a national sample of all 18?907 formal patient complaints filed against doctors with health service ombudsmen (Commissions) in Australia over an 11-year period. We analysed the distribution of complaints among practicing doctors. We then used recurrent-event survival analysis to identify characteristics of doctors at high risk of recurrent complaints, and to estimate each individual doctor's risk of incurring future complaints. Results The distribution of complaints among doctors was highly skewed: 3% of Australia's medical workforce accounted for 49% of complaints and 1% accounted for a quarter of complaints. Short-term risks of recurrence varied significantly among doctors: there was a strong dose-response relationship with number of previous complaints and significant differences by doctor specialty and sex. At the practitioner level, risks varied widely, from doctors with <10% risk of further complaints within 2?years to doctors with >80% risk. Conclusions A small group of doctors accounts for half of all patient complaints lodged with Australian Commissions. It is feasible to predict which doctors are at high risk of incurring more complaints in the near future. Widespread use of this approach to identify high-risk doctors and target quality improvement efforts coupled with effective interventions, could help reduce adverse events and patient dissatisfaction in health systems. PMID:23576774

  3. Dyadic analysis of child and parent trait and state pain catastrophizing in the process of children's pain communication.

    PubMed

    Birnie, Kathryn A; Chambers, Christine T; Chorney, Jill; Fernandez, Conrad V; McGrath, Patrick J

    2016-04-01

    When explored separately, child and parent catastrophic thoughts about child pain show robust negative relations with child pain. The objective of this study was to conduct a dyadic analysis to elucidate intrapersonal and interpersonal influences of child and parent pain catastrophizing on aspects of pain communication, including observed behaviours and perceptions of child pain. A community sample of 171 dyads including children aged 8 to 12 years (89 girls) and parents (135 mothers) rated pain catastrophizing (trait and state versions) and child pain intensity and unpleasantness following a cold pressor task. Child pain tolerance was also assessed. Parent-child interactions during the cold pressor task were coded for parent attending, nonattending, and other talk, and child symptom complaints and other talk. Data were analyzed using the actor-partner interdependence model and hierarchical multiple regressions. Children reporting higher state pain catastrophizing had greater symptom complaints regardless of level of parent state pain catastrophizing. Children reporting low state pain catastrophizing had similar high levels of symptom complaints, but only when parents reported high state pain catastrophizing. Higher child and parent state and/or trait pain catastrophizing predicted their own ratings of higher child pain intensity and unpleasantness, with child state pain catastrophizing additionally predicting parent ratings. Higher pain tolerance was predicted by older child age and lower child state pain catastrophizing. These newly identified interpersonal effects highlight the relevance of the social context to children's pain expressions and parent perceptions of child pain. Both child and parent pain catastrophizing warrant consideration when managing child pain. PMID:26713422

  4. Chief Complaint at Admission Relates to Troponin Level and Mortality in Patients With Non-ACS Troponin Elevation

    PubMed Central

    Piscator, Eva; Lowing Svensson, Lukas; Svensson, Per

    2015-01-01

    Background Elevated level of troponin T (TnT) in the absence of acute coronary syndrome (ACS) can be caused by a number of conditions but the relevance of the chief complaint at admission for TnT level and prognosis has not been reported previously. The aim was to study whether TnT level differs among chief complaints or underlying causes in patients with non-ACS TnT elevation and if these factors predict mortality. Methods Patients admitted with TnT elevation were categorized as ACS or non-ACS and followed for 1 year. Statistical comparisons between different chief complaints and underlying causes were performed. Results Patients with non-ACS TnT elevation (n = 71) were less likely to present with chest pain compared to ACS (n = 50) (37% vs. 74%, P < 0.001) whereas dyspnea (25%), syncope/arrhythmia (14%) or other chief complaints (24%) were more common. Patients with dyspnea and other chief complaints had higher peak values of TnT compared to chest pain (P < 0.05). The most common peak occurred within 3 hours after admission for chest pain, dyspnea and other chief complaints whereas for arrhythmia it occurred after 3 - 9 hours (P < 0.01). A peak value > 15 hours after admission was only observed among dyspnea and other chief complaints. Mortality was higher in patients presenting with dyspnea (50%) or other causes (35%) compared to chest pain (8%) or syncope/arrhythmia (10%) (P < 0.05). Renal failure was the only underlying cause that predicted mortality. Conclusion Among patients with non-ACS TnT elevation, patients presenting with dyspnea had higher TnT and higher 1-year mortality, whereas patients with chest pain were at lower risk. PMID:25883711

  5. Work activities and musculoskeletal complaints among preschool workers.

    PubMed

    Grant, K A; Habes, D J; Tepper, A L

    1995-12-01

    The potential for musculoskeletal trauma among preschool workers has been largely unexplored in the United States. This case report describes an investigation conducted to identify and evaluate possible causes of back and lower extremity pain among 22 workers at a Montessori day care facility. Investigators met with and distributed a questionnaire to school employees, and made measurements of workstation and furniture dimensions. Investigators also recorded the normal work activities of school employees on videotape, and performed a work sampling study to estimate the percentage of time employees spend performing various tasks and in certain postures. Questionnaire results from 18 employees indicated that back pain/discomfort was a common musculoskeletal complaint, reported by 61% of respondents. Neck/shoulder pain, lower extremity pain and hand/wrist pain were reported by 33, 33 and 11% of respondents, respectively. Observation and analysis of work activities indicated that employees spend significant periods of time kneeling, sitting on the floor, squatting, or bending at the waist. Furthermore, staff members who work with smaller children (i.e. six weeks to 18 months of age) performed more lifts and assumed more awkward lower extremity postures than employees who work with older children (3-4 years of age). Analysis of two lifting tasks using the revised NIOSH lifting equation indicated that employees who handle small children may be at increased risk of lifting-related low back pain. Investigators concluded that day care employees at this facility are at increased risk of low back pain and lower extremity (i.e. knee) injury due to work activities that require awkward or heavy lifts, and static working postures. Recommendations for reducing or eliminating these risks by modifying the workplace and changing the organization and methods of work are presented. PMID:15677041

  6. Low-back pain.

    PubMed

    Violante, Francesco S; Mattioli, Stefano; Bonfiglioli, Roberta

    2015-01-01

    Low-back pain is one of the most common painful conditions experienced by humans throughout their life. Some occupational risk factors (namely, heavy manual material handling) may also contribute to the development of low-back pain: due to the high prevalence of both low-back pain and manual material handling in the adult working population, it has been estimated that low-back pain is probably the most common occupational disorder worldwide. Lifetime prevalence of low-back pain has been reported to be as high as 84%, depending on the case definition used, and no age group is spared, even children. Although low-back pain is not a lethal condition, it was estimated at the third rank among all diseases by disability-adjusted life-years in 2010 in the USA, after ischemic heart disease and chronic obstructive pulmonary disease, and at the first rank by years lived with disability. It also ranked high (13th) globally for the same year, in disability-adjusted life-years. Low-back pain is currently classified as nonspecific/specific as to putative cause and as acute (lasting less than 6 weeks), subacute (6-12 weeks), or chronic (more than 12 weeks) according to duration of symptoms. The distinction between nonspecific/specific and acute/subacute/chronic low-back pain is useful not only for epidemiologic studies, but also (mainly) for choosing the appropriate strategy for the diagnosis and treatment of the disorder. Workplace risk factors for low-back pain include manual lifting and whole-body vibration exposure. This chapter will provide an overview of modern concepts of low-back pain (in general) and will then outline some distinctive features of work-related low-back pain. PMID:26563799

  7. Abdominal pain

    MedlinePLUS

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  8. Flank pain

    MedlinePLUS

    Pain - side; Side pain ... Flank pain can be a sign of a kidney problem. But, since many organs are in this area, other causes are possible. If you have flank pain and fever , chills, blood in the urine, or ...

  9. Pain (PDQ)

    MedlinePLUS

    ... moderate pain. 7 to 10 means severe pain. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to relieve mild pain. Acetaminophen and NSAIDs help relieve mild pain. They may ...

  10. 49 CFR 821.55 - Complaint, answer to complaint, motions and discovery.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... discovery. 821.55 Section 821.55 Transportation Other Regulations Relating to Transportation (Continued... to complaint, motions and discovery. (a) Complaint. In proceedings governed by this subpart, the Administrator's complaint shall be filed by overnight delivery service or facsimile, and simultaneously...

  11. Failure of physician documentation of sleep complaints in hospitalized patients.

    PubMed Central

    Meissner, H H; Riemer, A; Santiago, S M; Stein, M; Goldman, M D; Williams, A J

    1998-01-01

    Sleep disorders are acknowledged to be common but remain underrecognized by the medical community, often attributed to the failure to question patients about their sleep quality. We examined the prevalence of sleep complaints (insomnia or excessive daytime sleepiness) in a group of general medical patients by administering a questionnaire to hospitalized patients in a Veterans Affairs tertiary care medical center. A total of 222 consecutive adults (215 men, 60 +/- 14 years; body mass index, 24.8 +/- 5.6) completed the questionnaire. Of these, 105 patients (47%) had either insomnia, excessive daytime somnolence, or both; 63 (28%) had excessive daytime somnolence, which was severe in 27 (12%). Of 75 patients (34%) who had insomnia, a third were taking hypnotic medication. Forty patients (18%) had snoring, which was associated with excessive daytime somnolence in 36, whereas 46 patients (21%) had either restless legs or a combination of leg jerks and leg kicking or twitching during sleep, associated with a sleep complaint (insomnia in 32). The medical records were subsequently reviewed to assess the admitting physicians' recognition of these symptoms. No record included mention of any patient symptom related to sleep. We conclude that symptoms related to sleep, some of which may be clinically important, are common, and that none of these complaints appear to be recognized by the physicians of record. PMID:9771152

  12. Prevalence of post-treatment pain after cleaning and shaping of the root canal system using manual step-back versus rotary nickel titanium.

    PubMed

    Aqrabawi, J; Jamani, K

    2006-03-01

    To evaluate the effect of ProTaper rotary NiTi instrumentation technique on post-treatment pain at different time periods when compared with step-back technique, one hundred forty-six patients with 160 teeth participated in this study. All treated teeth (160) are having vital pulps and divided into two groups according to the canal instrumentation technique. Group (1) consisted of 80 teeth, cleaned and shaped with manual step-back technique using K-Flexo hand files. Group (2) was 80 teeth cleaned and shaped using ProTaper (NiTi) rotary files. Patients assessed post-treatment pain at 8 h, 24 h, and 48 h as none, mild, moderate, or severe. Evaluation of the two groups, according to the three post-treatment time period, was tabled as to the number of responses at each pain level at each interval. Comparisons were made by subjecting the collected data to a multiple- regression test. The results demonstrated that there were no statistically significant difference in post-treatment pain between the two groups at any time period P > 0.05. PMID:16704020

  13. Myofascial pain syndrome: a treatment review.

    PubMed

    Desai, Mehul J; Saini, Vikramjeet; Saini, Shawnjeet

    2013-06-01

    Myofascial pain syndrome (MPS) is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The appropriate evaluation and management of myofascial pain is an important part of musculoskeletal rehabilitation, and regional axial and limb pain syndromes. This article reviews the current hypotheses regarding the treatment modalities for myofascial trigger points and muscle pain. Through a critical evidence-based review of the pharmacologic and nonpharmacologic treatments, the authors aim to provide clinicians with a more comprehensive knowledge of the interventions for myofascial pain. PMID:25135034

  14. Complaints Soar over Student-Loan Collections

    ERIC Educational Resources Information Center

    Field, Kelly

    2012-01-01

    Over the past five years, the number of complaints filed against agencies collecting on behalf of the U.S. Department of Education has grown by 45 percent. The Federal Trade Commission, which oversees the entire industry, received 142,743 complaints involving debt-collection companies last year, though only some involved student loans. Consumer

  15. 29 CFR 1614.204 - Class complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... hearing shall be conducted in accordance with 29 CFR 1614.109 (a) through (f). (i) Decisions: The..., age, disability, or genetic information. (2) A class complaint is a written complaint of..., and the information is solely in the control of one party, such failure may, in...

  16. 29 CFR 1614.204 - Class complaints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... hearing shall be conducted in accordance with 29 CFR 1614.109 (a) through (f). (i) Report of findings and..., age, disability, or genetic information. (2) A class complaint is a written complaint of..., and the information is solely in the control of one party, such failure may, in...

  17. 29 CFR 1614.204 - Class complaints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... hearing shall be conducted in accordance with 29 CFR 1614.109 (a) through (f). (i) Decisions: The..., age, disability, or genetic information. (2) A class complaint is a written complaint of..., and the information is solely in the control of one party, such failure may, in...

  18. 43 CFR 4.450-4 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Complaints. 4.450-4 Section 4.450-4 Public Lands: Interior Office of the Secretary of the Interior DEPARTMENT HEARINGS AND APPEALS PROCEDURES Special Rules Applicable to Public Land Hearings and Appeals Hearings on Appeals Involving Questions of Fact 4.450-4 Complaints. (a) Contents...

  19. 12 CFR 308.506 - Complaint.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Complaint. 308.506 Section 308.506 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE RULES OF PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures 308.506 Complaint. (a) On or after the date the...

  20. 12 CFR 308.506 - Complaint.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Complaint. 308.506 Section 308.506 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE RULES OF PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures 308.506 Complaint. (a) On or after the date the...

  1. 12 CFR 308.506 - Complaint.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Complaint. 308.506 Section 308.506 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE RULES OF PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures 308.506 Complaint. (a) On or after the date the...

  2. 47 CFR 76.1713 - Complaint resolution.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Complaint resolution. 76.1713 Section 76.1713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Documents to be Maintained for Inspection 76.1713 Complaint resolution....

  3. 47 CFR 76.1713 - Complaint resolution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 4 2014-10-01 2014-10-01 false Complaint resolution. 76.1713 Section 76.1713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Documents to be Maintained for Inspection 76.1713 Complaint resolution....

  4. 47 CFR 76.1713 - Complaint resolution.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Complaint resolution. 76.1713 Section 76.1713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Documents to be Maintained for Inspection 76.1713 Complaint resolution....

  5. 47 CFR 76.1713 - Complaint resolution.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 4 2012-10-01 2012-10-01 false Complaint resolution. 76.1713 Section 76.1713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Documents to be Maintained for Inspection 76.1713 Complaint resolution....

  6. 47 CFR 76.1713 - Complaint resolution.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 4 2013-10-01 2013-10-01 false Complaint resolution. 76.1713 Section 76.1713 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Documents to be Maintained for Inspection 76.1713 Complaint resolution....

  7. 12 CFR 268.204 - Class complaints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... accordance with 12 CFR 268.108(a) through (f). (i) Report of findings and recommendations. (1) The... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Class complaints. 268.204 Section 268.204 Banks... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Provisions Applicable to Particular Complaints 268.204...

  8. 12 CFR 268.204 - Class complaints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... accordance with 12 CFR 268.108(a) through (f). (i) Report of findings and recommendations. (1) The... 12 Banks and Banking 4 2012-01-01 2012-01-01 false Class complaints. 268.204 Section 268.204 Banks... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Provisions Applicable to Particular Complaints 268.204...

  9. 12 CFR 268.204 - Class complaints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... accordance with 12 CFR 268.108(a) through (f). (i) Report of findings and recommendations. (1) The... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Class complaints. 268.204 Section 268.204 Banks... (CONTINUED) RULES REGARDING EQUAL OPPORTUNITY Provisions Applicable to Particular Complaints 268.204...

  10. 40 CFR 7.120 - Complaint investigations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... recipients of Federal assistance (see 28 CFR part 42, subpart H and 29 CFR part 1691). Complaints of... with the Equal Employment Opportunity Commission (see 29 CFR part 1626). Complainants are encouraged... Compliance Procedures 7.120 Complaint investigations. The OCR shall promptly investigate all...

  11. 14 CFR 13.5 - Formal complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Formal complaints. 13.5 Section 13.5 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES Investigative Procedures 13.5 Formal complaints. (a) Any person...

  12. 45 CFR 617.9 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Complaints. 617.9 Section 617.9 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM NSF 617.9 Complaints. (a) Any person, individually or as...

  13. 45 CFR 606.70 - Complaint procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Complaint procedures. 606.70 Section 606.70 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION 606.70 Complaint procedures....

  14. 7 CFR 271.6 - Complaint procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Complaint procedure. 271.6 Section 271.6 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM GENERAL INFORMATION AND DEFINITIONS § 271.6 Complaint procedure. (a) State agency...

  15. 15 CFR 20.11 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... others, may file a complaint with DOC alleging discrimination prohibited by the Act or these regulations..., for good cause shown, DOC may extend this time limit. (b) DOC will attempt to facilitate the filing of... representatives) of their right to contact DOC for information and assistance regarding the complaint...

  16. 15 CFR 20.11 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... others, may file a complaint with DOC alleging discrimination prohibited by the Act or these regulations..., for good cause shown, DOC may extend this time limit. (b) DOC will attempt to facilitate the filing of... representatives) of their right to contact DOC for information and assistance regarding the complaint...

  17. 12 CFR 308.506 - Complaint.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Complaint. 308.506 Section 308.506 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE RULES OF PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures § 308.506 Complaint. (a) On or after the date the...

  18. 12 CFR 308.506 - Complaint.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Complaint. 308.506 Section 308.506 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE RULES OF PRACTICE AND PROCEDURE Program Fraud Civil Remedies and Procedures § 308.506 Complaint. (a) On or after the date the...

  19. 47 CFR 1.1404 - Complaint.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Pole... for pole attachments. The complaint shall include a statement that the utility is not owned by any... State. (d) The complaint shall be accompanied by a copy of the pole attachment agreement, if...

  20. 47 CFR 1.1404 - Complaint.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Pole... for pole attachments. The complaint shall include a statement that the utility is not owned by any... State. (d) The complaint shall be accompanied by a copy of the pole attachment agreement, if...

  1. 10 CFR 590.317 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Complaints. 590.317 Section 590.317 Energy DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures § 590.317 Complaints. (a) Any person may file...

  2. 29 CFR 30.11 - Complaint procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... effective procedures for a review body to consider complaints of failure to follow the equal opportunity.... Sponsors may join together in establishing a review body to serve the needs of programs within the community. (b) Processing of complaints. (1)(i) When the sponsor has designated a review body for...

  3. 29 CFR 30.11 - Complaint procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... effective procedures for a review body to consider complaints of failure to follow the equal opportunity.... Sponsors may join together in establishing a review body to serve the needs of programs within the community. (b) Processing of complaints. (1)(i) When the sponsor has designated a review body for...

  4. 45 CFR 96.50 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Enforcement 96.50 Complaints... writing to the Assistant Secretary for Human Development Services. Complaints with respect to the low... will defer to a State's interpretation of its assurances and of the provisions of the block...

  5. 29 CFR 1614.204 - Class complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... hearing shall be conducted in accordance with 29 CFR 1614.109 (a) through (f). (i) Report of findings and... complaint shall, subject to subpart D of this part, be binding on all members of the class and the agency... 29 Labor 4 2010-07-01 2010-07-01 false Class complaints. 1614.204 Section 1614.204...

  6. 10 CFR 590.317 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Complaints. 590.317 Section 590.317 Energy DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures 590.317 Complaints. (a) Any person may file...

  7. 76 FR 52718 - Complaint About Postal Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ...San Francisco, in its municipal capacity, has filed a formal complaint alleging that there deficiencies in the Postal Service's delivery of mail to residents of certain multi-unit buildings, and that the Postal Service is therefore not acting in conformance with statutory requirements. This document identifies the grounds for the complaint, reviews key developments, and addresses certain......

  8. 14 CFR 13.208 - Complaint.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Complaint. 13.208 Section 13.208 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES Rules of Practice in FAA Civil Penalty Actions 13.208 Complaint....

  9. 14 CFR 13.208 - Complaint.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Complaint. 13.208 Section 13.208 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES Rules of Practice in FAA Civil Penalty Actions 13.208 Complaint....

  10. 14 CFR 13.208 - Complaint.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Complaint. 13.208 Section 13.208 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES Rules of Practice in FAA Civil Penalty Actions 13.208 Complaint....

  11. 14 CFR 13.208 - Complaint.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Complaint. 13.208 Section 13.208 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES Rules of Practice in FAA Civil Penalty Actions 13.208 Complaint....

  12. 14 CFR 13.208 - Complaint.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Complaint. 13.208 Section 13.208 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURAL RULES INVESTIGATIVE AND ENFORCEMENT PROCEDURES Rules of Practice in FAA Civil Penalty Actions 13.208 Complaint....

  13. 12 CFR 626.6030 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM NONDISCRIMINATION IN LENDING § 626.6030 Complaints. (a) Complaints regarding discrimination in lending by a Farm Credit institution under the Fair... regarding discrimination in lending by a Farm Credit institution under the Equal Credit Opportunity...

  14. 44 CFR 7.941 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Complaints. 7.941 Section 7.941 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND... file a complaint within 180 days from the date the complainant first had knowledge of the alleged...

  15. 48 CFR 422.1406 - Complaint procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Complaint procedures. 422.1406 Section 422.1406 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Employment of Workers With Disabilities 422.1406 Complaint procedures. The...

  16. 48 CFR 22.1406 - Complaint procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Complaint procedures. 22.1406 Section 22.1406 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Employment of Workers with Disabilities 22.1406 Complaint procedures....

  17. 39 CFR 952.5 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Complaints. 952.5 Section 952.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS 952.5 Complaints. When the Chief Postal Inspector or his or her...

  18. 39 CFR 952.5 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Complaints. 952.5 Section 952.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS 952.5 Complaints. When the the Chief Postal Inspector or his or her...

  19. 39 CFR 952.5 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Complaints. 952.5 Section 952.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS (EFF. UNTIL 7-22-2011) 952.5 Complaints. When the the Chief Postal Inspector...

  20. 39 CFR 952.5 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Complaints. 952.5 Section 952.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS 952.5 Complaints. When the Chief Postal Inspector or his or her...

  1. 39 CFR 952.5 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Complaints. 952.5 Section 952.5 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS 952.5 Complaints. When the Chief Postal Inspector or his or her...

  2. 45 CFR 617.9 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM NSF 617.9 Complaints... with NSF, alleging discrimination prohibited by the Act. A complainant shall file a complaint within.... However, for good cause shown, NSF may extend this time limit. (b) NSF will accept as a...

  3. 45 CFR 617.9 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM NSF 617.9 Complaints... with NSF, alleging discrimination prohibited by the Act. A complainant shall file a complaint within.... However, for good cause shown, NSF may extend this time limit. (b) NSF will accept as a...

  4. 45 CFR 617.9 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM NSF 617.9 Complaints... with NSF, alleging discrimination prohibited by the Act. A complainant shall file a complaint within.... However, for good cause shown, NSF may extend this time limit. (b) NSF will accept as a...

  5. 45 CFR 617.9 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM NSF 617.9 Complaints... with NSF, alleging discrimination prohibited by the Act. A complainant shall file a complaint within.... However, for good cause shown, NSF may extend this time limit. (b) NSF will accept as a...

  6. 77 FR 47823 - Zen Magnets, LLC; Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-10

    ...Under provisions of its Rules of Practice for Adjudicative Proceeding (16 CFR part 1025), the Consumer Product Safety Commission must publish in the Federal Register Complaints which it issues. Published below is a Complaint: In the Matter of Zen Magnets, LLC.\\1\\...

  7. 21 CFR 225.115 - Complaint files.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a... current good manufacturing practices. These complaints and experiences may reveal the existence of manufacturing problems not otherwise detected through the normal quality control procedures. Timely...

  8. 21 CFR 225.115 - Complaint files.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a... current good manufacturing practices. These complaints and experiences may reveal the existence of manufacturing problems not otherwise detected through the normal quality control procedures. Timely...

  9. 21 CFR 225.115 - Complaint files.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a... current good manufacturing practices. These complaints and experiences may reveal the existence of manufacturing problems not otherwise detected through the normal quality control procedures. Timely...

  10. 43 CFR 17.331 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... or on behalf of others, may file a complaint with DOI, alleging discrimination prohibited by the Act... good cause shown, however, DOI may extend this time limit. (b) DOI will consider the date a complaint... described in paragraphs (a) and (c)(1) of this section. (c) DOI will attempt to facilitate the filing...

  11. 45 CFR 606.70 - Complaint procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Complaint procedures. 606.70 Section 606.70 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION 606.70 Complaint procedures....

  12. Complaints Soar over Student-Loan Collections

    ERIC Educational Resources Information Center

    Field, Kelly

    2012-01-01

    Over the past five years, the number of complaints filed against agencies collecting on behalf of the U.S. Department of Education has grown by 45 percent. The Federal Trade Commission, which oversees the entire industry, received 142,743 complaints involving debt-collection companies last year, though only some involved student loans. Consumer…

  13. 48 CFR 8.711 - Quality complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Quality complaints. 8.711... Blind or Severely Disabled 8.711 Quality complaints. (a) When the quality of supplies or services... the appropriate central nonprofit agency. (b) When quality problems cannot be resolved by the...

  14. 48 CFR 8.711 - Quality complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Quality complaints. 8.711... Blind or Severely Disabled 8.711 Quality complaints. (a) When the quality of supplies or services... the appropriate central nonprofit agency. (b) When quality problems cannot be resolved by the...

  15. 48 CFR 8.711 - Quality complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Quality complaints. 8.711... Blind or Severely Disabled 8.711 Quality complaints. (a) When the quality of supplies or services... the appropriate central nonprofit agency. (b) When quality problems cannot be resolved by the...

  16. 48 CFR 8.711 - Quality complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Quality complaints. 8.711... Blind or Severely Disabled 8.711 Quality complaints. (a) When the quality of supplies or services... the appropriate central nonprofit agency. (b) When quality problems cannot be resolved by the...

  17. 21 CFR 820.198 - Complaint files.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... QUALITY SYSTEM REGULATION Records § 820.198 Complaint files. (a) Each manufacturer shall maintain... product code (UPC), and any other device identification(s) and control number(s) used; (4) The name... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Complaint files. 820.198 Section 820.198 Food...

  18. 45 CFR 704.2 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Complaints. 704.2 Section 704.2 Public Welfare Regulations Relating to Public Welfare (Continued) COMMISSION ON CIVIL RIGHTS INFORMATION DISCLOSURE AND COMMUNICATIONS 704.2 Complaints. Any person may bring to the attention of the Commission a grievance that he...

  19. Prevalence of gastroesophageal reflux disease in Moscow.

    PubMed

    Bor, S; Lazebnik, L B; Kitapcioglu, G; Manannikof, I; Vasiliev, Y

    2016-02-01

    Limited data exist to determine the prevalence and clinical spectrum of gastroesophageal reflux disease (GERD) in the Russian population, which might be different from those in Western countries. This study was performed in Moscow on randomized 1065 adults aged ≥15 years. A validated reflux questionnaire comprising 72 questions and an additional 29 sub-questions were used. The questions assessed (heartburn and regurgitation) and related (dyspepsia, dysphagia, odynophagia and chest pain) symptoms, the triggering factors of these symptoms, family history and data on demographic and socioeconomic features. GERD was defined as heartburn and/or regurgitation once a week or common. Of the 1065 participants, 42.1% were male and 57.9% were female. The prevalences of frequent and occasional symptoms were 17.6 and 22.1% for heartburn and 17.5 and 21.8% for regurgitation, respectively, over the last 12 months. The prevalence of GERD was found to be 23.6%. The rate of GERD was significantly higher in females than in males (15.4 vs. 29.5%, P < 0.001) and significantly increased as the age of the participants increased (P = 0.011). GERD was present in 20.4% of smokers, 24.2% of coffee drinkers, 21.5% of alcohol consumers and 45.9% of stressed participants. Although the rate of alcohol consumers was lower in those with GERD compared with those without GERD, the rate of coffee drinkers and stressed participants was higher among those with GERD. The rate of additional symptoms was higher even in participants complaining of regurgitation/heartburn rarely, compared with those without complaints. Using the same questionnaire, which makes it possible to compare the present results with those from different countries, we found the prevalence of GERD in Moscow to be 23.6%, one of highest in the Western populations. The rates of heartburn and regurgitation were found to be similar, which constitutes a different result than has been found in similar studies. Additional symptoms should be assessed, in all GERD patients even in the presence of rare complaints of regurgitation/heartburn. PMID:25604401

  20. Exertional Leg Pain.

    PubMed

    Rajasekaran, Sathish; Finnoff, Jonathan T

    2016-02-01

    Exertional leg pain is a common condition seen in runners and the general population. Given the broad differential diagnosis of this complaint, this article focuses on the incidence, anatomy, pathophysiology, clinical presentation, diagnostic evaluation, and management of common causes that include medial tibial stress syndrome, tibial bone stress injury, chronic exertional compartment syndrome, arterial endofibrosis, popliteal artery entrapment syndrome, and entrapment of the common peroneal, superficial peroneal, and saphenous nerves. Successful diagnosis of these conditions hinges on performing a thorough history and physical examination followed by proper diagnostic testing and appropriate management. PMID:26616179

  1. Pain in cancer survivors.

    PubMed

    Glare, Paul A; Davies, Pamela S; Finlay, Esm; Gulati, Amitabh; Lemanne, Dawn; Moryl, Natalie; Oeffinger, Kevin C; Paice, Judith A; Stubblefield, Michael D; Syrjala, Karen L

    2014-06-01

    Pain is a common problem in cancer survivors, especially in the first few years after treatment. In the longer term, approximately 5% to 10% of survivors have chronic severe pain that interferes with functioning. The prevalence is much higher in certain subpopulations, such as breast cancer survivors. All cancer treatment modalities have the potential to cause pain. Currently, the approach to managing pain in cancer survivors is similar to that for chronic cancer-related pain, pharmacotherapy being the principal treatment modality. Although it may be appropriate to continue strong opioids in survivors with moderate to severe pain, most pain problems in cancer survivors will not require them. Moreover, because more than 40% of cancer survivors now live longer than 10 years, there is growing concern about the long-term adverse effects of opioids and the risks of misuse, abuse, and overdose in the nonpatient population. As with chronic nonmalignant pain, multimodal interventions that incorporate nonpharmacologic therapies should be part of the treatment strategy for pain in cancer survivors, prescribed with the aim of restoring functionality, not just providing comfort. For patients with complex pain issues, multidisciplinary programs should be used, if available. New or worsening pain in a cancer survivor must be evaluated to determine whether the cause is recurrent disease or a second malignancy. This article focuses on patients with a history of cancer who are beyond the acute diagnosis and treatment phase and on common treatment-related pain etiologies. The benefits and harms of the various pharmacologic and nonpharmacologic options for pain management in this setting are reviewed. PMID:24799477

  2. Pain in Cancer Survivors

    PubMed Central

    Glare, Paul A.; Davies, Pamela S.; Finlay, Esmé; Gulati, Amitabh; Lemanne, Dawn; Moryl, Natalie; Oeffinger, Kevin C.; Paice, Judith A.; Stubblefield, Michael D.; Syrjala, Karen L.

    2014-01-01

    Pain is a common problem in cancer survivors, especially in the first few years after treatment. In the longer term, approximately 5% to 10% of survivors have chronic severe pain that interferes with functioning. The prevalence is much higher in certain subpopulations, such as breast cancer survivors. All cancer treatment modalities have the potential to cause pain. Currently, the approach to managing pain in cancer survivors is similar to that for chronic cancer-related pain, pharmacotherapy being the principal treatment modality. Although it may be appropriate to continue strong opioids in survivors with moderate to severe pain, most pain problems in cancer survivors will not require them. Moreover, because more than 40% of cancer survivors now live longer than 10 years, there is growing concern about the long-term adverse effects of opioids and the risks of misuse, abuse, and overdose in the nonpatient population. As with chronic nonmalignant pain, multimodal interventions that incorporate nonpharmacologic therapies should be part of the treatment strategy for pain in cancer survivors, prescribed with the aim of restoring functionality, not just providing comfort. For patients with complex pain issues, multidisciplinary programs should be used, if available. New or worsening pain in a cancer survivor must be evaluated to determine whether the cause is recurrent disease or a second malignancy. This article focuses on patients with a history of cancer who are beyond the acute diagnosis and treatment phase and on common treatment-related pain etiologies. The benefits and harms of the various pharmacologic and nonpharmacologic options for pain management in this setting are reviewed. PMID:24799477

  3. [Complaint analysis derived from surgical practice].

    PubMed

    Fajardo-Dolci, Germn; Rodrguez-Surez, Francisco Javier; Campos-Castolo, Esther Mahuina; Carrillo-Jaimes, Arturo; Zavala-Surez, Etelvina; Aguirre-Gas, Hctor Gerardo

    2009-01-01

    This study reports on the analysis of medical complaints presented to the National Commission on Medical Arbitration (Comisin Nacional de Arbitraje Mdico, CONAMED) between June 1996 and December 2007 to determine its magnitude and to identify the causes of safety problems in medical care. Out of 182,407 complaints presented to CONAMED, 87% were resolved by the Office of Orientation and Management. The remaining 18,443 complaints were presented to the Council Directorate. Of those cases, 48% were resolved by an agreement between the complainants and the physicians, 31% were not resolved by this method, and 3% were irresolute complaints. The highest frequency of complaints was registered in the Federal District (Distrito Federal) and the State of Mxico (Estado de Mxico), mainly corresponding to social security institutions and private hospitals. Among the nine most frequently involved specialties, six were surgical specialties. Malpractice was identified in 25% of all cases. The principal demands of those making complaints were the refunding of expenses in patient medical care (51%) and indemnification (40%) and, in those, the average amount of payments was 4.6 times greater. Due to the incidence of medical complaints, it was reasonable to investigate the causes and to take preventive and corrective actions required for its decrease. It was proposed to the Mexican Academy of Surgery that this organization should use their educational leadership and assume the vanguard in the dissemination and promotion of the WHO plan "Safe Surgery Saves Lives" and the implementation in Mexico of the "Surgical Safety Checklist." PMID:19671273

  4. Patellofemoral pain: epidemiology, pathophysiology, and treatment options.

    PubMed

    Rothermich, Marcus A; Glaviano, Neal R; Li, Jiacheng; Hart, Joe M

    2015-04-01

    Patients with anterior knee pain present a complex and common problem to health care providers. The diagnosis and treatment of these patients often involve a comprehensive evaluation that includes assessing the chronicity of the pain, the specific location of the complaint, and the previous treatment modalities attempted by the patient. This common diagnosis includes a wide variety of different pathologic abnormalities that can be present independently or concomitantly and cause a spectrum of disabilities for the patient. PMID:25818716

  5. Orofacial pain syndromes: evaluation and management.

    PubMed

    Balasubramaniam, Ramesh; Klasser, Gary D

    2014-11-01

    Patients will often visit their primary medical practitioner with orofacial pain complaints. Hence, it is important to recognize and have an understanding of these conditions to properly evaluate and potentially manage these disorders. If the practitioner is uncertain or uncomfortable with these conditions, then patient referral to a knowledgeable health care practitioner should be considered for further evaluation and management. In this article, the evaluation and management of various neuropathic, neurovascular, and vascular pains are discussed. PMID:25443681

  6. Back Pain

    MedlinePLUS

    ... Back Pain Find a Clinical Trial Journal Articles Back Pain March 2015 Handout on Health: Back Pain This publication is for people who have back ... to discuss them with your doctor. What Is Back Pain? Back pain is an all-too-familiar problem ...

  7. Somatic Complaints in Anxious Youth

    PubMed Central

    Crawley, Sarah A.; Caporino, Nicole E.; Birmaher, Boris; Ginsburg, Golda; Piacentini, John; Albano, Anne Marie; Sherrill, Joel; Sakolsky, Dara; Compton, Scott N.; Rynn, Moira; McCracken, James; Gosch, Elizabeth; Keeton, Courtney; March, John; Walkup, John T.; Kendall, Philip C.

    2013-01-01

    This study examined (a) demographic and clinical characteristics associated with physical symptoms in anxiety-disordered youth and (b) the impact of cognitive-behavioral therapy (Coping Cat), medication (sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7–17 years) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi-site, randomized controlled trial and received treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research are discussed. (ClinicalTrials.gov number, NCT00052078) PMID:24129543

  8. Somatic complaints in anxious youth.

    PubMed

    Crawley, Sarah A; Caporino, Nicole E; Birmaher, Boris; Ginsburg, Golda; Piacentini, John; Albano, Anne Marie; Sherrill, Joel; Sakolsky, Dara; Compton, Scott N; Rynn, Moira; McCracken, James; Gosch, Elizabeth; Keeton, Courtney; March, John; Walkup, John T; Kendall, Philip C

    2014-08-01

    This study examined (a) demographic and clinical characteristics associated with physical symptoms in anxiety-disordered youth and (b) the impact of cognitive-behavioral therapy (Coping Cat), medication (sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7-17 years) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi-site, randomized controlled trial and received treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research are discussed (ClinicalTrials.gov number, NCT00052078). PMID:24129543

  9. Postoperative pain outcomes after transvaginal mesh revision

    PubMed Central

    Osborn, David J.; Reynolds, W. Stuart; Biller, Daniel H.; Dmochowski, Roger R.

    2016-01-01

    Introduction and hypothesis Although the current literature discusses mesh complications including pain, as well as suggesting different techniques for removing mesh, there is little literature regarding pain outcomes after surgical removal or revision. The purpose of this study is to determine if surgical removal or revision of vaginal mesh improves patients subjective complaints of pelvic pain associated with original placement of mesh. Methods After obtaining approval from the Vanderbilt University Medical Center Institutional Review Board, a retrospective review of female patients with pain secondary to previous mesh placement who underwent excision or revision of vaginal mesh from January 2000 to August 2012 was performed. Patient age, relevant medical history including menopause status, previous hysterectomy, smoking status, and presence of diabetes, fibromyalgia, interstitial cystitis, and chronic pelvic pain, was obtained. Patients postoperative pain complaints were assessed. Results Of the 481 patients who underwent surgery for mesh revision, removal or urethrolysis, 233 patients met our inclusion criteria. One hundred and sixty-nine patients (73 %) reported that their pain improved, 19 (8 %) reported that their pain worsened, and 45 (19 %) reported that their pain remained unchanged after surgery. Prior history of chronic pelvic pain was associated with increased risk of failure of the procedure to relieve pain (OR 0.28, 95 % CI 0.120.64, p=0.003). Conclusions Excision or revision of vaginal mesh appears to be effective in improving patients pain symptoms most of the time. Patients with a history of chronic pelvic pain are at an increased risk of no improvement or of worsening pain. PMID:25011703

  10. Inguinoscrotal pain resistant to conventional treatment

    PubMed Central

    Jain, Anuj; Agarwal, Anil

    2015-01-01

    Inguinoscrotal pain (ISP) is a common complaint that affects almost all age groups. The etiology may be vascular, neurogenic, visceral, muscular or psychological. Most causes of ISP are benign, but Pott's spine as a cause of ISP, when missed, may lead to serious outcomes. PMID:25624580

  11. Foetal pain?

    PubMed

    Derbyshire, Stuart W G

    2010-10-01

    The majority of commentary on foetal pain has looked at the maturation of neural pathways to decide a lower age limit for foetal pain. This approach is sensible because there must be a minimal necessary neural development that makes pain possible. Very broadly, it is generally agreed that the minimal necessary neural pathways for pain are in place by 24 weeks gestation. Arguments remain, however, as to the possibility of foetal pain before or after 24 weeks. Some argue that the foetus can feel pain earlier than 24 weeks because pain can be supported by subcortical structures. Others argue that the foetus cannot feel pain at any stage because it is maintained in a state of sedation in the womb and lacks further neural and conceptual development necessary for pain. Much of this argument rests on the definition of terms such as 'wakefulness' and 'pain'. If a behavioural and neural reaction to a noxious stimulus is considered sufficient for pain, then pain is possible from 24 weeks and probably much earlier. If a conceptual subjectivity is considered necessary for pain, however, then pain is not possible at any gestational age. Regardless of how pain is defined, it is clear that pain for conceptual beings is qualitatively different than pain for non-conceptual beings. It is therefore a mistake to draw an equivalence between foetal pain and pain in the older infant or adult. PMID:20356798

  12. Childhood adversities and laboratory pain perception

    PubMed Central

    Pieritz, Karoline; Rief, Winfried; Euteneuer, Frank

    2015-01-01

    Childhood adversity has frequently been related to a wide range of psychosomatic complaints in adulthood. The present study examined the relationship between different forms of childhood adversity and laboratory measures of pain. Heat pain tolerance and perceived heat pain intensity were measured in a community-based sample of 62 women (aged 20–64 years). Participants completed the Childhood Trauma Questionnaire (CTQ), which assesses five forms of childhood adversity: physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect. Somatic symptoms, depressive symptoms, and pain catastrophizing were assessed as potential mediators. Bivariate analyses indicated that emotional abuse but no other forms of childhood adversity were significantly related to decreased heat pain tolerance (r=−0.27; P<0.05). Accordingly, multiple regression analyses revealed that only emotional abuse was a significant predictor of heat pain tolerance (β=−0.62; P=0.034) when entering all CTQ subscales simultaneously. Although emotional abuse was also related to somatic symptoms, depressive symptoms, and pain catastrophizing, none of these variables mediated the relationship between childhood adversity and laboratory pain (P>0.1). No significant associations were found between any forms of childhood adversity and heat pain intensity. Our findings indicate that the severity of emotional childhood abuse is associated with decreased pain tolerance, an affective component of pain, but not with heat pain intensity, which has been described as a sensory component of pain. PMID:26316757

  13. Pain Relievers

    MedlinePLUS

    Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There ... also have a slightly different response to a pain reliever. Over-the-counter (OTC) medicines are good for ...

  14. Elbow pain

    MedlinePLUS

    Pain - elbow ... Elbow pain can be caused by many problems. A common cause in adults is tendinitis . This is inflammation and ... a partial dislocation ). Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion ...

  15. Heel pain

    MedlinePLUS

    Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: When the tendon that connects the back ...

  16. Neck pain

    MedlinePLUS

    ... causes of neck pain: Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen ( ... prescribe a muscle relaxant or a more powerful pain reliever. Over-the-counter medications often work as well ...

  17. Knee pain

    MedlinePLUS

    Pain - knee ... Knee pain can have different causes. Being overweight puts you at greater risk for knee problems. Overusing your knee can trigger knee problems that cause pain. If you have a history of arthritis, it ...

  18. Depression, Pain, and Pain Behavior.

    ERIC Educational Resources Information Center

    Keefe, Francis J.; And Others

    1986-01-01

    Examined the degree to which depression predicted pain and pain behavior. The Beck Depression Inventory was administered to 207 low back pain patients. Depression and physical findings were the most important predictors of pain and pain behavior. Depression proved significant even after controlling for important demographic and medical status

  19. Depression, Pain, and Pain Behavior.

    ERIC Educational Resources Information Center

    Keefe, Francis J.; And Others

    1986-01-01

    Examined the degree to which depression predicted pain and pain behavior. The Beck Depression Inventory was administered to 207 low back pain patients. Depression and physical findings were the most important predictors of pain and pain behavior. Depression proved significant even after controlling for important demographic and medical status…

  20. 49 CFR 604.30 - Filing complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., 1200 New Jersey Ave., SE., Room E55-302, Washington, DC 20590 and file it electronically in the Charter... sending the complaint to 1200 New Jersey Ave., SE., West Building Ground Floor, Room W12-140,...

  1. 12 CFR 626.6030 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Congressional and Public Affairs, Farm Credit Administration, McLean, Virginia 22102-5090. (b) Complaints... shall be referred to the Office of Congressional and Public Affairs, Farm Credit Administration,...

  2. 12 CFR 626.6030 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Congressional and Public Affairs, Farm Credit Administration, McLean, Virginia 22102-5090. (b) Complaints... shall be referred to the Office of Congressional and Public Affairs, Farm Credit Administration,...

  3. 12 CFR 626.6030 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Congressional and Public Affairs, Farm Credit Administration, McLean, Virginia 22102-5090. (b) Complaints... shall be referred to the Office of Congressional and Public Affairs, Farm Credit Administration,...

  4. 12 CFR 626.6030 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Congressional and Public Affairs, Farm Credit Administration, McLean, Virginia 22102-5090. (b) Complaints... shall be referred to the Office of Congressional and Public Affairs, Farm Credit Administration,...

  5. 49 CFR 386.12 - Complaint.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... personal injury or death. Each complaint must be signed by the complainant and must contain: (1) The name... complainant shall be timely notified of findings resulting from such investigation. The...

  6. 49 CFR 386.12 - Complaint.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... personal injury or death. Each complaint must be signed by the complainant and must contain: (1) The name... complainant shall be timely notified of findings resulting from such investigation. The...

  7. 49 CFR 386.12 - Complaint.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... personal injury or death. Each complaint must be signed by the complainant and must contain: (1) The name... complainant shall be timely notified of findings resulting from such investigation. The...

  8. 40 CFR 22.14 - Complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., or any part thereof, without prejudice one time before the answer has been filed. After one... complaint, or any part thereof, without prejudice only upon motion granted by the Presiding Officer....

  9. 32 CFR 724.815 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... it is alleged that a decisional document issued by the NDRB or the SRA contains a specifically indentified violation of 32 CFR part 70 or any references thereto. Complaints will be reviewed pursuant to 32 CFR part 70....

  10. 32 CFR 724.815 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... it is alleged that a decisional document issued by the NDRB or the SRA contains a specifically indentified violation of 32 CFR part 70 or any references thereto. Complaints will be reviewed pursuant to 32 CFR part 70....

  11. 32 CFR 724.815 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... it is alleged that a decisional document issued by the NDRB or the SRA contains a specifically indentified violation of 32 CFR part 70 or any references thereto. Complaints will be reviewed pursuant to 32 CFR part 70....

  12. 32 CFR 724.815 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... it is alleged that a decisional document issued by the NDRB or the SRA contains a specifically indentified violation of 32 CFR part 70 or any references thereto. Complaints will be reviewed pursuant to 32 CFR part 70....

  13. 32 CFR 724.815 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... it is alleged that a decisional document issued by the NDRB or the SRA contains a specifically indentified violation of 32 CFR part 70 or any references thereto. Complaints will be reviewed pursuant to 32 CFR part 70....

  14. Primary care management of chronic musculoskeletal pain.

    PubMed

    Davis, A E

    1996-08-01

    Chronic musculoskeletal pain, a common problem seen in the primary care setting, is often frustrating for both the patient and the clinician. Despite its prevalence, chronic pain is often poorly understood and inconsistently managed by health care providers. Unlike acute pain, chronic pain serves no biologic function and persists long after the tissue has healed from injury. Patients with chronic pain may become isolated from friends and family, lose their jobs, and develop depression. Nonpharmacologic techniques such as acupuncture, massage, and relaxation may be helpful to the patient with chronic pain. In addition to nonsteroidal antiinflammatory drugs, antidepressants and opioid analgesics are useful for treating chronic musculoskeletal pain. This article explains that pathophysiology of chronic pain, lists aspects of chronic pain that distinguish it from acute pain, and develops a general primary care plan for patients with chronic musculoskeletal pain. PMID:8871991

  15. Time to Talk: 4 Things to Know about Spinal Manipulation for Low-Back Pain

    MedlinePLUS

    ... Things To Know About Spinal Manipulation for Low-Back Pain Share: Back pain is one of the most common health complaints, ... medical doctors with a goal of relieving low-back pain and improving physical functioning. These health professionals perform ...

  16. Cognitive complaints in obstructive sleep apnea.

    PubMed

    Vaessen, Tim J A; Overeem, Sebastiaan; Sitskoorn, Margriet M

    2015-02-01

    Obstructive sleep apnea (OSA) is associated with impairments in cognitive functioning. Although cognitive complaints are related to quality of life, work productivity and health care expenditures, most research and all reviews have focused exclusively on objective cognitive functioning so far. In this systematic review, we assessed the available literature on subjective measures of cognition in adult OSA patients. Concentration complaints were consistently found to be more severe in untreated OSA patients as compared to primary snorers and healthy controls. The same seems to be true for memory and executive function problems, but firm conclusions cannot be made as of yet, due to methodological limitations of the available studies. Cognitive complaints appear to be at least partially related to subjective sleepiness. Importantly, they are not necessarily a sign of objective cognitive impairment. Additional research is needed to explore the relation between cognitive complaints, sleepiness and mood problems using validated and norm-referenced questionnaires for cognitive complaints. In addition, the impact of continuous positive airway pressure (CPAP) treatment on cognitive complaints in OSA warrants further study. PMID:24846772

  17. Functional Abdominal Pain Syndrome in Morbidly Obese Patients Following Laparoscopic Gastric Bypass Surgery

    PubMed Central

    Eidy, Mohammad; Pazouki, Abdolreza; Raygan, Fahimeh; Ariyazand, Yazdan; Pishgahroudsari, Mohadeseh; Jesmi, Fatemeh

    2014-01-01

    Background: Roux-en-Y gastric bypass surgery (RYGBP) is one of the most common bariatric surgeries, which is being performed using various techniques like gastrojejunostomy by hand swen, linear or circular stapler. Abdominal pain is a common complaint following laparoscopic gastric bypass procedure (LGBP), which has different aetiologies, such as overeating, adhesion, internal herniation, bile reflux and many more. In this study LGBP was performed in an ante-colic ante-gastric pattern in a double loop manner and the prevalence and distribution of pain in morbidly obese patients undergoing LGBP was assessed. Objectives: The aim of this study was to analyze the distribution and frequency of post LGBP pain in morbidly obese patients. Patients and Methods: This study was performed on 190 morbidly obese patients referred to Hazrat Rasoul Hospital in Tehran. After LGBP, pain was measured in the following intervals: 24 hours, one week and one month after the operation. Before the operation onset, 2 mg Keflin and 5000 IU subcutaneous heparin were administered as prophylaxis. LGBP was performed using five ports including: one 11 mm port was placed 15-20 cm far from the xiphoid, one 12-mm port in mid-clavicular line at the level of camera port, one 5-mm port in subcostal area in ante-axillary region in the left, another 5-mm port in the right mid-clavicular area and a 5-mm port in sub-xyphoid. All operations were done by the same team. Staple was used for all anastomoses and hand sewn technique to close the staple insertion site. The mesenteric defect was left open and no effort was made to repair it. Results: The results of this study showed that 99.94 % of the patients had complains of pain in the first 24 hours of post operation, about 60% after one week and 29.5 % still had pain after one month. In addition, left upper quadrant (LUQ) was found to be the most prevalent site for the pain in 53.7% of the patients in the first 24 hours, 59.6% after one week and 16.8% after one month (except for obscure pain) with a significance of < 0.05. Conclusions: In this study, the authors analyzed the location and disturbance level of pain after LGBP, which could serve as a cornerstone for further researches. The authors suggest that long-term follow-up (for more than a year after operation) should be considered in future studies and also the relationship between the drainage site and pain should be investigated. PMID:25032167

  18. Managing patient complaints in China: a qualitative study in Shanghai

    PubMed Central

    Jiang, Yishi; Ying, Xiaohua; Zhang, Qian; Tang, Sirui Rae; Kane, Sumit; Mukhopadhyay, Maitrayee; Qian, Xu

    2014-01-01

    Objectives To examine the handling system for patient complaints and to identify existing barriers that are associated with effective management of patient complaints in China. Setting Key stakeholders of the handling system for patient complaints at the national, Shanghai municipal and hospital levels in China. Participants 35 key informants including policymakers, hospital managers, healthcare providers, users and other stakeholders in Shanghai. Primary and secondary outcome measures Semistructured interviews were conducted to understand the process of handling patient complaints and factors affecting the process and outcomes of patient complaint management. Results The Chinese handling system for patient complaints was established in the past decade. Hospitals shoulder the most responsibility of patient complaint handling. Barriers to effective management of patient complaints included service users’ low awareness of the systems in the initial stage of the process; poor capacity and skills of healthcare providers, incompetence and powerlessness of complaint handlers and non-transparent exchange of information during the process of complaint handling; conflicts between relevant actors and regulations and unjustifiable complaints by patients during solution settlements; and weak enforcement of regulations, deficient information for managing patient complaints and unwillingness of the hospitals to effectively handle complaints in the postcomplaint stage. Conclusions Barriers to the effective management of patient complaints vary at the different stages of complaint handling and perspectives on these barriers differ between the service users and providers. Information, procedure design, human resources, system arrangement, unified legal system and regulations and factors shaping the social context all play important roles in effective patient complaint management. PMID:25146715

  19. 14 CFR 16.21 - Pre-complaint resolution.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Pre-complaint resolution. 16.21 Section 16... to Complaints 16.21 Pre-complaint resolution. (a) Prior to filing a complaint under this part, a... responsible for the noncompliance. These efforts at informal resolution may include, without limitation,...

  20. 14 CFR 16.21 - Pre-complaint resolution.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pre-complaint resolution. 16.21 Section 16... to Complaints 16.21 Pre-complaint resolution. (a) Prior to filing a complaint under this part, a... responsible for the noncompliance. These efforts at informal resolution may include, without limitation,...

  1. 14 CFR 16.21 - Pre-complaint resolution.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Pre-complaint resolution. 16.21 Section 16... to Complaints 16.21 Pre-complaint resolution. (a) Prior to filing a complaint under this part, a... responsible for the noncompliance. These efforts at informal resolution may include, without limitation,...

  2. 14 CFR 16.21 - Pre-complaint resolution.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Pre-complaint resolution. 16.21 Section 16... to Complaints 16.21 Pre-complaint resolution. (a) Prior to filing a complaint under this part, a... responsible for the noncompliance. These efforts at informal resolution may include, without limitation,...

  3. 14 CFR 16.21 - Pre-complaint resolution.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... to Complaints 16.21 Pre-complaint resolution. (a) Except for those persons filing under 49 CFR 26... request to assist the parties with informal resolution. (b) Except for complaints filed under 49 CFR 26... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Pre-complaint resolution. 16.21 Section...

  4. 37 CFR 11.36 - Answer to complaint.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Answer to complaint. 11.36... Disciplinary Proceedings; Jurisdiction, Sanctions, Investigations, and Proceedings 11.36 Answer to complaint. (a) Time for answer. An answer to a complaint shall be filed within the time set in the complaint...

  5. 43 CFR 4.450-6 - Answer to complaint.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Answer to complaint. 4.450-6 Section 4.450... Questions of Fact 4.450-6 Answer to complaint. Within 30 days after service of the complaint or after the... answer specifically meeting and responding to the allegations of the complaint, together with proof...

  6. 37 CFR 11.36 - Answer to complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Answer to complaint. 11.36... Disciplinary Proceedings; Jurisdiction, Sanctions, Investigations, and Proceedings 11.36 Answer to complaint. (a) Time for answer. An answer to a complaint shall be filed within the time set in the complaint...

  7. Rheumatologists lack confidence in their knowledge of cannabinoids pertaining to the management of rheumatic complaints

    PubMed Central

    2014-01-01

    Background Arthritis pain is reported as one of the most common reasons for persons using medical herbal cannabis in North America. Severe arthritis is the condition justifying legal use of cannabis in over half of all authorizations in Canada, where cannabis remains a controlled substance. As champions for the care of persons with arthritis, rheumatologists must be knowledgeable of treatment modalities both traditional and non-traditional, used by their patients. As study of cannabinoid molecules in medicine is recent, we have examined the confidence in the knowledge of cannabinoids expressed by Canadian rheumatologists. Methods The confidence of rheumatologists in their knowledge of cannabinoid molecules and mechanisms relevant to rheumatology, and their ability to advise patients about cannabinoid treatments was recorded by an online questionnaire circulated via email to the entire Canadian Rheumatology Association membership. Results Over three quarters of the 128 respondents lacked confidence in their knowledge of cannabinoid molecules. While 45% of respondents believed there was no current role for cannabinoids in rheumatology patient care, only 25% supported any use of herbal cannabis. With 70% never having previously prescribed or recommended any cannabinoid treatment, uncertainty regarding good prescribing practices was prevalent. Concerns about risks of cannabis use were in line with the current literature. Conclusions Rheumatologists lacked confidence in their knowledge of cannabinoid molecules in general and in their competence to prescribe any cannabinoid for rheumatic complaints. In line with this uncertainty, there is reticence to prescribe cannabinoid preparations for rheumatology patients. Guidance is required to inform rheumatologists on the evidence regarding cannabinoids. PMID:25080153

  8. Playing-related musculoskeletal disorders in musicians: a systematic review of incidence and prevalence

    PubMed Central

    Zaza, C

    1998-01-01

    BACKGROUND: Work-related musculoskeletal disorders cause pain, disability and loss of employment for many workers, including musicians. Although performing arts medicine is a growing field, the health problems of musicians remain under-recognized and under-researched. Therefore, the author undertook a systematic review of published information on the incidence and prevalence of playing-related musculoskeletal disorders (PRMDs) in classical musicians. METHODS: Seven databases were searched for the period 1980 to 1996. The main textbook and performing arts medicine journals were searched manually, as were reference lists of all relevant papers. The author also contacted individuals familiar with the literature of performing arts medicine. Studies were included for review if they reported PRMD incidence or prevalence in classical musicians. Of the 24 studies identified, 18 cross-sectional surveys and cohort studies were reviewed. The author subjectively assessed the studies using criteria modified from an existing evaluation scale and used 4 criteria for data combination. On the basis of prevalence values from the eligible studies, chi 2 tests for heterogeneity were performed. RESULTS: Only one study estimated PRMD incidence. Ten of the 17 prevalence studies were ineligible for data combination, because of low response rates and other methodological problems. In the 7 eligible studies, PRMD point prevalence ranged from 39% to 87% in adult musicians and from 34% to 62% in secondary school music students. The best estimates of PRMD prevalence were derived from the 3 studies that excluded mild complaints; these studies indicated that PRMD prevalence was 39% and 47% in adults and 17% in secondary school music students respectively. Statistical combination of data across studies within each demographic category was not possible. INTERPRETATION: Available data indicate that the prevalence of PRMD in adult classical musicians is comparable to the prevalence of work-related musculoskeletal disorders reported for other occupational groups. Several recommendations for future research are outlined. PMID:9580730

  9. Changes in prevalence of subjective fatigue during 14-day 6° head-down bed rest

    NASA Astrophysics Data System (ADS)

    Hirayanagi, Kaname; Natsuno, Toyoki; Shiozawa, Tomoki; Yamaguchi, Nobuhisa; Watanabe, Yoriko; Suzuki, Satomi; Iwase, Satoshi; Mano, Tadaaki; Yajima, Kazuyoshi

    2009-06-01

    The present study examines the prevalence of subjective fatigue in young healthy males during 14 days of 6° head-down bed rest (HDBR) by using a multidimensional questionnaire. Forty-one subjects completed the Subjective Fatigue Scale questionnaire to assess the fatigue-related complaints and symptoms. The questionnaire is composed of three sections, with 10 items each. The sections measured drowsiness and dullness (Section 1), difficulty in concentration (Section 2), and the projection of physical disintegration (Section 3). The subjects answered simple questions between 1400 and 1700 on 6 measurement days before and during the HDBR period. The prevalence rate of low back pain was markedly high (80.5%) on the second day and more than 50% in the first half of the HDBR period, and any complaints related to either a lack of sleep or a deterioration in the quality of sleep continued until the end of the HDBR period. Our findings may be useful in developing preventive strategies against physical and mental fatigue associated with prolonged HDBR, horizontal bed rest, and microgravity environments.

  10. Predictors of Genital Pain in Young Women

    PubMed Central

    Farmer, Melissa A.; Meston, Cindy M.

    2010-01-01

    Despite the high prevalence of genital pain in healthy young adult women, limited research has addressed genital pain during intercourse using contemporary models of multidimensional sexual function. The objectives of this study were threefold: (1) to identify differences in sexual functioning in women who experience genital pain compared to pain free women; (2) to identify predictors of sexual functioning in women with and without genital pain; and (3) to identify predictors of sexual satisfaction in women with and without genital pain. Sexually active female undergraduates (n = 651) were administered the Female Sexual Function Index and the Derogatis Sexual Functioning Inventory. We evaluated the sexual factors that impact the sexual function of women with any pain (including high and low pain groups) versus women with no history of pain. Women with genital pain reported greater rates of sexual dysfunction as compared to pain-free women; however, sexual functioning in the high versus low pain groups was distinguished primarily by vaginal lubrication. Women in the high pain group showed negative correlations between domains of sexual satisfaction and genital pain frequency and intensity that were not found in the low pain group. For pain-free women, intercourse played a strong role in sexual satisfaction, whereas non-intercourse sexual behavior was central to sexual satisfaction in women who reported pain. The evaluation of levels of genital pain may provide insight into the mechanisms underlying the impairment of sexual function, sexual behavior, and sexual satisfaction. PMID:17674182

  11. Shoulder pain

    MedlinePLUS

    Pain - shoulder ... changes around the rotator cuff can cause shoulder pain. You may have pain when lifting the arm above your head or ... The most common cause of shoulder pain occurs when rotator cuff tendons ... The tendons become inflamed or damaged. This condition ...

  12. Pelvic Pain

    MedlinePLUS

    Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

  13. Back Pain

    MedlinePLUS

    ... Awards Enhancing Diversity Find People About NINDS NINDS Back Pain Information Page Condensed from Low Back Pain Fact ... en Español Additional resources from MedlinePlus What is Back Pain? Acute or short-term low back pain generally ...

  14. Vicarious pain while observing another in pain: an experimental approach

    PubMed Central

    Vandenbroucke, S.; Crombez, G.; Van Ryckeghem, D. M. L.; Brass, M.; Van Damme, S.; Goubert, L.

    2013-01-01

    Objective: This study aimed at developing an experimental paradigm to assess vicarious pain experiences. We further explored the putative moderating role of observer's characteristics such as hypervigilance for pain and dispositional empathy. Methods: Two experiments are reported using a similar procedure. Undergraduate students were selected based upon whether they reported vicarious pain in daily life, and categorized into a pain responder group or a comparison group. Participants were presented a series of videos showing hands being pricked whilst receiving occasionally pricking (electrocutaneous) stimuli themselves. In congruent trials, pricking and visual stimuli were applied to the same spatial location. In incongruent trials, pricking and visual stimuli were in the opposite spatial location. Participants were required to report on which location they felt a pricking sensation. Of primary interest was the effect of viewing another in pain upon vicarious pain errors, i.e., the number of trials in which an illusionary sensation was reported. Furthermore, we explored the effect of individual differences in hypervigilance to pain, dispositional empathy and the rubber hand illusion (RHI) upon vicarious pain errors. Results: Results of both experiments indicated that the number of vicarious pain errors was overall low. In line with expectations, the number of vicarious pain errors was higher in the pain responder group than in the comparison group. Self-reported hypervigilance for pain lowered the probability of reporting vicarious pain errors in the pain responder group, but dispositional empathy and the RHI did not. Conclusion: Our paradigm allows measuring vicarious pain experiences in students. However, the prevalence of vicarious experiences of pain is low, and only a small percentage of participants display the phenomenon. It remains however unknown which variables affect its occurrence. PMID:23781187

  15. 47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement 7.22...

  16. 47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement 7.22...

  17. 47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement 7.22...

  18. 47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.22...

  19. 47 CFR 7.22 - Formal complaints based on unsatisfied informal complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Formal complaints based on unsatisfied informal complaints. 7.22 Section 7.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO VOICEMAIL AND INTERACTIVE MENU SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Enforcement § 7.22...

  20. 49 CFR 821.55 - Complaint, answer to complaint, motions and discovery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Complaint, answer to complaint, motions and discovery. 821.55 Section 821.55 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD RULES OF PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Involving Emergency and...

  1. Beyond pain in fibromyalgia: insights into the symptom of fatigue

    PubMed Central

    2013-01-01

    Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue. PMID:24289848

  2. SLEEP COMPLAINTS IN COMMUNITY-LIVING OLDER PERSONS: A MULTIFACTORIAL GERIATRIC SYNDROME

    PubMed Central

    Vaz Fragoso, Carlos A.; Gill, Thomas M.

    2009-01-01

    Among older persons, sleep complaints in the form of insomnia and daytime drowsiness are highly prevalent and associated with adverse outcomes. The underlying mechanisms are linked to age-related declines in physiology, i.e., normal aging, and age-related increases in disease prevalence, i.e., usual aging. In this monograph, we describe how normal aging leads to less restorative sleep, characterized by reductions in homeostatic and circadian sleep, and to phase advancement of the sleep-wake cycle, characterized by older persons being more alert in the early morning but drowsier in the early evening. We also describe how usual aging leads to sleep complaints through reductions in health status, loss of physical function, and primary sleep disorders. Psychosocial influences are likewise described and their relevance to sleep complaints is discussed. We subsequently incorporate these aging-related changes into a conceptual model that describes sleep complaints as a consequence of multiple and interdependent predisposing, precipitating, and perpetuating factors, akin to a geriatric syndrome. We conclude our discussion by applying our conceptual model to the sleep-related care of an older person with insomnia and daytime drowsiness, and suggest that the diagnostic assessment consider, in addition to primary sleep disorders, multiple domains including medical, physical, cognitive, psychological, and social issues with the intent of developing an overall therapeutic plan and establishing long-term follow-up. PMID:17916123

  3. Neuropathic pain in leprosy.

    PubMed

    Raicher, Irina; Stump, Patrick Raymond Nicolas Andre Ghislain; Baccarelli, Rosemari; Marciano, Lucia H S C; Ura, Somei; Virmond, Marcos C L; Teixeira, Manoel Jacobsen; Ciampi de Andrade, Daniel

    2016-01-01

    Nerve impairment is a key clinical aspect of leprosy and may present the distribution of mononeuropathy or multiple nerve trunks, small cutaneous nerve fibers, and free nerve endings. The clinical range of leprosy is determined by individual cell-mediated immune response to infection that also may play a role in different types of pain syndromes in leprosy. Previous studies reported a high prevalence of neuropathic pain in leprosy. In an Ethiopian study with 48 patients, pure nociceptive pain was experienced by 43% of patients and pure neuropathic pain (NeP) by 11% of patients. In an Indian study, 21.8% of leprosy patients had pain with neuropathic characteristics. These rates underlie the need to develop tools for the early diagnosis and detection of infection and its complications, such as nerve damage and pain. In a larger sample with leprosy-associated NeP (n = 90), we have applied the Douleur Neuropathique en 4 questions (DN4) and found sensitivity = 97.1% and specificity = 57.9%. The high sensitivity of this tool in leprosy patients suggests that it could be a valuable tool to screen for neuropathic pain in this population and could be used as part of health care programs aimed at detecting, treating, and rehabilitating leprosy in endemic areas. PMID:26773624

  4. Cognitive and emotional control of pain and its disruption in chronic pain

    PubMed Central

    Bushnell, M. Catherine; ?eko, Marta; Low, Lucie A.

    2015-01-01

    Chronic pain is one of the most prevalent health problems in our modern world, with millions of people debilitated by conditions such as back pain, headache and arthritis. To address this growing problem, many people are turning to mindbody therapies, including meditation, yoga and cognitive behavioural therapy. This article will review the neural mechanisms underlying the modulation of pain by cognitive and emotional states important components of mindbody therapies. It will also examine the accumulating evidence that chronic pain itself alters brain circuitry, including that involved in endogenous pain control, suggesting that controlling pain becomes increasingly difficult as pain becomes chronic. PMID:23719569

  5. Cognitive and emotional control of pain and its disruption in chronic pain.

    PubMed

    Bushnell, M Catherine; Ceko, Marta; Low, Lucie A

    2013-07-01

    Chronic pain is one of the most prevalent health problems in our modern world, with millions of people debilitated by conditions such as back pain, headache and arthritis. To address this growing problem, many people are turning to mind-body therapies, including meditation, yoga and cognitive behavioural therapy. This article will review the neural mechanisms underlying the modulation of pain by cognitive and emotional states - important components of mind-body therapies. It will also examine the accumulating evidence that chronic pain itself alters brain circuitry, including that involved in endogenous pain control, suggesting that controlling pain becomes increasingly difficult as pain becomes chronic. PMID:23719569

  6. Greater Trochanteric Pain Syndrome: Epidemiology and Associated Factors

    PubMed Central

    Segal, Neil A.; Felson, David T.; Torner, James C.; Zhu, Yanyan; Curtis, Jeffrey R.; Niu, Jingbo; Nevitt, Michael C.

    2010-01-01

    Objectives To describe the prevalence of greater trochanteric pain syndrome (GTPS); to determine whether GTPS is associated with iliotibial band (ITB) tenderness, knee osteoarthritis (OA), body mass index (BMI), or low back pain (LBP); and to assess whether GTPS is associated with reduced hip internal rotation, physical activity, and mobility. Design Cross-sectional, population-based study. Setting Multicenter observational study. Participants Community-dwelling adults (N=3026) ages 50 to 79 years. Interventions Not applicable. Main Outcome Measures Greater trochanteric tenderness to palpation in subjects with complaints of hip pain and no signs of hip OA or generalized myofascial tenderness. Results The prevalence of unilateral and bilateral GTPS was 15.0% and 8.5% in women and 6.6% and 1.9% men. Odds ratio (OR) for women was 3.37 (95% confidence interval [CI], 2.674.25), but age and race were not significantly associated with GTPS. In a multivariate model, adjusting for age, sex, ITB tenderness, ipsilateral and contralateral knee OA, BMI, and LBP, ITB tenderness (OR=1.72; 95% CI, 1.342.19), knee OA ipsilaterally (OR=3.47; 95% CI, 2.724.42) and con-tralaterally (OR=1.74; 95% CI, 1.322.28), and LBP (OR=2.79; 95% CI, 2.223.50) were positively related to GTPS. In this complete model, BMI was not associated with GTPS (OR=1.10; 95% CI, 0.801.52 when comparing ? 30 with <25kg/m2). Hip internal rotation range of motion did not differ based on GTPS status. After multivariate adjustment, GTPS did not alter physical activity score, but bilateal GTPS was significantly associated with a higher 20-meter walk time and chair stand time. Conclusions The higher prevalence of GTPS in women and in adults with ITB pain or knee OA indicates that altered lower-limb biomechanics may be related to GTPS. Slower functional performance in those with GTPS suggests that the study of targeted rehabilitation may be useful. A longitudinal study will be necessary to identify causal factors and outcomes of interventions. PMID:17678660

  7. The psychological significance of somatic complaints.

    PubMed

    Anstett, R; Collins, M

    1982-02-01

    Patients experiencing psychological distress often come to their physicians with primarily somatic complaints. While patients provide their physicians with multiple clues that there is a functional cause to their complaints, physicians often fail to recognize these. Psychological states, including depression, schizophrenia, hypochondriasis, malingering, conversion reactions, anxiety states, the "identified patient" in a dysfunctional family, and the patient with a "hidden agenda" are examples of this somatization process. Physicians may recognize these problems and avoid needless interventions if they consider these diagnostic possibilities and ask their patients questions that differentiate the various psychological possibilities. PMID:7057147

  8. A cross-sectional study of elite adult Irish dancers: biopsychosocial traits, pain, and injury.

    PubMed

    Cahalan, Roisin; Purtill, Helen; O'Sullivan, Peter; O'Sullivan, Kieran

    2015-03-01

    Despite its growing popularity, scant research exists concerning musculoskeletal pain and injury in Irish dancing (ID). This study aimed to record the biopsychosocial characteristics of elite adult Irish dancers and to investigate potential relationships between these characteristics and musculoskeletal pain and injury. One hundred and four professional Irish dancers, elite competitive Irish dancers, and dancers in full time education studying ID completed a questionnaire providing data on dance and activity levels, physical and psychological health, and pain and injury history. Of these subjects, 84 underwent 1. a physical screening of lower limb flexibility, which involved balance and endurance; 2. a number of functional tests; and 3. anthropometric, biomechanical, and anatomical assessments. Subjects were divided into "significantly injured (SI)" and "not significantly injured (NSI)" categories based on the severity and impact of self-reported pain and injury. Thirty-three (31.7%) subjects were classified as SI and 71 (68.3%) as NSI. The factors significantly associated with being SI were female sex (p = 0.036), higher number of subjective general health (p = 0.001) and psychological (p = 0.036) complaints, low mood (p = 0.01), heightened catastrophizing (p = 0.047), and failure always to complete a warm-up (p = 0.006). A self-reported injury rate of 76.9% over the previous 5 years was reported. The mean number of injuries sustained to all body parts over the previous 5 years was 1.49, with a mean of 126.1 days lost annually to injury. Foot and ankle injuries were most prevalent. It was concluded that there is a significant level of musculoskeletal pain and injury in elite adult ID. A complex combination of biopsychosocial factors appears to be associated with pain and injury. PMID:25741782

  9. The effect of depressive symptoms on the association between radiographic osteoarthritis and knee pain: a cross-sectional study

    PubMed Central

    2013-01-01

    Background The progressive nature of knee osteoarthritis (OA) leads to not only to physical but also to psychosocial decline; this aspect can influence knee pain experience, manifestations and inevitably diagnostic accuracy. To analyze the role of depressive symptoms on the association between radiographic OA and knee pain, understanding the ability of knee pain symptoms to find out individuals with radiographic OA. Methods Data on 663 subjects was obtained by interview using a structured questionnaire on social, demographic, behavioural and clinical data. Painful knee was assessed regarding having pain: ever, in the last year, in the last 6 months and in the last month. Using factor analysis, participants were graded using a knee pain score, with higher scores representing more symptomatology. Depressive symptoms were evaluated with the Beck Depressive Inventory (BDI), and radiographic knee OA was classified using the Kellgren Lawrence (KL) scale; those with KL ≥ 2 were considered as having radiographic OA. Results Knee pain was reported by 53.2% of those with radiographic KL ≥ 2 and by 33.2% of those with radiographic KL < 2. The prevalence of depressive symptoms (BDI > 14) was 19.9% among participants with radiographic KL ≥ 2 and 12.6% among those with radiographic KL < 2 (p = 0.01). The association of knee pain with radiographic knee OA was higher in higher pain scores and in participants without depressive symptoms. Among participants with BDI ≤ 14 the likelihood ratio to identify patients with radiographic knee OA increased with increased pain scores: 1.02 for score 1; 2.19 for score 2 and 7.34 when participants responded positively to all pain questions (score 3). Among participants with depressive symptoms (BDI > 14) likelihood ratios were 0.51, 1.92, 1.82, respectively. The results were similar for both genders. Conclusions Knee pain scores increased ability to identify participants with radiographic KL ≥ 2 in both sexes. However, the presence of depressive symptoms impairs the ability of knee pain complaints to identify patients with radiographic OA. PMID:23875806

  10. Chest pain in young patients in an office setting: cardiac diagnoses, outcomes, and test burden.

    PubMed

    Cohn, Herbert E; Arnold, Lucy W

    2012-09-01

    This study determined the incidence of cardiac diagnoses demonstrably related to chest pain in young patients and determined whether those with exertional chest pain were more likely to have a cardiac diagnosis. It evaluated the course of patients with chest pain after pediatric cardiology evaluation regarding interventions, outcomes, and additional test burden. This was a retrospective study of 203 patients with an office pediatric cardiology assessment of chest pain from January 2000 through December 2004. Fifteen patients (7.4%) had cardiac diagnoses, 5 (2.5%) had cardiac diagnoses demonstrably related to their chest pain complaints (arrhythmias, mitral valve prolapse), and none had ischemia. Exertional chest pain, in this study, did not increase the risk of having a cardiac diagnosis. Following evaluation, 80% of patients did not return for complaints of chest pain. Ten percent had 2 or more additional visits to any medical site for chest pain but no additional cardiac diagnoses were found. PMID:22752294

  11. Adults with ADHD and Sleep Complaints: A Pilot Study Identifying Sleep-Disordered Breathing Using Polysomnography and Sleep Quality Assessment

    ERIC Educational Resources Information Center

    Surman, Craig B. H.; Thomas, Robert J.; Aleardi, Megan; Pagano, Christine; Biederman, Joseph

    2006-01-01

    Objective: ADHD and sleep-disordered breathing are both prevalent in adulthood. Because both conditions may be responsible for similar symptoms of cognitive impairment, the authors investigate whether their presentation may overlap in adults diagnosed with ADHD. Method: Data are collected from six adults with sleep complaints who were diagnosed

  12. Prevalence of otorhinolaryngologic diagnoses in the pediatric emergency room

    PubMed Central

    Signorelli, Luiz Gabriel; Mendes, Elaine de Abreu

    2013-01-01

    Summary Introduction:?Fever and pain, which are very common in ear, nose, and throat pathologies, are among the most frequent complaints recorded during emergency room pediatric patient treatment. Most of time, the pediatricians are called on to evaluate otorhinolaryngology disorders that requires specialist assessment. Aim:?To determine the prevalence of otorhinolaryngologic diagnoses in a pediatric population in a reference hospital in the city of Itatiba, So Paulo. Methods:?We evaluated 2,054 pediatric patients (age range, 012 years, 11 months) in this descriptive, transversal observational (survey) study. Data collection was performed by a single observer during 103 night shifts (07:00 p.m. to 07:00 a.m.) between January and December 2011, and included documentation of the main diagnosis, and patient age and sex. The ethics committee and research institution approved study. Patients were divided into 2 groups based on diagnosis: Group A otorhinolaryngology disease and Group B included diagnoses not contained in Group A. Results:?Of the total enrolled patients, 52.2% corresponded to Group A and 47.8% to Group B; 51.9% were male and 48.1% were female. The average age was 4.5 years (Group A, 3.93 years; Group B, 5.03 years). We compared the prevalence of the diagnostic hypotheses of the 2 groups. Conclusion:?A large number of patients sought treatment at pediatric emergency rooms for otorhinolaryngologic diagnoses. PMID:25991987

  13. Musculoskeletal Pain as a Marker of Health Quality. Findings from the Epidemiological Sleep Study among the Adult Population of São Paulo City

    PubMed Central

    Palombini, Luciana; Godoy, Luciana M.

    2015-01-01

    Background We are witnessing the growth of urban populations, particularly in the developing world. São Paulo, the largest city in South America, continues to grow, and this growth is dramatically effecting the environment and human health. The aim of this study was to estimate the point prevalence of chronic pain in São Paulo city dwellers and to explore the influence of aspects related to urbanicity. Methods A two-stage cluster randomized sample included 1100 individuals of the city of Sao Paulo, representing the population proportionally in terms of gender, age and social classes in 2007. For this observational cross-sectional study, the household sample was interviewed using validated questionnaires for sociodemographic aspects, the Beck inventories for anxiety and depression, the WHOQoL-REF for quality of life, the Chalder Fatigue Scale. Musculoskeletal pain was defined as diffuse pain or pain located in the back, joints or limbs. Data regarding sleep complaints and polysomnography were obtained from the Epidemiologic Sleep Study conducted in São Paulo city in 2007. Results The prevalence estimate of chronic musculoskeletal pain was approximately 27%, with a female/male ratio of approximately 2.6/1. The predictors were being in the age-range of 30–39 years, low socioeconomic and schooling levels, obesity, sedentarism, fatigue, non-restorative sleep, daytime sleepiness, poor sleep quality, poor life quality, anxiety and depression symptoms. Psychological wellbeing was the main discriminator between responders with chronic musculoskeletal pain and the controls, followed by depression for the participants with poor psychological wellbeing, and fatigue, for the remaining ones. Insomnia syndrome was the third-level discriminator for those with fatigue, whereas sleep quality for those without fatigue. Conclusions Musculoskeletal pain was frequently reported by São Paulo city dwellers and its correlates with psychological and sleep aspects are suggestive of a response to urbanicity. Trial Registration ClinicalTrials.gov NCT00596713 PMID:26600201

  14. Frequency of Migraine as a Chief Complaint in Otolaryngology Outpatient Practice

    PubMed Central

    Muhammad Ali, Maria; Al Zayer, Maha

    2015-01-01

    Objective. To identify the frequency of typical (headache and dizziness) and common atypical (ear fullness, pressure, pain, tinnitus, facial fullness, and nasal congestion) migraine symptoms as chief complaints among patients presenting to otolaryngology clinic. Methods. This is a descriptive study of prospectively collected data from a general otolaryngology practice. Typical migraine presentations were diagnosed by applying international headache society (IHS) criteria for migraine headache and Neuhauser's criteria for migrainous vertigo. Atypical otologic and rhinologic migraine symptoms were diagnosed using individualized criteria. Charts were reviewed at 6-month interval from the first presentation. Results. Out of 1002 consecutive patients, 10.8% presented with “migrainous chief complaint.” All migrainous chief complaint patients had a history of headache but not all of them presented with headache. Corrected female to male ratio in the migraine group was 3 to 1; age distributions were significantly different between the migraine and nonmigraine groups by applying t-test. Out of the atypical complaints, 86% of the patients had a history of concomitant typical presentation. Conclusion. Actual diagnostic criteria for migraine do not satisfy the diversity of its presentation. Investigating the history of migraine is enough to diagnose most atypical presentations. Sound knowledge about migraine seems essential for any ENT practitioner. PMID:25695049

  15. Low back pain - acute

    MedlinePLUS

    Backache; Low back pain; Lumbar pain; Pain - back; Acute back pain; Back pain - new; Back pain - short-term; Back strain - new ... back supports most of your body's weight. Low back pain is the number two reason that Americans see ...

  16. Comparison of Subjective Health Complaints between Chinese and German University Students: A Cross-Sectional Study

    PubMed Central

    Chu, Janet Junqing; Khan, Mobarak Hossain; Jahn, Heiko J.; Kraemer, Alexander

    2015-01-01

    High rates of health complaints (HCs) with substantial variation are reported in different university populations, which can be linked to socio-demographic, lifestyle-related factors, and cultural differences. HCs can be categorized into distinct components. This study aimed to identify and compare underlying dimensions of HCs (HC components); to access and compare HC prevalence, and the associations between HC components, socio-demographic, lifestyle-related factors, and perceived stress in German and Chinese university students. Two health surveys were conducted among 5159 university students (1853 Chinese, 3306 German). Factor analysis and logistic regression were applied. The prevalence of HC ranged from 4.6% to 40.2% over the two countries. Germans reported at least three HCs more often (47.2% vs. 35.8%). Chinese students more often reported gastrointestinal complaints. Perceived stress was positively associated with all three HC components in both countries (OR = 1.03–1.50) with stronger associations among Germans. Women more often reported HCs (OR = 1.32–2.43) with stronger associations among the Germans. Having a father with a low educational level was associated with high psychological symptoms among the Chinese (OR = 1.51), but with low gastrointestinal complaints among the Germans (OR = 0.79). The high prevalence of HCs in students requires country-specific interventions. PMID:26690463

  17. Neck Pain

    MedlinePLUS

    ... over-the counter medicine, such as acetaminophen or ibuprofen, to relieve pain, and apply heat to the ... an injury. Use anti-inflammatory medicines, such as ibuprofen and aspirin, to relieve pain and discomfort, and ...

  18. Finger pain

    MedlinePLUS

    Pain - finger ... Nearly everyone has had finger pain at some time. You may have: Tenderness Burning Stiffness Numbness Tingling Coldness Swelling Change in skin color Redness Many conditions, such ...

  19. Orofacial Pain

    MedlinePLUS

    ... Neck, shoulder or back pain Dizziness ?xml:namespace> Sleep disorders ; If you have gone through treatment and still experience orofacial pain, you may have a sleep disorder, such as bruxism, or a sleep-related breathing ...

  20. Chest pain

    MedlinePLUS

    ... your jaw, left arm, or between your shoulder blades. You have nausea, dizziness, sweating, a racing heart, ... such as: Is the pain between the shoulder blades? Under the breast bone? Does the pain change ...

  1. Ribcage pain

    MedlinePLUS

    ... not cause the pain in someone who has pleurisy (swelling of the lining of the lungs) or ... Inflammation of cartilage near the breastbone ( costochondritis ) Osteoporosis Pleurisy (the pain is worse when breathing deeply)

  2. Breast pain

    MedlinePLUS

    Pain - breast; Mastalgia; Mastodynia; Breast tenderness ... There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some swelling and tenderness just before your period ...

  3. Belly Pain

    MedlinePLUS

    ... Medical Words En Espaol What Other Kids Are Reading Movie: Digestive System Winter Sports: Sledding, Skiing, Snowboarding, ... cause pain in your belly or abdomen. Keep reading to find out what belly pain is, what ...

  4. Back Pain

    MedlinePLUS

    ... Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, ... 10 people at some point during their lives. Back pain can range from a dull, constant ache to ...

  5. Pelvic Pain

    MedlinePLUS

    ... practice bulletin no. 51. Chronic pelvic pain. Obstetrics & Gynecology, 103 ,589–605. [top] UCSF Medical Center. (2012). ... women with chronic pelvic pain. Clinical Obstetrics and Gynecology, 33 ,130–136 [top] What are common symptoms? » ...

  6. Penis pain

    MedlinePLUS

    ... pain. If penis pain is caused by a sexually transmitted disease, it is important for your sexual partner to ... Are you at risk for exposure to any sexually transmitted diseases? What other symptoms do you have? The physical ...

  7. Abdominal Pain following Gastric Bypass: Suspects & Solutions

    PubMed Central

    Greenstein, Alexander J.; O’Rourke, Robert W.

    2010-01-01

    Introduction Gastric bypass remains the mainstay of surgical therapy for obesity. Abdominal pain after gastric bypass is common, and accounts for up to half of all postoperative complaints and emergency room visits. This manuscript reviews the most important causes of abdominal pain specific to gastric bypass and discusses management considerations. Data Sources The current surgical literature was reviewed using PubMed, with a focus on abdominal pain after gastric bypass and the known pathologies that underlie its pathogenesis. Conclusions The differential diagnosis for abdominal pain after gastric bypass is large and includes benign and life-threatening entities. Its diverse causes require a broad evaluation that should be directed by history and clinical presentation. In the absence of a clear diagnosis, the threshold for surgical exploration in patients with abdominal pain after gastric bypass should be low. PMID:21333269

  8. Clinical Differentiation of Upper Extremity Pain Etiologies.

    PubMed

    Ponnappan, Ravi K; Khan, Mustafa; Matzon, Jonas L; Sheikh, Emran S; Tucker, Bradford S; Pepe, Matthew D; Tjoumakaris, Fotios P; Nassr, Ahmad N

    2015-08-01

    Upper extremity pain can result from many overlapping etiologies. These can be categorized into anatomic regions and specific organ systems. Anatomically, pain etiologies are classified into four major groups: neurologic, musculoskeletal, vascular, and other (eg, tumor, infection). Knowledge of the characteristic clinical presentation and physical examination findings of each group can help distinguish the source of the patient's complaints quickly so that an accurate clinical diagnosis can facilitate appropriate diagnostic measures and treatment. A focus on the neurologic causes of upper extremity pain (ie, cervical spine pathology, peripheral nerve compression, neuropathy) and musculoskeletal causes of shoulder and elbow pain (eg, adhesive capsulitis, calcific tendinitis, biceps tendinitis, synovitis) and the distinguishing characteristics (eg, periscapular pain, two-point discrimination, signal intensity on T2-weighted MRI) helps determine the appropriate diagnosis. PMID:26116851

  9. Self-reported risk factors related to the most frequent musculoskeletal complaints among Czech dentists.

    PubMed

    Hodacova, Lenka; Sustova, Zdenka; Cermakova, Eva; Kapitan, Martin; Smejkalova, Jindra

    2015-01-01

    The purpose of the study was to describe the occurrence of the most common complaints related to MSDs in Czech dentists and to assess the risk factors affecting them. A questionnaire survey of 581 Czech dentists (the response rate 72.6%) was conducted in 2011. The questionnaire ascertained general information about the respondents, their work habits and environment along with the occurrence of musculoskeletal disorders. The respondents filled out the questionnaires during the educational events organized by the Czech Dental Chamber. At least mild difficulties associated with the motoric system were reported by 96.9% of the respondents, with 66.3% of respondents reporting moderate or major difficulties. Back and neck pain followed by shoulder pain and headache were the most common complaints in our sample. According to our data: age, gender, length of practice, a history of serious MSDs, the occurrence of MSDs in blood relatives, the perception of work as psychologically demanding, and especially a perceived moderate/bad general health were significantly associated with the four most common musculoskeletal complaints. Some of the factors were found as protective. This study suggests that MSDs represent a significant burden for Czech dentists and further research is needed to elucidate this issue. PMID:25327296

  10. Self-reported risk factors related to the most frequent musculoskeletal complaints among Czech dentists

    PubMed Central

    HODACOVA, Lenka; SUSTOVA, Zdenka; CERMAKOVA, Eva; KAPITAN, Martin; SMEJKALOVA, Jindra

    2014-01-01

    The purpose of the study was to describe the occurrence of the most common complaints related to MSDs in Czech dentists and to assess the risk factors affecting them. A questionnaire survey of 581 Czech dentists (the response rate 72.6%) was conducted in 2011. The questionnaire ascertained general information about the respondents, their work habits and environment along with the occurrence of musculoskeletal disorders. The respondents filled out the questionnaires during the educational events organized by the Czech Dental Chamber. At least mild difficulties associated with the motoric system were reported by 96.9% of the respondents, with 66.3% of respondents reporting moderate or major difficulties. Back and neck pain followed by shoulder pain and headache were the most common complaints in our sample. According to our data: age, gender, length of practice, a history of serious MSDs, the occurrence of MSDs in blood relatives, the perception of work as psychologically demanding, and especially a perceived moderate/bad general health were significantly associated with the four most common musculoskeletal complaints. Some of the factors were found as protective. This study suggests that MSDs represent a significant burden for Czech dentists and further research is needed to elucidate this issue. PMID:25327296

  11. Patellofemoral Pain.

    PubMed

    Dutton, Rebecca A; Khadavi, Michael J; Fredericson, Michael

    2016-02-01

    Patellofemoral pain is characterized by insidious onset anterior knee pain that is exaggerated under conditions of increased patellofemoral joint stress. A variety of risk factors may contribute to the development of patellofemoral pain. It is critical that the history and physical examination elucidate those risk factors specific to an individual in order to prescribe an appropriate and customized treatment plan. This article aims to review the epidemiology, risk factors, diagnosis, and management of patellofemoral pain. PMID:26616176

  12. How to File a Consumer Credit Complaint.

    ERIC Educational Resources Information Center

    Board of Governors of the Federal Reserve System, Washington, DC.

    Designed for the general public and possibly suitable also for high school economics students, this pamphlet explains how a complaint against a Federal Reserve bank concerning a possible violation of any of the federal consumer credit laws can be filed. Seven consumer credit laws are listed with a brief statement about the major protections of…

  13. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Complaint file. 1271.320 Section 1271.320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current...

  14. 19 CFR 210.12 - The complaint.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... trade and commerce. For every intellectual property based complaint (regardless of the type of intellectual property right involved), include a showing that at least one complainant is the owner or exclusive licensee of the subject intellectual property; and (8) If the alleged violation involves an...

  15. 28 CFR 42.408 - Complaint procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Complaint procedures. 42.408 Section 42.408 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY... log. Federal agencies shall report to the Assistant Attorney General on January 1, 1977, and each...

  16. 28 CFR 42.408 - Complaint procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Complaint procedures. 42.408 Section 42.408 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY... log. Federal agencies shall report to the Assistant Attorney General on January 1, 1977, and each...

  17. 28 CFR 42.408 - Complaint procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Complaint procedures. 42.408 Section 42.408 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY... log. Federal agencies shall report to the Assistant Attorney General on January 1, 1977, and each...

  18. 28 CFR 42.408 - Complaint procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Complaint procedures. 42.408 Section 42.408 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY... log. Federal agencies shall report to the Assistant Attorney General on January 1, 1977, and each...

  19. 28 CFR 42.408 - Complaint procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Complaint procedures. 42.408 Section 42.408 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY... log. Federal agencies shall report to the Assistant Attorney General on January 1, 1977, and each...

  20. 49 CFR 604.30 - Filing complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Filing complaints. 604.30 Section 604.30 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION..., DC 20590. (b) Date and method of filing. Filing of any document shall be by personal delivery,...

  1. 49 CFR 604.30 - Filing complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Filing complaints. 604.30 Section 604.30 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION..., DC 20590. (b) Date and method of filing. Filing of any document shall be by personal delivery,...

  2. 49 CFR 604.30 - Filing complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Filing complaints. 604.30 Section 604.30 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION..., DC 20590. (b) Date and method of filing. Filing of any document shall be by personal delivery,...

  3. 49 CFR 604.30 - Filing complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Filing complaints. 604.30 Section 604.30 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION..., DC 20590. (b) Date and method of filing. Filing of any document shall be by personal delivery,...

  4. 40 CFR 7.120 - Complaint investigations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... recipients of Federal assistance (see 28 CFR part 42, subpart H and 29 CFR part 1691). Complainants are... administratively with the Equal Employment Opportunity Commission (see 29 CFR part 1626). * * * (d) * * * (1... Compliance Procedures 7.120 Complaint investigations. The OCR shall promptly investigate all...

  5. 12 CFR 528.8 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., Washington, DC 20410 for processing under the Fair Housing Act, and to the Director, Consumer Affairs, Office of Thrift Supervision, Washington, DC 20552 for processing under Office regulations. Complaints... Opportunity Commission, Washington, DC 20506 and a copy, for information only, sent to the Director,...

  6. 12 CFR 528.8 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., Washington, DC 20410 for processing under the Fair Housing Act, and to the Director, Consumer Affairs, Office of Thrift Supervision, Washington, DC 20552 for processing under Office regulations. Complaints... Opportunity Commission, Washington, DC 20506 and a copy, for information only, sent to the Director,...

  7. 12 CFR 528.8 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., Washington, DC 20410 for processing under the Fair Housing Act, and to the Director, Consumer Affairs, Office of Thrift Supervision, Washington, DC 20552 for processing under Office regulations. Complaints... Opportunity Commission, Washington, DC 20506 and a copy, for information only, sent to the Director,...

  8. 7 CFR 47.6 - Formal complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Formal complaints. 47.6 Section 47.6 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE MARKETING OF PERISHABLE AGRICULTURAL COMMODITIES RULES OF...

  9. 7 CFR 271.6 - Complaint procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Complaint procedure. 271.6 Section 271.6 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... Regional Office, U.S. Department of Agriculture, Food and Nutrition Service, CN 02150, Trenton, NJ...

  10. 7 CFR 271.6 - Complaint procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Complaint procedure. 271.6 Section 271.6 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... Regional Office, U.S. Department of Agriculture, Food and Nutrition Service, CN 02150, Trenton, NJ...

  11. 7 CFR 271.6 - Complaint procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Complaint procedure. 271.6 Section 271.6 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... Regional Office, U.S. Department of Agriculture, Food and Nutrition Service, CN 02150, Trenton, NJ...

  12. 7 CFR 271.6 - Complaint procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Complaint procedure. 271.6 Section 271.6 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... Regional Office, U.S. Department of Agriculture, Food and Nutrition Service, CN 02150, Trenton, NJ...

  13. 45 CFR 98.32 - Parental complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Parental complaints. 98.32 Section 98.32 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities 98.32 Parental...

  14. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Complaint file. 1271.320 Section 1271.320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES,...

  15. 7 CFR 250.22 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Complaints. 250.22 Section 250.22 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS AND POLICIES-FOOD DISTRIBUTION DONATION OF FOODS FOR USE IN THE UNITED STATES, ITS TERRITORIES AND POSSESSIONS AND AREAS...

  16. 21 CFR 211.198 - Complaint files.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Complaint files. 211.198 Section 211.198 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Records and Reports 211.198...

  17. 21 CFR 211.198 - Complaint files.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Complaint files. 211.198 Section 211.198 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Records and Reports 211.198...

  18. 25 CFR 11.300 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE... initiated by a complaint filed with the court by a law enforcement officer and sworn to by a person having... witness, or witnesses, sworn before a magistrate, a court clerk, a prosecutor, or any law...

  19. 48 CFR 8.711 - Quality complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Quality complaints. 8.711 Section 8.711 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Nonprofit Agencies Employing People Who...

  20. 41 CFR 50-201.1202 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Complaints. 50-201.1202 Section 50-201.1202 Public Contracts and Property Management Other Provisions Relating to Public Contracts... officer or employee of the United States Government or of any agency thereof has any knowledge of,...

  1. 41 CFR 101-8.716 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Complaints. 101-8.716 Section 101-8.716 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 8-NONDISCRIMINATION IN PROGRAMS RECEIVING...

  2. 24 CFR 108.35 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Complaints. 108.35 Section 108.35 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FAIR HOUSING...

  3. 20 CFR 405.30 - Discrimination complaints.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Discrimination complaints. 405.30 Section 405... INITIAL DISABILITY CLAIMS Introduction, General Description, and Definitions § 405.30 Discrimination... that an adjudicator has improperly discriminated against you, you may file a discrimination...

  4. 20 CFR 405.30 - Discrimination complaints.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Discrimination complaints. 405.30 Section 405... INITIAL DISABILITY CLAIMS Introduction, General Description, and Definitions § 405.30 Discrimination... that an adjudicator has improperly discriminated against you, you may file a discrimination...

  5. 20 CFR 405.30 - Discrimination complaints.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Discrimination complaints. 405.30 Section 405... INITIAL DISABILITY CLAIMS Introduction, General Description, and Definitions § 405.30 Discrimination... that an adjudicator has improperly discriminated against you, you may file a discrimination...

  6. 20 CFR 405.30 - Discrimination complaints.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Discrimination complaints. 405.30 Section 405... INITIAL DISABILITY CLAIMS Introduction, General Description, and Definitions § 405.30 Discrimination... that an adjudicator has improperly discriminated against you, you may file a discrimination...

  7. 20 CFR 405.30 - Discrimination complaints.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Discrimination complaints. 405.30 Section 405... INITIAL DISABILITY CLAIMS Introduction, General Description, and Definitions § 405.30 Discrimination... that an adjudicator has improperly discriminated against you, you may file a discrimination...

  8. 29 CFR 29.12 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... provisions in 29 CFR part 30, or applicable provisions of a State Plan for Equal Employment Opportunity in Apprenticeship adopted pursuant to 29 CFR part 30 and approved by the Department. (b) Except for matters... Secretary of Labor LABOR STANDARDS FOR THE REGISTRATION OF APPRENTICESHIP PROGRAMS 29.12 Complaints....

  9. 29 CFR 30.11 - Complaint procedure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Secretary of Labor EQUAL EMPLOYMENT OPPORTUNITY IN APPRENTICESHIP AND TRAINING 30.11 Complaint procedure. (a) Filing. (1) Any apprentice or applicant for apprenticeship who believes that he or she has been... apprenticeship or that the equal opportunity standards with respect to his or her selection have not...

  10. 29 CFR 29.12 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... provisions in 29 CFR part 30, or applicable provisions of a State Plan for Equal Employment Opportunity in Apprenticeship adopted pursuant to 29 CFR part 30 and approved by the Department. (b) Except for matters... Secretary of Labor LABOR STANDARDS FOR THE REGISTRATION OF APPRENTICESHIP PROGRAMS 29.12 Complaints....

  11. 29 CFR 30.11 - Complaint procedure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the Secretary of Labor EQUAL EMPLOYMENT OPPORTUNITY IN APPRENTICESHIP AND TRAINING 30.11 Complaint procedure. (a) Filing. (1) Any apprentice or applicant for apprenticeship who believes that he or she has... to apprenticeship or that the equal opportunity standards with respect to his or her selection...

  12. 29 CFR 30.11 - Complaint procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Secretary of Labor EQUAL EMPLOYMENT OPPORTUNITY IN APPRENTICESHIP AND TRAINING 30.11 Complaint procedure. (a) Filing. (1) Any apprentice or applicant for apprenticeship who believes that he or she has been... apprenticeship or that the equal opportunity standards with respect to his or her selection have not...

  13. 29 CFR 29.12 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... provisions in 29 CFR part 30, or applicable provisions of a State Plan for Equal Employment Opportunity in Apprenticeship adopted pursuant to 29 CFR part 30 and approved by the Department. (b) Except for matters... Secretary of Labor LABOR STANDARDS FOR THE REGISTRATION OF APPRENTICESHIP PROGRAMS 29.12 Complaints....

  14. 29 CFR 29.12 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... provisions in 29 CFR part 30, or applicable provisions of a State Plan for Equal Employment Opportunity in Apprenticeship adopted pursuant to 29 CFR part 30 and approved by the Department. (b) Except for matters... Secretary of Labor LABOR STANDARDS FOR THE REGISTRATION OF APPRENTICESHIP PROGRAMS 29.12 Complaints....

  15. 29 CFR 29.12 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... provisions in 29 CFR part 30, or applicable provisions of a State Plan for Equal Employment Opportunity in Apprenticeship adopted pursuant to 29 CFR part 30 and approved by the Department. (b) Except for matters... Secretary of Labor LABOR STANDARDS FOR THE REGISTRATION OF APPRENTICESHIP PROGRAMS 29.12 Complaints....

  16. 12 CFR 528.8 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., Washington, DC 20410 for processing under the Fair Housing Act, and to the Director, Consumer Affairs, Office of Thrift Supervision, Washington, DC 20552 for processing under Office regulations. Complaints... Opportunity Commission, Washington, DC 20506 and a copy, for information only, sent to the Director,...

  17. 12 CFR 528.8 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., Washington, DC 20410 for processing under the Fair Housing Act, and to the Director, Consumer Affairs, Office of Thrift Supervision, Washington, DC 20552 for processing under Office regulations. Complaints... Opportunity Commission, Washington, DC 20506 and a copy, for information only, sent to the Director,...

  18. 44 CFR 7.941 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SECURITY GENERAL NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS (FEMA REG. 5) Nondiscrimination on the Basis of Age in Programs or Activities Receiving Federal Financial Assistance From FEMA Investigation... class or on behalf of others, may file a complaint with FEMA, alleging discrimination prohibited by...

  19. 44 CFR 7.941 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SECURITY GENERAL NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS (FEMA REG. 5) Nondiscrimination on the Basis of Age in Programs or Activities Receiving Federal Financial Assistance From FEMA Investigation... class or on behalf of others, may file a complaint with FEMA, alleging discrimination prohibited by...

  20. 44 CFR 7.941 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SECURITY GENERAL NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS (FEMA REG. 5) Nondiscrimination on the Basis of Age in Programs or Activities Receiving Federal Financial Assistance From FEMA Investigation... class or on behalf of others, may file a complaint with FEMA, alleging discrimination prohibited by...

  1. 44 CFR 7.941 - Complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SECURITY GENERAL NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS (FEMA REG. 5) Nondiscrimination on the Basis of Age in Programs or Activities Receiving Federal Financial Assistance From FEMA Investigation... class or on behalf of others, may file a complaint with FEMA, alleging discrimination prohibited by...

  2. Self-reported musculoskeletal complaints among garment workers.

    PubMed

    Sokas, R K; Spiegelman, D; Wegman, D H

    1989-01-01

    One hundred forty-four sewing machine operators answered questionnaires concerning occupational history and musculoskeletal symptoms adapted from the National Health and Nutrition Examination Survey. They were matched for age within 5 years, race, and sex with persons completing the HANES I Augmentation Survey, and the prevalence of self-reported musculoskeletal morbidity was compared. Operators complained significantly more often of knee pain (prevalence odds ratio [POR] = 1.84, p = .0001) and knee swelling (POR = 9.98, p less than .00001), although they were no more likely to have had knee surgery. Similar increases were reported for upper-back pain (POR = 2.13, p = .002) joint ache, and joint swelling (both were significant for fingers, wrists, elbows, and shoulders at p less than .05 levels). No differences in low-back pain or in hospitalization for joint conditions were noted. Ergonomic redesign of sewing machines needs to address knee and upper-back movements as well as the arm, wrist, and finger movements. PMID:2786337

  3. Chronic Pain Associated with Upper-Limb Loss

    PubMed Central

    Hanley, Marisol A.; Ehde, Dawn M.; Jensen, Mark; Czerniecki, Joseph; Smith, Douglas G.; Robinson, Lawrence R.

    2011-01-01

    Objective To describe the prevalence, intensity, and functional impact of the following types of pain associated with upper-limb loss: phantom limb, residual limb, back, neck, and nonamputated-limb pain. Design Cross-sectional survey; 104 respondents with upper-limb loss at least 6 months postamputation completed measures of pain intensity, interference, disability, and health-related quality-of-life. Results Nearly all (90%) of the respondents reported pain, with 76% reporting more than one pain type. Phantom-limb pain and residual-limb pain were the most prevalent (79% and 71%, respectively), followed by back (52%), neck (43%), and nonamputated-limb pain (33%). Although nonamputated-limb pain was least prevalent, it was reported to cause the highest levels of interference and pain-related disability days. Self-reported quality-of-life was significantly lower for individuals with each type of pain compared with those without any pain. Age, time since amputation, and cause of amputation were not associated with pain. Conclusions In addition to pain in the phantom and residual limb, back, neck, and nonamputated-limb pain are also common after upper-limb loss. All of these pain types are associated with significant disability and activity interference for some individuals, suggesting that assessment of multiple pain types in persons with upper-limb amputation may be important. PMID:19692791

  4. The association between chronic pain and obesity

    PubMed Central

    Okifuji, Akiko; Hare, Bradford D

    2015-01-01

    Obesity and pain present serious public health concerns in our society. Evidence strongly suggests that comorbid obesity is common in chronic pain conditions, and pain complaints are common in obese individuals. In this paper, we review the association between obesity and pain in the general population as well as chronic pain patients. We also review the relationship between obesity and pain response to noxious stimulation in animals and humans. Based upon the existing research, we present several potential mechanisms that may link the two phenomena, including mechanical/structural factors, chemical mediators, depression, sleep, and lifestyle. We discuss the clinical implications of obesity and pain, focusing on the effect of weight loss, both surgical and noninvasive, on pain. The literature suggests that the two conditions are significant comorbidities, adversely impacting each other. The nature of the relationship however is not likely to be direct, but many interacting factors appear to contribute. Weight loss for obese pain patients appears to be an important aspect of overall pain rehabilitation, although more efforts are needed to determine strategies to maintain long-term benefit. PMID:26203274

  5. Synergistic Effects of Citalopram and Morphine in the Renal Colic Pain Relief; a Randomized Clinical Trial

    PubMed Central

    Esmailian, Mehrdad; Keshavarz, Mehdi

    2014-01-01

    Introduction: Although the synergistic effects of opioids and other analgesic drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) have been established in relieving acute pain due to renal calculi, no studies today have evaluated the concomitant administration of opiates and other drugs with analgesic effects, such as serotonin re-uptake inhibitors. Considering the high prevalence of renal colic, the present study was carried out to compare the effect of concomitant prescription of morphine and a placebo with that of morphine and citalopram on the management of acute pain due to renal calculi. Methods: The present double-blind randomized clinical trial was carried out from October 2012 to March 2013 in the Al-Zahra educational Hospital in Isfahan, Iran. 90 patients with acute renal colic pain were randomly divided into two groups of 45 subjects. The subjects in one group received morphine/ placebo and another one morphine/citalopram. The patients pain severity was determined by visual analogue scale (VAS) before and 20 minutes after administration of medications. In case of persistent pain, the second or even third dose was administered and the pain severity was once again determined. Data were analyzed with STATA 11.0 using chi-squared, two-way ANOVA, Bonferroni post hoc test, and log rank test. Results: The decrease in pain severity in the morphine/citalopram group was significantly compared to the morphine/placebo group and the time before administration of the medications (p<0.001). In contrast, administration of morphine/placebo did not have a significant effect on pain severity at this interval (p=0.32). Kaplan-Meier curve showed that the first injection was successful in relieving pain in 15 (33.3%) and 26 (57.8%) subjects in the morphine/placebo and morphine/citalopram groups, respectively. The second injection of these medications resulted in therapeutic success in 35 (87.8%) and 42 (95.6%) subjects in the above groups, respectively. Log rank test showed a significant difference in the treatment success between the two groups (p=0.001). Conclusion: It seems that the combination of citalopram and morphine sulfate causes increased efficacy and higher success rate in pain control of patients presented to the emergency department with a complaint of renal colic. PMID:26495338

  6. Orofacial pain management: current perspectives

    PubMed Central

    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. PMID:24591846

  7. 42 CFR 476.150 - Abandoned complaints and reopening rights.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATION REVIEW Review Responsibilities of Quality Improvement Organizations (QIOs) Qio Review Functions 476.150 Abandoned complaints... otherwise comply with the requirements of the beneficiary complaint review process and the QIO does not...

  8. On the relationship between blast noise complaints and community annoyance.

    PubMed

    Nykaza, Edward T; Hodgdon, Kathleen K; Gaugler, Trent; Krecker, Peg; Luz, George A

    2013-05-01

    Military installations typically rely on noise complaints to indicate adverse noise environments and often restrict the firing of certain weapons to reduce the number of noise complaints. Using complaints in this manner may also imply that the absence of complaints is an indicator of low community annoyance. The relationship between individual complaints and general community annoyance, however, is currently not established, and it is unknown whether implementing restrictions in reaction to individual complaints is an appropriate or necessary way to reduce community annoyance. This paper looks at whether there are significant differences in reported annoyance to complaint-referenced blast events and general military noise annoyance between those who complain and their non-complaining neighbors. Those who complained were significantly more annoyed to both complaint-referenced blast events and general military noise in comparison to their non-complaining neighbors. The implications of these findings are discussed in terms of range management. PMID:23654377

  9. 14 CFR 1264.107 - Service of complaint.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Federal Rules of Civil Procedure. (b) Proof of service, stating the name and address of the person on whom... FRAUD CIVIL PENALTIES ACT OF 1986 1264.107 Service of complaint. (a) Service of a complaint must...

  10. 31 CFR 16.8 - Service of complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Federal Rules of Civil Procedure. (b) Proof of service, stating the name and address of the person on whom... PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 16.8 Service of complaint. (a) Service of a complaint must...

  11. 45 CFR 160.306 - Complaints to the Secretary.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... administrative simplification provisions may file a complaint with the Secretary. (b) Requirements for filing... administrative simplification provision(s). (3) A complaint must be filed within 180 days of when the...

  12. 29 CFR 1603.103 - Referral of complaints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... THE GOVERNMENT EMPLOYEE RIGHTS ACT OF 1991 Administrative Process 1603.103 Referral of complaints. (a) The Commission will notify an FEP agency, as defined in 29 CFR 1601.3(a), when a complaint...

  13. 29 CFR 1603.103 - Referral of complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... THE GOVERNMENT EMPLOYEE RIGHTS ACT OF 1991 Administrative Process 1603.103 Referral of complaints. (a) The Commission will notify an FEP agency, as defined in 29 CFR 1601.3(a), when a complaint...

  14. 29 CFR 1603.103 - Referral of complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... THE GOVERNMENT EMPLOYEE RIGHTS ACT OF 1991 Administrative Process 1603.103 Referral of complaints. (a) The Commission will notify an FEP agency, as defined in 29 CFR 1601.3(a), when a complaint...

  15. 29 CFR 1603.103 - Referral of complaints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... THE GOVERNMENT EMPLOYEE RIGHTS ACT OF 1991 Administrative Process 1603.103 Referral of complaints. (a) The Commission will notify an FEP agency, as defined in 29 CFR 1601.3(a), when a complaint...

  16. 29 CFR 1603.103 - Referral of complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... THE GOVERNMENT EMPLOYEE RIGHTS ACT OF 1991 Administrative Process 1603.103 Referral of complaints. (a) The Commission will notify an FEP agency, as defined in 29 CFR 1601.3(a), when a complaint...

  17. Painful diabetic neuropathy: clinical aspects.

    PubMed

    Didangelos, Triantafyllos; Doupis, John; Veves, Aristidis

    2014-01-01

    Painful diabetic neuropathy (PDN) is one of several clinical syndromes in patients with diabetic peripheral neuropathy (DPN) and presents a major challenge for optimal management. The epidemiology of PDN has not been extensively studied. On the basis of available data, the prevalence of pain ranges from 10% to 20% in patients with diabetes and from 40% to 50% in those with diabetic neuropathy. Neuropathic pain can be disabling and devastating, with a significant impact on the patient's quality of life and associated healthcare cost. Pathophysiologic mechanisms underlying PDN are similar to other neuropathic pain disorders and broadly invoke peripheral and central sensitization. The natural course of PDN is variable, with the majority of patients experiencing spontaneous improvement and resolution of pain. Quantifying neuropathic pain is difficult, especially in clinical practice, but has improved recently in clinical trials with the development of neuropathic pain-specific tools, such as the Neuropathic Pain Questionnaire and the Neuropathic Pain Symptom Inventory. Hyperglycemia-induced pathways result in nerve dysfunction and damage, which lead to hyperexcitable peripheral and central pathways of pain. Glycemic control may prevent or partially reverse DPN and modulate PDN. PMID:25410214

  18. Low Back Pain in Port Machinery Operators

    NASA Astrophysics Data System (ADS)

    BOVENZI, M.; PINTO, I.; STACCHINI, N.

    2002-05-01

    The occurrence of several types of low back pain (LBP) was investigated by a standardized questionnaire in a group of 219 port machinery operators exposed to whole-body vibration (WBV) and postural load and in a control group of 85 maintenance workers employed at the same transport company. The group of port machinery operators included 85 straddle carrier drivers, 88 fork-lift truck drivers, and 46 crane operators. The vector sum of the frequency-weighted r.m.s. acceleration of vibration measured on the seatpan of port vehicles and machines averaged 0·90 m/s2 for fork-lift trucks, 0·48 m/s2 for straddle carriers, 0·53 m/s2 for mobile cranes, and 0·22 m/s2 for overhead cranes. The 12-month prevalence of low back symptoms (LBP, sciatic pain, treated LBP, sick leave due to LBP) was significantly greater in the fork-lift truck drivers than in the controls and the other two groups of port machinery operators. After adjusting for potential confounders, the prevalence of low back symptoms was found to increase with the increase of WBV exposure expressed as duration of exposure (driving years), equivalent vibration magnitude (m/s2), or cumulative vibration exposure (yr m2/s4). An excess risk for lumbar disc herniation was observed in the port machinery operators with prolonged driving experience. In both the controls and the port machinery operators, low back complaints were strongly associated with perceived postural load assessed in terms of frequency and/or duration of awkward postures at work. Multivariate analysis showed that vibration exposure and postural load were independent predictors of LBP. Even though the cross-sectional design of the present study does not permit firm conclusions on the relationship between WBV exposure and low back disorders, the findings of this investigation provide additional epidemiological evidence that seated WBV exposure combined with non-neutral trunk postures, as while driving, is associated with an increased risk of long-term adverse health effects on the lower back.

  19. Psychosocial Working Conditions and Cognitive Complaints among Swedish Employees

    PubMed Central

    Stenfors, Cecilia U. D.; Magnusson Hanson, Linda; Oxenstierna, Gabriel; Theorell, Töres; Nilsson, Lars-Göran

    2013-01-01

    Background Cognitive complaints involving problems with concentration, memory, decision-making and thinking are relatively common in the work force. The sensitivity of both subjective and objective cognitive functioning to common psychiatric conditions, stress levels and to cognitive load makes it plausible that psychosocial working conditions play a role in cognitive complaints. Thus, this study aimed to test the associations between psychosocial work factors and cognitive complaints in nationally representative samples of the Swedish work force. Cross-sectional (n = 9751) and prospective (n = 3644; two time points two years apart) sequential multiple regression analyses were run, adjusting for general confounders, depressive- and sleeping problems. Additional prospective analyses were run adjusting for baseline cognitive complaints. Cross-sectional results High quantitative demands, information and communication technology (ICT) demands, underqualification and conflicts were positively associated with cognitive complaints, while social support, good resources at work and overqualification were negatively associated with cognitive complaints in all models. Skill discretion and decision authority were weakly associated with cognitive complaints. Conflicts were more strongly associated with cognitive complaints in women than in men, after adjustment for general confounders. Prospective results Quantitative job demands, ICT demands and underqualification were positively associated with future cognitive complaints in all models, including when adjusted for baseline cognitive complaints. Decision authority was weakly positively associated with future cognitive complaints, only after adjustment for depressive- and sleeping problems respectively. Social support was negatively associated with future cognitive complaints after adjustment for general confounders and baseline cognitive complaints. Skill discretion and resources were negatively associated with future cognitive complaints after adjustment for general confounders. The associations between quantitative demands and future cognitive complaints were stronger in women. Discussion/Conclusions The findings indicate that psychosocial working conditions should be taken into account when considering cognitive complaints among employees. PMID:23560101

  20. Structural abnormalities and persistent complaints after an ankle sprain are not associated: an observational case control study in primary care

    PubMed Central

    van Ochten, John M; Mos, Marinka CE; van Putte-Katier, Nienke; Oei, Edwin HG; Bindels, Patrick JE; Bierma-Zeinstra, Sita MA; van Middelkoop, Marienke

    2014-01-01

    Background Persistent complaints are very common after a lateral ankle sprain. Aim To investigate possible associations between structural abnormalities on radiography and MRI, and persistent complaints after a lateral ankle sprain. Design and setting Observational case control study on primary care patients in general practice. Method Patients were selected who had visited their GP with an ankle sprain 6–12 months before the study; all received a standardised questionnaire, underwent a physical examination, and radiography and MRI of the ankle. Patients with and without persistent complaints were compared regarding structural abnormalities found on radiography and MRI; analyses were adjusted for age, sex, and body mass index. Results Of the 206 included patients, 98 had persistent complaints and 108 did not. No significant differences were found in structural abnormalities between patients with and without persistent complaints. In both groups, however, many structural abnormalities were found on radiography in the talocrural joint (47.2% osteophytes and 45.1% osteoarthritis) and the talonavicular joint (36.5% sclerosis). On MRI, a high prevalence was found of bone oedema (33.8%) and osteophytes (39.5) in the talocrural joint; osteophytes (54.4%), sclerosis (47.2%), and osteoarthritis (55.4%, Kellgren and Lawrence grade >1) in the talonavicular joint, as well as ligament damage (16.4%) in the anterior talofibular ligament. Conclusion The prevalence of structural abnormalities is high on radiography and MRI in patients presenting in general practice with a previous ankle sprain. There is no difference in structural abnormalities, however, between patients with and without persistent complaints. Using imaging only will not lead to diagnosis of the explicit reason for the persistent complaint. PMID:25179068

  1. 39 CFR 3030.2 - Scope and nature of complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Scope and nature of complaints. 3030.2 Section 3030.2 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS General § 3030.2 Scope and nature of complaints. Any interested person (including a duly appointed officer of...

  2. 39 CFR 3030.2 - Scope and nature of complaints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Scope and nature of complaints. 3030.2 Section 3030.2 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS General § 3030.2 Scope and nature of complaints. Any interested person (including a duly appointed officer of...

  3. 39 CFR 3030.2 - Scope and nature of complaints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Scope and nature of complaints. 3030.2 Section 3030.2 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS General § 3030.2 Scope and nature of complaints. Any interested person (including a duly appointed officer of...

  4. 39 CFR 3030.2 - Scope and nature of complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Scope and nature of complaints. 3030.2 Section 3030.2 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS General § 3030.2 Scope and nature of complaints. Any interested person (including a duly appointed officer of...

  5. 19 CFR 111.55 - Investigation of complaints.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... submit a report on the investigation to the director of the port and send a copy of it to the Assistant... 19 Customs Duties 1 2014-04-01 2014-04-01 false Investigation of complaints. 111.55 Section 111.55... in Lieu of Suspension or Revocation 111.55 Investigation of complaints. Every complaint or...

  6. 19 CFR 111.55 - Investigation of complaints.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... submit a report on the investigation to the director of the port and send a copy of it to the Assistant... 19 Customs Duties 1 2012-04-01 2012-04-01 false Investigation of complaints. 111.55 Section 111.55... in Lieu of Suspension or Revocation 111.55 Investigation of complaints. Every complaint or...

  7. 19 CFR 111.55 - Investigation of complaints.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Investigation of complaints. 111.55 Section 111.55... in Lieu of Suspension or Revocation 111.55 Investigation of complaints. Every complaint or charge... special agent in charge of the area in which the broker is located. The special agent in charge...

  8. 19 CFR 111.55 - Investigation of complaints.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Investigation of complaints. 111.55 Section 111.55... in Lieu of Suspension or Revocation 111.55 Investigation of complaints. Every complaint or charge... special agent in charge of the area in which the broker is located. The special agent in charge...

  9. 19 CFR 111.55 - Investigation of complaints.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Investigation of complaints. 111.55 Section 111.55... in Lieu of Suspension or Revocation 111.55 Investigation of complaints. Every complaint or charge... special agent in charge of the area in which the broker is located. The special agent in charge...

  10. 28 CFR 35.172 - Resolution of complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Resolution of complaints. 35.172 Section... STATE AND LOCAL GOVERNMENT SERVICES Compliance Procedures 35.172 Resolution of complaints. (a) The designated agency shall investigate each complete complaint, attempt informal resolution, and, if...

  11. 39 CFR 3031.12 - Treatment as a complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Treatment as a complaint. 3031.12 Section 3031.12... Inquiry Forms and Procedures 3031.12 Treatment as a complaint. If the Commission receives a volume of... treatment as a complaint, it may appoint an investigator to review the matter under 3030.21 of...

  12. 30 CFR 291.105 - What must a complaint contain?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What must a complaint contain? 291.105 Section 291.105 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR APPEALS OPEN AND... complaint contain? For purposes of this subpart, a complaint means a comprehensive written brief stating...

  13. 47 CFR 8.14 - General formal complaint procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false General formal complaint procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general...

  14. 47 CFR 8.14 - General formal complaint procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false General formal complaint procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general...

  15. 47 CFR 8.14 - General formal complaint procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false General formal complaint procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general...

  16. 47 CFR 8.14 - General formal complaint procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false General formal complaint procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general...

  17. 39 CFR 3030.2 - Scope and nature of complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Scope and nature of complaints. 3030.2 Section 3030.2 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL RULES FOR COMPLAINTS General § 3030.2 Scope and nature of complaints. Any interested person (including a duly appointed officer of...

  18. 46 CFR 502.62 - Complaints and fee.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 9 2011-10-01 2011-10-01 false Complaints and fee. 502.62 Section 502.62 Shipping FEDERAL MARITIME COMMISSION GENERAL AND ADMINISTRATIVE PROVISIONS RULES OF PRACTICE AND PROCEDURE Proceedings; Pleadings; Motions; Replies § 502.62 Complaints and fee. (a) The complaint must be verified and shall contain the name and address of...

  19. 14 CFR 302.507 - Computing time for filing complaints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Computing time for filing complaints. 302... Proceedings With Respect to Rates, Fares and Charges for Foreign Air Transportation 302.507 Computing time for filing complaints. In computing the time for filing formal complaints pursuant to 302.506,...

  20. 14 CFR 302.507 - Computing time for filing complaints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Computing time for filing complaints. 302... Proceedings With Respect to Rates, Fares and Charges for Foreign Air Transportation 302.507 Computing time for filing complaints. In computing the time for filing formal complaints pursuant to 302.506,...

  1. 14 CFR 302.507 - Computing time for filing complaints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Computing time for filing complaints. 302... Proceedings With Respect to Rates, Fares and Charges for Foreign Air Transportation 302.507 Computing time for filing complaints. In computing the time for filing formal complaints pursuant to 302.506,...

  2. 45 CFR 672.8 - Answer to the complaint.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Answer to the complaint. 672.8 Section 672.8 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES 672.8 Answer to the complaint. (a) General. Where respondent (1) contests any material fact upon which the complaint...

  3. 45 CFR 672.8 - Answer to the complaint.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Answer to the complaint. 672.8 Section 672.8 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES 672.8 Answer to the complaint. (a) General. Where respondent (1) contests any material fact upon which the complaint...

  4. 77 FR 47820 - Invention Promoters/Promotion Firms Complaints

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-10

    ... United States Patent and Trademark Office Invention Promoters/Promotion Firms Complaints ACTION: Proposed... concerning invention promoters and responses from the invention promoters to these complaints. An individual may submit a complaint concerning an invention promoter to the USPTO, which will forward the...

  5. Development of the Ghent Multidimensional Somatic Complaints Scale

    ERIC Educational Resources Information Center

    Beirens, Koen; Fontaine, Johnny R. J.

    2010-01-01

    The present study aimed at developing a new scale that operationalizes a hierarchical model of somatic complaints. First, 63 items representing a wide range of symptoms and sensations were compiled from somatic complaints scales and emotion literature. These complaints were rated by Belgian students (n = 307) and Belgian adults (n = 603).

  6. 45 CFR 1225.14 - Consolidation of complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Consolidation of complaints. 1225.14 Section 1225.14 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND... § 1225.14 Consolidation of complaints. The EO Director may consolidate the complaint if it involves...

  7. 49 CFR 821.33 - Motion to dismiss stale complaint.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Motion to dismiss stale complaint. 821.33 Section... SAFETY BOARD RULES OF PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Under 49 U.S.C. 44709 821.33 Motion to dismiss stale complaint. Where the complaint states allegations...

  8. 49 CFR 821.33 - Motion to dismiss stale complaint.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Motion to dismiss stale complaint. 821.33 Section... SAFETY BOARD RULES OF PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Under 49 U.S.C. 44709 821.33 Motion to dismiss stale complaint. Where the complaint states allegations...

  9. 49 CFR 821.33 - Motion to dismiss stale complaint.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Motion to dismiss stale complaint. 821.33 Section... SAFETY BOARD RULES OF PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Under 49 U.S.C. 44709 821.33 Motion to dismiss stale complaint. Where the complaint states allegations...

  10. 49 CFR 821.33 - Motion to dismiss stale complaint.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Motion to dismiss stale complaint. 821.33 Section... SAFETY BOARD RULES OF PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Under 49 U.S.C. 44709 821.33 Motion to dismiss stale complaint. Where the complaint states allegations...

  11. Complaint Handling in the Library. Occasional Papers Number 166.

    ERIC Educational Resources Information Center

    Robinson, William C.

    Arguing that complaints are inevitable and that complaint handling should be an integral part of the library's public service program, this paper identifies and discusses the components of such a program. Concerns discussed are those that should be of general interest to all types of libraries, and the primary focus is on external complaints,

  12. 40 CFR 22.15 - Answer to the complaint.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Answer to the complaint. 22.15 Section... SUSPENSION OF PERMITS Prehearing Procedures 22.15 Answer to the complaint. (a) General. Where respondent... answer to the complaint with the Regional Hearing Clerk and shall serve copies of the answer on all...

  13. 5 CFR 1201.130 - Rights; answer to complaint.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Rights; answer to complaint. 1201.130... 1201.130 Rights; answer to complaint. (a) Rights. (1) A person on whose behalf the Special Counsel... default. An agency named as respondent in a Special Counsel corrective action complaint may file an...

  14. 5 CFR 1201.130 - Rights; answer to complaint.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Rights; answer to complaint. 1201.130... 1201.130 Rights; answer to complaint. (a) Rights. (1) A person on whose behalf the Special Counsel... default. An agency named as respondent in a Special Counsel corrective action complaint may file an...

  15. 40 CFR 22.15 - Answer to the complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Answer to the complaint. 22.15 Section... SUSPENSION OF PERMITS Prehearing Procedures 22.15 Answer to the complaint. (a) General. Where respondent... answer to the complaint with the Regional Hearing Clerk and shall serve copies of the answer on all...

  16. 49 CFR 1111.4 - Answers and cross complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Answers and cross complaints. 1111.4 Section 1111... Answers and cross complaints. (a) Generally. An answer shall be filed within the time provided in paragraph (c) of this section. An answer should be responsive to the complaint and should fully advise...

  17. 46 CFR 502.312 - Answer to complaint.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 9 2014-10-01 2014-10-01 false Answer to complaint. 502.312 Section 502.312 Shipping... Procedure for Adjudication of Small Claims 502.312 Answer to complaint. The respondent shall file with the Commission an answer within twenty-five (25) days of service of the complaint and shall serve a copy of...

  18. 49 CFR 1111.4 - Answers and cross complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 8 2014-10-01 2014-10-01 false Answers and cross complaints. 1111.4 Section 1111... Answers and cross complaints. (a) Generally. An answer shall be filed within the time provided in paragraph (c) of this section. An answer should be responsive to the complaint and should fully advise...

  19. 46 CFR 502.312 - Answer to complaint.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 9 2011-10-01 2011-10-01 false Answer to complaint. 502.312 Section 502.312 Shipping... Procedure for Adjudication of Small Claims 502.312 Answer to complaint. The respondent shall file with the Commission an answer within twenty-five (25) days of service of the complaint and shall serve a copy of...

  20. 32 CFR 112.5 - Processing of debt complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Processing of debt complaints. 112.5 Section 112... CIVILIAN INDEBTEDNESS OF MILITARY PERSONNEL § 112.5 Processing of debt complaints. (a) Debt complaints... made a bona fide effort to collect the debt directly from the military member; (2) Whose claims...