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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, Jörg; Brähler, 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. The prevalence of chronic pain in Canada

    PubMed Central

    Schopflocher, Donald; Taenzer, Paul; Jovey, Roman

    2011-01-01

    BACKGROUND: While chronic pain appears to be relatively common, published population prevalence estimates have been highly variable, partly due to differences in the definition of chronic pain and in survey methodologies. OBJECTIVES: To estimate the prevalence of chronic pain in Canada using clear case definitions and a validated survey instrument. METHODS: A telephone survey was administered to a representative sample of adults from across Canada using the same screening questionnaire that had been used in a recent large, multicountry study conducted in Europe. RESULTS: The prevalence of chronic pain prevalence for adults older than 18 years of age was 18.9%. This was comparable with the overall mean reported using identical survey questions and criteria for chronic pain used in the European study. Chronic pain prevalence was greater in older adults, and females had a higher prevalence at older ages compared with males. Approximately one-half of those with chronic pain reported suffering for more than 10 years. Approximately one-third of those reporting chronic pain rated the intensity in the very severe range. The lower back was the most common site of chronic pain, and arthritis was the most frequently named cause. CONCLUSIONS: A consensus is developing that there is a high prevalence of chronic pain within adult populations living in industrialized nations. Recent studies have formulated survey questions carefully and have used large samples. Unfortunately, a substantial proportion of Canadian adults continue to live with chronic pain that is longstanding and severe. PMID:22184555

  3. 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.

  4. 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 =…

  5. 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 1.61–3.05, p?=?0.022). The OR at the time of the questionnaire is 2.25 (95% CI 1.77–2.73, 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 2.18–3.63) and 1.83 (95% CI 1.63–2.04) 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

  6. 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

  7. 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 16 years 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

  8. Pain hypersensitivity and spinal nociceptive hypersensitivity in chronic pain: prevalence and associated factors.

    PubMed

    Curatolo, Michele; Müller, Monika; Ashraf, Aroosiah; Neziri, Alban Y; Streitberger, Konrad; Andersen, Ole K; Arendt-Nielsen, Lars

    2015-11-01

    Hypersensitivity of pain pathways is considered a relevant determinant of symptoms in chronic pain patients, but data on its prevalence are very limited. To our knowledge, no data on the prevalence of spinal nociceptive hypersensitivity are available. We studied the prevalence of pain hypersensitivity and spinal nociceptive hypersensitivity in 961 consecutive patients with various chronic pain conditions. Pain threshold and nociceptive withdrawal reflex threshold to electrical stimulation were used to assess pain hypersensitivity and spinal nociceptive hypersensitivity, respectively. Using 10th percentile cutoff of previously determined reference values, the prevalence of pain hypersensitivity and spinal nociceptive hypersensitivity (95% confidence interval) was 71.2 (68.3-74.0) and 80.0 (77.0-82.6), respectively. As a secondary aim, we analyzed demographic, psychosocial, and clinical characteristics as factors potentially associated with pain hypersensitivity and spinal nociceptive hypersensitivity using logistic regression models. Both hypersensitivity parameters were unaffected by most factors analyzed. Depression, catastrophizing, pain-related sleep interference, and average pain intensity were significantly associated with hypersensitivity. However, none of them was significant for both unadjusted and adjusted analyses. Furthermore, the odds ratios were very low, indicating modest quantitative impact. To our knowledge, this is the largest prevalence study on central hypersensitivity and the first one on the prevalence of spinal nociceptive hypersensitivity in chronic pain patients. The results revealed an impressively high prevalence, supporting a high clinical relevance of this phenomenon. Electrical pain thresholds and nociceptive withdrawal reflex explore aspects of pain processing that are mostly independent of sociodemographic, psychological, and clinical pain-related characteristics. PMID:26172555

  9. 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 patient’s 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

  10. Pain prevalence and trajectories following pediatric spinal fusion surgery

    PubMed Central

    Sieberg, Christine B.; Simons, Laura E.; Edelstein, Mark R.; DeAngelis, Maria R.; Pielech, Melissa; Sethna, Navil; Hresko, M. Timothy

    2013-01-01

    Factors contributing to pain following surgery are poorly understood with previous research largely focused on adults. With approximately 6 million children undergoing surgery each year8, there is a need to study pediatric persistent postsurgical pain. The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospective, multi-centered registry examining post-surgical outcomes. The Scoliosis Research Society Questionnaire- Version 30, which includes pain, activity, mental health, and self-image subscales, was administered to 190 patients prior to surgery and at 1 and 2 years post-surgery. A subset (n=77) completed 5-year post-surgery data. Pain prevalence at each time point and longitudinal trajectories of pain outcomes derived from SAS PROC TRAJ were examined using ANOVAs and post-hoc pairwise analyses across groups. Thirty-five percent of patients reported pain in the moderate-severe range prior to surgery. One year postoperative, 11% reported pain in this range while 15% reported pain at two years post-surgery. At five years post-surgery, 15% of patients reported pain in the moderate to severe range. Among the five empirically-derived pain trajectories, there were significant differences on self-image, mental health, and age. Identifying predictors of poor long-term outcomes in children with postsurgical pain may prevent the development of chronic pain into adulthood. PMID:24290449

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

    PubMed Central

    Sobas, Eva M; Videla, Sebastián; 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 (19–64) years. Sixty-nine patients had surgery done on both eyes. Postoperative pain was the most frequent comorbidity (97% [95% confidence interval {CI}: 90–100]) with a median (range) of intensity (verbal numerical rating scale) score of 7 (2–10). Photophobia: 85% (95% CI: 75–92); burning sensation: 62% (95% CI: 50–73); tearing: 59% (95% CI: 47–70); and foreign body sensation: 48% (95% CI: 36–60) were also prevalent postoperative symptoms. Pain during ASA was reported for 44% (95% CI: 32–56) 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

  12. Prevalence of Chronic Axial Pain, Inflammatory Back Pain, and Spondyloarthritis in Diagnosed Psoriasis

    PubMed Central

    Thom, Nicole; Ritchlin, Christopher T.; Zhang, Xiao; Reveille, John; Weisman, Michael H.

    2015-01-01

    Objective To provide prevalence estimates for inflammatory back pain (IBP) and spondyloarthritis (SpA) in those subjects with psoriasis using 2009–2010 National Health and Nutrition Examination Survey (NHANES) data. Methods In the NHANES 2009–2010 sample set, 6,684 persons ages 20–69 years were screened for participation, and 5,103 answered questions regarding onset of back pain, location of pain, and functional limitations. Data set assembly and statistical analysis were performed using SASTM and SUDAAN software. SEs were estimated by Taylor series linearization. The equality of the prevalence estimates for selected variables was tested (univariately) at an alpha level of 0.05 using 2-sided Student’s t-test with appropriate degrees of freedom. Results A total of 148 persons had self-reported medically diagnosed psoriasis. The psoriasis group versus the nonpsoriasis group had a significantly higher prevalence of axial pain using the 3-month duration criterion (31.1% versus 18.9%; P = 0.04) and alternating buttock pain (7.2% versus 2.4%; P = 0.03) and more frequently met IBP criteria from Berlin criteria 7b and 8a (P = 0.04 and 0.02, respectively). The prevalence of SpA was significantly higher in the psoriasis group versus the nonpsoriasis group when using Amor or European Spondyloarthritis Study Group criteria (14.3% versus 1.5%; P < 0.001). Sudden onset of axial pain was significantly higher in the psoriasis group (23.3% versus 13.0%; P = 0.01). Conclusion There is a higher prevalence of lower axial pain, IBP, SpA, and alternating buttock pain associated with a prior diagnosis of psoriasis. These data may influence the way psoriasis patients are approached in primary care and specialty clinics. PMID:25469666

  13. 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

  14. 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

  15. 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

  16. 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.

  17. Pain prevalence and its determinants after spinal cord injury: a systematic review.

    PubMed

    van Gorp, S; Kessels, A G; Joosten, E A; van Kleef, M; Patijn, J

    2015-01-01

    Pain prevalence studies are important as they illustrate the magnitude of pain problems in a certain patient population, such as patients living with a spinal cord injury (SCI). Strikingly, reported pain prevalence rates in SCI patients are found to vary greatly, while determinants for the differences between pain prevalence reports remain unclear. We here aim to identify determinants for the differences (heterogeneity) in pain prevalence reports through a systematic review of all SCI pain prevalence reporting studies. Literature search was done using Medline, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Knowledge and Embase. Data abstraction was performed while blinded and was followed by meta-(regression)-analyses. We identified 82 studies. Study design-related determinants of SCI pain prevalence reports were pain definition strictness (mild, moderate or high), primary study goal (pain study or not), data source (retrospective or not), and in a limited number of cases response/attrition rates. While correcting for these items, population characteristics correlating with pain prevalence rates were both proportion of patients with a depression and average time after injury (positive correlations). Between-study heterogeneity may remain even after the identification/correction of above-mentioned causes of heterogeneity.Pain after SCI does seem to relate to the duration of the injury and depression, yet major causes of bias in reported pain prevalence are found to be related to the primary study goal (pain study or not), choice of pain definition and the use of retrospective data. PMID:24824334

  18. The Prevalence and Characteristics of Pain in Critically Ill Cancer Patients: A Prospective Nonrandomized Observational Study

    PubMed Central

    Gupta, Mayank; Sahi, Malvinder Singh; Bhargava, AK; Talwar, Vineet

    2015-01-01

    Context: Pain is a distressing symptom common to all stages and ubiquitous at all levels of care in cancer patients. However, there is a lack of scientific literature on prevalence, severity, predictors, and the quality of pain in cancer patients admitted to an Intensive Care Unit (ICU). Objectives: To elucidate the prevalence of pain, moderate to severe pain, neuropathic pain, chronic pain, and pain as the most distressing symptom in critically ill-cancer patients at the time of ICU admission. Methods: We prospectively interviewed 126 patients within first 24 h of admission to a medical ICU. The patients were assessed for the presence of pain, its severity, sites, duration, nature, and its impact as a distressing symptom. Numerical Rating Scale and self-report version of Leeds Assessment of Neuropathic Signs and Symptoms were used to elucidate intensity of pain and neuropathic pain, respectively. Demographic characteristics such as age and sex, primary site, and stage of cancer were considered for a possible correlation with the prevalence of pain. Results: Of 126 patients included in the study 95 (75.40%), 79 (62.70%), 34 (26.98%), and 17 (13.49%) patients had pain, moderate-severe, chronic, and neuropathic pain, respectively. The average duration of pain was 171.16 ± 716.50 days. Totally, 58 (46.03%) and 42 (42.01%) patients had at least one and more than equal to 2 neuropathic pain symptoms, respectively. The primary malignancies associated with the highest prevalence of pain were genitourinary, hematological, and head and neck whereas breast and lung cancers were associated with the highest prevalence of neuropathic and chronic pain, respectively. Conclusion: The prevalence of pain among critically ill-cancer patients is high. Assessment for pain at the time of ICU admission would ensure appropriate assessment for the presence, type, severity, and the significance imparted to it. PMID:26600692

  19. 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

  20. 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

  1. 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…

  2. 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

  3. Prevalence of pain among residents in Japanese nursing homes: a descriptive study.

    PubMed

    Takai, Yukari; Yamamoto-Mitani, Noriko; Chiba, Yumi; Nishikawa, Yuri; Sugai, Yuichi; Hayashi, Kunihiko

    2013-06-01

    It is often observed that pain causes substantial problems for nursing home residents. However, there has been little research about the prevalence of pain for nursing home residents in Japan. This study aimed to examine the prevalence of pain in older adults living in nursing homes in Japan by using self-reporting and the Abbey Pain Scale-Japanese version (APS-J) and to explore factors related to pain. This is a descriptive study. Residents in two Special Nursing Homes for the Elderly in Tokyo, Japan, were asked to participate in this study, with the exclusion of short-term temporary residents. Data collected from participating residents included their demographics and the results from the Barthel Index, the Folstein Mini-Mental State Examination, the APS-J, and the Verbal Descriptor Scale for pain. The residents were divided into two groups: residents able to report their pain (self-report group) and residents not able to report their pain. The second group was assessed by using the APS-J (APS-J group). The Mann-Whitney U test, the ?2 test, and logistic analyses were performed to derive factors related to pain prevalence. Data were obtained from 171 residents. The prevalence of pain in the self-report group (n = 96) was 41.7%. For the 75 residents unable to report their pain, 52.0% were assessed by the APS-J to have pain. The overall pain prevalence of all residents was 46.2%. Age, Barthel Index score, and length of time of institutionalization were significantly associated with residents' pain in the APS-J group. Logistic regression analysis showed that contracture (odds ratio 3.8) and previous injury (odds ratio 3.4) were associated with residents' pain in the self-report group, whereas only the length of nursing home stay (odds ratio 1.03) was a predictor for pain in the APS-J group. Nearly one-half of residents had pain when they moved or were moved. Pain assessment and management is needed for residents. PMID:23688366

  4. [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

  5. Pain is prevalent and persisting in cancer survivors: Differential factors across age groups

    PubMed Central

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

    2015-01-01

    Objective The Institute of Medicine documents a significant gap in care for long term side effects of cancer treatment, including pain. This paper characterizes age differences in the prevalence and predictive characteristics of pain to guide clinicians in identification and treatment. Materials and Methods A sample of 170 adults with head and neck, esophageal, gastric, or colorectal cancers were recruited from two regional Veterans Administration Medical Centers. Face to face interviews were conducted 6, 12, and 18 months after diagnosis with the PROMIS scale to assess pain and PHQ-9 scale to assess depression. Descriptive statistics characterized incidence and prevalence of pain impact and intensity ratings. Multivariate linear hierarchical regression identified clinical characteristics associated with pain in older versus younger age groups. Results Clinically significant pain was endorsed in one third (32%) of the sample, with younger adults reporting higher levels of the impact of pain on daily activities and work, and also higher pain intensity ratings than older adults. In younger adults, pain ratings were most associated with lower social support and higher depression, as well as advanced cancer stage. In older adults, pain was multifactorial, associated with baseline comorbidities, adjuvant treatment, and both combat post-traumatic stress disorder (PTSD) and depression. Conclusions Pain is a significant persisting problem for one in three cancer survivors, requiring ongoing assessment, even months later. Important differences in pain’s determinants and impact are present by age group. Identification and treatment of pain, as well as associated conditions such as depression, may improve the quality of life in cancer survivors. PMID:24495701

  6. Head and Neck Cancer Pain: Systematic Review of Prevalence and Associated Factors

    PubMed Central

    Wirth, Tanja; Ranasinghe, Sriyani; Ah-See, Kim W.; Renny, Nick; Hurman, David

    2012-01-01

    ABSTRACT Objectives Pain is a major symptom in patients with cancer; however information on head and neck cancer related pain is limited. The aim of this review was to investigate the prevalence of pain and associated factors among patients with HNC. Material and Methods The systematic review used search of MEDLINE, EMBASE and CINAHL databases to December 2011. Cancers of the oral mucosa, oropharynx, hypopharynx and larynx were included in this review with pain as main outcome. The review was restricted to full research reports of observational studies published in English. A checklist was used to assess the quality of selected studies. Results There were 82 studies included in the review and most of them (84%) were conducted in the past ten years. Studies were relatively small, with a median of 80 patients (IQR 44, 154). The quality of reporting was variable. Most studies (77%) used self-administered quality of life questionnaires, where pain was a component of the overall scale. Only 33 studies reported pain prevalence in HNC patients (combined estimate from meta-analysis before (57%, 95% CI 43% - 70%) and after (42%, 95% CI 33% - 50%) treatment. Only 49 studies (60%) considered associated factors, mostly tumour- or treatment-related. Conclusions The study has shown high levels of pain prevalence and some factors associated with higher levels of pain. There is a need for higher quality studies in a priority area for the care of patients with head and neck cancer. PMID:24422003

  7. 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

  8. 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

  9. 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

  10. 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

  11. Prevalence and conditions associated with chronic pelvic pain in women from São Luís, Brazil

    PubMed Central

    Coelho, L.S.C.; Brito, L.M.O.; Chein, M.B.C.; Mascarenhas, T.S.; Costa, J.P.L.; Nogueira, A.A.; Poli-Neto, O.B.

    2014-01-01

    The objective of the present study was to estimate the prevalence of chronic pelvic pain in the community of São Luís, capital of the State of Maranhão, Northeastern Brazil, and to identify independent conditions associated with it. A cross-sectional study was conducted, including a sample of 1470 women older than 14 years predominantly served by the public health system. The interviews were held in the subject's home by trained interviewers not affiliated with the public health services of the municipality. The homes were visited at random according to the city map and the prevalence of the condition was estimated. To identify the associated conditions, the significant variables (P=0.10) were selected and entered in a multivariate analysis model. Data are reported as odds ratio and 95% confidence interval, with the level of significance set at 0.05. The prevalence of chronic pelvic pain was 19.0%. The independent conditions associated with this diagnosis were: dyspareunia (OR=3.94), premenopausal status (OR=2.95), depressive symptoms (OR=2.33), dysmenorrhea (OR=1.77), smoking (OR=1.72), irregular menstrual flow (OR=1.62), and irritative bladder symptoms (OR=1.90). The prevalence of chronic pelvic pain in Sao Luís is high and is associated with the conditions cited above. Guidelines based on prevention and/or early identification of risk factors may reduce the prevalence of chronic pelvic pain in São Luís, Brazil. PMID:25075577

  12. 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 1 year. 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

  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 1–3 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 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

  15. 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

  16. Pain, Work-related Characteristics, and Psychosocial Factors among Computer Workers at a University Center

    PubMed Central

    Mainenti, Míriam Raquel Meira; Felicio, Lilian Ramiro; Rodrigues, Érika de Carvalho; Ribeiro da Silva, Dalila Terrinha; Vigário dos Santos, Patrícia

    2014-01-01

    [Purpose] Complaint of pain is common in computer workers, encouraging the investigation of pain-related workplace factors. This study investigated the relationship among work-related characteristics, psychosocial factors, and pain among computer workers from a university center. [Subjects and Methods] Fifteen subjects (median age, 32.0?years; interquartile range, 26.8–34.5?years) were subjected to measurement of bioelectrical impedance; photogrammetry; workplace measurements; and pain complaint, quality of life, and motivation questionnaires. [Results] The low back was the most prevalent region of complaint (76.9%). The number of body regions for which subjects complained of pain was greater in the no rest breaks group, which also presented higher prevalences of neck (62.5%) and low back (100%) pain. There were also observed associations between neck complaint and quality of life; neck complaint and head protrusion; wrist complaint and shoulder angle; and use of a chair back and thoracic pain. [Conclusion] Complaint of pain was associated with no short rest breaks, no use of a chair back, poor quality of life, high head protrusion, and shoulder angle while using the mouse of a computer. PMID:24764635

  17. 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 40–49 years, 30% in those aged 50–59 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

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

    PubMed Central

    Choinière, Manon; Watt-Watson, Judy; Victor, J. Charles; Baskett, Roger J.F.; Bussières, Jean S.; Carrier, Michel; Cogan, Jennifer; Costello, Judy; Feindel, Christopher; Guertin, Marie-Claude; Racine, Mélanie; 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

  19. 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

  20. A preliminary report on prevalence of acetabular labrum tears in sports patients with groin pain.

    PubMed

    Narvani, A A; Tsiridis, E; Kendall, S; Chaudhuri, R; Thomas, P

    2003-11-01

    To the best of our knowledge, this prospective study is the first to investigate the prevalence of acetabular labrum tears in athletes presenting with groin pain. Eighteen athletes who presented to our sports clinic with groin pain, underwent clinical assessment and magnetic resonance arthrography (MRa) to detect presence or absence of acetabular labrum tears. Ethical committee approval and informed consent was obtained from each patient. In four out of these eighteen athletes (22%) the MRa demonstrated the presence of acetabular labrum tear. Three of them underwent arthroscopic debridement of their acetabular labrum tears and returned to their sporting activities within 8 months. Clicking sensation of the hip was a sensitive (100%) and specific (85%) clinical symptom to predict labral tears. The internal rotation-flexion-axial compression manoeuvre was sensitive (75%) but not specific (43%). The Thomas test was neither sensitive nor specific. The conclusion of the study is that acetabular labrum tears can be a common cause of groin pain in athletes. Sports clinicians managing athletes with groin pain have to be well aware of the condition. PMID:12897984

  1. Work-related musculoskeletal pain among dentists in Madhya Pradesh, India: prevalence, associated risk factors, and preventive measures.

    PubMed

    Saxena, Payal; Gupta, Saurabh Kumar; Jain, Sandhya; Jain, Deshraj

    2014-05-01

    Dentists are at risk for developing musculoskeletal problems. This provided the impetus for a study of prevalence, distribution, and the associated risk factors of these problems in the dentist population of Madhya Pradesh, India. The data were analyzed from 213 dentists of Madhya Pradesh, India, who fulfilled the inclusion criteria and gave their consent for this cross-sectional study. Subjects were assessed by a special questionnaire using demographic details with working conditions. Chi-square test was used for the statistical analysis of the data. Of total 213 participants, 83.10% had at least one musculoskeletal pain in the past 12 months. Low back pain was most frequent (57.75%) followed by neck pain (31.17%) and wrist pain (17.84%). The pain was significantly prevalent among the group who worked in direct vision, without assistant, in standing position or following none of the fitness regimen. PMID:24097923

  2. Musculoskeletal complaints among Italian X-ray technology students: a cross-sectional questionnaire survey

    PubMed Central

    2010-01-01

    Background There is a high prevalence of musculoskeletal disorders among healthcare professional students. Although recent studies show musculoskeletal disorders are a common problem among X-ray technologists, there are no data on these disorders among students of this healthcare profession. We have therefore estimated the prevalence of musculoskeletal complaints among a group of X-ray technology students. Methods The students (n = 109) currently attending the 3-year X-ray technologist school at a large University in the Apulia region of Southern Italy were recruited for the study, with a 100% participation rate. A questionnaire collected data concerning personal characteristics, physical exposure during training activities, and the presence of musculoskeletal symptoms in the neck, shoulders, low back, hand/wrist and legs. Results The prevalence of complaints in any body site over the previous 12 months was 37%. Low back pain was the most frequently reported symptom (27%), followed by neck (16%), shoulder (11%), leg (8%) and hand/wrist (5%) pain. Poor physical activity was associated with the complaints. Conclusions Our study showed prevalence rates of musculoskeletal complaints among X-ray technology students to be somewhat high, representing about half of those found in Italian technologists. The most common musculoskeletal problem was low back pain, which had also been found in research conducted among nursing students. Our research also showed a significant association between poor physical activity and the presence of musculoskeletal disorders in young university students. PMID:20416101

  3. Radiating low back pain in general practice: Incidence, prevalence, diagnosis, and long-term clinical course of illness

    PubMed Central

    Groenhof, Feikje; Winters, Jan C.; van Wijhe, Marten; Groenier, Klaas H.; van der Meer, Klaas

    2015-01-01

    Abstract Objective. The aim of this study was to calculate the incidence and prevalence of radiating low back pain, to explore the long-term clinical course of radiating low back pain including the influence of radiculopathy (in a subsample of the study population) and non-radiating low back pain thereon, and to describe general practitioners’ (GPs’) treatment strategies for radiating low back pain. Design. A historic prospective cohort study. Setting. Dutch general practice. Subjects. Patients over 18 years of age with a first episode of radiating low back pain, registered by the ICPC code L86. Main outcome measures. Incidence and prevalence, clinical course of illness, initial diagnoses established by the GPs, and treatment strategies. Results. Mean incidence was 9.4 and mean prevalence was 17.2 per 1000 person years. In total, 390 patients had 1193 contacts with their GPs; 50% had only one contact with their GP. Consultation rates were higher in patients with a history of non-radiating low back pain and in patients with a diagnosis of radiculopathy in the first five years. In this study's subsample of 103 patients, L86 episodes represented radiculopathy in 50% of cases. Medication was prescribed to 64% of patients, mostly NSAIDs. Some 53% of patients were referred, mainly to physiotherapists and neurologists; 9% of patients underwent surgery. Conclusion. Watchful waiting seems to be sufficient general practice care in most cases of radiating low back pain. Further research should be focused on clarifying the relationship between radicular radiating low back pain, non-radicular radiating low back pain, and non-radiating low back pain. PMID:25693788

  4. 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

  5. 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

  6. 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

  7. 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

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

    PubMed Central

    Graup, Susane; de Araújo Bergmann, Mauren Lúcia; 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 10–17 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

  9. 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

  10. Musculoskeletal pain in Arctic indigenous and non-indigenous adolescents, prevalence and associations with psychosocial factors: a population-based study

    PubMed Central

    2014-01-01

    Background Pain is common in otherwise healthy adolescents. In recent years widespread musculoskeletal pain, in contrast to single site pain, and associating factors has been emphasized. Musculoskeletal pain has not been examined in Arctic indigenous adolescents. The aim of this study was to explore the prevalence of widespread musculoskeletal pain and its association with psychosocial factors, with emphasis on gender- and ethnic differences (Sami vs. non-Sami), and the influence of pain related functional impairment. Methods This is a cross-sectional study based on The Norwegian Arctic Adolescent Health Study; a school-based survey responded by 4,881 10th grade students (RR: 83%) in North Norway, in 2003–2005. 10% were indigenous Sami. Musculoskeletal pain was based on reported pain in the head, shoulder/neck, back and/or arm/knee/leg, measured by the number of pain sites. Linear multiple regression was used for the multivariable analyses. Results The prevalence of musculoskeletal pain was high, and significantly higher in females. In total, 22.4% reported 3–4 pain sites. We found a strong association between musculoskeletal pain sites and psychosocial problems, with a higher explained variance in those reporting pain related functional impairment and in females. There were no major differences in the prevalence of musculoskeletal pain in Sami and non-Sami, however the associating factors differed somewhat between the indigenous and non-indigenous group. The final multivariable model, for the total sample, explained 21.2% of the variance of musculoskeletal pain. Anxiety/depression symptoms was the dominant factor associated with musculoskeletal pain followed by negative life events and school-related stress. Conclusions Anxiety/depression, negative life events, and school-related stress were the most important factors associated with musculoskeletal pain, especially in those reporting pain related functional impairment. The most important sociocultural aspect is the finding that the indigenous Sami are not worse off. PMID:24939210

  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 (2007–2009) 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 0.70–0.90), 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 0.70–0.94, and 0.81; 95% CI 0.68–0.96, 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 0.63–0.85). 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. 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

  13. 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; Kyröläinen, 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

  14. 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 Cantril’s 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 77.8–85.3], 38.6% males) reported 13,524 hindering complaints (median 1, range 0–18); 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, Cantril’s 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

  15. Pain.

    PubMed

    Melzack, Ronald; Katz, Joel

    2013-01-01

    Pain has many valuable functions. It often signals injury or disease, generates a wide range of adaptive behaviors, and promotes healing through rest. Despite these beneficial aspects of pain, there are negative features that challenge our understanding of the puzzle of pain, including persistent phantom limb pain after amputation or total spinal cord transection. Pain is a personal, subjective experience influenced by cultural learning, the meaning of the situation, attention, and other psychological variables. Pain processes do not begin with the stimulation of receptors. Rather, injury or disease produces neural signals that enter an active nervous system that (in the adult organism) is the substrate of past experience, culture, and a host of other environmental and personal factors. These brain processes actively participate in the selection, abstraction, and synthesis of information from the total sensory input. Pain is not simply the end product of a linear sensory transmission system; it is a dynamic process that involves continuous interactions among complex ascending and descending systems. The neuromatrix theory guides us away from the Cartesian concept of pain as a sensation produced by injury, inflammation, or other tissue pathology and toward the concept of pain as a multidimensional experience produced by multiple influences. These influences range from the existing synaptic architecture of the neuromatrix-which is determined by genetic and sensory factors-to influences from within the body and from other areas in the brain. Genetic influences on synaptic architecture may determine-or predispose toward-the development of chronic pain syndromes. WIREs Cogn Sci 2013, 4:1-15. doi: 10.1002/wcs.1201 For further resources related to this article, please visit the WIREs website. PMID:26304172

  16. 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

  17. 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

  18. 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 4–17 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

  19. Prevalence and Associated Risk Factors of Low-Back Pain in Textile Fishing Net Manufacturing

    E-print Network

    Kaber, David B.

    , & Jorgensen, 2003; Solomonow et al., 2003; Spengler et al., 1986). Load- ing of the spinal column to spinal structure dam- age and LBP (Deyo & Weinstein, 2001). Back pain can also occur due to multiple

  20. Pain

    MedlinePLUS

    ... to play a role in causing the pain Chronic fatigue syndrome Symptoms • long-lasting fatigue that doesn’t get ... painfoundation. org Phone number: (888) 615-7246 The Chronic Fatigue and Immune Dysfunction Syndrome Association of America PO Box 220398 Charlotte, NC ...

  1. 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

  2. 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

  3. 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

  4. 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

  5. Prevalence of illicit drug use in patients without controlled substance abuse in interventional pain management.

    PubMed

    Manchikanti, Laxmaiah; Pampati, Vidyasagar; Damron, Kim S; Beyer, Carla D; Barnhill, Renee C

    2003-04-01

    Drug abuse with illicit drugs and licit drugs has been increasing steadily over the past decade. A recent National Household Survey on Drug Abuse found statistically significant increases between 2000 and 2001 in the use of multiple drugs, including marijuana, cocaine, and non-medical use of pain relievers and tranquilizers. Prescription controlled substance abuse is a major issue in chronic pain management. Various means suggested to avoid or monitor abuse in patients in treatment include urine/serum drug screening whenever requested, along with other precautions including one prescribing physician and one designated pharmacy, etc. Based on the present evidence, physicians assume that patients adhering to controlled substance agreements and without obvious dependency behavior do not abuse either illicit or licit drugs. Thus, it is accepted that there is no necessity to perform routine urine/drug testing in this specific group of the patient population. One hundred patients undergoing interventional pain management and receiving controlled substances were randomly selected for evaluation of illicit drug abuse by urine drug testing. They were selected from a total of 250 patients who were identified as non-abusers of prescription drugs. Results showed that illicit drug abuse in patients without history of controlled substance abuse was seen in 16 patients. Thirteen of the 16 patients tested positive for marijuana and 3 patients tested positive for cocaine. Only one patient tested positive for a combined use of both marijuana and cocaine. This study showed that, in an interventional pain management setting, there is significant use of illicit drugs (16%) with 13% use of marijuana and 3% use of cocaine in patients who are considered as non-abusers of prescription controlled substances and those who are adherent to controlled substance agreements. However, if cocaine is considered as a hardcore drug in contrast to marijuana, abuse of hardcore illicit drugs is only 3%. PMID:16883377

  6. 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

  7. 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

  8. Prevalence and Predictive Factors of Chronic Postsurgical Pain and Global Surgical Recovery 1 Year After Outpatient Knee Arthroscopy: A Prospective Cohort Study.

    PubMed

    Hoofwijk, Daisy M N; Fiddelers, Audrey A A; Emans, Peter J; Joosten, Elbert A; Gramke, Hans-Fritz; Marcus, Marco A E; Buhre, Wolfgang F F A

    2015-11-01

    Outpatient knee arthroscopy is one of the most commonly performed surgical procedures. Previous research has demonstrated that chronic postsurgical pain (CPSP) after outpatient surgery is prevalent. Our objective was to determine the prevalence and predictive factors of CPSP and Global Surgical Recovery (GSR) 1 year after knee arthroscopy.A prospective longitudinal cohort study was performed. Patients were included during an 18-month period. Data were collected by using 3 questionnaires: at 1 week preoperatively, 4 days postoperatively, and 1 year postoperatively. A value of >3 on an 11-point numeric rating scale (NRS) was defined as moderate to severe pain. A score of ?80% on the Global Surgical Recovery Index was defined as poor GSR. Stepwise logistic regression analysis was performed to determine which variables were predictors for CPSP and poor GSR.The prevalence of moderate to severe preoperative pain in patients undergoing knee arthroscopy (n?=?104) was 71.2%, of acute postsurgical pain 37.5%, and of CPSP 32.7%. Risk factors for CPSP were the presence of preoperative pain and preoperative analgesic use, with odds ratios of 6.31 (1.25-31.74) and 4.36 (1.58-12.07), respectively. The prevalence of poor GSR 1 year after outpatient knee arthrosocpy was 50.0%. Poor GSR 4 days after the surgery was a risk factor with an odds ratio of 8.38 (0.92-76.58) and quality of life 4 days after surgery was a protective factor with and odds ratio of 0.10 (0.02-0.64).Both CPSP and poor GSR are common 1 year after knee arthroscopy. Patients at risk for CPSP can be identified during the preoperative phase. Prediction of poor GSR 1 year after surgery is mainly related to early postoperative recovery. PMID:26559300

  9. 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, Siobhán; 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 5–12-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 5–12-year-olds living in Ireland). PMID:25976764

  10. The effect of education on decreasing the prevalence and severity of neck and shoulder pain: a longitudinal study in Korean male adolescents

    PubMed Central

    Koh, Min Jung; Park, Eun Jung; Park, Sang Hoon; Jeon, Hea Rim; Kim, Mun-Gyu; Lee, Se-Jin; Kim, Sang Ho; Ok, Si Young; Kim, Soon Im

    2014-01-01

    Background Neck and shoulder pain is fairly common among adolescents in Korea and results in significant health problem. The aims of this prospective study was to identify the effects of education, in terms of recognition of this issue and posture correction, on prevalence and severity of neck and shoulder pain in Korean adolescents. Methods A prospective, observational cohort design was used. The 912 students from two academic high schools in the city of Seoul were eligible for the current study and 887 completed this study. After a baseline cross-sectional survey, students listened to a lecture about cervical health, focusing on good posture, habits, and stretching exercises to protect the spine, and were encouraged by their teachers to keep the appropriate position. And follow-ups were conducted 3 months later, to evaluate the effect of education. Results The prevalence of neck and shoulder pain was decreased 19.5% (from 82.5 to 66.4%). The baseline mean usual and worst numeric rating scale were 19.9/100 (95% CI, 18.1-21.7) and 31.2/100 (95% CI, 28.7-33.2), respectively. On the follow-up survey, the mean usual and worst numeric rating scale were decreased significantly by 24.1 and 21.7%, respectively, compared with baseline (P < 0.01). Of the 570 students reporting neck and shoulder pain, 16.4% responded that they had experienced improvement during the 3 months. Conclusions Education; recognition of this issue and posture correction, for cervical health appeared to be effective in decreasing the prevalence and severity of neck and shoulder pain at a 3 month follow-up. PMID:25301193

  11. 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

  12. 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?±?2.1 years. 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?

  13. 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

  14. Prevalence, Distribution, and Significance of Incidental Thoracic Ossification of the Ligamentum Flavum in Korean Patients with Back or Leg Pain : MR-Based Cross Sectional Study

    PubMed Central

    Moon, Bong Ju; Kuh, Sung Uk; Kim, Sungjun; Kim, Keun Su; Cho, Yong Eun

    2015-01-01

    Objective Thoracic ossification of the ligamentum flavum (OLF) is a relatively rare disease. Because of ambiguous clinical symptom, it is difficult for early diagnosis of OLF and subsequent treatment can be delayed or missed. Therefore, the purpose of this study is to comprehensively assess the prevalence and distribution of thoracic OLF by magnetic resonance imaging (MRI) and coexisting spinal disease in Korean patients with back pain or leg pain. Methods The sample included 2134 Korean patients who underwent MRI evaluation for back pain. The prevalence and distribution of thoracic OLF were assessed using lumbar MRI with whole spine sagittal images. Additionally, we examined the presence of coexisting lumbar and cervical diseases. The presence of thoracic OLF as well as clinical parameters such as age, sex, and surgery were retrospectively reviewed. Results The prevalence of thoracic OLF in total patients was 16.9% (360/2134). The prevalence tended to increase with aging and was higher in women than in men. The lower thoracic segment of T10-11 was the most frequently affected segment. Of the 360 patients with OLF, 31.9% had coexisting herniated thoracic discs at the same level. Approximately 74% of the patients with OLF had coexisting lumbar and cervical disease. Nine (2.5%) of 360 OLF patients underwent surgery for thoracic lesion. Conclusion The prevalenceof thoracic OLF was relatively higher than those of previous reports. And coexisting lumbar and cervical disease were very frequent. Therefore, we should check coexisting spinal diseases and the exact diagnostic localization of ossification besides lumbar disease. PMID:26361526

  15. Pain relief can be painful

    PubMed Central

    Bindra, Ashish; Bithal, Parmod; Sokhal, Navdeep; Arora, Ankit

    2015-01-01

    Mandibular nerve block is periodically used procedure used to treat neuralgic pain in the distribution of trigeminal nerve. It is a commonly performed block in outpatient settings at our institute. We present a case of an elderly edentulous patient with trigeminal neuralgia who suffered recurrent temporomandibular joint (TMJ) dislocation following mandibular nerve block. The patient presented with complaints of severe pain, inability to close mouth, and eat food since 2 days. Anterior closed reduction of TMJ resulted in reduction of joint and immediate pain relief. However, the maneuver failed due to recurrent dislocation of the joint. A Barton dressing was applied to prevent another dislocation. This was followed by autologous blood injection into the joint. This case focuses on the preponderance of clinical evaluation and accentuates the need for additional forethought to be taken during pain procedures, particularly in the geriatric population.

  16. 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

  17. Prevalence and influencing factors of chronic back pain among staff at special schools with multiple and severely handicapped children in Germany: results of a cross-sectional study

    PubMed Central

    2014-01-01

    Background In Germany, about 70,000 teachers and educational staff were teaching at more than 3,000 special schools during the school year 2010/2011. Nursing services like lifting pupils form a substantial part of the work content of the staff at special schools. Since nursing care often involves carrying and lifting pupils, there is a reason to assume an adverse effect on the musculoskeletal health of teachers and other professionals. With the present study we aimed to describe the prevalence and risk factors of chronic back pain among employees at this type of school. Methods The cross-sectional survey was carried out between August 2010 and August 2012 at 13 special schools focusing on motoric and/or holistic development of handicapped children in Rhineland-Palatinate (Germany). Teachers and educational staff were interviewed using a questionnaire. We applied multivariable logistic regression analyses to identify influencing factors of chronic back pain. Results Altogether 395 persons (response rate: 59.7%) participated in our study. Respondents were mostly female (86.8%) with a mean age of 45 years. The prevalence of chronic back pain was 38.7%. More than 40% reported frequently carrying and lifting heavy loads (>20 kg). Age [adjusted OR?=?1.03 (95%-CI 1.00-1.05) for 1-year increase in age], current smoking [adjusted OR?=?2.31 (95%-CI 1.27-4.23)], depression/depressive mood [adjusted OR?=?1.85 (95%-CI 1.12-3.06)], frequently carrying and lifting heavy loads [adjusted OR?=?2.69 (95%-CI 1.53-4.75)], and frequent exposure to environmental impacts [adjusted OR?=?2.18 (95%-CI 1.26-3.76)] were influencing factors of chronic back pain in the final multivariable regression model. Conclusions A large proportion of teachers and educational staff suffered from chronic back pain in our study, indicating a high need for treatment in this professional group. Increasing age, current smoking, a diagnosed depression/depressive mood, carrying and lifting heavy loads, and exposure to environmental impacts were associated with chronic back pain. Due to the sparse literature on the topic, further studies using a longitudinal design are necessary for a better understanding of the risk factors of chronic back pain. PMID:24568286

  18. 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

  19. Vulvovaginal candida in a young sexually active population: prevalence and association with oro-genital sex and frequent pain at intercourse

    PubMed Central

    Rylander, E; Berglund, A; Krassny, C; Petrini, B

    2004-01-01

    Objective: To study the prevalence of vulvovaginal candida among sexually active adolescents. To determine past and present symptoms, including pain at intercourse and potential behavioural risk factors associated with vulvovaginal candidiasis. Methods: At an adolescent centre, 219 sexually active women who underwent genital examination, also completed a questionnaire on a history of genital symptoms and infections, sexual and hygiene habits, and the use of contraceptives. Symptoms and clinical signs were registered. Vaginal samples were analysed for candida species and urine for Chlamydia trachomatis. Results: Candida culture was positive in 42% of the women and only 15% were asymptomatic. A history of recurrent candidiasis was given by 22%. Frequent pain at intercourse was reported by 24% and frequent oro-genital sex by 42% of the women. Frequent pain at intercourse was significantly associated with both the growth of candida and a history of recurrent candidiasis. Oro-genital sex was an independent risk factor for the growth of candida. Conclusion: In sexually active adolescents, who underwent genital examination, candida cultures were positive in 42%. The habit of frequent oro-genital sex was associated with the growth of candida. Pain at intercourse was associated with the growth of candida and recurrent candidiasis. PMID:14755037

  20. 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

  1. Assessing the Prevalence of Recurrent Neck and Shoulder Pain in Korean High School Male Students: A Cross-sectional Observational Study

    PubMed Central

    Koh, Min Jung; Woo, Young Sun; Kang, Sung Hyun; Park, Sang Hoon; Chun, Hye Jung; Park, Eun Jung

    2012-01-01

    Background Neck and shoulder pain (NSP) is fairly common in adolescents, which is associated with a high prevalence of NSP found during adulthood as well; therefore, its significance during adolescence should not be underestimated. We surveyed the prevalence of recurrent NSP, lifestyle, and risk factors in Korean high school students, and examined the influence of recurrent NSP on the quality of life. Methods Nine hundred thirty one male students (16-19 years old) from two academic high schools in Seoul were included in this study. The survey consisted of a questionnaire to assess the prevalence of recurrent NSP, with questions regarding having an occurrence more than once a week, characteristics of NSP, activity and lifestyle of the students, and the risk factors for recurrent NSP. A 36-item Short Form questionnaire was also examined. Results We found that 44.3% of the high school students surveyed had recurrent NSP (more than once a week) and the overall prevalence of NSP was 79.1%. The average sitting time was 10.2 ± 2.7 h/day. 59.0% did not sit straight, 14.7% used assisting devices during reading, and 11.9% answered that they stretched regularly. Found from their self assessed health, frequent fatigue and frequent depressed mood presented significant associations with the higher prevalence of recurrent NSP. Conclusions Korean high school students had a high prevalence of recurrent NSP. Clinical attention is needed for the prevention and resolution of recurrent NSP found in high school students. PMID:22787546

  2. 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

  3. 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…

  4. 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

  5. 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

  6. Anal complaints in Nigerians attending Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu.

    PubMed

    Tade, A O; Salami, B A; Musa, A A; Adeniji, A O

    2004-09-01

    The objective of this study was to determine prospectively the prevalence of anal complaints amongst Nigerians attending the General Out-patient Department (GOPD) of the hospital and review the records of those admitted to the surgical service with related complications. All the 272 patients attending the GOPD of OOUTH in November, 1999 were interviewed using a structured questionnaire. Information concerning age, sex, educational status, present or past history of at least one of the following symptoms viz recurrent bleeding per rectum, anal prolapse, anal/perianal pain, pruritus ani and anal discharge were obtained. Also obtained were reason(s) for current hospital attendance and any previous medical consultation. Those with at least one of the symptoms were classified as symptomatic. The symptomatic group had rectal examination including proctoscopy. The results showed that 82/272 (30.15% ) were symptomatic. Rectal examination on these 82 patients showed that 10(3.7% of 272) had haemorrhoids, 2(0.7% ) had rectal prolapse, 0.7% had peri-anal warts; 15(5.5% ) anal tags, 10(3.7% ) chronic anal fissure, 2 (0.7% ) perianal fistulae. In 29(10.4% ), the examination was normal and in 12 the rectum was too loaded with feaces to permit proctoscopy. However, only 5/272 (1.84% ) attended the clinic for the anal complaint, while 12(4.4% ) had previously consulted a physician for same. Fear of impotence following surgery in 24 males and belief in herbal remedies in 32 patients were the main reasons for not consulting a physician. During the year 1999, out of a total of 558 admissions into our surgical service, only 4(0.6% ) were for complications related to anal complaints. This study indicated the prevalence of anal complaints in the study population of Nigerians as 30.15% , haemorrhoids constitute 3.7% and anal fissure 3.7% , contrary to low rates reported for developing countries. While this result cannot be extended to represent prevalence amongst Nigerians, it may be a pointer to what is to be expected. PMID:15505655

  7. 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

  8. Physical inactivity is associated with chronic musculoskeletal complaints 11 years later: results from the Nord-Trøndelag 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-Trøndelag, 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 1984–86, and to questions about musculoskeletal complaints 11 years later (1995–97). 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 0.85–0.97) 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 0.59–0.88) 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

  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. Complaining about chronic pain.

    PubMed

    Kugelmann, R

    1999-12-01

    This paper examines how a group of working class people describes and experiences chronic pain. This hermeneutical-phenomenological study concentrates on the lived body of pain from three perspectives, drawing on interviews with 14 people who were attending a pain management program. First I consider the terms in which pain is circumscribed in the narratives, stories told in the context of learning to manage pain. These terms are polarities, ways of specifying and legitimating pain in relation to "mind" and "body." Pain, in the discursive polarities that define it, is the private property of an individual, who must in some fashion prove that pain exists in an objective manner. The speaker, in this discourse, stands as the one responsible for the production of pain. In the second part, the analysis turns to what this discourse reveals about pain as a lived body phenomenon. Here the analysis centers upon the torment of having to inhabit the intolerable, upon how pain unmakes the lifeworld of the sufferer, and how, simultaneously, people make pain. The place of pain is the body, as body-in-place. The place of pain is at the boundaries of human dwelling, a kind of non-place, expressed metaphorically as "prison" or "homelessness." Finally, after these considerations of how pain is described, in part three, I turn to the act of "saying" pain, that is, to the narratives as addressed to someone else. The participants were not simply dispensing information; they were saying something to me. The narratives had the form of complaints. The form of the narratives, in the context of the pain program, was a quasi-legal call to rectify wrongs. PMID:10574237

  11. The significance of low back pain in older adults.

    PubMed Central

    Fernbach, J. C.; Langer, F.; Gross, A. E.

    1976-01-01

    A retrospective study of the practice of an orthopedic surgeon at a university teaching hospital was done to evaluate the significance of low back pain in older adults. All 259 patients in a 3-year period 50 years of age and over whose presenting complaint was low back pain or sciatica or both were identified and classified by final diagnosis. A comparison was similarly identified and classified. Systemic disease, particularly cancer, was much more prevalent in the older group. It was demonstrated that a simple screening routine consisting of measuring the erythrocyte sedimentation rate and serum concentrations of alkaline phosphatase and calcium would identify all cases of unsuspected malignant disease--that is, at least one of the values would be abnormal in every case. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 PMID:136293

  12. Pathways Underlying Somatic Complaints in Children and Adolescents Who Are Deaf or Hard of Hearing

    ERIC Educational Resources Information Center

    Kouwenberg, Maartje; Rieffe, Carolien; Theunissen, Stephanie C. P. M.; Oosterveld, Paul

    2012-01-01

    Frequent somatic complaints are not only a problem in themselves but also related to other difficulties. So far, no conclusive findings have been reported about the prevalence of and factors underlying these complaints in children and adolescents who are deaf or hard of hearing (DHH). Such information would be valuable for prevention and…

  13. Clinical evaluation of tinnitus in patients with sleep bruxism: prevalence and characteristics.

    PubMed

    Camparis, C M; Formigoni, G; Teixeira, M J; de Siqueira, J T T

    2005-11-01

    Evaluation of the prevalence and characteristics of tinnitus in a Brazilian series of sleep bruxism patients. In this descriptive study, 100 patients (80 women and 20 men) were selected through the self-report of grinding teeth during sleep, confirmed by room mate or family member. They were evaluated according to a systematized approach: a questionnaire for orofacial pain and the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders. The patients were divided into two groups: group A, 54 patients with complaint of tinnitus and group B, 46 patients without tinnitus complaint. The mean age was 37.85 (13-66 years) and 34.02 years (20-59 years), respectively, for groups A and B (P = 0.1164). There was statistically significant difference between the two groups, with higher prevalence for the group A, in relation to: presence of chronic facial pain (P = 0.0007); number of areas painful to palpation in the masticatory and cervical muscles (P = 0.0032); myofascial pain in the masticatory muscles (P = 0.0003); absence of teeth without prosthetic replacement (P = 0.0145) and indices of depression (P = 0.0234). Structural alterations of the TMJ, like disc displacement and vertical dimension loss did not differ for the two groups. Tinnitus frequency was higher in patients with sleep bruxism and chronic facial pain. Myofascial pain, number of areas painful to palpation in the masticatory and cervical muscles, higher levels of depression and tooth absence without prosthetic replacement were more frequent in the group with tinnitus. PMID:16202044

  14. Prevalence of narcotic bowel syndrome in opioid abusers in iran.

    PubMed

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

    2014-10-01

    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

  15. 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

  16. [Groin pain in athletes].

    PubMed

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

  17. Chronic Facial Pain: A Clinical Approach

    PubMed Central

    Marotta, Joseph T.

    1983-01-01

    Facial pain is a common presenting complaint requiring patience and diagnostic acumen. The proliferation of eponyms attached to various syndromes complicates the subject. The most frequent cause of pain is likely to be muscle spasm in masticatory or temporalis muscles. This article presents a rank order for the common causes of facial pain that present diagnostic difficulty, such as temporomandibular joint pain, trigeminal neuralgia, giant cell arteritis, and post-herpetic neuralgia. PMID:21286580

  18. 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.

  19. Special Education Complaint Investigation Procedures.

    ERIC Educational Resources Information Center

    Maine State Dept. of Education, Augusta. Div. of Special Services.

    This document presents guidelines for Maine special education complaint investigation procedures. The introduction stresses the requirement that complaints must be in writing and must state that an educational agency or service provider has violated a requirement of the 1997 Individuals with Disabilities Education Act or Maine special education…

  20. 47 CFR 8.12 - Formal complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...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...

  1. 47 CFR 8.12 - Formal complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...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...

  2. 47 CFR 8.12 - Formal Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...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...

  3. 47 CFR 8.12 - Formal complaints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...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...

  4. 47 CFR 1.1404 - Complaint.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...1404 Section 1.1404 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Pole Attachment Complaint Procedures § 1.1404 Complaint. (a) The complaint shall contain...

  5. 32 CFR 776.78 - Informal complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...SUPERVISION OF THE JUDGE ADVOCATE GENERAL Complaint Processing Procedures § 776.78 Informal complaints. Informal, anonymous, or “hot line” type complaints alleging professional misconduct must be referred to appropriate authority (such as...

  6. 32 CFR 776.78 - Informal complaints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...SUPERVISION OF THE JUDGE ADVOCATE GENERAL Complaint Processing Procedures § 776.78 Informal complaints. Informal, anonymous, or “hot line” type complaints alleging professional misconduct must be referred to appropriate authority (such as...

  7. 32 CFR 776.78 - Informal complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...SUPERVISION OF THE JUDGE ADVOCATE GENERAL Complaint Processing Procedures § 776.78 Informal complaints. Informal, anonymous, or “hot line” type complaints alleging professional misconduct must be referred to appropriate authority (such as...

  8. 32 CFR 776.78 - Informal complaints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...SUPERVISION OF THE JUDGE ADVOCATE GENERAL Complaint Processing Procedures § 776.78 Informal complaints. Informal, anonymous, or “hot line” type complaints alleging professional misconduct must be referred to appropriate authority (such as...

  9. 32 CFR 776.78 - Informal complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...SUPERVISION OF THE JUDGE ADVOCATE GENERAL Complaint Processing Procedures § 776.78 Informal complaints. Informal, anonymous, or “hot line” type complaints alleging professional misconduct must be referred to appropriate authority (such as...

  10. 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

  11. Mental Health Levels and Incidence of Musculoskeletal Complaints among Speed Boat Crew Members

    PubMed Central

    Zigheimat, Farzaneh; Ebadi, Abbas; Rahmati Najarkolaei, Fatemeh; Malakoti, Mohammad; Kheiri Tootkaleh, Farhad

    2013-01-01

    Background The occupational health is an important issue. In some jobs, the working conditions contribute to musculoskeletal complaints and the overall health of the individual is compromised. Musculoskeletal complaints have gained credence in the public as one of the most important problems in the field of occupational diseases. Physical and mental health of crew members with critical jobs and stressful environments must be considered as well. Objectives This study performed an assessment on levels of mental health and the correlation with the frequency of accompanying musculoskeletal complaints (such as neck, back and knee pain) of crew members of speed boats. Material and Methods 149 onboard crew members of speed boats were recruited in a descriptive-correlation study by nonrandom sampling using conducted GHQ12, NMQ and demographic questionnaires. Results Although 63.8% (95 people) had what is conventionally defined as normal mental health, 36.2% (54 cases) had an inherent mental health condition. Overall, 61.1% (91 cases) suffered from back pain, 60.4% (90 cases) complained of knee pain, and 40.3% (60 patients) complained of neck pain. The combination of knee and back pain (48.3%) were the most common complaints whereas the combination of neck and knee pain (31.5%) were the least frequent; 28.2% complained of pain in all three areas. Interestingly, there was correlation between the presence of musculoskeletal complaints and less than optimum mental health. Conclusions Due to the high number of musculoskeletal complaints and the compromised mental health conditions among one-third of the onboard crew members of speed boats, attention for maintaining and improving the health of these members must be considered. PMID:24350130

  12. 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.

  13. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Complaint file. 1271.320 Section 1271.320 Food and... CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.320 Complaint file. (a) Procedures... the investigation of complaints as appropriate. (b) Complaint file. You must maintain a record...

  14. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Complaint file. 1271.320 Section 1271.320 Food and... CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.320 Complaint file. (a) Procedures... the investigation of complaints as appropriate. (b) Complaint file. You must maintain a record...

  15. 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... CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.320 Complaint file. (a) Procedures... the investigation of complaints as appropriate. (b) Complaint file. You must maintain a record...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. Code of Practice on Student Concerns & Complaints

    E-print Network

    Birmingham, University of

    Code of Practice on Student Concerns & Complaints 2015-16 1 UNIVERSITY OF BIRMINGHAM CODE OF PRACTICE ON STUDENT CONCERNS AND COMPLAINTS #12;Code of Practice on Student Concerns & Complaints 2015-16 2 #12;Code of Practice on Student Concerns & Complaints 2015-16 3 Index of points 1. Introduction 2

  2. 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 ...

  3. 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 (>6 months' 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

  4. Pain: CE Breakout Session May 2, 2015

    E-print Network

    Nicholson, Bruce J.

    5/20/2015 1 Pain: CE Breakout Session May 2, 2015 Ken Hargreaves, DDS, PhD UT Health Science Center San Antonio The Challenge of Pain · Prevalence in U.S. ­ Chronic Pain ~100 million ­ Diabetes: 26 of Medicine 2010 #12;5/20/2015 2 Pain 156:569, 2015 · Analysis of 38 studies on >1,000,000 · 2119% rate

  5. Posterior Hip Pain in an Athletic Population

    PubMed Central

    Frank, Rachel M.; Slabaugh, Mark A.; Grumet, Robert C.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.

    2010-01-01

    Context: Posterior hip pain is a relatively uncommon but increasingly recognized complaint in the orthopaedic community. Patient complaints and presentations are often vague or nonspecific, making diagnosis and subsequent treatment decisions difficult. The purposes of this article are to review the anatomy and pathophysiology related to posterior hip pain in the athletic patient population. Evidence Acquisition: Data were collected through a thorough review of the literature via a MEDLINE search of all relevant articles between 1980 and 2010. Results: Many patients who complain of posterior hip pain actually have pain referred from another part of the body—notably, the lumbar spine or sacroiliac joint. Treatment options for posterior hip pain are typically nonoperative; however, surgery is warranted in some cases. Conclusions: Recent advancements in the understanding of hip anatomy, pathophysiology, and treatment options have enabled physicians to better diagnosis athletic hip injuries and select patients for appropriate treatment. PMID:23015944

  6. 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

  7. 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 ...

  8. 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 does not always reflect the seriousness ...

  9. 21 CFR 17.5 - Complaint.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...by filing a copy of the complaint with the Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. (b) The complaint shall state: (1) The allegations of liability...

  10. 21 CFR 17.5 - Complaint.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...by filing a copy of the complaint with the Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. (b) The complaint shall state: (1) The allegations of liability...

  11. 48 CFR 408.711 - Quality complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Nonprofit Agencies Employing People Who Are Blind or Severely Disabled 408.711 Quality complaints. Prior to attempting to resolve a complaint regarding the...

  12. 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

  13. 77 FR 37558 - Disclosure of Certain Credit Card Complaint Data

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-22

    ...information--including narrative information from consumers...particular, complaint narratives...complaints against, or inquiries concerning, a covered...is a complaint, an inquiry, or feedback about...including the complaint narrative, the consumer's...

  14. 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...

  15. Pain in cancer survivors.

    PubMed

    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

    2014-06-01

    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

  16. 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

  17. Page 1 of 5 Sexual Harassment Complaint,

    E-print Network

    .1 Who May File a Complaint Any member of the campus community who believes he or she has been the recipient of sexually harassing behavior, including retaliation, may file a complaint. Complaints may be filed against employees, students, or third parties not affiliated with the School who are present

  18. 21 CFR 820.198 - Complaint files.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Complaint files. 820.198 Section 820.198 Food and... QUALITY SYSTEM REGULATION Records § 820.198 Complaint files. (a) Each manufacturer shall maintain complaint files. Each manufacturer shall establish and maintain procedures for receiving, reviewing,...

  19. 21 CFR 820.198 - Complaint files.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Complaint files. 820.198 Section 820.198 Food and... QUALITY SYSTEM REGULATION Records § 820.198 Complaint files. (a) Each manufacturer shall maintain complaint files. Each manufacturer shall establish and maintain procedures for receiving, reviewing,...

  20. 21 CFR 211.198 - Complaint files.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Complaint files. 211.198 Section 211.198 Food and... files. (a) Written procedures describing the handling of all written and oral complaints regarding a...) A written record of each complaint shall be maintained in a file designated for drug...

  1. 21 CFR 820.198 - Complaint files.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Complaint files. 820.198 Section 820.198 Food and... QUALITY SYSTEM REGULATION Records § 820.198 Complaint files. (a) Each manufacturer shall maintain complaint files. Each manufacturer shall establish and maintain procedures for receiving, reviewing,...

  2. 21 CFR 211.198 - 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. 211.198 Section 211.198 Food and... files. (a) Written procedures describing the handling of all written and oral complaints regarding a...) A written record of each complaint shall be maintained in a file designated for drug...

  3. 21 CFR 820.198 - Complaint files.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Complaint files. 820.198 Section 820.198 Food and... QUALITY SYSTEM REGULATION Records § 820.198 Complaint files. (a) Each manufacturer shall maintain complaint files. Each manufacturer shall establish and maintain procedures for receiving, reviewing,...

  4. 21 CFR 211.198 - Complaint files.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Complaint files. 211.198 Section 211.198 Food and... files. (a) Written procedures describing the handling of all written and oral complaints regarding a...) A written record of each complaint shall be maintained in a file designated for drug...

  5. 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....

  6. 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....

  7. 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....

  8. 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....

  9. 6 CFR 13.7 - Complaint.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 6 Domestic Security 1 2011-01-01 2011-01-01 false Complaint. 13.7 Section 13.7 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.7 Complaint. (a) On or after the date the Department of Justice approves the issuance of a Complaint in...

  10. 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 Criminal Procedure § 11.300 Complaints. (a) A complaint is a written statement of the essential facts... initiated by a complaint filed with the court by a law enforcement officer and sworn to by a person...

  11. 25 CFR 11.300 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Criminal Procedure § 11.300 Complaints. (a) A complaint is a written statement of the essential facts... initiated by a complaint filed with the court by a law enforcement officer and sworn to by a person...

  12. 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

  13. Duloxetine in the management of chronic musculoskeletal pain

    PubMed Central

    Smith, Howard S; Smith, Eric J; Smith, Benjamin R

    2012-01-01

    Chronic musculoskeletal pain is among the most frequent painful complaints that healthcare providers address. The bulk of these complaints are chronic low back pain and chronic osteoarthritis. Osteoarthritis is the most common form of arthritis in the United States. It is a chronic degenerative disorder characterized by a loss of cartilage, and occurs most often in older persons. The management of osteoarthritis and chronic low back pain may involve both nonpharmacologic (eg, weight loss, resistive and aerobic exercise, patient education, cognitive behavioral therapy) and pharmacologic approaches. Older adults with severe osteoarthritis pain are more likely to take analgesics than those with less severe pain. The pharmacologic approaches to painful osteoarthritis remain controversial, but may include topical as well as oral nonsteroidal antiinflammatory drugs, acetaminophen, duloxetine, and opioids. The role of duloxetine for musculoskeletal conditions is still evolving. PMID:22767991

  14. 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 (?=?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

  15. 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 ...

  16. Hip pain

    MedlinePLUS

    ... or around the hip joint. You may not feel pain from your hip directly over the hip area. ... your provider will ask questions about: Where you feel the pain When and how the pain started Things that ...

  17. 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 ...

  18. 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

  19. 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.

  20. Oxycodone/Naloxone: role in chronic pain management, opioid-induced constipation, and abuse deterrence.

    PubMed

    DePriest, Anne Z; Miller, Katie

    2014-06-01

    The use of opioids in the treatment of chronic pain is widespread; the prevalence of specific opioids varies from country to country and depends on product availability, national formulary systems, and provider preferences. Patients often receive opioids for legitimate treatment of pain conditions, but on the opposite side of the spectrum, nonmedical use of opioids is a significant public health concern. Opioids are associated with several side effects, and constipation is the most commonly reported and persistent symptom. Unlike some adverse effects associated with opioid use, tolerance does not develop to constipation. Opioid-induced constipation (OIC) is the most prevalent patient complaint associated with opioid use and has been associated with declines in various quality of life measures. OIC can be extremely difficult for patients to tolerate and may prompt patients to decrease or discontinue opioid treatment. Current management strategies for OIC are often insufficient. A prolonged-release formulation of oxycodone/naloxone (OXN) has been investigated for the treatment of nonmalignant and cancer pain and mitigation of OIC, and evidence is largely favorable. Studies have demonstrated the capability of OXN to alleviate OIC while maintaining pain control comparable to oxycodone-only regimens. There is insufficient evidence for OXN efficacy for patients with mild OIC or patients maintained on high doses of opioids, and use in these populations is controversial. The reduction of costs associated with OIC may provide overall cost effectiveness with OXN. Additionally, the presence of naloxone may deter abuse/misuse by those seeking to misuse the formulation by modes of administration other than oral ingestion. Most studies to date have occurred in European countries, and phase 3 trials continue in the United States. This review will include current therapeutic options for pain and constipation, unique characteristics of OXN, evidence related to use of OXN and its place in therapy, discussion of opioid abuse/misuse, and various abuse-deterrent mechanisms, and areas of continuing research. PMID:25135384

  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. 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

  3. 29 CFR 1614.302 - Mixed case complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal...

  4. 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 ...

  5. 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 ...

  6. Postoperative Pain Control

    PubMed Central

    Garimella, Veerabhadram; Cellini, Christina

    2013-01-01

    The effective relief of pain is of the utmost importance to anyone treating patients undergoing surgery. Pain relief has significant physiological benefits; hence, monitoring of pain relief is increasingly becoming an important postoperative quality measure. The goal for postoperative pain management is to reduce or eliminate pain and discomfort with a minimum of side effects. Various agents (opioid vs. nonopioid), routes (oral, intravenous, neuraxial, regional) and modes (patient controlled vs. “as needed”) for the treatment of postoperative pain exist. Although traditionally the mainstay of postoperative analgesia is opioid based, increasingly more evidence exists to support a multimodal approach with the intent to reduce opioid side effects (such as nausea and ileus) and improve pain scores. Enhanced recovery protocols to reduce length of stay in colorectal surgery are becoming more prevalent and include multimodal opioid sparing regimens as a critical component. Familiarity with the efficacy of available agents and routes of administration is important to tailor the postoperative regimen to the needs of the individual patient. PMID:24436674

  7. 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 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

  8. 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

  9. 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

  10. 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...

  11. 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…

  12. 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... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a... feed manufacturer shall maintain on the premises a file which contains the following information:...

  13. 21 CFR 225.115 - Complaint files.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Complaint files. 225.115 Section 225.115 Food and... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a... feed manufacturer shall maintain on the premises a file which contains the following information:...

  14. 21 CFR 225.115 - 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. 225.115 Section 225.115 Food and... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a... feed manufacturer shall maintain on the premises a file which contains the following information:...

  15. 21 CFR 225.115 - Complaint files.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Complaint files. 225.115 Section 225.115 Food and... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a... feed manufacturer shall maintain on the premises a file which contains the following information:...

  16. 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... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Records and Reports § 225.115 Complaint files. (a... feed manufacturer shall maintain on the premises a file which contains the following information:...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 21 CFR 820.198 - Complaint files.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Complaint files. 820.198 Section 820.198 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES..., address, and phone number of the complainant; (5) The nature and details of the complaint; (6) The...

  2. 45 CFR 704.2 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 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 or she believes falls within...

  3. 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...

  4. 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...

  5. 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 PUBLIC CONTRACTS, DEPARTMENT OF LABOR 201-GENERAL REGULATIONS § 50-201.1202 Complaints. Whenever any officer or employee of the United...

  6. 45 CFR 704.2 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 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 or she believes falls within...

  7. 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....

  8. 49 CFR 1313.10 - Procedures for complaints and discovery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 false Procedures for complaints and discovery. 1313.10 Section 1313.10 Transportation... § 1313.10 Procedures for complaints and discovery. (a) Complaints, discovery petitions, replies, and appeals...

  9. 49 CFR 1313.10 - Procedures for complaints and discovery.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 false Procedures for complaints and discovery. 1313.10 Section 1313.10 Transportation... § 1313.10 Procedures for complaints and discovery. (a) Complaints, discovery petitions, replies, and appeals...

  10. 49 CFR 1313.10 - Procedures for complaints and discovery.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...2012-10-01 false Procedures for complaints and discovery. 1313.10 Section 1313.10 Transportation... § 1313.10 Procedures for complaints and discovery. (a) Complaints, discovery petitions, replies, and appeals...

  11. 49 CFR 1313.10 - Procedures for complaints and discovery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 false Procedures for complaints and discovery. 1313.10 Section 1313.10 Transportation... § 1313.10 Procedures for complaints and discovery. (a) Complaints, discovery petitions, replies, and appeals...

  12. 49 CFR 1313.10 - Procedures for complaints and discovery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...2011-10-01 false Procedures for complaints and discovery. 1313.10 Section 1313.10 Transportation... § 1313.10 Procedures for complaints and discovery. (a) Complaints, discovery petitions, replies, and appeals...

  13. 47 CFR 1.1406 - Dismissal of complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...1406 Section 1.1406 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants by Random Selection Pole Attachment Complaint Procedures § 1.1406 Dismissal of complaints. (a) The complaint...

  14. 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

  15. The use of a chronic pain diary in older people.

    PubMed

    Hager, Kathy; Brockopp, Dorothy

    This article describes clinical data retrieved using a chronic pain diary in older people residing in a nursing home. Twenty-one diary entries provided the information necessary to formulate an effective plan of care. Residents reported duration of pain, pain at rest, pain with movement, number and location of pain sites, and pain descriptors. Although estimates of chronic pain among nursing home residents range from 4480%, the nursing home participating in this project reported 0% persistent or chronic pain. Diary entries revealed that 17% of communicative residents reported chronic pain. Data showed that a majority of participants experienced pain with movement. They experienced pain an average of 11 hours a day and lower limbs and hips were the most prevalent sites, and residents averaged three pain sites. The dominant pain descriptors used were 'achy' and 'exhausting'. PMID:19377395

  16. 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

  17. Genital and sexual pain in women.

    PubMed

    Graziottin, Alessandra; Gambini, Dania; Bertolasi, Laura

    2015-01-01

    This chapter discusses the all too common problem of sex-related pain in women. Pain is a complex perceptive experience, involving biologic as well as psychologic and relational meanings. They become increasingly important with the chronicity of pain. Neurologists are quite aware of the painful aspect of many neurologic disorders, but lifelong and acquired genital and sexual pain is still neglected in a consistent percentage of women. One reason is the view - still held by many - that psychologic factors play the most important role in sex-related pain complaints. The consequences of diagnostic delay can be dramatic. Persisting tissue inflammation induces pain to change from acute and "nociceptive," which indicates a "friendly signal," alerting one to ongoing tissue damage, to chronic and "neuropathic," a disease per se. Whilst the primary disease is progressing and neuroinflammation becomes a prominent feature, affected women have to bear years of pain and distress, huge quantifiable and non-quantifiable costs, and a progressive deterioration of personal and relational health and happiness. The scenario is even more dramatic when pain complicates an already disabling disease. The main aspects considered in this chapter include neuroinflammation as a key feature of pain; genital and sexual pain as part of neurologic diseases; and genital and sexual pain syndrome (dyspareunia and vaginismus) as primary problems, and their pelvic comorbidities (bladder pain syndrome, endometriosis, irritable bowel syndrome, provoked vestibulodynia/vulvodynia). Finally, we discuss iatrogenic pain, i.e., genital and sexual pain caused by ill-conceived medical, surgical, pharmacologic or radiologic therapeutic interventions. PMID:26003257

  18. 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

  19. 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

  20. 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 ...

  1. Chronic Pain

    MedlinePLUS

    ... Complex Regional Pain Syndrome (also called Causalgia and Reflex Sympathetic Dystrophy Syndrome) information page compiled by the ... Complex Regional Pain Syndrome (also called Causalgia and Reflex Sympathetic Dystrophy Syndrome) information page compiled by the ...

  2. 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)

  3. Pain Assessment

    MedlinePLUS

    ... clarify its impact, and evaluate other medical and psychosocial problems. The assessment determines whether additional evaluation is ... pain Describe the negative effects on physical and psychosocial functioning caused by the pain Understand the medical ...

  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. [Complaint analysis derived from surgical practice].

    PubMed

    Fajardo-Dolci, Germán; Rodríguez-Suárez, Francisco Javier; Campos-Castolo, Esther Mahuina; Carrillo-Jaimes, Arturo; Zavala-Suárez, Etelvina; Aguirre-Gas, Héctor Gerardo

    2009-01-01

    This study reports on the analysis of medical complaints presented to the National Commission on Medical Arbitration (Comisión Nacional de Arbitraje Médico, 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 México (Estado de México), 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

  6. 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

  7. Abdominal Pain

    MedlinePLUS

    ... cope. You could also try progressive relaxation or self-hypnosis . For more information about non-drug pain relief techniques, see YourChild : Pain and Your Child or Teen . What diet and medication treatments are available for the pain of functional ...

  8. Chronic Pain

    MedlinePLUS

    ... anything you do to relax or get your mind off your problems may help control pain. It's important to include relaxing activities in your daily life, even if you are already taking medicine for pain. Relaxation can actually change the body's chemicals that produce pain. You might have to ...

  9. Challenges of the pregnant athlete and low back pain.

    PubMed

    Noon, Megan L; Hoch, Anne Z

    2012-01-01

    Low back pain during pregnancy is a common problem with a high prevalence among pregnant athletes. The etiology of pregnancy-related low back pain remains unclear, although more evidence is supporting a biomechanical/musculoskeletal origin. This article will review the causes of low back pain in athletes and pregnant women, differentiate low back from pelvic girdle pain, and discuss the treatment and prevention of pregnancy-related low back and pelvic girdle pain. PMID:22236825

  10. 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

  11. 45 CFR 98.93 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Monitoring, Non-compliance and Complaints...submitted in writing to the Assistant Secretary for Children and Families, 370 L'Enfant Promenade,...

  12. 45 CFR 98.93 - Complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Monitoring, Non-compliance and Complaints...submitted in writing to the Assistant Secretary for Children and Families, 370 L'Enfant Promenade,...

  13. 45 CFR 98.93 - Complaints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Monitoring, Non-compliance and Complaints...submitted in writing to the Assistant Secretary for Children and Families, 370 L'Enfant Promenade,...

  14. 45 CFR 98.93 - Complaints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Monitoring, Non-compliance and Complaints...submitted in writing to the Assistant Secretary for Children and Families, 370 L'Enfant Promenade,...

  15. 45 CFR 606.70 - Complaint procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...

  16. 45 CFR 606.70 - Complaint procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...

  17. 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....

  18. 21 CFR 17.5 - Complaint.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. (b) The complaint...Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. For a civil...

  19. 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,...

  20. 45 CFR 606.70 - Complaint procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...

  1. 45 CFR 606.70 - Complaint procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...

  2. 45 CFR 606.70 - Complaint procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...

  3. 12 CFR 626.6030 - Complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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, 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,...

  5. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...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 Good Tissue Practice § 1271.320 Complaint file....

  6. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...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 Good Tissue Practice § 1271.320 Complaint file....

  7. Anterior knee pain.

    PubMed

    LLopis, Eva; Padrón, Mario

    2007-04-01

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries. PMID:17350782

  8. Complaints of Sleep Disturbances Are Associated with Cardiovascular Disease: Results from the Gutenberg Health Study

    PubMed Central

    Michal, Matthias; Wiltink, Jörg; Kirschner, Yvonne; Schneider, Astrid; Wild, Philipp S.; Münzel, Thomas; Blettner, Maria; Schulz, Andreas; Lackner, Karl; Pfeiffer, Norbert; Blankenberg, Stefan; Tschan, Regine; Tuin, Inka; Beutel, Manfred E.

    2014-01-01

    Background Despite their high prevalence, sleep disorders often remain unrecognized and untreated because of barriers to assessment and management. The aims of the present study were to examine associations of complaints of sleep disturbances with cardiovascular disease, related risk factors, and inflammation in the community and to determine the contribution of sleep disturbances to self-perceived physical health. Method The sample consists of n?=?10.000 participants, aged 35 to 74 years of a population based community sample in Germany. Cross-sectional associations of complaints of sleep disturbances with cardiovascular risk factors and disease, biomarkers of inflammation, depression, anxiety, and physical health status were analyzed. Results 19% of our sample endorsed clinically significant sleep disturbances. In the unadjusted analyses severity of sleep disturbances increased with female sex, low socioeconomic status, living without a partnership, cardiovascular disease, depression, anxiety, poor physical health, increased levels of C-reactive protein and fibrinogen. After multivariate adjustment robust associations with coronary heart disease, myocardial infarction and dyslipidemia remained. Complaints of sleep disturbances were strong and independent contributors to self-perceived poor physical health beyond depression, anxiety and medical disease burden. Conclusions Given the high prevalence of complaints of sleep disturbances and their strong impact on health status, increased efforts should be undertaken for their identification and treatment. PMID:25093413

  9. 47 CFR 1.721 - Format and content of complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Format and content of complaints. 1.721 Section 1.721 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Complaints, Applications, Tariffs, and Reports Involving Common Carriers Formal Complaints § 1.721 Format and content of complaints. (a) Subject to paragraph...

  10. 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

  11. 49 CFR 821.55 - Complaint, answer to complaint, motions and discovery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD...PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Involving Emergency and... (a) Complaint. In proceedings governed by...

  12. 49 CFR 821.55 - Complaint, answer to complaint, motions and discovery.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD...PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Involving Emergency and... (a) Complaint. In proceedings governed by...

  13. 49 CFR 821.55 - Complaint, answer to complaint, motions and discovery.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD...PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Involving Emergency and... (a) Complaint. In proceedings governed by...

  14. 49 CFR 821.55 - Complaint, answer to complaint, motions and discovery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD...PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Involving Emergency and... (a) Complaint. In proceedings governed by...

  15. 49 CFR 821.55 - Complaint, answer to complaint, motions and discovery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD...PRACTICE IN AIR SAFETY PROCEEDINGS Special Rules Applicable to Proceedings Involving Emergency and... (a) Complaint. In proceedings governed by...

  16. Sex differences in experimental measures of pain sensitivity and endogenous pain inhibition

    PubMed Central

    Bulls, Hailey W; Freeman, Emily L; Anderson, Austen JB; Robbins, Meredith T; Ness, Timothy J; Goodin, Burel R

    2015-01-01

    It has been suggested that increased pain sensitivity and disruption of endogenous pain inhibitory processes may account, at least in part, for the greater prevalence and severity of chronic pain in women compared to men. However, previous studies addressing this topic have produced mixed findings. This study examined sex differences in pain sensitivity and inhibition using quantitative sensory testing (QST), while also considering the influence of other important factors such as depressive symptoms and sleep quality. Healthy men (n=24) and women (n=24) each completed a QST battery. This battery included an ischemic pain task (IPT) that used a submaximal effort tourniquet procedure as well as a conditioned pain modulation (CPM) procedure for the assessment of endogenous pain inhibition. Prior to QST, participants completed the Center for Epidemiologic Studies Depression Scale and the Pittsburgh Sleep Quality Index. Analyses revealed significant sex differences for the ischemic pain task and the conditioned pain modulation procedure, such that women tolerated the ischemic pain for a shorter amount of time and demonstrated less pain inhibition compared with men. This remained true even when accounting for sex differences in depressive symptoms and sleep quality. The results of this study suggest that women may be more pain sensitive and possess less-efficient endogenous pain inhibitory capacity compared with men. Whether interventions that decrease pain sensitivity and enhance pain inhibition in women ultimately improve their clinical pain outcomes is an area of research that deserves additional attention in the future. PMID:26170713

  17. Pregnancy-related low back pain

    PubMed Central

    Katonis, P; Kampouroglou, A; Aggelopoulos, A; Kakavelakis, K; Lykoudis, S; Makrigiannakis, A; Alpantaki, K

    2011-01-01

    Pregnancy related low back pain is a common complaint among pregnant women. It can potentially have a negative impact on their quality of life. The aim of this article is to present a current review of the literature concerning this issue. By using PubMed database and low back pain, pelvic girdle pain, pregnancy as keywords, abstracts and original articles in English investigating the diagnosis treatment of back pain during pregnancy were searched and analyzed Low back pain could present as either a pelvic girdle pain between the posterior iliac crest and the gluteal fold or as a lumbar pain over and around the lumbar spine. The source of the pain should be diagnosed and differentiated early.The appropriate treatment aims to reduce the discomfort and the impact on the pregnant womans quality of life. This article reveals the most common risk factors, as well as treatment methods, which may help to alleviate the pain. Some suggestions for additional research are also discussed. PMID:22435016

  18. Parental Influence on Children's Chronic Abdominal Pain Experiences: Exploring the Relationship between Parental Protective Behaviors and Child Quality of Life

    E-print Network

    Kessler, Emily D.

    2011-08-31

    Initial studies examining relationships between parent behaviors and child functioning in chronic pain populations have documented positive associations between parental protective behaviors and child somatic complaints, emotional difficulties (e...

  19. Low Back Pain and Pelvic Girdle Pain in Pregnancy.

    PubMed

    Casagrande, Danielle; Gugala, Zbigniew; Clark, Shannon M; Lindsey, Ronald W

    2015-09-01

    Pregnancy has a profound effect on the human body, particularly the musculoskeletal system. Hormonal changes cause ligamentous joint laxity, weight gain, and a shift in the center of gravity that leads to lumbar spine hyperlordosis and anterior tilting of the pelvis. In addition, vascular changes may lead to compromised metabolic supply in the low back. The most common musculoskeletal complaints in pregnancy are low back pain and/or pelvic girdle pain. They can be diagnosed and differentiated from each other by history taking, clinical examination, provocative test maneuvers, and imaging. Management ranges from conservative and pharmacologic measures to surgical treatment. Depending on the situation, and given the unique challenges pregnancy places on the human body and the special consideration that must be given to the fetus, an orthopaedic surgeon and the obstetrician may have to develop a plan of care together regarding labor and delivery or when surgical interventions are indicated. PMID:26271756

  20. 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…

  1. Parents' Experiences of Pain and Discomfort in People with Learning Disabilities

    ERIC Educational Resources Information Center

    Clarke, Zara Jane; Thompson, Andrew R.; Buchan, Linda; Combes, Helen

    2008-01-01

    There are few measures of pain for people with limited ability to communicate. Eight parents of adults with a known learning disability and associated physical health complaint were interviewed to explore their experience of identifying and managing the pain felt by their children. The parents did not often perceive their son or daughter to be in…

  2. The re-evaluation of the measurement of pain in population-based epidemiological studies: The SHAMA study

    PubMed Central

    Flüß, Elisa; Bond, Christine M; Jones, Gareth T

    2015-01-01

    Background: While many pain patients rely on pain-relieving treatments to manage their pain, pain-related research commonly quantifies pain status using validated questionnaires without taking into account that information. This will lead to an underestimate of the burden of pain in the community. To ensure a more accurate assessment of the prevalence and severity of pain, this study aimed to develop a pain management questionnaire and to assess how much population-based pain estimates change when pain management is considered. Methods: This study was a cross-sectional population-based study in Grampian, north-east Scotland. A total of 4600 people, aged 25?years and over, were randomly selected from a population sample frame and sent a questionnaire on pain and pain management. Population estimates of pain were determined twice: with the use of standard pain status questionnaires (‘current pain’) and with the use of a newly developed enhanced pain status questionnaire to determine patients’ estimated pain without pain management (‘all pain’). Results: The prevalence of current pain was 50.5% (95% CI?=?48.0, 52.9). Of those who reported no current pain, 11.6% (95% CI?=?9.4, 13.8) reported that they would have had pain had they not managed their pain. Thus, the all pain prevalence was 56.2% (95% CI?=?53.7, 58.7). This difference in prevalence rates was statistically significant (difference?=?5.7%; 95% CI?=?2.2, 9.2). Likewise, participants’ pain severity significantly increased when they estimated their pain without pain management (p?pain management information results in an underestimation of pain prevalence and severity. This should be considered in future epidemiological studies. Summary points Pain management information is currently not considered for the assessment of pain in epidemiological population-based studies. Since pain management can affect people’s pain status drastically, it is likely that we currently underestimate the true burden of pain in studies assessing pain. Incorporating self-reported pain management information in an epidemiological study of pain led to significantly increased estimates of both pain prevalence and pain severity. It is therefore crucial to collect and take into account people’s pain management information in future studies for a more accurate measurement of pain. PMID:26516569

  3. Determining the Pain-Affecting Factors of University Students with Nonspecific Low Back Pain

    PubMed Central

    Taspinar, Ferruh; Taspinar, Betul; Cavlak, Ugur; Celik, Erdal

    2014-01-01

    [Purpose] This study was conducted on university students with nonspecific low back pain in order to determine the independent variables that affect their pain. [Methods] A total of 514 students were included in this study. Pain was evaluated using a Visual Analogue Scale (VAS). A special form was prepared in order to evaluate the following independent variables: gender, weight, height, Body Mass Index (BMI), working periods sitting straight (television, computer, seminar, etc.), working periods bending at a table (reading, writing, etc.), using lumbar support while sitting, the mean duration of pain within the last one year, type of pain, time of the pain, faculty, class, physical activity habits and smoking. The collected data were evaluated using the CHAID (Chi-squared Automatic Interaction Detection) analysis method. [Results] The working hours bending at a table, physical activity, height, weight, BMI and educational departments were found not to affect the severity of the pain. The pain severity was affected by the duration of pain complaints within the last one year, the duration of working staying upright, smoking, classes, usage of lumbar support and age variables. [Conclusions] The results of this study show that nonspecific low back pain of university students is affected by many factors such as smoking, class, age, using a computer and lumbar support. PMID:24409020

  4. 2.11 Discrimination Complaints Page 1 of 7 Discrimination Complaints

    E-print Network

    Hung, I-Kuai

    on the basis of race, color, religion, national origin, sex, age, disability, genetic information, citizenship, and veteran status. Unlawful discrimination based on sex includes discrimination defined as sexual harassment complaints and the results of such complaints. Instances of sex discrimination based on sexual harassment

  5. [Greater trochanteric pain syndrome of the hip].

    PubMed

    Haviv, Barak; Bronak, Shlomo; Thein, Rafael

    2014-02-01

    Lateral pain of the hip with point tenderness at the Greater Trochanter is a common musculoskeletal complaint. It is frequently diagnosed as trochanteric bursitis; however, this term is inaccurate because of evident non-inflammatory pathologies, particularly of the abductor tendons of the hip. It is important to differentiate this extra-articular source from an intra-articular or a lower back source of pain. Imaging is useful in cases of trauma, prolonged pain or uncertain diagnosis. Non-operative treatment that involves modifying activities, physiotherapy, analgesics, steroid injections and shock wave therapy is usually helpful. Nevertheless, despite the above treatments, about one third of the patients suffer from chronic pain and disability. These patients may be candidates for operative intervention. Currently, there are endoscopic surgical techniques for local decompression, bursectomy and suture of torn tendons similar to surgery used in the shoulder. PMID:24716427

  6. 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

  7. Treatment Considerations for Cancer Pain: A Global Perspective.

    PubMed

    Pergolizzi, Joseph V; Gharibo, Christopher; Ho, Kok-Yuen

    2015-11-01

    Cancer pain is prevalent, undertreated, and feared by patients with cancer. In April 2013, a panel of pain experts convened in Singapore to address the treatment of cancer pain. They discussed the various types of cancer pain, including breakthrough pain, which is sometimes clinically confused with analgesic gaps. Reasons for undertreating cancer pain include attitudes of patients, clinicians, and factors associated with healthcare systems. The consequences of not treating cancer pain may include reduced quality of life for patients with cancer (who now live longer than ever), functional decline, and increased psychological stress. Early analgesic intervention for cancer pain may reduce the risk of central sensitization and chronification of pain. To manage pain in oncology patients, clinicians should assess pain during regular follow-up visits using validated pain measurement tools and follow prescribing guidelines, if necessary referring patients with cancer to pain specialists. Many patients with cancer require opioids for pain relief. Pain associated with cancer may also relate to cancer treatments, such as chemotherapy-induced peripheral neuropathy. Many patients with cancer are what might be considered "special populations," in that they may be elderly, frail, comorbid, or have end-stage organ failure. Specific pain therapy guidelines for those populations are reviewed. Patients with cancer with a history of or active substance abuse disorder deserve pain control but may require close medical supervision. While much "treatment inertia" exists in cancer pain control, cancer pain can be safely and effectively managed and should be carried out to alleviate suffering and improve outcomes. PMID:25469726

  8. Persistent post-surgical pain and neuropathic pain after total knee replacement

    PubMed Central

    Drosos, Georgios I; Triantafilidou, Triantafilia; Ververidis, Athanasios; Agelopoulou, Cristina; Vogiatzaki, Theodosia; Kazakos, Konstantinos

    2015-01-01

    AIM: To study the prevalence of persistent post-surgical pain (PPSP) and neuropathic pain (NP) after total knee replacement (TKR). METHODS: MEDLINE and Embase databases were searched for articles published until December 2014 in English language. Published articles were included if they referred to pain that lasts at least 3 mo after primary TKR for knee osteoarthritis, and measured pain with pain specific instruments. Studies that referred to pain caused by septic reasons and implant malalignment were excluded. Both prospective and retrospective studies were included and only 14 studies that match the inclusion criteria were selected for this review. RESULTS: The included studies were characterized by the heterogeneity on the scales used to measure pain and pre-operative factors related to PPSP and NP. The reported prevalence of PPSP and NP seems to be relatively high, but it varies among different studies. There is also evidence that the prevalence of post-surgical pain is related to the scale used for pain measurement. The prevalence of PPSP is ranging at 6 mo from 16% to 39% and at 12 mo from 13.1% to 23% and even 38% of the patients. The prevalence of NP at 6 mo post-operatively is ranging from 5.2% to 13%. Pre-operative factors related to the development of PPSP also differ, including emotional functioning, such as depression and pain catastrophizing, number of comorbidities, pain problems elsewhere and operations in knees with early grade of osteoarthritis. CONCLUSION: No firm conclusions can be reached regarding the prevalence of PPSP and NP and the related factors due to the heterogeneity of the studies. PMID:26301182

  9. A 30-year-old industrial worker with upper back pain.

    PubMed

    Perrin, Angela; Bergman, Cheryl; Hart, Leigh

    2013-01-01

    This column presents the case of a 30-year-old man seeking care for upper back pain at a freestanding emergency center. His occupation involved carrying 50-lb buckets of chemicals up ladders to the rooftops of industrial buildings. Back pain is a common complaint in emergency departments and most often musculoskeletal in nature. In this case, the back pain was not musculoskeletal but resulted from bilateral pulmonary emboli. The patient did not know that he had Factor V Leiden disorder. This column emphasizes the importance of ruling out serious life-threatening conditions in patients who present with common complaints and no traditional red flag symptoms. PMID:23636041

  10. Central Sensitization and Perceived Indoor Climate among Workers with Chronic Upper-Limb Pain: Cross-Sectional Study

    PubMed Central

    Sundstrup, Emil; Jakobsen, Markus D.; Brandt, Mikkel; Jay, Kenneth; Persson, Roger; Andersen, Lars L.

    2015-01-01

    Monitoring of indoor climate is an essential part of occupational health and safety. While questionnaires are commonly used for surveillance, not all workers may perceive an identical indoor climate similarly. The aim of this study was to evaluate perceived indoor climate among workers with chronic pain compared with pain-free colleagues and to determine the influence of central sensitization on this perception. Eighty-two male slaughterhouse workers, 49 with upper-limb chronic pain and 33 pain-free controls, replied to a questionnaire with 13 items of indoor climate complaints. Pressure pain threshold (PPT) was measured in muscles of the arm, shoulder, and lower leg. Cross-sectional associations were determined using general linear models controlled for age, smoking, and job position. The number of indoor climate complaints was twice as high among workers with chronic pain compared with pain-free controls (1.8 [95% CI: 1.3–2.3] versus 0.9 [0.4–1.5], resp.). PPT of the nonpainful leg muscle was negatively associated with the number of complaints. Workers with chronic pain reported more indoor climate complaints than pain-free controls despite similar actual indoor climate. Previous studies that did not account for musculoskeletal pain in questionnaire assessment of indoor climate may be biased. Central sensitization likely explains the present findings. PMID:26425368

  11. Postoperative sleep disruptions: a potential catalyst of acute pain?

    PubMed

    Chouchou, Florian; Khoury, Samar; Chauny, Jean-Marc; Denis, Ronald; Lavigne, Gilles J

    2014-06-01

    Despite the substantial advances in the understanding of pain mechanisms and management, postoperative pain relief remains an important health care issue. Surgical patients also frequently report postoperative sleep complaints. Major sleep alterations in the postoperative period include sleep fragmentation, reduced total sleep time, and loss of time spent in slow wave and rapid eye movement sleep. Clinical and experimental studies show that sleep disturbances may exacerbate pain, whereas pain and opioid treatments disturb sleep. Surgical stress appears to be a major contributor to both sleep disruptions and altered pain perception. However, pain and the use of opioid analgesics could worsen sleep alterations, whereas sleep disruptions may contribute to intensify pain. Nevertheless, little is known about the relationship between postoperative sleep and pain. Although the sleep-pain interaction has been addressed from both ends, this review focuses on the impact of sleep disruptions on pain perception. A better understanding of the effect of postoperative sleep disruptions on pain perception would help in selecting patients at risk for more severe pain and may facilitate the development of more effective and safer pain management programs. PMID:24074687

  12. Pain frequency moderates the relationship between pain catastrophizing and pain

    PubMed Central

    Kjøgx, Heidi; Zachariae, Robert; Pfeiffer-Jensen, Mogens; Kasch, Helge; Svensson, Peter; Jensen, Troels S.; Vase, Lene

    2014-01-01

    Background: Pain frequency has been shown to influence sensitization, psychological distress, and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method: A non-clinical (247 students) and a clinical (223 pain patients) sample completed the Danish versions of the Pain Catastrophizing Scale (PCS), Beck Depression Inventory, and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency. Results: In both samples, high pain frequency was found to moderate the association between pain catastrophizing and pain intensity, whereas low pain frequency did not. The psychometric properties and the factor structure of the Danish version of the PCS were confirmed. Conclusions: This is the first study to validate the Danish version of the PCS and to show that pain frequency moderates the relationship between pain catastrophizing and reported pain in both non-clinical and clinical populations. PMID:25646089

  13. Pain in patients with COPD: a systematic review and meta-analysis

    PubMed Central

    van Dam van Isselt, Eléonore F; Groenewegen-Sipkema, Karin H; Spruit-van Eijk, Monica; Chavannes, Niels H; de Waal, Margot W M; Janssen, Daisy J A; Achterberg, Wilco P

    2014-01-01

    Objectives To systematically investigate the prevalence of pain, factors related with pain and pain management interventions in patients with chronic obstructive pulmonary disease (COPD). Design Systematic review and meta-analysis. Data sources and study eligibility criteria PubMed (MEDLINE), EMBASE, CINAHL and PsychINFO from 1966 to December 2013. Studies were included if they presented clinical data on pain or symptom burden in patients with COPD, or pain as a domain of quality of life (QoL). All types of study designs were included. Results Of the 1571 articles that were identified, 39 met the inclusion criteria and were included in this review. Fourteen studies focused on pain and symptom burden (including pain) in patients with COPD and 25 studies focused on QoL using a questionnaire that included a separate pain domain. Reported pain prevalence in high-quality studies ranged from 32 to 60%. Included studies report that pain is more prevalent in patients with COPD compared to participants from the general population. Comorbidity, nutritional status, QoL and several symptoms were related to pain. None of the included studies reported a significant relationship between lung function and pain prevalence or severity. However, studies investigating pain in patients with moderate COPD reported higher pain prevalence compared to studies in patients with severe of very severe COPD. Conclusions Although literature on this topic is limited and shows substantial heterogeneity, pain seems to be a significant problem in patients with COPD and is related to several other symptoms, comorbidity and QoL. Data synthesis suggests that pain is more prevalent in patients with moderate COPD compared to patients with severe or very severe COPD. Further research is needed and should focus on determining a more accurate pain prevalence, investigating the relationship between pain prevalence, disease severity and comorbidity and explore implementation and efficacy of pain management interventions in patients with COPD. PMID:25260370

  14. Pain behaviour and pain intensity in older persons with severe dementia: reliability of the MOBID Pain Scale by video uptake.

    PubMed

    Husebo, Bettina S; Strand, Liv I; Moe-Nilssen, Rolf; Husebo, Stein B; Ljunggren, Anne E

    2009-03-01

    Advancing age is associated with high prevalence of dementia, often combined with under-diagnosed and under-treated pain. A nurse-administered assessment tool has been developed to unmask pain during standardised, guided movements, called Mobilisation-Observation-Behaviour-Intensity-Dementia (MOBID) Pain Scale. The aim was to examine intra- and inter-rater reliability of pain behaviour indicators, inferred pain intensity, and the overall MOBID Pain Score. Twenty-six nursing home patients with severe dementia and chronic pain, 11 primary caregivers and three external raters at the Red Cross Nursing Home, Bergen were included. During video uptake the patients were guided by their primary caregivers to standardised movements of different body parts. Pain behaviour indicators (pain noises, facial expression and defence) were registered for each movement with subsequent rating of pain intensity by external raters, who assessed and scored the videos concurrently and independently at day 1, 4 and 8. Facial expression was most commonly observed, followed by pain noises and defence. Repeated assessments increased the number of observed pain behaviours, but did not improve reliability. Inter-rater reliability was highest for noises, followed by defence and facial expression (kappa = 0.44-0.92, kappa = 0.10-0.76 and kappa = 0.05-0.76 respectively, at day 8). Mobilisation of arms and legs were rated most painful. Intra- and inter-rater reliability of overall pain were very good [intraclass correlation coefficient (1,1) ranging 0.92-0.97 and 0.94-0.96 respectively, at day 8]. Reliability of pain intensity scores tended to increase by repeated assessment. Using video uptake, MOBID Pain Scale was shown to be sufficiently reliable to assess pain in older persons with severe dementia. PMID:19192240

  15. Orbitofrontal Gray Matter Relates to Early Morning Awakening: A Neural Correlate of Insomnia Complaints?

    PubMed Central

    Stoffers, Diederick; Moens, Sarah; Benjamins, Jeroen; van Tol, Marie-José; Penninx, Brenda W. J. H.; Veltman, Dick J.; Van der Wee, Nic J. A.; Van Someren, Eus J. W.

    2012-01-01

    Sleep complaints increase profoundly with age; prevalence estimates of insomnia in the elderly reach up to 37%. The three major types of nocturnal complaints are difficulties initiating (DIS) and maintaining (DMS) sleep and early morning awakening (EMA), of which the latter appears most characteristic for aging. The neural correlates associated with these complaints have hardly been investigated, hampering the development of rational treatment and prevention. A recent study on structural brain correlates of insomnia showed that overall severity, but not duration, of insomnia complaints is associated with lower gray matter (GM) density in part of the left orbitofrontal cortex (OFC). Following up on this, we investigated, in an independent sample of people not diagnosed with insomnia, whether individual differences in GM density are associated with differences in DIS, DMS, and EMA. Sixty five healthy participants (mean age?=?41?years, range 18–56) filled out questionnaires and underwent structural magnetic resonance imaging. Three compound Z-scores were computed for questionnaire items relating to DIS, DMS, and EMA. Whole-brain voxel-based morphometry was used to investigate their association with GM density. Results show that participants with lower GM density in a region where the left inferior OFC borders the insula report more EMA, but not DIS or DMS. This is the first study to investigate structural brain correlates of specific sleep characteristics that can translate into complaints in insomniacs. The selective association of EMA with orbitofrontal GM density makes our findings particularly relevant to elderly people, where EMA represents the most characteristic complaint. It is hypothesized that low GM density in aforementioned orbitofrontal area affects its role in sensing comfort. An intact ability to evaluate comfort may be crucial to maintain sleep, especially at the end of the night when sleep is vulnerable because homeostatic sleep propensity has dissipated. PMID:23060850

  16. 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

  17. Chronic pain - resources

    MedlinePLUS

    Pain - resources; Resources - chronic pain ... The following organizations are good resources for information on chronic pain: American Chronic Pain Association -- www.theacpa.org National Fibromyalgia and Chronic Pain Association -- www.fmcpaware.org ...

  18. Music related upper limb pain in schoolchildren.

    PubMed Central

    Fry, H J; Rowley, G L

    1989-01-01

    Two British secondary schools (one a specialist music school) were surveyed to assess the prevalence of upper limb pain among specialist music students compared with students in a regular school setting. Female students tended to report pain more often than male students, but for both significantly higher prevalence was found in the music school. Pain in the regular school was most often attributed to writing, whereas in the music school it was associated with the playing of all instruments, but most particularly with cello, clarinet, and flute. Music students reported long hours of practice, but it appeared that the intensity of practice may be more important as a determinant of pain than the total hours spent practising. The results of the study are in substantial agreement with those previously published from Australia and North America. On the balance of probabilities the pain is due to overuse syndrome, which is very common in musicians and well known in writers. PMID:2619360

  19. Music related upper limb pain in schoolchildren.

    PubMed

    Fry, H J; Rowley, G L

    1989-12-01

    Two British secondary schools (one a specialist music school) were surveyed to assess the prevalence of upper limb pain among specialist music students compared with students in a regular school setting. Female students tended to report pain more often than male students, but for both significantly higher prevalence was found in the music school. Pain in the regular school was most often attributed to writing, whereas in the music school it was associated with the playing of all instruments, but most particularly with cello, clarinet, and flute. Music students reported long hours of practice, but it appeared that the intensity of practice may be more important as a determinant of pain than the total hours spent practising. The results of the study are in substantial agreement with those previously published from Australia and North America. On the balance of probabilities the pain is due to overuse syndrome, which is very common in musicians and well known in writers. PMID:2619360

  20. Chest pain in lupus patients: the emergency department experience.

    PubMed

    Modi, Masoom; Ishimori, Mariko L; Sandhu, Vaneet K; Wallace, Daniel J; Weisman, Michael H

    2015-11-01

    Heart disease, a major cause of morbidity and mortality in SLE patients, often manifests as chest pain (CP). Our goal was to understand the prevalence and outcome of CP presentations for SLE patients in the emergency department (ED). Billing records of patients who presented to Cedars-Sinai Medical Center ED with ICD-9 codes for SLE and secondary ICD-9 codes for CP (786.50-786.59) between March 2009 and October 2013 were reviewed. Two study groups were formed: discharge from ED versus hospital admission. Visits were evaluated for basic cardiac work-up with an electrocardiogram (EKG) and cardiac enzymes; hospital admissions were evaluated for CP etiology and discharge diagnoses. Of 2675 ED visits with ICD-9 codes for SLE, 397 visits had secondary codes for CP (15 %); 173 were discharged and 224 became hospital admissions. While 92 % of admissions had basic cardiac work-up, over 50 % had chest pain attributed to non-cardiac causes. Only 7.2 % had a discharge diagnosis related to cardiovascular disease. Fifteen percent of all SLE coded patients had complaints of CP, a figure higher than the national average for non-SLE CP (10 %). There is a majority of non-cardiac diagnoses given to SLE patients at discharge. CP is likely to be a window of opportunity to address the known cardiac morbidity and mortality in SLE patients perhaps at an early stage of development of this complication. Our study strengthens the need for more investigations to assess the etiology of CP in this population. PMID:25912215

  1. Experiences of employees with arm, neck or shoulder complaints: a focus group study

    PubMed Central

    2014-01-01

    Background Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. Methods A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. Results Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). Conclusions Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an existing self-management program to the characteristics of employees suffering from CANS. PMID:24779360

  2. Manualized psychodynamic-interactional group therapy for the treatment of somatoform pain disorders.

    PubMed

    Nickel, Ralf; Ademmer, Karin; Egle, Ulrich T

    2010-01-01

    Medically unexplained and clinically significant symptoms of pain are highly prevalent in the general population. More than one third of all patients in general practices and various departments of hospitals suffer from somatoform disorders with pain being the main complaint of 70% of these patients. This treatment manual is the first disorder-specific, psychodynamically oriented treatment for these patients. Based on psychodynamic-interactional group psychotherapy, it focuses on disorder-specific aspects as well as on psychic and interpersonal problems which have resulted from adverse childhood experiences and insecure attachment. In three treatment phases comprising an "information and motivational phase" followed by "work" and ultimately "transfer" phase spread over a period of 6 to 7 months, between seven and nine patients were treated in 40 group therapy sessions. The group started with psychoeducational elements intended to inform them about their illness. Through the discussion and formulation of individual treatment goals, the patients are drawn into the work phase of the group therapy, in which the relationship of the patients in the group and their behavior is the main focus of the therapeutic interventions. PMID:20925485

  3. 76 FR 76628 - Disclosure of Certain Credit Card Complaint Data

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ...can also populate two narrative fields. These cover...in addition to any narrative material that the issuer...consumer complaints or inquiries concerning financial...consumer complaints or inquiries concerning financial...of disclosure of the narrative fields of...

  4. 47 CFR 8.14 - General formal complaint procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...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 pleading...

  5. 47 CFR 8.14 - General formal complaint procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...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 pleading...

  6. 47 CFR 8.14 - General formal complaint procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...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 pleading...

  7. 47 CFR 8.14 - General formal complaint procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...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 pleading...

  8. 24 CFR 7.25 - Pre-complaint processing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Pre-Complaint Processing § 7.25 Pre-complaint...

  9. 24 CFR 7.25 - Pre-complaint processing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Pre-Complaint Processing § 7.25 Pre-complaint...

  10. 24 CFR 7.30 - Presentation of complaint.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Complaints § 7.30 Presentation of complaint. At any...

  11. 24 CFR 7.30 - Presentation of complaint.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Complaints § 7.30 Presentation of complaint. At any...

  12. 24 CFR 7.25 - Pre-complaint processing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Pre-Complaint Processing § 7.25 Pre-complaint...

  13. 24 CFR 7.30 - Presentation of complaint.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Complaints § 7.30 Presentation of complaint. At any...

  14. 24 CFR 7.30 - Presentation of complaint.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Complaints § 7.30 Presentation of complaint. At any...

  15. 24 CFR 7.30 - Presentation of complaint.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Complaints § 7.30 Presentation of complaint. At any...

  16. 24 CFR 7.25 - Pre-complaint processing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Pre-Complaint Processing § 7.25 Pre-complaint...

  17. 24 CFR 7.25 - Pre-complaint processing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...EQUAL EMPLOYMENT OPPORTUNITY; POLICY, PROCEDURES AND PROGRAMS Equal Employment Opportunity Without Regard to Race, Color Religion, Sex, National Origin, Age, Disability or Reprisal Pre-Complaint Processing § 7.25 Pre-complaint...

  18. 76 FR 5161 - Determination Regarding National Appraisal Complaint Hotline

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-28

    ...Regarding National Appraisal Complaint Hotline AGENCY: Appraisal Subcommittee (ASC...regarding a national appraisal complaint hotline...has determined that no one national hotline presently exists that fully complies...

  19. 29 CFR 1980.103 - Filing of discrimination complaint.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...DISCRIMINATION COMPLAINTS UNDER SECTION 806 OF THE CORPORATE AND CRIMINAL FRAUD ACCOUNTABILITY ACT OF 2002, TITLE VIII OF THE SARBANES-OXLEY ACT OF 2002 Complaints, Investigations, Findings and Preliminary Orders § 1980.103 Filing of...

  20. 29 CFR 1981.103 - Filing of discrimination complaint.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...CONTINUED) PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 6 OF THE PIPELINE SAFETY IMPROVEMENT ACT OF 2002 Complaints, Investigations, Findings, and Preliminary Orders § 1981.103 Filing of discrimination...

  1. 29 CFR 1980.103 - Filing of discrimination complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...DISCRIMINATION COMPLAINTS UNDER SECTION 806 OF THE CORPORATE AND CRIMINAL FRAUD ACCOUNTABILITY ACT OF 2002, TITLE VIII OF THE SARBANES-OXLEY ACT OF 2002 Complaints, Investigations, Findings and Preliminary Orders § 1980.103 Filing of...

  2. 29 CFR 1981.103 - Filing of discrimination complaint.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...CONTINUED) PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 6 OF THE PIPELINE SAFETY IMPROVEMENT ACT OF 2002 Complaints, Investigations, Findings, and Preliminary Orders § 1981.103 Filing of discrimination...

  3. 34 CFR 99.63 - Where are complaints filed?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Where are complaints filed? 99.63 Section 99...FAMILY EDUCATIONAL RIGHTS AND PRIVACY What Are the Enforcement Procedures? § 99.63 Where are complaints filed? A parent or...

  4. Academic Integrity Leiden University Regulation on Complaints regarding Academic Integrity

    E-print Network

    Galis, Frietson

    Academic Integrity Leiden University Regulation on Complaints regarding Academic Integrity CONTENTS ........................................................................2 Article 4 Academic Integrity Committee ... .....................................3 Article 5 ..................................................................................................................5 Appendix to Leiden University Regulation on Complaints regarding Academic Integrity

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 2010-10-01 false Answer to complaint. 4.450-6...Hearings on Appeals Involving Questions of Fact § 4.450-6 Answer to complaint. Within...where the contest is pending an answer specifically meeting...

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 2011-10-01 false Answer to complaint. 4.450-6...Hearings on Appeals Involving Questions of Fact § 4.450-6 Answer to complaint. Within...where the contest is pending an answer specifically meeting...

  7. Heel Pain

    MedlinePLUS

    ... inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the ... quite painful. The condition occurs when the plantar fascia is strained over time beyond its normal extension, ...

  8. Neuropathic Pain

    MedlinePLUS

    ... know that it can erode quality of life. Communication Tools View All Everyday Tools During Your Visit ... pain. Online Tool Printable Tool (PDF) Show More Communication Tools Where Does It Hurt? / Nerve Man With ...

  9. Joint pain

    MedlinePLUS

    ... both rest and exercise are important. Warm baths, massage, and stretching exercises should be used as often ... Does keeping the joint elevated help? Do medicines, massage, or applying heat reduce the pain? What other ...

  10. Pain (PDQ)

    MedlinePLUS

    ... swelling. Decrease pain caused by muscle spasms and tension. Massage has a direct effect on body tissues ... slowly, feel yourself begin to relax; feel the tension leaving your body. Step 3. Breathe in and ...

  11. Orofacial Pain

    MedlinePLUS

    ... percent of all headaches are caused by muscle tension, which may be related to the bite. Headaches ... the touch Earaches or ringing in the ears Neck, shoulder or back pain Dizziness ?xml:namespace> Sleep ...

  12. Urination Pain

    MedlinePLUS

    ... small masses of minerals) in the urinary tract. Urinary tract infections (UTIs) are the most common cause of painful ... For Kids For Parents MORE ON THIS TOPIC Urinary Tract Infections A to Z: Dysuria Recurrent Urinary Tract Infections ...

  13. Penis pain

    MedlinePLUS

    Pain - penis ... Bites, either human or insect Cancer of the penis Erection that does not go away (priapism) Genital herpes Infected hair follicles Infected prosthesis of the penis Infection under the foreskin of uncircumcised men ( balanitis ) ...

  14. Phantom Pain 

    E-print Network

    Valentine, A.

    , and neurotransmitter release, thereby making them immensely important therapeutic targets for treating medical conditions such as pain, depression, obesity, learning, and memory.61,62 Despite their sequence homology, NTs elicit their action by binding to two...

  15. Neck Pain

    MedlinePLUS

    ... Use anti-inflammatory medicines, such as ibuprofen and aspirin, to relieve pain and discomfort, and apply heat ... Use anti-inflammatory medicines, such as ibuprofen or aspirin, and apply heat to the sore area. See ...

  16. Subjective memory complaints among patients on sick leave are associated with symptoms of fatigue and anxiety

    PubMed Central

    Aasvik, Julie K.; Woodhouse, Astrid; Jacobsen, Henrik B.; Borchgrevink, Petter C.; Stiles, Tore C.; Landrø, Nils I.

    2015-01-01

    Objective: The aim of this study was to identify symptoms associated with subjective memory complaints (SMCs) among subjects who are currently on sick leave due to symptoms of chronic pain, fatigue, depression, anxiety, and insomnia. Methods: This was a cross-sectional study, subjects (n = 167) who were currently on sick leave were asked to complete an extensive survey consisting of the following: items addressing their sociodemographics, one item from the SF-8 health survey measuring pain, Chalder Fatigue Questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and Everyday Memory Questionnaire – Revised. General linear modeling was used to analyze variables associated with SMCs. Results: Symptoms of fatigue (p-value < 0.001) and anxiety (p-value = 0.001) were uniquely and significantly associated with perceived memory failures. The associations with symptoms of pain, depression, and insomnia were not statistically significant. Conclusions: Subjective memory complaints should be recognized as part of the complex symptomatology among patients who report multiple symptoms, especially in cases of fatigue and anxiety. Self-report questionnaires measuring perceived memory failures may be a quick and easy way to incorporate and extend this knowledge into clinical practice. PMID:26441716

  17. Knee complaints seen in general practice: active sport participants versus non-sport participants

    PubMed Central

    van Middelkoop, Marienke; van Linschoten, Robbart; Berger, Marjolein Y; Koes, Bart W; Bierma-Zeinstra, Sita MA

    2008-01-01

    Background Since knee complaints are common among athletes and are frequently presented in general practice, it is of interest to investigate the type of knee complaints represented in general practice of athletes in comparison with those of non-athletes. Therefore, the aim of this study is to investigate the differences in type of knee complaints between sport participants, in this study defined as athletes, and non-sport participants, defined as non-athletes, presenting in general practice. Further, differences in the initial policy of the GP, medical consumption, and outcome at one-year follow-up were also investigated. Methods Patients consulting their GP for a new episode of knee complaints were invited to participate in this prospective cohort study. From the total HONEUR knee cohort population (n = 1068) we extracted patients who were athletes (n = 421) or non-athletes (n = 388). Results The results showed that acute distortions of the knee were significantly more diagnosed in athletes than in non-athletes (p = 0.04). Further, more athletes were advised by their GP to 'go easy on the knee' than the non-athletes (p < 0.01), but no differences were found in number of referrals and medication prescribed by the GP. The medical consumption was significantly higher among athletes; however, no significant differences were found between the two groups for recovery at one-year follow-up. Conclusion There are no major differences in the diagnosis and prognosis of knee complaints between athletes and non-athletes presented to the GP. This implies that there are no indications for different treatment strategies applied in both groups. However, athletes are more often advised to 'go easy on the knee' and to rest than non-athletes. Further, there is a trend towards increased medical consumption among athletes while functional disability and pain are lower than among the non-athletes. PMID:18366679

  18. 21 CFR 211.198 - Complaint files.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...the date that the complaint was received, whichever is longer. In the case of certain OTC drug products lacking expiration dating because they meet the criteria for exemption under § 211.137, such written records shall be maintained for 3 years...

  19. 21 CFR 211.198 - Complaint files.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...the date that the complaint was received, whichever is longer. In the case of certain OTC drug products lacking expiration dating because they meet the criteria for exemption under § 211.137, such written records shall be maintained for 3 years...

  20. 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... Jackson Blvd., 20th Floor, Chicago, IL 60604-3507. (iv) For Arkansas, Louisiana, New Mexico, Oklahoma,...

  1. 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... Jackson Blvd., 20th Floor, Chicago, IL 60604-3507. (iv) For Arkansas, Louisiana, New Mexico, Oklahoma,...

  2. How to File a Complaint of Discrimination

    E-print Network

    Emshwiller, Eve

    How to File a Complaint of Discrimination Office for Equity and Diversity 179A Bascom Hall 500 of continuous improvement principles. Establish collaborative partnerships with Schools/Colleges and Divisions/EEO compliance. Barbara A. Lanser Disability Coordinator/Employment 608-263-2407 WTRS: 7-1-1 The Disability

  3. THE UNIVERSITY OF LEEDS STUDENT COMPLAINTS PROCEDURE

    E-print Network

    Haase, Markus

    THE UNIVERSITY OF LEEDS STUDENT COMPLAINTS PROCEDURE 1. The University values the views of its a variety of sources, but in the first instance students are encouraged to consult the Leeds University ­ these are set out in the Taught Students Guide (http://www.leeds.ac.uk/qmeu/tsg/10appeals.htm), the Research

  4. 21 CFR 226.115 - 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. 226.115 Section 226.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... files. Records shall be maintained for a period of 2 years of all written or verbal...

  5. 21 CFR 226.115 - 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. 226.115 Section 226.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... files. Records shall be maintained for a period of 2 years of all written or verbal...

  6. 21 CFR 226.115 - 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. 226.115 Section 226.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... files. Records shall be maintained for a period of 2 years of all written or verbal...

  7. 21 CFR 226.115 - Complaint files.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Complaint files. 226.115 Section 226.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... files. Records shall be maintained for a period of 2 years of all written or verbal...

  8. 21 CFR 226.115 - Complaint files.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Complaint files. 226.115 Section 226.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL... files. Records shall be maintained for a period of 2 years of all written or verbal...

  9. COMPLAINT FORM Submit To: Today's Date

    E-print Network

    Sin, Peter

    Phone City / State / Zip _________ Cell Phone II. TYPE & BASIS OF COMPLAINT (Check the boxes that apply.) Complainant (Name & Title) ______ Department UFID # Address (University) Work Phone Address (Residence) Home #1 (Name & Title) ______ Address (Work) Work Phone Address (Home) Home Phone Mobile Phone Respondent

  10. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.320 Complaint file. (a) Procedures... as defined in § 1271.3(aa), relating to core current good tissue practice (CGTP) requirements,...

  11. 21 CFR 1271.320 - Complaint file.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.320 Complaint file. (a) Procedures... as defined in § 1271.3(aa), relating to core current good tissue practice (CGTP) requirements,...

  12. Abuses Students Experience after Filing Judicial Complaints.

    ERIC Educational Resources Information Center

    Schuh, John H.; Oblander, Douglas

    1984-01-01

    Surveyed 78 students to examine the nature of physical and verbal abuse experienced by students who filed judicial complaints. Verbal abuse was the most common, while 24 percent reported pranks, property damage, or physical abuse. Over one-third of the students reported being pressured to drop charges. (JAC)

  13. 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,...

  14. 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,...

  15. 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,...

  16. 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,...

  17. 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,...

  18. 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...

  19. 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...

  20. 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...

  1. 76 FR 52718 - Complaint About Postal Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ...C2011-2; Order No. 808] Complaint About Postal Services AGENCY: Postal Regulatory...1\\ It involves two statutory claims about the mode of delivery the Postal Service...Francisco (San Francisco or Complainant) about the reliability and security of mail...

  2. 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...

  3. 19 CFR 210.12 - The complaint.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... established as a result of the domestic activities of one or more licensees. (11) Contain a request for relief, and if temporary relief is requested under section 337 (e) and/or (f) of the Tariff Act of 1930, a motion for such relief shall accompany the complaint as provided in § 210.52(a) or may follow...

  4. UMBC Interim Discrimination Complaint Procedure 1) Introduction

    E-print Network

    Suri, Manil

    to Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973 (revised 1992), Title VII of the Civil Rights Act of 1964, and the Americans of discrimination complaints. Use of this procedure does not affect other complainant rights and remedies that may

  5. 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 FOOD STAMP AND FOOD DISTRIBUTION PROGRAM GENERAL INFORMATION AND DEFINITIONS § 271.6...

  6. 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 FOOD STAMP AND FOOD DISTRIBUTION PROGRAM GENERAL INFORMATION AND DEFINITIONS § 271.6...

  7. 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 FOOD STAMP AND FOOD DISTRIBUTION PROGRAM GENERAL INFORMATION AND DEFINITIONS § 271.6...

  8. 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...

  9. 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...

  10. Neonatal pain

    PubMed Central

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  11. Conscientiousness is modified by genetic variation in catechol-O-methyltransferase to reduce symptom complaints in IBS patients

    PubMed Central

    Hall, Kathryn T; Tolkin, Benjamin R; Chinn, Garrett M; Kirsch, Irving; Kelley, John M; Lembo, Anthony J; Kaptchuk, Ted J; Kokkotou, Efi; Davis, Roger B; Conboy, Lisa A

    2015-01-01

    Background Attention to and perception of physical sensations and somatic states can significantly influence reporting of complaints and symptoms in the context of clinical care and randomized trials. Although anxiety and high neuroticism are known to increase the frequency and severity of complaints, it is not known if other personality dimensions or genes associated with cognitive function or sympathetic tone can influence complaints. Genetic variation in catechol-O-methyltransferase (COMT) is associated with anxiety, personality, pain, and response to placebo treatment. We hypothesized that the association of complaint reporting with personality might be modified by variation in the COMT val158met genotype. Methods We administered a standard 25-item complaint survey weekly over 3-weeks to a convenience sample of 187 irritable bowel syndrome patients enrolled in a placebo intervention trial and conducted a repeated measures analysis. Results We found that complaint severity rating, our primary outcome, was negatively associated with the personality measures of conscientiousness (? = ?0.31 SE 0.11, P = 0.003) and agreeableness (? = ?0.38 SE 0.12, P = 0.002) and was positively associated with neuroticism (? = 0.24 SE 0.09, P = 0.005) and anxiety (? = 0.48 SE 0.09, P < 0.0001). We also found a significant interaction effect of COMT met alleles (? = ?32.5 SE 14.1, P = 0.021). in patients genotyped for COMT val158met (N  = 87) specifically COMT × conscientiousness (? = 0.73 SE 0.26, P = 0.0042) and COMT × anxiety (? = ?0.42 SE 0.16, P = 0.0078) interaction effects. Conclusion These findings potentially broaden our understanding of the factors underlying clinical complaints to include the personality dimension of conscientiousness and its modification by COMT. PMID:25722948

  12. 34 CFR 300.508 - Due process complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... a due process complaint. (1) If the LEA has not sent a prior written notice under § 300.503 to the... 10 days of receiving the due process complaint, send to the parent a response that includes— (i) An..., within 10 days of receiving the due process complaint, send to the other party a response...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  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. 30 CFR 291.105 - What must a complaint contain?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false What must a complaint contain? 291.105 Section 291.105 Mineral Resources MINERALS...CONTINENTAL SHELF LANDS ACT § 291.105 What must a complaint contain? For purposes of this subpart, a complaint means...

  19. 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...

  20. 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...

  1. 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,…

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Service 1 2011-07-01 2011-07-01 false Scope and nature of complaints. 3030.2 Section 3030.2 Postal Service...PERSONNEL RULES FOR COMPLAINTS General § 3030.2 Scope and nature of complaints. Any interested person (including...

  3. 39 CFR 3030.2 - Scope and nature of complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Service 1 2010-07-01 2010-07-01 false Scope and nature of complaints. 3030.2 Section 3030.2 Postal Service...PERSONNEL RULES FOR COMPLAINTS General § 3030.2 Scope and nature of complaints. Any interested person (including...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 78 FR 21218 - Disclosure of Consumer Complaint Data

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... request for comment), 76 FR 76628 (Dec. 8, 2011) (Proposed Credit Card Complaint Data Disclosure Policy Statement); Disclosure of Certain Credit Card Complaint Data (Notice of final policy statement), 77 FR 37558... Consumer Complaint Data (Notice of proposed policy statement), 77 FR 37616 (June 22, 2012)...

  9. 6 CFR 13.8 - Service of Complaint.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 6 Domestic Security 1 2011-01-01 2011-01-01 false Service of Complaint. 13.8 Section 13.8 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.8 Service of Complaint. (a) Service of a Complaint must be Made by certified or registered mail or...

  10. 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).…

  11. 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...

  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. Foodborne Illness Complaint Form 1CDC EHS-Net

    E-print Network

    Foodborne Illness Complaint Form 1CDC EHS-Net The Environmental Health Specialists Network (EHS to use to capture information from consumers about their foodborne illness complaints. The information collected with this form can be used to help determine whether a consumer foodborne illness complaint should

  14. Student Complaint Information by State and Agency October 2011

    E-print Network

    Olszewski Jr., Edward A.

    Student Complaint Information by State and Agency October 2011 State Agency Name Link to and Effectiveness and Planning Complaints for out of state institutions are referred to the licensing agency (ADPE by State and Agency October 2011 State Agency Name Link to and/or Information about Complaint Process

  15. Chronic Pain in People with an Intellectual Disability: Under-Recognised and Under-Treated?

    ERIC Educational Resources Information Center

    McGuire, B. E.; Daly, P.; Smyth, F.

    2010-01-01

    Aim: To examine the nature, prevalence and impact of chronic pain in adults with an intellectual disability (ID) based on carer report. Methods: Postal questionnaires were sent to 250 care-givers and 157 responses were received (63%). Results: Chronic pain was reported in 13% of the sample (n = 21), 6.3% had pain in two sites and 2% had pain in…

  16. Is all pain is treated equally? A multicenter evaluation of acute pain care by age

    PubMed Central

    Hwang, Ula; Belland, Laura K; Handel, Daniel A; Yadav, Kabir; Heard, Kennon; Rivera, Laura; Eisenberg, Amanda; Noble, Matthew; Mekala, Sudha; Valley, Morgan; Winkel, Gary; Todd, Knox H; Morrison, R Sean

    2014-01-01

    Pain is highly prevalent in healthcare settings, however disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older versus younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the US evaluating the 2 most commonly presenting pain conditions for older adults - abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (?65 years) and oldest (?85 years) were less likely to receive analgesics when compared to younger patients (<65 years), yet older patients had greater reductions in final pain scores. When evaluating pain treatment and final pain scores, differences appeared to be based on type of pain. Older abdominal pain patients were less likely to receive pain medications, while older fracture patients were more likely to receive analgesics and opioids when compared to younger patients. Differences in pain care for older patients appear to be driven by type of presenting pain. PMID:25244947

  17. Is all pain is treated equally? A multicenter evaluation of acute pain care by age.

    PubMed

    Hwang, Ula; Belland, Laura K; Handel, Daniel A; Yadav, Kabir; Heard, Kennon; Rivera-Reyes, Laura; Eisenberg, Amanda; Noble, Matthew J; Mekala, Sudha; Valley, Morgan; Winkel, Gary; Todd, Knox H; Morrison, R Sean

    2014-12-01

    Pain is highly prevalent in health care settings; however, disparities continue to exist in pain care treatment. Few studies have investigated if differences exist based on patient-related characteristics associated with aging. The objective of this study was to determine if there are differences in acute pain care for older vs younger patients. This was a multicenter, retrospective, cross-sectional observation study of 5 emergency departments across the United States evaluating the 2 most commonly presenting pain conditions for older adults, abdominal and fracture pain. Multivariable adjusted hierarchical modeling was completed. A total of 6,948 visits were reviewed. Older (? 65 years) and oldest (? 85 years) were less likely to receive analgesics compared to younger patients (<65 years), yet older patients had greater reductions in final pain scores. When evaluating pain treatment and final pain scores, differences appeared to be based on type of pain. Older patients with abdominal pain were less likely to receive pain medications, while older patients with fracture were more likely to receive analgesics and opioids compared to younger patients. Differences in pain care for older patients appear to be driven by the type of presenting pain. PMID:25244947

  18. Diagnosis and treatment of discogenic low back pain.

    PubMed

    Fischgrund, J S; Montgomery, D M

    1993-03-01

    Low back pain (LBP) is very prevalent in the general population. Treatment of nonradicular back pain, in the absence of deformity, continues to be controversial. Recently, anatomic dissections, magnetic resonance imaging studies, and the use of provocative discograms (pain-related response during the injection similar to the typical pattern of pain reported prior to the procedure) have contributed to our understanding of the etiology of discogenic back pain. Various techniques of spine fusion, with and without instrumentation, have altered the natural history of LBP unresponsive to conservative treatment. This review discusses the etiology and diagnosis of discogenic back pain and the treatment options available to the spine surgeon. PMID:8474769

  19. Effect of pain in pediatric inherited neuropathies

    PubMed Central

    Jaiswal, Mamta; Feldman, Eva; Shy, Michael

    2014-01-01

    Objective: Assess the prevalence and impact of pain in children with Charcot-Marie-Tooth (CMT) disease. Methods: In this prospective cross-sectional study on children with CMT disease seen at study sites of the Inherited Neuropathy Consortium, we collected standardized assessments of pain (Wong-Baker FACES Pain Rating Scale) from 176 patients (140 children aged 8–18 years, and 36 children aged 2–7 years through parent proxies), along with standardized clinical assessments and quality-of-life (QOL) outcomes. We then developed a series of multivariate regression models to determine whether standardized measures of neuropathy severity, functional impact, or structural changes to the feet explained the observed pain scores. Results: The mean score on the Wong-Baker FACES Pain Rating Scale was 2 (range 0–5). Increased pain strongly correlated with worse QOL scores but not with more severe neuropathy. Independent determinants of increased pain in children with CMT disease included measures of ankle inflexibility. Conclusion: Pain is present in children with CMT disease and negatively affects QOL. Pain scores do not positively correlate with neuropathy severity but do correlate in limited univariate analyses with measures of ankle inflexibility. Further studies to elucidate the mechanisms of pain may help identify treatments that can reduce pain and improve QOL in patients with CMT disease. PMID:24477108

  20. Idiopathic Hand and Arm Pain: Delivering Cognitive Behavioral Therapy as Part of a Multidisciplinary Team in a Surgical Practice

    ERIC Educational Resources Information Center

    Vranceanu, Ana-Maria.; Ring, David; Kulich, Ronald; Zhao, Meijuan; Cowan, James; Safren, Steven

    2008-01-01

    Cognitive behavioral therapists may have a unique and growing role in orthopedics departments. In helping patients cope with pain, particularly where there is no specific biomedical treatment or cure, cognitive behavioral practitioners can help prevent, early on, the transition from an acute pain complaint to a costly, disabling, and interfering…

  1. Atypical manifestation of cat-scratch disease: isolated epigastric pain in an immunocompetent, 12-year-old child

    PubMed Central

    Kayemba-Kay’s, Simon; Kovács, Tamas; Rakotoharinandrasana, Iarolalao; Benosman, Sidi Mohamed

    2015-01-01

    Key Clinical Message We present a 12-year-old immunocompetent girl with hepato splenic cat-scratch disease (CSD). Her sole inaugural complaint was isolated epigastric pain. She fully recovered, with normalized abdominal CT scan following 2 weeks course of Azythromycin®. CSD should be included in differential diagnosis in children with epigastric pain, especially in those with domestic pets. PMID:26273467

  2. Atypical manifestation of cat-scratch disease: isolated epigastric pain in an immunocompetent, 12-year-old child.

    PubMed

    Kayemba-Kay's, Simon; Kovács, Tamas; Rakotoharinandrasana, Iarolalao; Benosman, Sidi Mohamed

    2015-07-01

    We present a 12-year-old immunocompetent girl with hepato splenic cat-scratch disease (CSD). Her sole inaugural complaint was isolated epigastric pain. She fully recovered, with normalized abdominal CT scan following 2 weeks course of Azythromycin®. CSD should be included in differential diagnosis in children with epigastric pain, especially in those with domestic pets. PMID:26273467

  3. Pain management.

    PubMed

    Wild, L

    1990-12-01

    Postoperative pain management in the critically ill patient is a challenge for nurses. Knowing the basis of pain transmission and mechanisms of action of interventions can assist the critical care nurse in making clinical decisions regarding pain control for individual patients. There are a number of modalities available to treat postoperative pain including both pharmacologic and nonpharmacologic interventions. Techniques such as PCA not only can provide good analgesia, but allow the critically ill patient at least one aspect of control in the otherwise highly controlled environment of the critical care unit. Epidural or intrathecal analgesia, using either opioids or LAAs alone or in combination, provides excellent analgesic effect (with minimal side effects) and may improve patient outcomes. Nonpharmacologic techniques, unfortunately, are commonly overlooked as adjuncts to traditional analgesia routines because of the nature of the illness in the critically ill patient. Nonpharmacologic techniques of pain management have a place in the care of the critically ill when applied based on the assessment of an individual patient's needs and abilities to participate in his or her care. Ensuring optimal patient comfort can benefit critically ill patients and improve clinical outcomes. PMID:2096859

  4. Depression, Pain Intensity, and Interference in Acute Spinal Cord Injury

    PubMed Central

    Kalpakjian, Claire Z.

    2014-01-01

    Background: The high prevalence of pain and depression in persons with spinal cord injury (SCI) is well known. However the link between pain intensity, interference, and depression, particularly in the acute period of injury, has not received sufficient attention in the literature. Objective: To investigate the relationship of depression, pain intensity, and pain interference in individuals undergoing acute inpatient rehabilitation for traumatic SCI. Methods: Participants completed a survey that included measures of depression (PHQ-9), pain intensity (“right now”), and pain interference (Brief Pain Inventory: general activity, mood, mobility, relations with others, sleep, and enjoyment of life). Demographic and injury characteristics and information about current use of antidepressants and pre-injury binge drinking also were collected. Hierarchical multiple regression was used to test depression models in 3 steps: (1) age, gender, days since injury, injury level, antidepressant use, and pre-injury binge drinking (controlling variables); (2) pain intensity; and (3) pain interference (each tested separately). Results: With one exception, pain interference was the only statistically significant independent variable in each of the final models. Although pain intensity accounted for only 0.2% to 1.2% of the depression variance, pain interference accounted for 13% to 26% of the variance in depression. Conclusion: Our results suggest that pain intensity alone is insufficient for understanding the relationship of pain and depression in acute SCI. Instead, the ways in which pain interferes with daily life appear to have a much greater bearing on depression than pain intensity alone in the acute setting. PMID:24574820

  5. Referred speech-language and hearing complaints in the western region of São Paulo, Brazil

    PubMed Central

    Samelli, Alessandra Giannella; Rondon, Silmara; Oliver, Fátima Correa; Junqueira, Simone Rennó; Molini-Avejonas, Daniela Regina

    2014-01-01

    OBJECTIVE: The aim of this study was to characterize the epidemiological profile of the population attending primary health care units in the western region of the city of São Paulo, Brazil, highlighting referred speech-language and hearing complaints. METHOD: This investigation was a cross-sectional observational study conducted in primary health care units. Household surveys were conducted and information was obtained from approximately 2602 individuals, including (but not limited to) data related to education, family income, health issues, access to public services and access to health services. The speech-language and hearing complaints were identified from specific questions. RESULTS: Our results revealed that the populations participating in the survey were heterogeneous in terms of their demographic and economic characteristics. The prevalence of referred speech-language and hearing complaints in this population was 10%, and only half the users of the public health system in the studied region who had complaints were monitored or received specific treatment. CONCLUSIONS: The results demonstrate the importance of using population surveys to identify speech-language and hearing complaints at the level of primary health care. Moreover, these findings highlight the need to reorganize the speech-language pathology and audiology service in the western region of São Paulo, as well as the need to improve the Family Health Strategy in areas that do not have a complete coverage, in order to expand and improve the territorial diagnostics and the speech-language pathology and audiology actions related to the prevention, identification, and rehabilitation of human communication disorders. PMID:24964306

  6. Neuropathic pain referrals to a multidisciplinary pediatric cancer pain service.

    PubMed

    Anghelescu, Doralina L; Faughnan, Lane G; Popenhagen, Mark P; Oakes, Linda L; Pei, Deqing; Burgoyne, Laura L

    2014-03-01

    Neuropathic pain (NP) in children with cancer is not well characterized. In a retrospective review of patient data from a 3.5-year period, we describe the prevalence of NP and the characteristics, duration of follow-up, and interventions provided for NP among patients referred to a pediatric oncology center's pain management service. Fifteen percent (66/439) of all referrals to our pain service were for NP (56/323 patients [17%]; 34 male, 22 female). The NP patient group had 1,401 clinical visits (778 inpatient visits [55.5%] and 623 outpatient visits [44.5%]). Patients with NP had a significantly greater mean number of pain visits per consultation (p = .008) and significantly more days of pain service follow-up (p < .001) than did other patients. The most common cause of NP was cancer treatment rather than the underlying malignancy. Pharmacologic management of NP was complex, often comprising three medications. Nonpharmacologic approaches were used for 57.6% of NP referrals. Neuropathic pain is less frequently encountered than non-NP in children with cancer; nevertheless, it is more difficult to treat, requiring longer follow-up, more clinical visits, complex pharmacologic management, and the frequent addition of nonpharmacologic interventions. PMID:24602431

  7. Pain volatility and prescription opioid addiction treatment outcomes in patients with chronic pain.

    PubMed

    Worley, Matthew J; Heinzerling, Keith G; Shoptaw, Steven; Ling, Walter

    2015-12-01

    The combination of prescription opioid dependence and chronic pain is increasingly prevalent and hazardous to public health. Variability in pain may explain poor prescription opioid addiction treatment outcomes in persons with chronic pain. This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = -0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (odds ratio = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A 1 standard deviation increase in pain volatility was associated with a 44% reduction in the probability of endpoint abstinence. The significant reduction in subjective pain during treatment provides observational support for the analgesic effects of BUP/NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk of returning to opioid use by the conclusion of an intensive treatment with BUP/NLX and counseling. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain. (PsycINFO Database Record PMID:26302337

  8. Assessment and treatment of pain in children and adolescents.

    PubMed

    Lalloo, Chitra; Stinson, Jennifer N

    2014-04-01

    Pain is one of the most common and distressing symptoms experienced by children and adolescents with juvenile idiopathic arthritis. Pain is known to negatively affect all aspects of health-related quality of life, including physical, emotional, social, and role functioning. The valid and reliable assessment of pain is the first critical step to developing an effective plan for pain management. This chapter will address the following key questions: (1) What is the prevalence and impact of pain in children and adolescents with arthritis? (2) Why is it important for clinicians to assess the multidimensional nature of pain and what are the practical issues that should be considered? (3) What tools are available to help clinicians to assess pain? (4) How can Internet and mobile technologies be used to improve the assessment of pain? (5) What are the recommended strategies for clinically managing pain, including pharmacological, physical, and psychological approaches? PMID:24974065

  9. Anatomical and physiological factors contributing to chronic muscle pain.

    PubMed

    Gregory, Nicholas S; Sluka, Kathleen A

    2014-01-01

    Chronic muscle pain remains a significant source of suffering and disability despite the adoption of pharmacologic and physical therapies. Muscle pain is mediated by free nerve endings distributed through the muscle along arteries. These nerves project to the superficial dorsal horn and are transmitted primarily through the spinothalamic tract to several cortical and subcortical structures, some of which are more active during the processing of muscle pain than other painful conditions. Mechanical forces, ischemia, and inflammation are the primary stimuli for muscle pain, which is reflected in the array of peripheral receptors contributing to muscle pain-ASIC, P2X, and TRP channels. Sensitization of peripheral receptors and of central pain processing structures are both critical for the development and maintenance of chronic muscle pain. Further, variations in peripheral receptors and central structures contribute to the significantly greater prevalence of chronic muscle pain in females. PMID:24633937

  10. Pain in elderly people with severe dementia: A systematic review of behavioural pain assessment tools

    PubMed Central

    Zwakhalen, Sandra MG; Hamers, Jan PH; Abu-Saad, Huda Huijer; Berger, Martijn PF

    2006-01-01

    Background Pain is a common and major problem among nursing home residents. The prevalence of pain in elderly nursing home people is 40–80%, showing that they are at great risk of experiencing pain. Since assessment of pain is an important step towards the treatment of pain, there is a need for manageable, valid and reliable tools to assess pain in elderly people with dementia. Methods This systematic review identifies pain assessment scales for elderly people with severe dementia and evaluates the psychometric properties and clinical utility of these instruments. Relevant publications in English, German, French or Dutch, from 1988 to 2005, were identified by means of an extensive search strategy in Medline, Psychinfo and CINAHL, supplemented by screening citations and references. Quality judgement criteria were formulated and used to evaluate the psychometric aspects of the scales. Results Twenty-nine publications reporting on behavioural pain assessment instruments were selected for this review. Twelve observational pain assessment scales (DOLOPLUS2; ECPA; ECS; Observational Pain Behavior Tool; CNPI; PACSLAC; PAINAD; PADE; RaPID; Abbey Pain Scale; NOPPAIN; Pain assessment scale for use with cognitively impaired adults) were identified. Findings indicate that most observational scales are under development and show moderate psychometric qualities. Conclusion Based on the psychometric qualities and criteria regarding sensitivity and clinical utility, we conclude that PACSLAC and DOLOPLUS2 are the most appropriate scales currently available. Further research should focus on improving these scales by further testing their validity, reliability and clinical utility. PMID:16441889

  11. Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation

    PubMed Central

    Rayhan, Rakib U.; Ravindran, Murugan K.; Baraniuk, James N.

    2013-01-01

    Objective: To assess the prevalence of headache subtypes in Gulf War Illness (GWI) and Chronic Fatigue Syndrome (CFS) compared to controls. Background: Approximately, 25% of the military personnel who served in the 1990–1991 Persian Gulf War have developed GWI. Symptoms of GWI and CFS have considerable overlap, including headache complaints. Migraines are reported in CFS. The type and prevalence of headaches in GWI have not been adequately assessed. Methods: 50 GWI, 39 CFS and 45 controls had structured headache evaluations based on the 2004 International Headache Society criteria. All subjects had history and physical examinations, fatigue and symptom related questionnaires, measurements of systemic hyperalgesia (dolorimetry), and assessments for exclusionary conditions. Results: Migraines were detected in 64% of GWI (odds ratio = 11.6 [4.1–32.5]) (mean [±95% CI]) and 82% of CFS subjects (odds ratio = 22.5 [7.8–64.8]) compared to only 13% of controls. There was a predominance of females in the CFS compared to GWI and controls. However, migraine status was independent of gender in GWI and CFS groups (x2 = 2.7; P = 0.101). Measures of fatigue, pain, and other ancillary criteria were comparable between GWI and CFS subjects with and without headache. Conclusion: The high prevalence of migraine in CFS was confirmed and extended to GWI subjects. GWI and CFS may share dysfunctional central pathophysiological pathways that contribute to migraine and subjective symptoms. The high migraine prevalence warrants the inclusion of a structured headache evaluation in GWI and CFS subjects, and treatment when present. PMID:23898301

  12. Ethnomedicinal Evaluation of Medicinal Plants Used against Gastrointestinal Complaints

    PubMed Central

    Tariq, Akash; Mussarat, Sakina; Adnan, Muhammad; Abd_Allah, E. F.; Hashem, Abeer; Alqarawi, Abdulaziz Abdullah

    2015-01-01

    Aim of the present study was to document ethnomedicinal plants used against gastrointestinal complaints in five selected remote regions of Pakistan and to select potential medicinal plants for further in vitro and in vivo investigation. Data on ethnomedicinal plants and ethnographic profile of respondents was documented using semistructured questionnaires. The present study revealed utilization of 52 medicinal plants for the treatment of different gastrointestinal infections in studied regions. Apiaceae was the most dominant family reported to be used for the treatment of these infections (4 plants). Among all the plant parts fruit (24%), whole plants and leaves (23% each) were the most preferred plant parts used by the healers. Dosage of recipe was found to be related with the age of the patient. Highest degree of informant consensus was reported for vomiting, nausea (0.92 each), abdominal pain (0.9), and diarrhea (0.89). Withania coagulans scored highest FL value (86%) followed by Mentha longifolia and Melia azadirachta ranked second with FL value (75% each). Young generation was found to possess little traditional knowledge about utilizing plant recipes against these infections. Plants with high Fic and FL values should be subjected for further phytochemical and pharmacological investigation for scientific validation. PMID:26114117

  13. Ethnomedicinal Evaluation of Medicinal Plants Used against Gastrointestinal Complaints.

    PubMed

    Tariq, Akash; Mussarat, Sakina; Adnan, Muhammad; Abd Allah, E F; Hashem, Abeer; Alqarawi, Abdulaziz Abdullah; Ullah, Riaz

    2015-01-01

    Aim of the present study was to document ethnomedicinal plants used against gastrointestinal complaints in five selected remote regions of Pakistan and to select potential medicinal plants for further in vitro and in vivo investigation. Data on ethnomedicinal plants and ethnographic profile of respondents was documented using semistructured questionnaires. The present study revealed utilization of 52 medicinal plants for the treatment of different gastrointestinal infections in studied regions. Apiaceae was the most dominant family reported to be used for the treatment of these infections (4 plants). Among all the plant parts fruit (24%), whole plants and leaves (23% each) were the most preferred plant parts used by the healers. Dosage of recipe was found to be related with the age of the patient. Highest degree of informant consensus was reported for vomiting, nausea (0.92 each), abdominal pain (0.9), and diarrhea (0.89). Withania coagulans scored highest FL value (86%) followed by Mentha longifolia and Melia azadirachta ranked second with FL value (75% each). Young generation was found to possess little traditional knowledge about utilizing plant recipes against these infections. Plants with high Fic and FL values should be subjected for further phytochemical and pharmacological investigation for scientific validation. PMID:26114117

  14. Performance on selected visual and auditory subtests of the Wechsler Memory Scale-Fourth Edition during laboratory-induced pain.

    PubMed

    Etherton, Joseph L; Tapscott, Brian E

    2015-01-01

    Although chronic pain patients commonly report problems with concentration and memory, recent research indicates that induced pain alone causes little or no impairment on several Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) subtests, suggesting that cognitive complaints in chronic pain may be attributable to factors other than pain. The current studies examined potential effects of induced pain on Wechsler Memory Scale-Fourth Edition (WMS-IV) visual working memory index (VWM) subtests (Experiment 1, n = 32) and on the immediate portions of WMS-IV auditory memory (IAM) subtests (Experiment 2, n = 55). In both studies, participants were administered one of two subtests (Symbol Span or Spatial Addition for Experiment 1; Logical Memory or Verbal Paired Associates for Experiment 2) normally and were then administered the alternate subtest while experiencing either cold pressor pain induction or a nonpainful control condition. Results indicate that induced pain in nonclinical volunteers did not impair performance on either VWM or IAM performance, suggesting that pain alone does not account for complaints or deficits in these domains in chronic pain patients. Nonpainful variables such as sleep deprivation or emotional disturbance may be responsible for reported cognitive complaints in chronic pain patients. PMID:25655774

  15. Challenges in Using Opioids to Treat Pain in Persons With Substance Use Disorders

    PubMed Central

    Savage, Seddon R.; Kirsh, Kenneth L.; Passik, Steven D.

    2008-01-01

    Pain and substance abuse co-occur frequently, and each can make the other more difficult to treat. A knowledge of pain and its interrelationships with addiction enhances the addiction specialist’s efficacy with many patients, both in the substance abuse setting and in collaboration with pain specialists. This article discusses the neurobiology and clinical presentation of pain and its synergies with substance use disorders, presents methodical approaches to the evaluation and treatment of pain that co-occurs with substance use disorders, and provides practical guidelines for the use of opioids to treat pain in individuals with histories of addiction. The authors consider that every pain complaint deserves careful investigation and every patient in pain has a right to effective treatment. PMID:18497713

  16. Is Healthier Nutrition Behaviour Associated with Better Self-Reported Health and Less Health Complaints? Evidence from Turku, Finland.

    PubMed

    Ansari, Walid El; Suominen, Sakari; Berg-Beckhoff, Gabriele

    2015-01-01

    We examined nutrition behaviour, self-reported health and 20 health complaints of undergraduates in Finland. Students at the University of Turku in Finland participated in a cross-sectional online survey (N = 1189). For nutrition behaviour, we computed two composite food intake pattern scores (sweets, cakes and snacks; and fruits and vegetables), a dietary guideline adherence index and the subjective importance of healthy eating. Multinomial logistic regression assessed the association of students' nutrition behaviour with three levels of self-reported health, controlling for many potential confounders (age, sex, living with partner, economic situation, moderate physical activity, Faculty and BMI). Factor analysis of the 20 health complaints revealed three components (psychological, pains/aches and circulatory/breathing symptoms). Multiple linear regression tested the association of students' eating habits with the three components of health complaints, controlling for the same confounders. Fruits and raw and cooked vegetable consumption, dietary guideline adherence index and subjective importance of healthy eating were highest among students with excellent/very good self-reported health, exhibiting a decreasing trend for those individuals with poor/fair self-reported health. High levels of psychological symptoms were associated with decreased consumption of fruits and vegetables, less dietary guideline adherence and less subjective importance of healthy eating. Pain/aches symptoms were associated with a higher consumption of sweets, cookies and snacks and a lower adherence to dietary guidelines. More healthy nutrition behaviour was consistently associated with better self-reported health and less health complaints. Of the four nutrition behaviour indicators we employed, the dietary guideline adherence index was the best indicator and exhibited the most consistent associations with self-reported health and health complaints. PMID:26473918

  17. Is Healthier Nutrition Behaviour Associated with Better Self-Reported Health and Less Health Complaints? Evidence from Turku, Finland

    PubMed Central

    El Ansari, Walid; Suominen, Sakari; Berg-Beckhoff, Gabriele

    2015-01-01

    We examined nutrition behaviour, self-reported health and 20 health complaints of undergraduates in Finland. Students at the University of Turku in Finland participated in a cross-sectional online survey (N = 1189). For nutrition behaviour, we computed two composite food intake pattern scores (sweets, cakes and snacks; and fruits and vegetables), a dietary guideline adherence index and the subjective importance of healthy eating. Multinomial logistic regression assessed the association of students’ nutrition behaviour with three levels of self-reported health, controlling for many potential confounders (age, sex, living with partner, economic situation, moderate physical activity, Faculty and BMI). Factor analysis of the 20 health complaints revealed three components (psychological, pains/aches and circulatory/breathing symptoms). Multiple linear regression tested the association of students’ eating habits with the three components of health complaints, controlling for the same confounders. Fruits and raw and cooked vegetable consumption, dietary guideline adherence index and subjective importance of healthy eating were highest among students with excellent/very good self-reported health, exhibiting a decreasing trend for those individuals with poor/fair self-reported health. High levels of psychological symptoms were associated with decreased consumption of fruits and vegetables, less dietary guideline adherence and less subjective importance of healthy eating. Pain/aches symptoms were associated with a higher consumption of sweets, cookies and snacks and a lower adherence to dietary guidelines. More healthy nutrition behaviour was consistently associated with better self-reported health and less health complaints. Of the four nutrition behaviour indicators we employed, the dietary guideline adherence index was the best indicator and exhibited the most consistent associations with self-reported health and health complaints. PMID:26473918

  18. Back pain during growth.

    PubMed

    Hasler, Carol C

    2013-01-01

    It is wrong to believe that back pain only burdens adults: the yearly incidence during growth ranges from 10-20%, continuously increasing from childhood to adolescence. Rapid growth-related muscular dysbalance and insufficiency, poor physical condition in an increasingly sedentary adolescent community or - vice versa - high level sports activities, account for the most prevalent functional pain syndromes. In contrast to adults the correlation of radiographic findings with pain is high: the younger the patient, the higher the probability to establish a rare morphologic cause such as benign or malignant tumours, congenital malformations and infections. In children younger than 5 years old, the likelihood is more than 50%. The following red flags should lower the threshold for a quick in-depth analysis of the problem: Age of the patient <5 years, acute trauma, functional limitation for daily activities, irradiating pain, loss of weight, duration >4 weeks, history of tumour, exposition to tuberculosis, night pain and fever. High level sport equals a biomechanical field test which reveals the biologic individual response of the growing spine to the sports-related forces. Symptomatic or asymptomatic inhibitory or stimulatory growth disturbances like Scheuermann disease, scoliosis or fatigue fractures represent the most frequent pathomorphologies. They usually occur at the disk-growth plate compound: intraspongious disk herniation, diminuition of anterior growth with vertebral wedging and apophyseal ring fractures often occur when the biomechanical impacts exceed the mechanical resistance of the cartilaginous endplates. Spondylolysis is a benign condition which rarely becomes symptomatic and responds well to conservative measures. Associated slippage of L5 on S1 is frequent but rarely progresses. The pubertal spinal growth spurt is the main risk factor for further slippage, whereas sports activity - even at a high level - is not. Therefore, the athlete should only be precluded from training if pain persists or in case of high grade slips. Perturbance of the sagittal profile with increase of lumbar lordosis, flattening of the thoracic spine and retroflexion of the pelvis with hamstrings contractures are strong signs for a grade IV olisthesis or spondyloptosis with subsequent lumbosacral kyphosis. Idiopathic scoliosis is not related to pain unless it is a marked (thoraco-) lumbar curve or if there is an underlying spinal cord pathology. Chronic back pain is an under recognised entity characterised by its duration (>3 months or recurrence within 3 months) and its social impacts such as isolation and absence from school or work. It represents an independent disease, uncoupled from any initial trigger. Multimodal therapeutic strategies are more successful than isolated, somatising orthopaedic treatment. Primary and secondary preventive active measures for the physically passive adolescents, regular sports medical check-up's for the young high level athletes, the awareness for the rare but potentially disastrous pathologies and the recognition of chronic pain syndromes are the cornerstones for successful treatment of back pain during growth. PMID:23299906

  19. Somatoform pain disorder

    MedlinePLUS

    Pain disorder ... thought to be related to emotional stress. The pain was often said to be "all in their head." However, patients with somatoform pain disorder seem to experience painful sensations in a ...

  20. Complex Regional Pain Syndrome

    MedlinePLUS

    Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. ... in skin temperature, color, or texture Intense burning pain Extreme skin sensitivity Swelling and stiffness in affected ...

  1. Body mass index and musculoskeletal pain: is there a connection?

    PubMed Central

    2013-01-01

    Background Back pain is one of the most common complaints that patients report to physicians and two-thirds of the population has an elevated body mass index (BMI), indicating they are either overweight or obese. It was once assumed that extra body weight would stress the low back and lead to pain, however, researchers have reported inconsistencies association between body weight and back pain. In contrast, more recent studies do indicate that an elevated BMI is associated with back pain and other musculoskeletal pain syndromes due to the presence of a chronic systemic inflammatory state, suggesting that the relationship between BMI and musculoskeletal pains be considered in more detail. Objective To describe how an elevated BMI can be associated with chronic systemic inflammation and pain expression. To outline measurable risk factors for chronic inflammation that can be used in clinical practice and discuss basic treatment considerations. Discussion Adiposopathy, or “sick fat” syndrome, is a term that refers to an elevated BMI that is associated with a chronic systemic inflammatory state most commonly referred to as the metabolic syndrome. The best available evidence suggests that the presence of adiposopathy determines if an elevated BMI will contribute to musculoskeletal pain expression. It is not uncommon for physicians to fail to identify the presence of adiposopathy/metabolic syndrome. Conclusion Patients with an elevated BMI should be further examined to identify inflammatory factors associated with adiposopathy, such as the metabolic syndrome, which may be promoting back pain and other musculoskeletal pain syndromes. PMID:23687943

  2. Back Pain

    MedlinePLUS

    ... least 6 months. Other studies are comparing different health care approaches to the management of acute low back pain (standard care versus chiropractic, acupuncture, or massage therapy). These studies are measuring ... changes in health-related quality of life among patients suffering from ...

  3. Achilles Pain.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

  4. Abdominal Pain

    MedlinePLUS

    ... that is sudden and sharp You also have pain in your chest, neck or shoulder You're vomiting blood or have blood in your stool Your abdomen is stiff, hard and tender to touch You can't move your bowels, especially if you're also vomiting

  5. Breast pain

    PubMed Central

    2011-01-01

    Introduction Breast pain may be cyclical (worse before a period) or non-cyclical, originating from the breast or the chest wall, and occurs at some time in 70% of women. Cyclical breast pain resolves spontaneously in 20% to 30% of women, but tends to recur in 60% of women. Non-cyclical pain responds poorly to treatment but tends to resolve spontaneously in half of women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for breast pain? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 24 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, bromocriptine, combined oral contraceptive pill, danazol, diuretics, evening primrose oil, gestrinone, gonadorelin analogues, hormone replacement therapy (HRT), lisuride, low-fat diet, progestogens, pyridoxine, tamoxifen, tibolone, topical or oral non-steroidal anti-inflammatory drugs (NSAIDs), toremifene, and vitamin E. PMID:21477394

  6. [Social pain].

    PubMed

    Shimoyama, Naohito; Shimoyama, Megumi

    2011-09-01

    This chapter focuses on what social pain is and how it should be managed. In order to understand social pain in a cancer patient, it is necessary to recognize the change in the patient's daily life after the diagnosis of cancer. Because the degree of suffering and the relationships with family members and the people he or she worked with differ from patient to patient, it is important to note that the context of social pain is different in each patient. Five points shown below are essential in managing social pain. 1. Economical suffering may be alleviated by utilization of the social security system while taking into account each patient's standard of living. 2. Burdens on family members should be lessened, such as by not having them stay at the patient's bedside every day and letting them go home occasionally. 3. The normal patterns of communication, support, and conflict in the family should be identified, and the extent to which they have been disrupted by the illness should be assessed. 4. It is important to understand the ethnic, cultural, and religious background of the patient and the potential impact of their influence on the individual and the illness. 5. Practical or emotional unfinished business that the patient has needs to be identified, and efforts should be made to support fulfillment. PMID:21950034

  7. Does Fatigue Complaint Reflect Memory Impairment in Multiple Sclerosis?

    PubMed Central

    Jougleux-Vie, Caroline; Duhin, Emeline; Deken, Valerie; Outteryck, Olivier; Vermersch, Patrick; Zéphir, Hélène

    2014-01-01

    Background and Purpose. Fatigue and memory impairment are common symptoms in multiple sclerosis (MS) and both may interact with cognition. This can contribute to making a complaint misrepresentative of the objective disorder. We sought to determine whether fatigue complaint in MS reflects memory impairment and investigated whether patients' subjective fatigue is associated with memory complaint. Methods. Fifty MS patients complaining of fatigue underwent subjective assessment of fatigue and memory complaint measured using self-assessment scales. Cognitive functions were assessed using a battery of neuropsychological tests, including a test of verbal episodic memory, the selective reminding test (SRT). Correlations were studied between subjective fatigue, memory complaint, and performance in verbal episodic memory. Results. Depression score, psychotropic and/or antiepileptic drug use, Expanded Disability Status Scale (EDSS) score, and MS form were confounding factors. After adjusting for these confounding factors, neither fatigue complaint nor memory complaint was correlated with SRT performance. Subjective fatigue was significantly associated with memory complaint. Conclusion. Although complaint of fatigue in MS was correlated with memory complaint, subjective fatigue was not the expression of memory impairment. PMID:24724029

  8. Influence of complaints and singing style in singers voice handicap.

    PubMed

    Moreti, Felipe; Ávila, Maria Emília Barros de; Rocha, Clara; Borrego, Maria Cristina de Menezes; Oliveira, Gisele; Behlau, Mara

    2012-01-01

    The aim of this research was to verify whether the difference of singing styles and the presence of vocal complaints influence the perception of voice handicap of singers. One hundred eighteen singing voice handicap self-assessment protocols were selected: 17 popular singers with vocal complaints, 42 popular singers without complaints, 17 classic singers with complaints, and 42 classic singers without complaints. The groups were similar regarding age, gender and voice types. Both protocols used--Modern Singing Handicap Index (MSHI) and Classical Singing Handicap Index (CSHI)--have specific questions to their respective singing styles, and consist of 30 items equally divided into three subscales: disability (functional domain), handicap (emotional domain) and impairment (organic domain), answered according to the frequency of occurrence. Each subscale has a maximum of 40 points, and the total score is 120 points. The higher the score, the higher the singing voice handicap perceived. For statistical analysis, we used the ANOVA test, with 5% of significance. Classical and popular singers referred higher impairment, followed by disability and handicap. However, the degree of this perception varied according to the singing style and the presence of vocal complaints. The classical singers with vocal complaints showed higher voice handicap than popular singers with vocal complaints, while the classic singers without complaints reported lower handicap than popular singers without complaints. This evidences that classical singers have higher perception of their own voice, and that vocal disturbances in this group may cause greater voice handicap when compared to popular singers. PMID:23128180

  9. Musculoskeletal pain, fear avoidance behaviors, and functional decline in obesity: potential interventions to manage pain and maintain function.

    PubMed

    Vincent, Heather K; Adams, Meredith C B; Vincent, Kevin R; Hurley, Robert W

    2013-01-01

    Individuals with musculoskeletal pain exhibit abnormal movement patterns, including antalgic gait, postural dysfunction, increased thoracolumbar stiffness, decreased proprioception, and altered activation of abdominal and extensor muscles. Additionally, aberrant or increased biomechanical forces over time produce joint or structural damage that results in pain. A large body habitus resulting from excessive weight can accelerate these musculoskeletal complaints. Irrespective of age, obesity contributes to chronic musculoskeletal pain, impairment of mobility, and eventual physical disability. Potential mechanisms that may mediate the relationships between obesity-related pain and functional decline include skeletal muscle strength deterioration, systemic inflammation, and psychosocial characteristics (eg, pain catastrophizing, kinesiophobia, and depression). Treatment considerations for obese patients with musculoskeletal pain include assessment of kinesiophobia levels, biomechanical analysis, and pain medication use. Ideally, a multidisciplinary team of physicians, psychologists, and physical therapists should optimize the design of interventions specific to the patient. In some cases, the use of appropriate pain medications or intra-articular injectable agents may help control pain, fostering sustained activity, caloric expenditure, and weight loss. Morbid obesity is a medical condition that alters biomechanical forces on the tissues of the body. This condition provides the opportunity to examine accelerated development of musculoskeletal pain syndromes and etiology. The proposed therapeutic interventions can have multiple benefits in the obese population including weight loss, improved psychological outlook and self-efficacy, reduced kinesiophobia levels, reduced risk of functional dependence, and improved quality of life. PMID:24141874

  10. [Pain, the elderly and verbal communication disorders].

    PubMed

    Marcel, Jacqueline

    2014-05-01

    The prevalence of pain increases with age and multiple pathologies. Care procedures and movement are often triggers: dressings, injections, perfusions, washing, changes, transfers, walking, meals, etc. Which tools should be used when speech is lacking? What are the challenges in geriatrics for the patient and the caregivers? How should we orient our observations or behavioural disorders in terms of pain, anxiety or dementia? PMID:25055588

  11. Using Chief Complaints for Syndromic Surveillance: A Review of Chief Complaint Based Classifiers in North America

    PubMed Central

    Conway, Mike; Dowling, John N.; Chapman, Wendy W.

    2013-01-01

    A major goal of Natural Language Processing in the public health informatics domain is the automatic extraction and encoding of data stored in free text patient records. This extracted data can then be utilized by computerized systems to perform syndromic surveillance. In particular, the chief complaint — a short string that describes a patient’s symptoms — has come to be a vital resource for syndromic surveillance in the North American context due to its near ubiquity. This paper reviews fifteen systems in North America — at the city, county, state and federal level — that use chief complaints for syndromic surveillance. PMID:23602781

  12. Consistency of Knee Pain: Correlates and Association with Function

    PubMed Central

    Neogi, Tuhina; Nevitt, Michael C.; Yang, Mei; Curtis, Jeffrey R.; Torner, James; Felson, David T.

    2010-01-01

    Objective The extent and factors associated with knee pain fluctuation are not well-known. We evaluated the prevalence, correlates, and association with function of consistency of knee pain. Design Participants of The Multicenter Osteoarthritis (MOST) Study, a cohort of individuals with or at high risk of knee osteoarthritis (OA) had baseline knee x-rays, questionnaires, and a question about frequent knee pain (FKnP) (pain on most of the past 30 days) at two time points: a telephone screen and a later clinic visit. We computed the prevalence of inconsistent knee pain (positive answer to FKnP question at only one time point) and consistent knee pain (positive answer to FKnP question at both time points). We evaluated the association of consistency of FKnP with a number of sociodemographic factors, pain severity, and function. Results There were 2940 participants with complete data (5867 knees) (mean age 62, mean BMI 30.7, 60% female). Of those, 2977 knees had pain, with 43% having inconsistent and 57% having consistent knee pain. Those with radiographic OA (OR 0.46), depressive symptoms (OR 0.73), and widespread pain (OR 0.68) (all p<0.05) were less likely to have inconsistent compared with consistent knee pain. Pain, function, and strength were significantly better in persons with 2 knees that had inconsistent compared with consistent pain. Conclusions A substantial proportion of persons with knee pain have inconsistent knee pain, associated with better physical function and strength (adjusting for pain severity). Such pain may be suggestive of an earlier stage of disease. PMID:20708003

  13. Prevalence Projections

    Cancer.gov

    Close Window State Cancer Profiles Quick Reference Guides ? Quick Reference Guides Index Prevalence Projections Send to Printer Text description of this image. Site Home Policies Accessibility Viewing Files FOIA Contact Us U.S. Department of Health

  14. Complaints in gynaecology in England: an effective learning tool.

    PubMed

    Prabakar, I M; Samra, J

    2012-11-01

    The highest increase of 13.4% in complaints registered in hospital and community services in England, was observed in 2009-2010, since the beginning of data collection from 1997. We observed that complaints in gynaecology have remained a comparatively less explored area against its obstetric counterpart. We investigated the increasing trend observed in our gynaecology services of a district general hospital, over a period of 5 years. All complaints registered were subjected to a retrospective qualitative analysis and causes or contributory factors were classified in a standardised way, as followed by the National Health Services (NHS) Information Centre. Inappropriate communication was responsible for 38.6% of complaints lodged, followed by administrative or organisational errors accounting for 33.9% of complaints. A significant proportion of complainants had recorded more than three sequential events, which is recognised as a potential opportunity to prevent escalation of complaints. PMID:23075360

  15. Pain and pressure pain thresholds in adolescents with chronic fatigue syndrome and healthy controls: a cross-sectional study

    PubMed Central

    Winger, Anette; Kvarstein, Gunnvald; Wyller, Vegard Bruun; Sulheim, Dag; Fagermoen, Even; Småstuen, Milada Cvancarova; Helseth, Sølvi

    2014-01-01

    Objectives Although pain is a significant symptom in chronic fatigue syndrome (CFS), pain is poorly understood in adolescents with CFS. The aim of this study was to explore pain distribution and prevalence, pain intensity and its functional interference in everyday life, as well as pressure pain thresholds (PPT) in adolescents with CFS and compare this with a control group of healthy adolescents (HC). Methods This is a case–control, cross-sectional study on pain including 120 adolescents with CFS and 39 HCs, aged 12–18?years. We measured pain frequency, pain severity and pain interference using self-reporting questionnaires. PPT was measured using pressure algometry. Data were collected from March 2010 until October 2012 as part of the Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial. Results Adolescents with CFS had significantly lower PPTs compared with HCs (p<0.001). The Pain Severity Score and the Pain Interference Score were significantly higher in adolescents with CFS compared with HCs (p<0.001). Almost all adolescents with CFS experienced headache, abdominal pain and/or pain in muscles and joints. Moreover, in all sites, the pain intensity levels were significantly higher than in HCs (p<0.001). Conclusions We found a higher prevalence of severe pain among adolescents with CFS and lowered pain thresholds compared with HCs. The mechanisms, however, are still obscure. Large longitudinal population surveys are warranted measuring pain thresholds prior to the onset of CFS. Trial registration number Clinical Trials, NCT01040429; The Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial (NorCAPITAL) http://www.clinicaltrials.gov. PMID:25287104

  16. [Update on oncological pain in the elderly].

    PubMed

    Cabezón-Gutiérrez, Luis; Gómez-Pavón, Javier; Pérez-Cajaraville, Javier; Viloria-Jiménez, María Aurora; Álamo-González, Cecilio; Gil-Gregorio, Pedro

    2015-01-01

    Pain is a prevalent symptom in cancer geriatric patients, appearing in up to 90% of patients with terminal cancer. This requires a multidimensional approach, as there is a high percentage of inappropriate assessments and treatments. Unrecognized or poorly treated pain in the geriatric population, especially in cancer patients, leads to the development of disabling symptoms such as depression, anxiety, isolation, sleep disturbances, and appetite, and very especially, loss of functional capacity and quality of life. In this review an analysis is made on the most relevant studies on the diagnosis and management of cancer pain in the geriatric population. PMID:25777946

  17. Neck pain

    PubMed Central

    2008-01-01

    Introduction Non-specific neck pain has a postural or mechanical basis and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but may become chronic in about 10% of people. Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident, although this varies between countries. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for people with non-specific neck pain without severe neurological deficit? What are the effects of treatments for acute whiplash injury? What are the effects of treatments for chronic whiplash injury? What are the effects of treatments for neck pain with radiculopathy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 91 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of the evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, biofeedback, drug treatments (analgesics, antidepressants, epidural steroid injections, muscle relaxants, non-steroidal anti-inflammatory drugs [NSAIDs]), early mobilisation, early return to normal activity, exercise, heat or cold, manipulation (alone or plus exercise), mobilisation, multimodal treatment, patient education, percutaneous radiofrequency neurotomy, physical treatments, postural techniques (yoga, pilates, Alexander technique), pulsed electromagnetic field (PEMF) treatment, soft collars and special pillows, spray and stretch, surgery, traction, and transcutaneous electrical nerve stimulation (TENS). PMID:19445809

  18. Symptoms and Health Complaints and Their Association with Perceived Stressors among Students at Nine Libyan Universities

    PubMed Central

    El Ansari, Walid; Khalil, Khalid; Stock, Christiane

    2014-01-01

    University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall), socio-demographic characteristics (five variables), health behaviours/lifestyle factors (six variables), as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints). A sample of 2100 undergraduate students from nine institutions (six universities, three colleges) located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%–60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15–2.02), depressive mood (OR 2.20; 95% CI 1.64–2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19–2.03). Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population. PMID:25429678

  19. Underestimation and undertreatment of pain in HIV disease: multicentre study.

    PubMed Central

    Larue, F.; Fontaine, A.; Colleau, S. M.

    1997-01-01

    OBJECTIVE: To measure the prevalence, severity, and impact of pain on quality of life for HIV patients; to identify factors associated with undertreatment of pain. DESIGN: Multicentre cross sectional survey. SETTINGS: 34 HIV treatment facilities, including inpatient hospital wards, day hospitals, and ambulatory care clinics, in 13 cities throughout France. SUBJECTS: 315 HIV patients at different stages of the disease. MAIN OUTCOME MEASURES: Patients: recorded presence and severity of pain and rated quality of life. Doctors: reported disease status, estimate of pain severity, and analgesic treatment ordered. RESULTS: From 30% (17/56) of outpatients to 62% (73/118) of inpatients reported pain due to HIV disease. Pain severity significantly decreased patients' quality of life. Doctors underestimated pain severity in 52% (70/135) of HIV patients reporting pain. Underestimation of pain severity was more likely for patients who reported moderate (odds ratio 24) or severe pain (165) and less likely for patients whose pain source was identified or who were perceived as more depressed. Of the patients reporting moderate or severe pain, 57% (61/107) did not receive any analgesic treatment; only 22% (23/107) received at least weak opioids. Likelihood of analgesic prescription increased when doctors estimated pain to be more severe and regarded patients as sicker. CONCLUSIONS: Pain is a common and debilitating symptom of HIV disease which is gravely underestimated and undertreated. PMID:9001475

  20. 47 CFR 68.417 - Informal complaints; form and content.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...417 Section 68.417 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint Procedures § 68.417 Informal...

  1. 47 CFR 68.419 - Answers to informal complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...419 Section 68.419 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint Procedures § 68.419 Answers to...

  2. Low Back Pain and Obesity

    PubMed Central

    Ibrahimi-Kaçuri, Dafina; Murtezani, Ardiana; Rrecaj, Shkurta; Martinaj, Merita; Haxhiu, Bekim

    2015-01-01

    Introduction: Low back pain poses a significant problem in clinics and public health. It presents one of the main problems with adults, since 70-80% of adults experience it at least once in their lifetime. Causes of the low back pain are numerous and often unknown. Objectives: The aim of the study is to find the most prevalent age group, pain localisation, and the frequency of physical therapy sessions in obese and non-obese subjects with LBP. Materials and Methods: The study has been conducted by the Physical Rehabilitation Service of the Occupational Medicine Institute, during one year period. The total number of patients studied was 101 and all were Kosovo Energy Corporation (KEC) employees. The study was retrospective. Results: Looking at the body weight index, out of 101 patients, 69.3% are classified as non-obese and 30.7% as obese. Using T-Test we have found a difference of high statistical significance between the average number of the physical therapy sessions applied in relation to the examined groups (T-Test=2.78, P=0.0065, so, P<0.01). Conclusion: Obesity and age have no direct influence in back pain, but they could prolong healing. Professional occupation and binding position are factors that affect back pain. Physical workload can cause the manifestation of sciatica; whereas psycho-social factors can prolong the overall healing process. PMID:26005262

  3. Pain sensitivity in major depression and its relationship to central serotoninergic function as reflected by the neuroendocrine response to clomipramine.

    PubMed

    Kundermann, Bernd; Hemmeter-Spernal, Julia; Strate, Peter; Gebhardt, Stefan; Huber, Martin Tobias; Krieg, Jürgen-Christian; Lautenbacher, Stefan

    2009-12-01

    Several studies reported a decreased pain sensitivity in patients with depression, but the underlying neurobiological mechanisms of this phenomenon are unclear. While there is extensive evidence that the serotoninergic system plays a key role in pain modulation, especially in pain inhibitory mechanisms via descending pathways, as well as in the pathophysiology of depression, no study so far has examined its potential relevance in mediating the alteration of pain processing. The present study addresses the question of whether indices of serotoninergic dysfunction, as investigated by a neuroendrocine challenge paradigm, are related to pain sensitivity. Nineteen drug-free inpatients with unipolar major depression underwent a neuroendocrine challenge test by measuring cortisol and prolactin in response to intravenously administered clomipramine (12.5mg). Heat/cold pain thresholds, warmth/cold detection thresholds, measures of current pain complaints and mood were assessed the day before and three day after challenge procedure. When patients were classified in subgroups based on a median split of their cortisol response values, the low-responsive group showed significantly elevated heat pain thresholds and nearly significantly elevated cold pain thresholds compared to the high-responsive group. No such group differences were found with regard to somatosensory thresholds, measures of pain complaints and mood. Subgrouping on the basis of prolactin responsiveness did not reveal significant differences in any parameter. In summary, a decreased pain sensitivity was demonstrated in patients characterized by a reduced neuroendocrine responsiveness to clomipramine, suggesting an involvement of serotoninergic dysfunction underlying altered pain perception in depression. PMID:19467668

  4. Pain Behind Bars: The Epidemiology of Pain in Older Jail Inmates in a County Jail

    PubMed Central

    Ahalt, Cyrus; Stijacic-Cenzer, Irena; Smith, Alexander K.; Goldenson, Joe; Ritchie, Christine S.

    2014-01-01

    Abstract Background: The number of older jail inmates in poor health is increasing rapidly. Among older adults, pain is common and leads to greater acute care use. In jail, pain management is complicated by concerns about misuse and diversion. A lack of data about the prevalence and management of pain in older jail inmates limits our ability to develop optimal palliative care strategies for this population. Objective: To describe the prevalence of and factors associated with pain and analgesic use in a population of older jail inmates. Design: Cross-sectional study. ?2 tests assessed association between characteristics, pain, and analgesic use. Setting/Subjects: Two hundred ten jail inmates age 55 or older. Measurements: “Severe frequent pain” defined as “severe or very severe” pain experienced “frequently or constantly” using the validated Memorial Symptom Assessment Scale. Medical conditions, substance use, and analgesic treatment determined through self-report and jail medical records. Results: Participants' mean age was 59 years; 69% had multimorbidity; 75% reported any pain; 39% reported severe frequent pain. Report of severe frequent pain was associated with multimorbidity, functional impairment, and pre-jail acute care use (p<0.05), but not with substance use (57% versus 56%, p=0.89). Within a week of their interview, most participants with severe frequent pain had received an analgesic (87%) and many received an opioid (70%). Conclusion: High rates of pain in a rapidly growing population of older jail inmates with multimorbidity and functional impairment suggest that jails are an important site for assessing symptom burden and developing appropriate palliative care interventions. PMID:25265035

  5. Pain and Hand Function.

    PubMed

    Howland, Nicholas; Lopez, Mariela; Zhang, Andrew Y

    2016-02-01

    Pain is a unique somatosensory perception that can dramatically affect our ability to function. It is also a necessary perception, without which we would do irreparable damage to ourselves. In this article, the authors assess the impact of pain on function of the hand. Pain can be categorized into acute pain, chronic pain, and neuropathic pain. Hand function and objective measurements of hand function are analyzed as well as the impact of different types of pain on each of these areas. PMID:26611383

  6. Barriers to cancer pain management in Danish and Lithuanian patients treated in pain and palliative care units.

    PubMed

    Jacobsen, Ramune; Samsanaviciene, Jurgita; Liubarskiene, Zita; Sjøgren, Per; Møldrup, Claus; Christrup, Lona; Sciupokas, Arunas; Hansen, Ole Bo

    2014-03-01

    The prevalence of cancer-related pain is high despite available guidelines for the effective assessment and management of that pain. Barriers to the use of opioid analgesics partially cause undertreatment of cancer pain. The aim of this study was to compare pain management outcomes and patient-related barriers to cancer pain management in patient samples from Denmark and Lithuania. Thirty-three Danish and 30 Lithuanian patients responded to, respectively, Danish and Lithuanian versions of the Brief Pain Inventory pain scale, the Barriers Questionnaire II, the Hospital Anxiety and Depression Scale, the Specific Questionnaire On Pain Communication, and the Medication Adherence Report Scale. Emotional distress and patient attitudes toward opioid analgesics in cancer patient samples from both countries explained pain management outcomes in the multivariate regression models. Pain relief and pain medication adherence were better in Denmark, and the country of origin significantly explained the difference in the regression models for these outcomes. In conclusion, interventions in emotional distress and patient attitudes toward opioid analgesics may result in better pain management outcomes generally, whereas poor adherence to pain medication and poor pain relief appear to be more country-specific problems. PMID:24602424

  7. Effect of pain neuroscience education and dry needling on chronic elbow pain as a result of cyberchondria: a case report.

    PubMed

    Anandkumar, Sudarshan

    2015-03-01

    This case report describes a 31-year-old male who presented with complaints of chronic pain in his right elbow. Detailed subjective examination revealed that the patient had searched Google for extensive online information relating to his pain, ultimately self-labeling with various diagnoses. After researching in YouTube, the patient self-treated with ice, exercises, neural mobilization, self-massage and taping, all resulting in a failed outcome. Clinical findings revealed trigger points in his right brachioradialis muscle with added symptoms of central pain. This is a potential first-time description of physical therapy management of brachioradialis myofascial pain syndrome with superadded central pain caused as a result of cyberchondria where the patient used the Internet for arriving at a wrong self-diagnosis and incorrect self-treatment with failed or worsening pain outcomes leading to pain sustenance or chronicity. Physical therapy consisted of Pain Neuroscience Education, dry needling and exercise therapy. The patient was completely pain free and fully functional at the end of the sixth session, which was maintained at a one-month follow-up. PMID:25487824

  8. Innate Immune Signalling Genetics of Pain, Cognitive Dysfunction and Sickness Symptoms in Cancer Pain Patients Treated with Transdermal Fentanyl

    PubMed Central

    Barratt, Daniel T.; Klepstad, Pål; Dale, Ola; Kaasa, Stein; Somogyi, Andrew A.

    2015-01-01

    Common adverse symptoms of cancer and chemotherapy are a major health burden; chief among these is pain, with opioids including transdermal fentanyl the mainstay of treatment. Innate immune activation has been implicated generally in pain, opioid analgesia, cognitive dysfunction, and sickness type symptoms reported by cancer patients. We aimed to determine if genetic polymorphisms in neuroimmune activation pathways alter the serum fentanyl concentration-response relationships for pain control, cognitive dysfunction, and other adverse symptoms, in cancer pain patients. Cancer pain patients (468) receiving transdermal fentanyl were genotyped for 31 single nucleotide polymorphisms in 19 genes: CASP1, BDNF, CRP, LY96, IL6, IL1B, TGFB1, TNF, IL10, IL2, TLR2, TLR4, MYD88, IL6R, OPRM1, ARRB2, COMT, STAT6 and ABCB1. Lasso and backward stepwise generalised linear regression were used to identify non-genetic and genetic predictors, respectively, of pain control (average Brief Pain Inventory < 4), cognitive dysfunction (Mini-Mental State Examination ? 23), sickness response and opioid adverse event complaint. Serum fentanyl concentrations did not predict between-patient variability in these outcomes, nor did genetic factors predict pain control, sickness response or opioid adverse event complaint. Carriers of the MYD88 rs6853 variant were half as likely to have cognitive dysfunction (11/111) than wild-type patients (69/325), with a relative risk of 0.45 (95% CI: 0.27 to 0.76) when accounting for major non-genetic predictors (age, Karnofsky functional score). This supports the involvement of innate immune signalling in cognitive dysfunction, and identifies MyD88 signalling pathways as a potential focus for predicting and reducing the burden of cognitive dysfunction in cancer pain patients. PMID:26332828

  9. Sexual, Physical, Verbal/Emotional Abuse and Unexplained Chest Pain

    ERIC Educational Resources Information Center

    Eslick, Guy D.; Koloski, Natasha A.; Talley, Nicholas J.

    2011-01-01

    Objectives: Approximately one third of patients with non cardiac chest pain (NCCP) report a history of abuse, however no data exists on the prevalence of abuse among people with unexplained chest pain in the general population. We aimed to determine if there is a relationship between childhood sexual, physical, emotional abuse and unexplained…

  10. Pain, Nicotine, and Smoking: Research Findings and Mechanistic Considerations

    ERIC Educational Resources Information Center

    Ditre, Joseph W.; Brandon, Thomas H.; Zale, Emily L.; Meagher, Mary M.

    2011-01-01

    Tobacco addiction and chronic pain represent 2 highly prevalent and comorbid conditions that engender substantial burdens upon individuals and systems. Interrelations between pain and smoking have been of clinical and empirical interest for decades, and research in this area has increased dramatically over the past 5 years. We conceptualize the…

  11. Chronic widespread musculoskeletal pain in patients with obstructive sleep apnea syndrome and the relationship between sleep disorder and pain level, quality of life, and disability

    PubMed Central

    Aytekin, Ebru; Demir, Saliha Eroglu; Komut, Ece Akyol; Okur, Sibel Caglar; Burnaz, Ozer; Caglar, Nil Sayiner; Demiryontar, Dilay Yilmaz

    2015-01-01

    [Purpose] The aim of this study was to ascertain the prevalence of chronic widespread musculoskeletal pain in patients with obstructive sleep apnea syndrome and to assess the relationship between sleep disorder and pain, quality of life, and disability. [Subjects and Methods] Seventy-four patients were included in the study and classified as having mild, moderate, or severe obstructive sleep apnea. Chronic widespread pain, quality of life, and disability were evaluated. [Results] Forty-one patients (55.4%) had chronic widespread pain. Female patients had a higher incidence of chronic pain, and female patients with chronic pain had higher body mass indexes, pain levels, and disability scores than did male patients. Physical component scores of female patients with chronic pain were lower than those of male patients. No correlation was observed between the degree of sleep disorder and severity of pain, pain duration, disability, or quality of life in obstructive sleep apnea patients with pain. [Conclusion] This study showed a 55.4% prevalence of chronic widespread pain in patients with obstructive sleep apnea and a greater risk of chronic pain in female than in male patients. Female patients with obstructive sleep apnea and chronic pain have higher pain and disability levels and a lower quality of life. PMID:26504332

  12. Ultrasound Detection of a Renal Mass in a Patient with Flank Pain and Hematuria

    PubMed Central

    Marzec, Karl; Mailhot, Thomas; Perera, Phillips

    2013-01-01

    Flank pain with hematuria is a common chief complaint in the emergency department (ED). Patients are often diagnosed with renal calculi or pyelonephritis and discharged with analgesics or antibiotics and follow-up. This case study describes a patient who presented to the ED with a 1 week history of flank pain and hematuria and was subsequently found to have a large renal mass on bedside ultrasound. PMID:23599845

  13. Abrupt onset of severe pain at term. A case report.

    PubMed

    Skovgaard, R L; Christenson, C S; McClard, M M; Spoor-Sandefur, C D; Kedley, K E

    1997-01-01

    This case report involves an adolescent primigravida at term who was admitted with urinary complaints to the labor and delivery unit of a medical center. Within an hour, she suddenly began screaming and complaining of severe pain running from her anterior pelvis through her vagina and up her spine. Three days of very challenging co-management of the patient, with several recurrences of acute pain, followed. Differential diagnoses that could explain this patient's symptoms are reviewed and discussed. Difficult management issues, including the stress of clinical management in the face of unidentified disease processes, are addressed. Lacking a certain diagnosis even retrospectively, the authors request comments from readers. PMID:9037934

  14. Descending pain modulation and chronification of pain

    PubMed Central

    Ossipov, Michael H.; Morimura, Kozo; Porreca, Frank

    2015-01-01

    Purpose of review Chronic pain is an important public health problem that negatively impacts quality of life of affected individuals and exacts an enormous socio-economic cost. Currently available therapeutics provide inadequate management of pain in many patients. Acute pain states generally resolve in most patients. However, for reasons that are poorly understood, in some individuals, acute pain can transform to a chronic state. Our understanding of the risk factors that underlie the development of chronic pain is limited. Recent studies have suggested an important contribution of dysfunction in descending pain modulatory circuits to pain ‘chronification’. Human studies provide insights into possible endogenous and exogenous factors that may promote the conversion of pain into a chronic condition. Recent findings Descending pain modulatory systems have been studied and characterized in animal models. Human brain imaging techniques, deep brain stimulation and the mechanisms of action of drugs that are effective in the treatment of pain confirm the clinical relevance of top-down pain modulatory circuits. Growing evidence supports the concept that chronic pain is associated with a dysregulation in descending pain modulation. Disruption of the balance of descending modulatory circuits to favour facilitation may promote and maintain chronic pain. Recent findings suggest that diminished descending inhibition is likely to be an important element in determining whether pain may become chronic. This view is consistent with the clinical success of drugs that enhance spinal noradrenergic activity, such as serotonin/norepinephrine reuptake inhibitors (SNRIs), in the treatment of chronic pain states. Consistent with this concept, a robust descending inhibitory system may be normally engaged to protect against the development of chronic pain. Imaging studies show that higher cortical and subcortical centres that govern emotional, motivational and cognitive processes communicate directly with descending pain modulatory circuits providing a mechanistic basis to explain how exogenous factors can influence the expression of chronic pain in a susceptible individual. Summary Preclinical studies coupled with clinical pharmacologic and neuroimaging investigations have advanced our understanding of brain circuits that modulate pain. Descending pain facilitatory and inhibitory circuits arising ultimately in the brainstem provide mechanisms that can be engaged to promote or protect against pain ‘chronification’. These systems interact with higher centres, thus providing a means through which exogenous factors can influence the risk of pain chronification. A greater understanding of the role of descending pain modulation can lead to novel therapeutic directions aimed at normalizing aberrant processes that can lead to chronic pain. PMID:24752199

  15. Medications for back pain

    MedlinePLUS

    ... help with your back pain. Over-the-counter pain relievers Over-the-counter pain relievers can help with your back pain. Over-the- ... your health care provider. If you are taking pain relievers for more than a week, tell your doctor. ...

  16. Damage to taste system and oral pain: burning mouth syndrome.

    PubMed

    Femiano, F

    2004-09-01

    The burning mouth syndrome (BMS) is an oral pain disorder. Central or peripheral pain mechanisms may play a role in the oral burning of BMS. Various local, systemic and psychological factors have been found to be associated with BMS, but its etiology is not fully understood. This syndrome mostly affects middle-aged women and is frequently accompanied by taste complaints. This association of symptoms suggests an interaction between the mechanisms of nociception and gustation, 2 senses with strong hedonic components. There are connections between taste and oral pain in the central nervous system and it is possible that BMS and other oral pain phantoms result from damage to the taste system. This suggests that individuals who suffer from BMS are likely to be supertasters. PMID:15499299

  17. [Neuropathic pain due to herpes zoster infection with atypical localization].

    PubMed

    Sa??r, Özlem; Özaslan, Sabri; Meriç, Yücel; Arslan, ?smail; Köro?lu, Ahmet

    2013-01-01

    Acute herpes zoster infection appears in the situation of depression of immune system and reactivation of varicella zoster virus which causes small pox. Pain and maculopapular lesion accompany clinical symptoms. Various pharmacological and invasive methods can be used for treatment. Efficient therapy is important for prevention of postherpetic neuralgia and cure of acute pain and dermatological lesions. A 55 years old, 160 cm height and 65 kg weight female patient with complaints of severe pain, sensation of burning, tingling at the right hand and forearm was admitted to our pain department. The patient who was diagnosed as cervical hernia at an other medical center had a normal physical servical spine examination. Patient history and physical examination findings with acute herpes zoster infection was considered. Right stellate ganglion blockade for diagnosis and treatment was performed because of regressed and atypically located lesions and a visual analog scale score of 10. VAS score decreased 50% at 9th min after block, VAS score at 2nd hour was 2. Antiviral, gabapentin, and tricyclic antidepressant treatment was started after stellat ganglion blockade and patient was discharged. After 3 months complaints dissapeared and drug doses were discreased and stopped. In conclusion we think that stellate ganglion blockade can be useful in diagnosis, acute pain control, improving patient comfort and compatibility to drug therapy in atypically located herpes zoster. PMID:24264553

  18. An evidence-based approach to the evaluation and treatment of low back pain in the emergency department.

    PubMed

    Borczuk, Pierre

    2013-07-01

    Low back pain is the most common musculoskeletal complaint that results in a visit to the emergency department, and it is 1 of the top 5 most common complaints in emergency medicine. Estimates of annual healthcare expenditures for low back pain in the United States exceed $90 billion annually, not even taking lost productivity and business costs into account. This review explores an evidence-based rationale for the evaluation of the patient with low back pain, and it provides guidance on risk stratification pertaining to laboratory assessment and radiologic imaging in the emergency department. Published guidelines from the American College of Physicians and American Pain Society are reviewed, with emphasis on best evidence for pharmacologic treatments, self-care interventions, and more invasive procedures and surgery in management of low back pain. Utilizing effective and proven strategies will avoid medical errors, provide better care for patients, and help manage healthcare resources and costs. PMID:24044786

  19. Geriatric pain competencies and knowledge assessment for nurses in long term care settings

    PubMed Central

    Swafford, Kristen L.; Miller, Lois L.; Herr, Keela; Forcucci, Chris; Kelly, Anne Marie L.; Bakerjian, Debra

    2015-01-01

    Pain in older adults is a prevalent problem that affects quality of life and challenges nurses, particularly those caring for older adults living in long term care settings. Despite the national priority of pain management, insufficient knowledge of nurses about geriatric pain is a documented barrier to effective geriatric pain management in all long term care settings. To address this knowledge gap, a website (GeriatricPain.org) was developed by the National Geriatric Pain Collaborative with a grant from the MayDay Fund to provide a single site for evidenced-based, easy-to-use, downloadable resources on pain management. This paper describes the development of the most recent addition to the website, a set of evidence-based core geriatric pain management competencies and a geriatric pain knowledge assessment, and discusses their potential uses in improving pain care for older adults. Geriatric Pain Competencies and Knowledge Assessment for Nurses in Long Term Care Settings. PMID:25037079

  20. Pain Medication Requirements After Sacropexy and Combination Interventions

    PubMed Central

    Schiermeier, Sven; Hatzmann, Wolfgang; Soltész, Stefan; Spüntrup, Carolin; Anapolski, Michael

    2014-01-01

    Background and Objectives: Laparoscopic surgery is associated with reduced morbidity, and postoperative pain is reduced. The aim of this study was to assess postoperative pain intensity, analgesic requirements, and the influence of cofactors after laparoscopic sacral colpopexy. Methods: The study assessed 287 patients treated with laparoscopic sacropexy for genital prolapse with a Pelvic Organ Prolapse Quantification grade >1. Patients were asked to evaluate their pain postoperatively using a 4-point verbal pain rating scale. In addition, medical records were analyzed regarding the requirement for analgesic medication. Results: Patients distinguished between abdominal pain and shoulder pain after laparoscopy. Abdominal pain reached maximum severity on day 1 and showed a good response to nonsteroidal antiphlogistics, whereas shoulder pain was rarely found (6.27%). Of the patients, 38% required no pain treatment or required 1 dose at most. The need for pain medication reached its climax on day 1 and decreased during the 5 following days. Non-opioid analgesics provided a sufficient therapeutic effect. Conclusion: Laparoscopic sacropexy is associated with a moderate degree of postoperative pain. Non-opioid analgesics should be preferred as first-line therapy. The typical shoulder-tip pain showed only a low prevalence in our study group. From our point of view, the low rate of shoulder-tip pain corresponded with the low intra-abdominal carbon dioxide pressure. PMID:25392656

  1. 12 CFR 268.302 - Mixed case complaints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... jurisdiction. The Board will apply sections 1614.302 to 1614.310 of 29 CFR to the processing of a mixed case... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Mixed case complaints. 268.302 Section 268.302... RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed...

  2. 32 CFR 935.92 - Service of complaint.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Service of complaint. 935.92 Section 935.92 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE TERRITORIAL AND INSULAR REGULATIONS WAKE ISLAND CODE Civil Actions § 935.92 Service of complaint. (a) A peace officer or other person designated by the Court to make...

  3. 34 CFR 300.508 - Due process complaint.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... (1) If the LEA has not sent a prior written notice under § 300.503 to the parent regarding the... the due process complaint, send to the parent a response that includes— (i) An explanation of why the... complaint, send to the other party a response that specifically addresses the issues raised in the...

  4. 47 CFR 76.1606 - Rate change while complaint pending.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rate change while complaint pending. 76.1606 Section 76.1606 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1606 Rate change while complaint pending....

  5. 7 CFR 6.42 - Complaints of price-undercutting.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Cheese by Quota Cheeses § 6.42 Complaints of price-undercutting. (a) Submission of complaint. Any person who has reason to believe that the price at which any article of quota cheese is offered for sale or... a subsidy with respect to such article of quota cheese may file with the Investigating Authority...

  6. 7 CFR 6.42 - Complaints of price-undercutting.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Cheese by Quota Cheeses § 6.42 Complaints of price-undercutting. (a) Submission of complaint. Any person who has reason to believe that the price at which any article of quota cheese is offered for sale or... a subsidy with respect to such article of quota cheese may file with the Investigating Authority...

  7. 7 CFR 6.42 - Complaints of price-undercutting.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Cheese by Quota Cheeses § 6.42 Complaints of price-undercutting. (a) Submission of complaint. Any person who has reason to believe that the price at which any article of quota cheese is offered for sale or... a subsidy with respect to such article of quota cheese may file with the Investigating Authority...

  8. 7 CFR 6.42 - Complaints of price-undercutting.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Cheese by Quota Cheeses § 6.42 Complaints of price-undercutting. (a) Submission of complaint. Any person who has reason to believe that the price at which any article of quota cheese is offered for sale or... a subsidy with respect to such article of quota cheese may file with the Investigating Authority...

  9. 32 CFR 1901.04 - Suggestions and complaints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Suggestions and complaints. 1901.04 Section 1901.04 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY PUBLIC RIGHTS UNDER THE PRIVACY ACT OF 1974 General § 1901.04 Suggestions and complaints. The Agency...

  10. 31 CFR 15.737-12 - Contents of complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Contents of complaint. 15.737-12 Section 15.737-12 Money and Finance: Treasury Office of the Secretary of the Treasury POST EMPLOYMENT CONFLICT OF INTEREST Administrative Enforcement Proceedings § 15.737-12 Contents of complaint. (a)...

  11. 31 CFR 8.55 - Contents of complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Contents of complaint. 8.55 Section 8.55 Money and Finance: Treasury Office of the Secretary of the Treasury PRACTICE BEFORE THE BUREAU OF ALCOHOL, TOBACCO AND FIREARMS Disciplinary Proceedings § 8.55 Contents of complaint. (a) Charges....

  12. 31 CFR 10.62 - Contents of complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Contents of complaint. 10.62 Section 10.62 Money and Finance: Treasury Office of the Secretary of the Treasury PRACTICE BEFORE THE INTERNAL REVENUE SERVICE Rules Applicable to Disciplinary Proceedings § 10.62 Contents of complaint....

  13. 45 CFR 672.7 - Issuance of complaint.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Issuance of complaint. 672.7 Section 672.7 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.7 Issuance of complaint. (a) General. If the complainant has reason to believe that a person has violated any provision...

  14. 41 CFR 51-6.11 - Quality complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Quality complaints. 51-6.11 Section 51-6.11 Public Contracts and Property Management Other Provisions Relating to Public... § 51-6.11 Quality complaints. (a) When the quality of a commodity received is not...

  15. DOES FAMILY OF ORIGIN FUNCTIONING PREDICT ADULT SOMATIC COMPLAINTS?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    It has long been believed that adult somatic complaints are associated with early family dysfunction. Yet few studies have examined this hypothesis in community samples, where medically unexplained symptom complaints are estimated to be very common. Given the potential population-wide impact of subt...

  16. 40 CFR 135.4 - Service of complaint.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Service of complaint. 135.4 Section 135.4 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS PRIOR NOTICE OF CITIZEN SUITS Prior Notice Under the Clean Water Act § 135.4 Service of complaint. (a)...

  17. 24 CFR 3282.256 - Distributor or dealer complaint handling.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Distributor or dealer complaint... Distributor Responsibilities § 3282.256 Distributor or dealer complaint handling. (a) When a distributor or... contains an imminent safety hazard, serious defect, defect, or noncompliance, the distributor or...

  18. 47 CFR 68.417 - Informal complaints; form and content.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Informal complaints; form and content. 68.417 Section 68.417 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint Procedures § 68.417...

  19. 47 CFR 68.419 - Answers to informal complaints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Answers to informal complaints. 68.419 Section 68.419 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint Procedures § 68.419...

  20. 47 CFR 68.417 - Informal complaints; form and content.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Informal complaints; form and content. 68.417 Section 68.417 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint Procedures § 68.417...

  1. Customer complaints: a managed care firm's best weapon in CQI.

    PubMed

    Polonski, G J

    1995-01-01

    Encouraging customer feedback and developing an automated customer complaint system are two essential steps a health plan must take if it wishes to develop a balanced relationship with the customer. The author explores how the right attitude and appropriate action can ensure that both customers and the company reap the benefits of a comprehensive customer complaint system. PMID:10139955

  2. 40 CFR 7.180 - Mediation of age discrimination complaints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Discrimination Prohibited on the Basis of Age § 7.180 Mediation of age discrimination complaints. (a) The OCR... mediator at least once before the OCR will accept a judgment that an agreement is not possible. The... the OCR, which will take no further action on the complaint unless the complainant or the...

  3. 40 CFR 7.180 - Mediation of age discrimination complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Discrimination Prohibited on the Basis of Age § 7.180 Mediation of age discrimination complaints. (a) The OCR... mediator at least once before the OCR will accept a judgment that an agreement is not possible. The... the OCR, which will take no further action on the complaint unless the complainant or the...

  4. 6 CFR 13.6 - Prerequisites for issuing a Complaint.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 6 Domestic Security 1 2011-01-01 2011-01-01 false Prerequisites for issuing a Complaint. 13.6 Section 13.6 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.6 Prerequisites for issuing a Complaint. (a) The Reviewing Official may issue...

  5. 37 CFR 4.1 - Complaints regarding invention promoters.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... invention promoters. 4.1 Section 4.1 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL COMPLAINTS REGARDING INVENTION PROMOTERS § 4.1 Complaints regarding invention promoters. These regulations govern the Patent and Trademark Office's...

  6. 37 CFR 4.1 - Complaints regarding invention promoters.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... invention promoters. 4.1 Section 4.1 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL COMPLAINTS REGARDING INVENTION PROMOTERS § 4.1 Complaints regarding invention promoters. These regulations govern the Patent and Trademark Office's...

  7. 37 CFR 4.1 - Complaints regarding invention promoters.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... invention promoters. 4.1 Section 4.1 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL COMPLAINTS REGARDING INVENTION PROMOTERS § 4.1 Complaints regarding invention promoters. These regulations govern the Patent and Trademark Office's...

  8. 37 CFR 4.1 - Complaints regarding invention promoters.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... invention promoters. 4.1 Section 4.1 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL COMPLAINTS REGARDING INVENTION PROMOTERS § 4.1 Complaints regarding invention promoters. These regulations govern the Patent and Trademark Office's...

  9. 37 CFR 4.1 - Complaints regarding invention promoters.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... invention promoters. 4.1 Section 4.1 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL COMPLAINTS REGARDING INVENTION PROMOTERS § 4.1 Complaints regarding invention promoters. These regulations govern the Patent and Trademark Office's...

  10. 29 CFR 1903.11 - Complaints by employees.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 5 2011-07-01 2011-07-01 false Complaints by employees. 1903.11 Section 1903.11 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR INSPECTIONS, CITATIONS AND PROPOSED PENALTIES § 1903.11 Complaints by employees. (a) Any employee...

  11. 29 CFR 1903.11 - Complaints by employees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 5 2010-07-01 2010-07-01 false Complaints by employees. 1903.11 Section 1903.11 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR INSPECTIONS, CITATIONS AND PROPOSED PENALTIES § 1903.11 Complaints by employees. (a) Any employee...

  12. 29 CFR 1903.11 - Complaints by employees.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 5 2012-07-01 2012-07-01 false Complaints by employees. 1903.11 Section 1903.11 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR INSPECTIONS, CITATIONS AND PROPOSED PENALTIES § 1903.11 Complaints by employees. (a) Any employee...

  13. 29 CFR 1903.11 - Complaints by employees.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 5 2014-07-01 2014-07-01 false Complaints by employees. 1903.11 Section 1903.11 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR INSPECTIONS, CITATIONS AND PROPOSED PENALTIES § 1903.11 Complaints by employees. (a) Any employee...

  14. 29 CFR 1903.11 - Complaints by employees.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 5 2013-07-01 2013-07-01 false Complaints by employees. 1903.11 Section 1903.11 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR INSPECTIONS, CITATIONS AND PROPOSED PENALTIES § 1903.11 Complaints by employees. (a) Any employee...

  15. 77 FR 37558 - Disclosure of Certain Credit Card Complaint Data

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-22

    ...The Bureau of Consumer Financial Protection (the ``Bureau'') is issuing a final policy statement (the ``Policy Statement'') to provide guidance on how the Bureau plans to exercise its discretion to publicly disclose certain credit card complaint data that do not include personally identifiable information. The Bureau receives credit card complaints from consumers under the terms of Title X of......

  16. 18 CFR 385.206 - Complaints (Rule 206).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... electronic media as specified by the Secretary. (11) Explain with respect to requests for Fast Track... before an ALJ; (h) Fast Track processing. (1) The Commission may resolve complaints using Fast Track procedures if the complaint requires expeditious resolution. Fast Track procedures may include...

  17. 49 CFR 1111.6 - Satisfaction of complaint.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction...

  18. 49 CFR 1111.6 - Satisfaction of complaint.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction...

  19. 10 CFR 1045.7 - Suggestions or complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Suggestions or complaints. 1045.7 Section 1045.7 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NUCLEAR CLASSIFICATION AND DECLASSIFICATION Program Management of the Restricted Data and Formerly Restricted Data Classification System § 1045.7 Suggestions or complaints. (a) Any person who has suggestions...

  20. 12 CFR 268.302 - Mixed case complaints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... jurisdiction. The Board will apply sections 1614.302 to 1614.310 of 29 CFR to the processing of a mixed case... complaint is a complaint of employment discrimination filed with the Board based on race, color, religion... whole or in part, because of discrimination on the basis of race, color, religion, sex, national...

  1. 12 CFR 268.302 - Mixed case complaints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... jurisdiction. The Board will apply sections 1614.302 to 1614.310 of 29 CFR to the processing of a mixed case... complaint is a complaint of employment discrimination filed with the Board based on race, color, religion... whole or in part, because of discrimination on the basis of race, color, religion, sex, national...

  2. 22 CFR 96.70 - Operation of the Complaint Registry.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Operation of the Complaint Registry. 96.70 Section 96.70 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Oversight Through Review of Complaints § 96.70 Operation of the...

  3. 22 CFR 96.70 - Operation of the Complaint Registry.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Operation of the Complaint Registry. 96.70 Section 96.70 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Oversight Through Review of Complaints § 96.70 Operation of the...

  4. 49 CFR 1111.6 - Satisfaction of complaint.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 8 2012-10-01 2012-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction...

  5. 49 CFR 1111.6 - Satisfaction of complaint.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 8 2014-10-01 2014-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction...

  6. 49 CFR 1111.6 - Satisfaction of complaint.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 8 2013-10-01 2013-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction...

  7. 32 CFR 1901.04 - Suggestions and complaints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Suggestions and complaints. 1901.04 Section 1901.04 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY PUBLIC RIGHTS UNDER THE PRIVACY ACT OF 1974 General § 1901.04 Suggestions and complaints. The Agency...

  8. 29 CFR 37.83 - What happens if a complaint does not contain enough information?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... What happens if a complaint does not contain enough information? 37.83 Section... What happens if a complaint does not contain enough information? (a) If a complaint does not contain enough information, the Director...

  9. 29 CFR 37.73 - What information must a complaint contain?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...true What information must a complaint contain? 37.73 Section 37.73 Labor...73 What information must a complaint contain? Each complaint must be filed in writing, and must contain the following information:...

  10. 20 CFR 636.3 - Complaint and hearing procedures at the grantee level.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 2010-04-01 false Complaint and hearing procedures at the grantee level. 636.3...DEPARTMENT OF LABOR COMPLAINTS, INVESTIGATIONS AND HEARINGS § 636.3 Complaint and hearing procedures at the grantee level. (a)...

  11. 20 CFR 636.3 - Complaint and hearing procedures at the grantee level.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 2011-04-01 false Complaint and hearing procedures at the grantee level. 636.3...DEPARTMENT OF LABOR COMPLAINTS, INVESTIGATIONS AND HEARINGS § 636.3 Complaint and hearing procedures at the grantee level. (a)...

  12. 20 CFR 636.3 - Complaint and hearing procedures at the grantee level.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 2012-04-01 false Complaint and hearing procedures at the grantee level. 636.3...DEPARTMENT OF LABOR COMPLAINTS, INVESTIGATIONS AND HEARINGS § 636.3 Complaint and hearing procedures at the grantee level. (a)...

  13. 77 FR 18860 - Certain Consumer Electronics, Including Mobile Phones and Tablets; Notice of Receipt of Complaint...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... Certain Consumer Electronics, Including Mobile Phones and Tablets; Notice of Receipt of Complaint... complaint entitled Certain Consumer Electronics, Including Mobile Phones and Tablets, DN 2885; the... importation of certain consumer electronics, including mobile phones and tablets. The complaint names...

  14. 76 FR 38743 - Proposed Information Collection (Complaint of Employment Discrimination) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-01

    ...a complaint of employment discrimination. DATES: Written comments...Complaint of Employment Discrimination, VA Form 4939. OMB Control...race, color, religion, gender, national origin age, physical...4939 to file a complaint of discrimination. Affected Public:...

  15. 76 FR 56506 - Agency Information Collection (Complaint of Employment Discrimination) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ...Complaint of Employment Discrimination) Activity Under OMB Review...Complaint of Employment Discrimination, VA Form 4939. OMB Control...race, color, religion, gender, national origin, age...4939 to file complaint of discrimination. An agency may not...

  16. Patellofemoral pain syndrome in Iranian female athletes.

    PubMed

    Nejati, Parisa; Forogh, Bijan; Moeineddin, Reza; Baradaran, Hamid Reza; Nejati, Mina

    2011-01-01

    Patellofemoral pain syndrome (PFPS) is the most common overuse syndrome in athletes. It is one of the causes of anterior knee pain in athletic population who come to the sports medicine clinic. Patellofemoral pain is more common among female athletes especially adolescents and young adults. Symptoms include: persistent pain behind the patella or peripatella. Pain increases on ascending and descending stairs and squatting and prolonged sitting. The aim of this study was to evaluate the prevalence of PFPS in Iranian female athletes. 418 female athletes aged 15-35 years were examined in five sports: Soccer (190), volleyball (103), running (42), fencing (45) and rock climbing (38). The athletes who had non- traumatic onset anterior knee pain of at least 3 months that increased in descending and ascending stairs and squatting, had no other causes of anterior knee pain such as ligament instability, bursitis, meniscal injury, tendonitis and arthritis and no history of knee surgery during the one past year were diagnosed as PFPS. 26/190 (13.68 %) soccer players, 21/103(20.38 %) volleyball players, 7/42 (16.66 %) runners, 6/45(13.33 %) fencers and 10/38 (26.31%) rock climbers had patellofemoral pain. Among the 418 female athletes who were evaluated 70 had PFPS. Rock climbers were the most common athletes with PFPS followed by volleyball players and runners. PMID:21681705

  17. Pain and pain management in dermatology.

    PubMed

    Beiteke, Ulrike; Bigge, Stefan; Reichenberger, Christina; Gralow, Ingrid

    2015-10-01

    It is estimated that 23 million Germans suffer from chronic pain. A recent survey has revealed that 30 % of chronic pain patients are dissatisfied with their pain management. Furthermore, five million Germans suffer from neuropathic pain, 20 % of whom are inadequately treated. Pain is also a symptom of many dermatologic diseases, which is mostly somatic and may be classified as mild in the majority of cases. Nevertheless, research on the quality of life (QoL) has increasingly shown a marked impairment of QoL by moderate pain such as in psoriatic arthritis. -Severe pain is associated with herpes zoster (shingles), leg ulcers, and pyoderma gangrenosum. This article addresses the basics of pain classification and, in a short excerpt, pain transduction/transmission and modulation. The use of standardized diagnostic -scales is recommended for the purpose of recording and monitoring pain intensity, which allows for the optimization of therapy and consistent interdisciplinary -communication. Any dermatology residency program includes the acquisition of knowledge and skills in pain management. This review therefore aims to present fundamental therapeutic concepts based on the expanded WHO analgesic ladder, and describes a step-wise therapeutic approach and combination therapies. The article focuses on the pain management of the above-mentioned severely painful, conservatively treated dermatoses. Besides well-established therapeutic agents and current -therapeutic standards, it discusses specific options based on guidelines (where available). Current knowledge on peri- and postoperative pain management is briefly outlined. This article addresses: ? The fundamentals of the classification and neurophysiology of pain; ? Standards for pain documentation in children and adults; ? General standards for pharmaceutical pain management; ? Current specific treatment options for postherpetic neuralgia, leg ulcers, and -pyoderma gangrenosum in conjunction with the expanded WHO analgesic -ladder. PMID:26408457

  18. Pain drawings in somatoform-functional pain

    PubMed Central

    2012-01-01

    Background Pain drawings are a diagnostic adjunct to history taking, clinical examinations, and biomedical tests in evaluating pain. We hypothesized that somatoform-functional pain, is mirrored in distinctive graphic patterns of pain drawings. Our aim was to identify the most sensitive and specific graphic criteria as a tool to help identifying somatoform-functional pain. Methods We compared 62 patients with somatoform-functional pain with a control group of 49 patients with somatic-nociceptive pain type. All patients were asked to mark their pain on a pre-printed body diagram. An investigator, blinded with regard to the patients’ diagnoses, analyzed the drawings according to a set of numeric or binary criteria. Results We identified 13 drawing criteria pointing with significance to a somatoform-functional pain disorder (all p-values???0.001). The most specific and most sensitive criteria combination for detecting somatoform-functional pain included the total number of marks, the length of the longest mark, and the presence of symmetric patterns. The area under the ROC-curve was 96.3% for this criteria combination. Conclusion Pain drawings are an easy-to-administer supplementary technique which helps to identify somatoform-functional pain in comparison to somatic-nociceptive pain. PMID:23256679

  19. Central Pain Syndrome

    MedlinePLUS

    ... Enhancing Diversity Find People About NINDS NINDS Central Pain Syndrome Information Page Table of Contents (click to ... being done? Clinical Trials Organizations What is Central Pain Syndrome? Central pain syndrome is a neurological condition ...

  20. Overview of Neck Pain

    MedlinePLUS

    ... Back) > Overview of Neck Pain Overview of Neck Pain Page Content Developing a Program That's Right for ... activity? What Kinds of Problems Might Cause Neck Pain? Treatment for any neck condition is recommended as ...

  1. Anterior knee pain

    MedlinePLUS

    Anterior knee pain is pain that occurs at the front and center of the knee. It can be caused by ... attach to the top of the kneecap) Anterior knee pain begins when the kneecap does not move properly ...

  2. What Is Back Pain?

    MedlinePLUS

    ... some types of treatments for chronic back pain. Hot or Cold Packs (or Both) Hot or cold packs can soothe sore, stiff backs. ... helps reduce swelling and numbs deep pain. Using hot or cold packs may relieve pain, but this ...

  3. NIH Pain Consortium

    MedlinePLUS

    Skip Navigation Search: header Home About PC Symposia & Meetings NIH Pain Programs Funding Opportunities Conferences & Seminars Federal Pain Activities News & Health Info Recent News NINDS Director's Message on Pain ...

  4. What Is Chronic Pain?

    MedlinePLUS Videos and Cool Tools

    ... Chronic Pain Medications & Treatments The Art of Pain Management What We Have Learned Going to the ER Communication Tools Pain Management Programs Videos Resources Glossary FAQs Surveys September is ...

  5. Pain: Hope through Research

    MedlinePLUS

    ... pain management. Together the opioids provide effective pain relief for many people with pain. Other peptide s also ... the use of imagery as a distraction provide relief. These methods may be powerful and effective, according ...

  6. Pelvic Pain: Other FAQs

    MedlinePLUS

    ... it affect my ability to become pregnant? Can alternative therapies help? Can it affect my emotional well-being? ... pain affect my ability to become pregnant? Can alternative therapies treat my pain? Can pelvic pain affect my ...

  7. Palliative care - managing pain

    MedlinePLUS

    End of life - pain management; Hospice - pain management ... or if you have side effects from your pain treatments. ... Bookbinder M, McHugh ME. Symptom management in palliative care and ... Medicine . 1st ed. Philadelphia, PA: Elsevier Saunders; 2008:chap ...

  8. Hysteria Scale Elevations in Low Back Pain Patients: A Risk Factor for Misdiagnosis?

    ERIC Educational Resources Information Center

    Prokop, Charles K.

    1986-01-01

    Examined the nature of elevations on the Hysteria scale of the Minnesota Multiphasic Personality Inventory in low back pain patients. Subscales reflecting somatic complaints were more powerful predictors of diagnostic status than were subscales with nonsomatic content. Overlapping and nonoverlapping items on the Hysteria and Hypochondriasis scales…

  9. Acute Pain Experience in Individuals with Autism Spectrum Disorders: A Review

    ERIC Educational Resources Information Center

    Moore, David J.

    2015-01-01

    In addition to the diagnostic criteria for autism spectrum disorder, a number of clinically important comorbid complaints, including sensory abnormalities, are also discussed. One difference often noted in these accounts is hyposensitivity to pain; however, evidence for this is limited. The purpose of the current review therefore was to examine…

  10. Managing Chronic Pain in People with Learning Disabilities: A Case Study

    ERIC Educational Resources Information Center

    Lewis, Sarah; Bell, Dorothy; Gillanders, David

    2007-01-01

    Chronic pain is a prevalent, under-diagnosed problem in the learning disability population. This is in part due to communication problems, unrecognized pain behaviours and the effects of medication. As a consequence, chronic pain often goes untreated and causes ongoing distress. This paper initially describes the main research that has been…

  11. [An epidemiologic study of workers with low back pain].

    PubMed

    Zheng, Y G; Hu, Y G; Zhou, B W

    1994-01-01

    To evaluate the impact of low back pain we conducted a cross-sectional epidemiologic study of 10087 workers in factories of textile, machinery auto-transportation, clothing and sea cultivation. The prevalence of pain was compared with ages, sexes, duration of employment, types of jobs as well as body posture. The prevalence of low back in males was 13.66%, and in females 8.75% (average 11.53%). The risk factors included lifting, bending, twisting prolonged sitting and vibration as well as moisture and coldness prolonged sitting was. The important contributing factor of low back pain in sedentary workers. PMID:8045203

  12. Assessment of Pain

    PubMed Central

    Jeans, Mary-Ellen; Stratford, Joseph G.; Melzack, Ronald; Monks, Richard C.

    1979-01-01

    The assessment of pain presents a major problem in both research and clinical practice. Until recently our methods for evaluating pain were based on a sensory conceptual model of pain and an acute care approach to illness. These traditional views are often inadequate, particularly in relation to chronic pain syndromes. Clinical assessment of chronic pain must include extensive physical and psychological examination. New approaches to pain measurement and clinical assessment of the patient are discussed.

  13. 31 CFR 10.63 - Service of complaint; service of other papers; service of evidence in support of complaint...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...other entity, or appraiser. (b) Service of papers other than complaint. Any paper other than the complaint may be served on the...10.69(a)(2) by: (1) Mailing the paper by first class mail to the last known address (as...

  14. 31 CFR 10.63 - Service of complaint; service of other papers; service of evidence in support of complaint...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...other entity, or appraiser. (b) Service of papers other than complaint. Any paper other than the complaint may be served on the...10.69(a)(2) by: (1) Mailing the paper by first class mail to the last known address (as...

  15. 31 CFR 10.63 - Service of complaint; service of other papers; service of evidence in support of complaint...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...other entity, or appraiser. (b) Service of papers other than complaint. Any paper other than the complaint may be served on the...10.69(a)(2) by: (1) Mailing the paper by first class mail to the last known address (as...

  16. 31 CFR 10.63 - Service of complaint; service of other papers; service of evidence in support of complaint...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...other entity, or appraiser. (b) Service of papers other than complaint. Any paper other than the complaint may be served on the...10.69(a)(2) by: (1) Mailing the paper by first class mail to the last known address (as...

  17. 31 CFR 10.63 - Service of complaint; service of other papers; service of evidence in support of complaint...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...other entity, or appraiser. (b) Service of papers other than complaint. Any paper other than the complaint may be served on the...10.69(a)(2) by: (1) Mailing the paper by first class mail to the last known address (as...

  18. What a Pain! Kids and Growing Pains

    MedlinePLUS

    ... Games Kids' Medical Dictionary En Español What Other Kids Are Reading Girls and Puberty Boys and Puberty ... the Body Works Main Page What a Pain! Kids and Growing Pains KidsHealth > Kids > Illnesses & Injuries > Aches, ...

  19. Pain Management: Post-Amputation Pain

    MedlinePLUS

    Pain Management Post-Amputation Pain Volume 8 · Issue 2 · March/April 1998 Text size Larger text Smaller text Java ... of the most frequently asked questions. Ideas about management are one of the frequent topics of conversation ...

  20. 75 FR 54910 - Notice of Receipt of Complaint; Solicitation of Comments Relating to the Public Interest

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... Trade Commission has received a complaint entitled In Re Certain Ground Fault Circuit Interrupters and... ground fault circuit interrupters and products containing same. The complaint names as respondents...