Microendoscopic excision of C2 osteoid osteoma: a technical report.

PubMed

Kulkarni, Arvind G; Dhruv, Abhilash N; Bassi, Anupreet J

2013-09-01

Case report and description of technique. To describe a microendoscopic posterior approach for excision of an osteoid osteoma of C2. Microendoscopic techniques are widely used in the management of degenerative disorders of the spine. This is the first report of their use in the management of an osteoid osteoma via the posterior approach. A 12-year-old-boy presented with left-sided neck pain of 3-month duration. Investigations revealed an osteoid osteoma of C2 lamina-lateral mass complex. The patient underwent a posterior microendoscopic excision using 18-mm diameter METRx system (Medtronic Sofamor Danek, Memphis, TN) of tubular retractors. A postoperative computed tomographic scan was done and preoperative and postoperative visual analogue scale and Neck Disability Index were evaluated. The patient was periodically followed up for 1 year. The postoperative computed tomographic scan revealed complete excision of the tumor. The visual analogue scale score for neck pain improved from 3/5 (preoperative) to 0/5 (postoperative) and Neck Disability Index from 33.33 (preoperative) to 0 (postoperative) at 1-year follow-up. Microendoscopic techniques can be extended to excise lesions of the spine. It is a safe procedure in experienced hands. The advantages are minimal morbidity, minimal postoperative pain and discomfort, less analgesic dependence, and better cosmesis. The authors recommend this technique for accessible lesions involving the spine.

Vehicle infrastructure integration proof of concept : technical description--vehicle : final report

DOT National Transportation Integrated Search

2009-05-19

This report provides the technical description of the VII system developed for the Cooperative Agreement VII Program between the USDOT and the VII Consortium. The basic architectural elements are summarized and detailed descriptions of the hardware a...

Parents' knowledge, attitudes, use of pain relief methods and satisfaction related to their children's postoperative pain management: a descriptive correlational study.

PubMed

Chng, Hui Yi; He, Hong-Gu; Chan, Sally Wai-Chi; Liam, Joanne Li Wee; Zhu, Lixia; Cheng, Karis Kin Fong

2015-06-01

To examine parents' knowledge about and attitudes towards pain management, use of pain relief strategies and satisfaction with their children's postoperative pain management, as well as the relationships among these variables. Children's postoperative pain is inadequately managed worldwide. Despite increasing emphasis on parental involvement in children's postoperative pain management, few studies have examined parents' management of their child's postoperative pain in Singapore. A descriptive correlational study. A convenience sample of 60 parents having 6- to 14-year-old children undergoing inpatient elective surgery in a public hospital in Singapore was recruited. Data were collected one day after each child's surgery using the Pain Management Knowledge and Attitudes questionnaire and the Parents' Use of Pain Relief Strategies questionnaire. Descriptive statistics, Mann-Whitney U tests, Kruskal-Wallis tests and Spearman's rank correlation coefficient were used for data analyses. Parents displayed moderate levels of knowledge, attitudes and use of pain relief methods in relation to their children's postoperative pain and pain management. They were generally satisfied with the management of their child's postoperative pain. There was significant difference in Parents' Use of Pain Relief Strategies scores between parents with and without previous experience of caring for their hospitalised child. Statistically significant positive correlations were found between parents' knowledge and attitude, knowledge and satisfaction, attitude and satisfaction, knowledge and pain relief strategies, as well as attitude and pain relief strategies. This study indicates the need to provide parents with more information regarding their children's postoperative pain management. Future studies are needed to develop educational interventions for parents to improve their knowledge and attitudes, which will eventually improve their use of pain relief strategies for their children. Health professionals need to provide more information to equip parents with knowledge and skills regarding paediatric postoperative pain management. © 2015 John Wiley & Sons Ltd.

Supporting Parents' Pain Care Involvement With Their Children With Acute Lymphoblastic Leukemia: A Qualitative Interpretive Description.

PubMed

Bettle, Amanda; Latimer, Margot; Fernandez, Conrad; Hughes, Jean

Children with acute lymphoblastic leukemia experience pain from the disease, treatment, and procedures. Parents can be effective in managing their child's pain, but little is systematically known about how they do this. Appreciative inquiry was used to frame the study within a strengths-based lens and interpretive descriptive methods were used to describe pain sources, parents' pain care role, and key structures supporting parents pain care involvement. Eight paediatric oncology clinic nurses and 10 parents participated. Six key themes per group were identified. Parent themes included establishing therapeutic relationships, relearning how to care for my child, overcoming challenges and recognizing pain, learning parent specific strategies, empowering to take active pain care role, and maintaining relationships. Nurse themes included establishing therapeutic relationships, preparing parents to care for their child, facilitating pain assessment, teaching parents best pain care, empowering parents, and maintaining relationships. These findings can be used to guide clinical practice and future research.

Numeric rating scale: patients' perceptions of its use in postoperative pain assessments.

PubMed

Eriksson, Kerstin; Wikström, Lotta; Årestedt, Kristofer; Fridlund, Bengt; Broström, Anders

2014-02-01

The purpose of this study was to describe how patients perceive the use of the numeric rating scale in postoperative pain assessments. There are recommendations to use a pain scale to follow patients' postoperative pain. Most patients prefer the NRS but there is a discrepancy between patients and healthcare professionals how to interpret the ratings from the pain assessments. A descriptive design with a phenomenographic approach was used. Semi structured interviews were held with 25 patients. Three description categories emerged that illustrate patients' perceptions; use of the NRS facilitated communication of pain, it put demands on healthcare professionals and care routines and it contained interpretation difficulties. The NRS has a place in pain management according to the patients but there is a need for a dialogue to give the patients the opportunity to describe their pain and set a common goal. Copyright © 2014 Elsevier Inc. All rights reserved.

Short hospitalization after caesarean delivery: effects on maternal pain and stress at discharge.

PubMed

Zanardo, Vincenzo; Giliberti, Lara; Volpe, Francesca; Simbi, Alphonse; Guerrini, Pietro; Parotto, Matteo; Straface, Gianluca

2018-09-01

To characterize predischarge maternal pain and stress after caesarean delivery and short hospitalization. This is a descriptive study with 60 women in the postoperative period of caesarean section and 60 control women after vaginal delivery. Pain and stress were measured by McGill Pain Questionnaire (MGPQ) and by the Stress Measure (Psychological Stress Measure (PSM)), respectively, at mother-infant dyad discharge, scheduled at 36 hours after delivery. Caesarean section was the delivery modality with the highest MGPQ pain and sensorial, evaluative and mixed pain descriptive categories scores. The pain location involved lower abdomen, with associated localizations at back, breast and shoulders. Conversely, vaginal delivery was the delivery modality with the highest stress scores. This study provides important information on the quality of care implications of early discharge practices in puerperae after caesarean delivery, a critical time characterized by qualitatively and quantitatively high pain and stress.

Spinal cord stimulation for axial low back pain: a prospective, controlled trial comparing dual with single percutaneous electrodes.

PubMed

North, Richard B; Kidd, David H; Olin, John; Sieracki, Jeffrey M; Farrokhi, Farrokh; Petrucci, Loredana; Cutchis, Protagoras N

2005-06-15

A prospective, controlled, clinical trial comparing single and dual percutaneous electrodes in the treatment of axial low back pain from failed back surgery syndrome. To clarify technical requirements and test the hypothesis that placing two linear arrays in parallel, thereby doubling the number of contacts, improves outcome. Technical improvements have enhanced outcomes of spinal cord stimulation for chronic axial low back pain. Dual, parallel electrodes reportedly improve these outcomes. Acting as their own controls, 20 patients who passed screening with single, 4-contact electrodes received permanent dual, 4-contact electrodes with 7- or 10-mm intercontact distances at the same vertebral level(s). We quantified and compared the technical and clinical results of the single and dual electrodes, adjusting stimulation parameters to specific psychophysical thresholds. Single electrodes provided significant (P < 0.01) advantages in patient- and computer-calculated ratings of pain coverage by paresthesias and in the scaled amplitude necessary to cover the low back, compared with dual 7-mm electrodes. Slight advantages without statistical significance were observed for the single over the dual 10-mm electrodes. Amplitude requirements were significantly lower for the single electrode than for either dual electrode. At long-term follow-up, 53% of patients met the criteria for clinical success. While we observed disadvantages for dual electrodes in treating axial low back pain, we achieved technical success with single or dual electrodes in most patients and maintained this success clinically with dual electrodes in 53%.

The Influence of Pain Severity and Interference on Satisfaction with Pain Management among Middle-Aged and Older Adults

PubMed Central

Krok-Schoen, Jessica L.; O'Connor, Melissa L.; Brooks, Amber K.

2016-01-01

Background. Health outcomes are often contingent on how effective the individual is able to manage existent illness-related symptoms. This is all the more relevant among chronic pain patients. Objective. This study aimed to identify indicators of pain treatment satisfaction among middle-aged and older adults (N = 150) receiving outpatient treatment from a comprehensive cancer center. Methods. Patients were surveyed on questions assessing pain treatment satisfaction, pain severity, and additional social characteristics. Results. Descriptive data showed that middle-aged adults reported more pain locations, greater pain severity, and less satisfaction with pain treatment. A multivariate model was specified, showing older adults being more satisfied with their pain treatment. For the middle-aged adults, treatment satisfaction was generally lower with greater pain severity. This counters that for the older adults, where treatment satisfaction remained consistent despite increased levels of pain severity. Conclusion. These findings address an important issue regarding how pain is experienced across the life course. This suggests that general assumptions cannot be made about the health outcomes of older adults. Beyond the descriptive definitions of pain, there remains the need to develop models that account for determinants that may account for the pain experience among a diverse adult population. PMID:28100956

Gun Control for VBE-E: User Guide and Technical Description

DTIC Science & Technology

2006-11-01

Defence R& D Canada – Atlantic DEFENCE DÉFENSE & Gun Control for VBE-E User Guide and Technical Description Tania E. Wentzell Technical Memorandum...Defence R& D Canada – Atlantic Technical Memorandum DRDC Atlantic TM 2006-245 November 2006 DRDC Atlantic TM 2006-245...component of the distributed experimentation environment used by the Virtual Combat System (VCS) Group at Defence R& D Canada – Atlantic (DRDC Atlantic

[Pain management nursing in hospitalized patients with non-oncological diseases].

PubMed

Sepúlveda-Sánchez, Juana María; Canca-Sánchez, José Carlos; Rivas-Ruiz, Francisco; Martín-García, Mónica; Pérez-González, María Josefa; Timonet-Andreu, Eva María

2016-01-01

To assess pain management in patients hospitalized with a non-oncological disease and evaluate factors involved in pain assessment. A descriptive, cross-sectional study. We reviewed pain episodes documented in the medical records of 105 patients aged>18 years admitted to the medical units of a regional hospital between September and December 2014. Reports of pain episodes were evaluated by assessing 22 variables related to pain management quality criteria. A total of 184 reports were reviewed. Pain was measured using the visual analogue scale (VAS) in 70.1% of patients (n=129); pain was reassessed in 44.3% (n=54) of patients. Pain reassessment was significantly more frequent in patients aged<70 years, as compared to older patients (53.1 vs. 26.8%, respectively; p=0.01). Pain was more frequently considered to be unrelated to the cause of admission in women as compared to men (50 vs. 25.7% p=0.027). Pain was identified in the patient care plan as a collaborative problem by the nurse for 21.1% of the patients. Some aspects of pain management should be improved, especially those regarding pain description and reassessment. The age and sex of patients significantly influence the approach of pain. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Pain experiences of patients with advanced cancer: A qualitative descriptive study.

PubMed

Erol, Ozgul; Unsar, Serap; Yacan, Lale; Pelin, Meryem; Kurt, Seda; Erdogan, Bülent

2018-04-01

Uncontrolled pain, especially in patients with advanced cancer, affects quality of life negatively and causes negative physical and psychological conditions. The aim of this study was to explore the pain experiences of patients with advanced cancer and how they manage with pain, and to present a view of pain management approaches of nurses from the perspectives of the patients. This was a qualitative descriptive study of sixteen hospitalized patients with advanced cancer. Data were collected using semi-structured interviews with patients. Data were analysed by Colaizzi's phenomenological method. This study found that patients with advanced cancer who had pain experienced anxiety, helplessness, hopelessness and many restrictions in daily life as well as inability to manage with pain. Most of the patients with advanced cancer were not satisfied with their nursing care with regard to pain management. The themes that emerged were pain perception and experiences, effects of pain on daily life, pain management and management strategies and the patients' perspectives about nursing approaches to pain. This study demonstrated the difficulties of patients with advanced cancer who experienced pain in their daily lives, yet lack pain management strategies. Furthermore, nurses' caring approaches to patients with advanced cancer who experienced pain was found inadequate. Oncology nurses should provide educational interventions in order to enhance knowledge and skills about pain assessment and non-pharmacologic and pharmacologic strategies used in pain management. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Develoment of Anesthesia.

ERIC Educational Resources Information Center

Davis, Audrey B.

1982-01-01

Until the eighteenth century, doctors were reluctant to use chemicals to alleviate pain because they accepted the religious/moral beliefs of their day, claiming that pain was beneficial for the body. Traces technical developments in the control of pain, discussing relationships of anesthesia to social, cultural, and scientific factors and…

Can improvised somatic dance reduce acute pain for young people in hospital?

PubMed

Dowler, Lisa

2016-11-08

Aim This study explores the effects of improvised somatic dance (ISD) on children and young people experiencing acute pain following orthopaedic or cardiac surgery, or post-acquired brain injury. Methods The study involved 25 children and young people and adopted a mixed methods approach. This included a descriptive qualitative approach to help the participants and witnesses verbalise their experience of ISD, and pain scores were assessed before and after ISD using validated pain assessment tools. Data were analysed using descriptive statistical analysis. Findings A total of 92% of participants experienced a reduction in pain, with 80% experiencing a >50% reduction. There was an improved sense of well-being for all. Conclusion Although not a replacement for pharmacological treatments, a multidimensional, child-centred and inclusive approach with ISD can be a useful complementary, non-pharmacological method of pain management in children and young people.

Pain management in home hospice patients: A retrospective descriptive study.

PubMed

Campbell, Cathy L; Kelly, Meghan; Rovnyak, Virginia

2017-09-01

The development and evaluation of evidence-based, safe, and effective home-based pain management models for caregivers implementation is receiving greater attention in the literature because of international initiatives intended to increase the number of people who receive end-of-life care in home-based settings. The purpose of this "retrospective descriptive design" study was to describe pharmacological pain management and outcomes for 40 cancer and non-cancer patients receiving hospice care at home. While the median pain score was higher at admission in the cancer group than in the hospice care at home group, the difference was not significant at or within 48 hour of admission. Overall, there was a significant decrease in pain from the first measurement to the second. Within the last seven days of life, the majority of participants were not able to provide a pain severity score when asked to evaluate the effectiveness of pain management, thus their caregiver provided a proxy evaluation. Pain management was effective in the home setting. More research is needed on the best methods to teach lay caregivers to assess pain and evaluate the effectiveness of pharmacological modalities to manage pain. © 2017 John Wiley & Sons Australia, Ltd.

Method of identification of patent trends based on descriptions of technical functions

NASA Astrophysics Data System (ADS)

Korobkin, D. M.; Fomenkov, S. A.; Golovanchikov, A. B.

2018-05-01

The use of the global patent space to determine the scientific and technological priorities for the technical systems development (identifying patent trends) allows one to forecast the direction of the technical systems development and, accordingly, select patents of priority technical subjects as a source for updating the technical functions database and physical effects database. The authors propose an original method that uses as trend terms not individual unigrams or n-gram (usually for existing methods and systems), but structured descriptions of technical functions in the form “Subject-Action-Object” (SAO), which in the authors’ opinion are the basis of the invention.

Analgesic Activity.

PubMed

2016-01-01

Analgesics are agents which selectively relieve pain by acting in the CNS and peripheral pain mediators without changing consciousness. Analgesics may be narcotic or non-narcotic. The study of pain in animals raises ethical, philosophical, and technical problems. Both peripheral and central pain models are included to make the test more evident for the analgesic property of the plant. This chapter highlights methods such as hot plate and formalin and acetic acid-induced pain models to check the analgesic activity of medicinal plants.

Creating a Strain Relief Loop during S1 Transforaminal Lead Placement for Dorsal Root Ganglion Stimulation for Foot Pain: A Technical Note.

PubMed

van Velsen, Valery; van Helmond, Noud; Chapman, Kenneth B

2018-04-01

Chronic neuropathic pain is often refractory to conventional medical treatments and leads to significant disability and socio-economic burden. Dorsal root ganglion (DRG) stimulation has recently emerged as a treatment for persistent neuropathic pain, but creating a strain relief loop at the S1 level has thus far been a challenging technical component of DRG lead placement. We describe a refined technique for strain relief loop formation at the S1 level using a transforaminal approach that we employed in a 45-year-old patient with intractable foot pain. We successfully placed a strain relief loop in the sacral space in a predictable and easily reproducible manner using a transforaminal anchorless approach. The patient experienced a decrease in visual analog pain score (85%), and improvement in function during the trial period, and proceeded with permanent implantation. The described sacral transforaminal strain relief loop formation technique appears to be a more reliable and predictable technique of DRG lead placement in the sacrum than those previously documented. © 2017 World Institute of Pain.

Predictors of ICU patients' pain management satisfaction: A descriptive cross-sectional survey.

PubMed

Darawad, Muhammad W; Al-Hussami, Mahmoud; Saleh, Ali M; Al-Sutari, Manal; Mustafa, Waddah Mohammad

2015-08-01

(1) To assess Jordanian ICU patients' pain characteristics (intensity and interference) and levels of pain management satisfaction; and (2) to determine potential predictors of pain management satisfaction among ICU patients. A descriptive cross-sectional design was utilised using the American Pain Society-Patient Outcome Questionnaire to survey 139 Jordanian ICU patients from different health care sectors in Jordan. High levels of pain and pain interferences were reported by participants, which were higher than those reported by previous studies in other countries. However, participants were relatively satisfied with pain management approaches. Also, the results showed a predictive model of three potential predictors, which accounted for 36% of the variance in participants' satisfaction with pain management (adjusted R(2)=0.36, F=12.14, df=7129, p<0.005). The strongest predictor to participants' satisfaction with pain management was time needed to get analgesia (beta=-0.480, p<0.001), followed by average pain interference (beta=0.218, p=0.02), and being told about importance of reporting pain (beta=0.198, p=0.006). Jordanian ICU patients reported high pain levels, which supports the need for applying a caring attitude in managing patients' pain reports. Also, such a study is among the first pain management studies in Jordan aiming at setting the stage for future research studies. Finally, results can be included in planning pain management strategies and protocols within hospitals. Copyright © 2014 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Chronic pain experience and pain management in persons with spinal cord injury in Nepal.

PubMed

Thapa, Sagun; Kitrungrote, Luppana; Damkliang, Jintana

2018-04-25

Chronic pain is the frequent and significantly challenging complications in persons with spinal cord injury (SCI). Socio-cultural background may lead people perceive and manage pain differently. The study aims to describe the chronic pain experience and pain management of SCI persons in Nepal. A descriptive cross sectional study was conducted among purposively selected sample of 120 SCI persons with chronic pain living in the eight districts of Bagmati Zone of Nepal. The data were collected using the International Spinal Cord Injury Pain Basic Data Set Version 2 (ISCIPBDS-2) and Open-ended Pain Management Questionnaire. The data were analyzed using descriptive statistics and content analysis method. The back (n=84), lower legs/feet (n=63) and buttocks/hips (n=51) was found as the common pain locations. In common, the onset of pain was found within the first 6 month of the injury. Overall pain intensity and pain interference were found to be at the moderate level. The SCI persons used pain medications and non-pharmacological pain management. Ibuprofen was the commonly used pain medication and commonly used non-pharmacological pain management methods included physical support (e.g. massage, exercise), relaxation (e.g. distraction, substance abuse), coping (e.g. acceptance, praying), and traditional herbs. SCI persons had chronic pain experience which interfered with their daily living. They used pain medications and non-pharmacological pain management methods based on their beliefs, knowledge, and community resources in Nepal. This study provides some evidence to help the team of rehabilitation professional to plan and help SCI persons with chronic pain. Based on these findings, chronic pain management intervention for SCI persons should be developed and supported continuously from hospital to home based community context of Nepal.

Comparison of Low Back Pain Recovery and Persistence: A Descriptive Study of Characteristics at Pain Onset.

PubMed

Starkweather, Angela R; Lyon, Debra E; Kinser, Patricia; Heineman, Amy; Sturgill, Jamie L; Deng, Xiaoyan; Siangphoe, Umaporn; Elswick, R K; Greenspan, Joel; Dorsey, Susan G

2016-07-01

Persistent low back pain is a significant problem worldwide. Early identification and treatment of individuals at high risk for persistent low back pain have been suggested as strategies to decrease the rate of disability associated with this condition. To examine and compare demographic, pain-related, psychological, and somatosensory characteristics in a cohort of participants with acute low back pain who later went on to experience persistent low back pain or whose pain resolved within the first 6 weeks after initial onset. A descriptive study was conducted among men and women 18-50 years of age who had an acute episode of low back pain. Study questionnaires were administered to collect demographic information and measures of pain, coping, reactivity, mood, work history and satisfaction, and disability. A standardized protocol of quantitative sensory testing was performed on each participant at the painful area of their low back and at a remote site on their arm. The sample consisted of 48 participants, of whom 19 went on to develop persistent low back pain and 29 resolved. Compared to the resolved group, the persistent low back pain group was significantly older and had a lower level of educational attainment, a higher body mass index, and higher mean "least" pain score on the Brief Pain Inventory-Short Form. Significantly higher thermal detection thresholds at the painful and remote sites as well as signs of central sensitivity differentiated the persistent pain group from the resolved group during the acute stage of low back pain. © The Author(s) 2016.

Characterization of chronic pain in breast cancer survivors using the McGill Pain Questionnaire.

PubMed

Ferreira, Vânia Tie Koga; Guirro, Elaine Caldeira de Oliveira; Dibai-Filho, Almir Vieira; Ferreira, Simone Mara de Araújo; de Almeida, Ana Maria

2015-10-01

The aim of the present study was to characterize pain in breast cancer survivors using the McGill Pain Questionnaire (MPQ). A descriptive, cross-sectional study was conducted with 30 women aged 30-80 years who had been submitted to treatment for breast cancer (surgery and complementary treatment) at least 12 months earlier with reports of pain related to the therapeutic procedures. Pain was characterized using the full-length version of the MPQ, which is made up of 78 descriptors divided into four categories: sensory (ten items), affective (five items), evaluative (one item) and miscellaneous (four items). Two indices were also used to measure pain through the use of the descriptors: the number of words chosen (NWC) and the pain rating index (PRI). The most frequent descriptive terms were "agonizing" (n = 16; 53.3%), "tugging" (n = 15; 50%), "sore" (n = 14; 46.7%), "wretched" (n = 14; 46.7%), "troublesome" (n = 13; 43.3%) and "spreading" (n = 11; 36.7%). The sensory category had the highest PRI value based on the descriptors chosen (mean: 0.41). Women with chronic pain following treatment for breast cancer employed the "agonizing", "tugging" and "sore" descriptors with greatest frequency and rated pain in the sensory category as having the greatest impact. Copyright © 2014 Elsevier Ltd. All rights reserved.

Longitudinal Assessment of Self-Reported Recent Back Pain and Combat Deployment in the Millennium Cohort Study

DTIC Science & Technology

2016-11-15

participants who were followed for the development of back pain for an average of 3.9 years. Methods. Descriptive statistics and longitudinal...health, military personnel, occupational health, outcome assessment, statistics, survey methodology . Level of Evidence: 3 Spine 2016;41:1754–1763ack...based on the National Health and Nutrition Examination Survey.21 Statistical Analysis Descriptive and univariate analyses compared character- istics

Nurses' response to pain communication from patients: a post-test experimental study.

PubMed

McDonald, Deborah Dillon; Laporta, Matthew; Meadows-Oliver, Mikki

2007-01-01

Inadequate communication about pain can result in increased pain for patients. The purpose of the current pilot study was to test how nurses respond when patients use their own words, a pain intensity scale, or both to communicate pain. A post-test only experimental design was used with three pain description conditions, personal and numeric; personal only; numeric only. The setting included six hospitals and one school of nursing located in the northeastern United States. PARTICIPANTS included 122 registered medical surgical nurses. Nurses were randomly assigned to condition, and read a vignette about a trauma patient with moderately severe pain. The vignettes were identical except for the patient's pain description and age. The nurses then wrote how they would respond to the patient's pain. Two blind raters content analyzed the responses, giving nurses one point for including each of six a priori criteria derived from the Acute Pain Management Panel [1992. Acute Pain Management: operative or medical procedures and trauma. Clinical practice guideline (AHCPR Publication No. 92-0032)., Rockville, MD, USA] and the American Pain Society [2003. Principles of analgesic use in the treatment of acute pain and cancer pain, Glenville, IL, USA]. Nurses planned similar numbers of pain management strategies across the three conditions, with a mean of 2.1 (SD=1.14) strategies out of the recommended six. Nurses did not respond with more pain management strategies when patients describe pain in their own words, or in their own words and a pain intensity scale. The relatively small number of pain management strategies planned by the nurses suggests that nurses use few strategies to respond to moderately severe pain problems.

Specifying Skill-Based Training Strategies and Devices: A Model Description

DTIC Science & Technology

1990-06-01

Technical Report 897 Specifying Skill-Based Training N Strategies and Devices: A Model Description I Paui J. Sticha and Mark Schlager Human Resources...unlimied 90 ’ Technical Report 897 Specifying Skill-Based Training Strategies and Devices: A Model Description Paul J. Sticha and Mark Schlager Human...SECURITY CLASSIFICATION OF THIS PAGE Form Approved REPORT DOCUMENTATION PAGE FMNo o7 ote la. REPORT SECURITY CLASSIFICATION lb. RESTRICTWE MARKINGS

Paresthesia-Independence: An Assessment of Technical Factors Related to 10 kHz Paresthesia-Free Spinal Cord Stimulation.

PubMed

De Carolis, Giuliano; Paroli, Mery; Tollapi, Lara; Doust, Matthew W; Burgher, Abram H; Yu, Cong; Yang, Thomas; Morgan, Donna M; Amirdelfan, Kasra; Kapural, Leonardo; Sitzman, B Todd; Bundschu, Richard; Vallejo, Ricardo; Benyamin, Ramsin M; Yearwood, Thomas L; Gliner, Bradford E; Powell, Ashley A; Bradley, Kerry

2017-05-01

Spinal cord stimulation (SCS) has been successfully used to treat chronic intractable pain for over 40 years. Successful clinical application of SCS is presumed to be generally dependent on maximizing paresthesia-pain overlap; critical to achieving this is positioning of the stimulation field at the physiologic midline. Recently, the necessity of paresthesia for achieving effective relief in SCS has been challenged by the introduction of 10 kHz paresthesia-free stimulation. In a large, prospective, randomized controlled pivotal trial, HF10 therapy was demonstrated to be statistically and clinically superior to paresthesia-based SCS in the treatment of severe chronic low back and leg pain. HF10 therapy, unlike traditional paresthesia-based SCS, requires no paresthesia to be experienced by the patient, nor does it require paresthesia mapping at any point during lead implant or post-operative programming. To determine if pain relief was related to technical factors of paresthesia, we measured and analyzed the paresthesia responses of patients successfully using HF10 therapy. Prospective, multicenter, non-randomized, non-controlled interventional study. Outpatient pain clinic at 10 centers across the US and Italy. Patients with both back and leg pain already implanted with an HF10 therapy device for up to 24 months were included in this multicenter study. Patients provided pain scores prior to and after using HF10 therapy. Each patient's most efficacious HF10 therapy stimulation program was temporarily modified to a low frequency (LF; 60 Hz), wide pulse width (~470 mus), paresthesia-generating program. On a human body diagram, patients drew the locations of their chronic intractable pain and, with the modified program activated, all regions where they experienced LF paresthesia. Paresthesia and pain drawings were then analyzed to estimate the correlation of pain relief outcomes to overlap of pain by paresthesia, and the mediolateral distribution of paresthesia (as a surrogate of physiologic midline lead positioning). A total of 61 patients participated across 11 centers. Twenty-eight men and 33 women with a mean age of 56 ± 12 years of age participated in the study. The average duration of implantable pulse generator (IPG) implant was 19 ± 9 months. The average predominant pain score, as measured on a 0 - 10 visual analog scale (VAS), prior to HF10 therapy was 7.8 ± 1.3 and at time of testing was 2.5 ± 2.1, yielding an average pain relief of 70 ± 24%. For all patients, the mean paresthesia coverage of pain was 21 ± 28%, with 43% of patients having zero paresthesia coverage of pain. Analysis revealed no correlation between percentage of LF paresthesia overlap of predominant pain and HF10 therapy efficacy (P = 0.56). Exact mediolateral positioning of the stimulation electrodes was not found to be a statistically significant predictor of pain relief outcomes. Non-randomized/non-controlled study design; short-term evaluation; certain technical factors not investigated. Both paresthesia concordance with pain and precise midline positioning of the stimulation contacts appear to be inconsequential technical factors for successful HF10 therapy application. These results suggest that HF10 therapy is not only paresthesia-free, but may be paresthesia-independent.

Intensity, perception, and descriptive characteristics of chronic pain in children with cerebral palsy.

PubMed

Houlihan, Christine M; Hanson, Amber; Quinlan, Nicole; Puryear, Carol; Stevenson, Richard D

2008-01-01

Children with cerebral palsy (CP) experience bodily pain, leading to functional impairment and decreased quality of life. The purpose of this study is to characterize subjective descriptors of chronic pain in children with CP. One hundred fifty-seven children were invited to participate in a quantitative pilot survey. Parents were mailed the Varni-Thompson Pediatric Pain Questionnaire, designed to assess three dimensions of pain: sensory (physical aspects), affective (emotional response), and evaluative (the combined intensity of the emotional and physical responses). Parents assessed their child's pain using non-verbal and verbal cues. Fifty-two families responded (33% return rate). Thirty-eight children ages 6-8 years with CP and Gross Motor Function Classification System (GMFCS) levels I-V were included. Ninety percent of families reported that their child was experiencing some pain at the time of the survey. At the time of assessment the children's pain was mild. Their pain, at its worst, was in the distressing range. The two largest GMFCS groups of children, levels I and IV, were compared in both severity and intensity of pain experienced. Increasing intensity of pain was reported in children in the level IV group compared to children classified as level I. Pain severity in all dimensions was reported as increasing in Level IV children compared to Level I. Children with CP experience frequent pain, which increases with worsening impairment. Descriptive qualifiers of pain help to elucidate the etiology of various types of pain which would lead to the development of more effective approaches to pain management and treatment.

EEG Radiotelemetry in Small Laboratory Rodents: A Powerful State-of-the Art Approach in Neuropsychiatric, Neurodegenerative, and Epilepsy Research

PubMed Central

Lundt, Andreas; Wormuth, Carola; Siwek, Magdalena Elisabeth; Müller, Ralf; Henseler, Christina; Broich, Karl; Papazoglou, Anna; Weiergräber, Marco

2016-01-01

EEG radiotelemetry plays an important role in the neurological characterization of transgenic mouse models of neuropsychiatric and neurodegenerative diseases as well as epilepsies providing valuable insights into underlying pathophysiological mechanisms and thereby facilitating the development of new translational approaches. We elaborate on the major advantages of nonrestraining EEG radiotelemetry in contrast to restraining procedures such as tethered systems or jacket systems containing recorders. Whereas a main disadvantage of the latter is their unphysiological, restraining character, telemetric EEG recording overcomes these disadvantages. It allows precise and highly sensitive measurement under various physiological and pathophysiological conditions. Here we present a detailed description of a straightforward successful, quick, and efficient technique for intraperitoneal as well as subcutaneous pouch implantation of a standard radiofrequency transmitter in mice and rats. We further present computerized 3D-stereotaxic placement of both epidural and deep intracerebral electrodes. Preoperative preparation of mice and rats, suitable anaesthesia, and postoperative treatment and pain management are described in detail. A special focus is on fields of application, technical and experimental pitfalls, and technical connections of commercially available radiotelemetry systems with other electrophysiological setups. PMID:26819775

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

PubMed

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

2009-06-01

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

Loin Pain Haematuria Syndrome - A Narrative Review of Pain Management Strategies

PubMed Central

2016-01-01

Loin pain haematuria syndrome (LPHS) is an uncommon clinical entity that has divided renal physicians, pain practitioners, and even psychiatrists since its initial description. A relative paucity of data exists regarding the condition, with best practice guidelines lacking amid the existing threads of anecdotal experiences and variable follow-up observations. The aim of this article was to review the cumulative published experience of pain relief strategies for LPHS. PMID:27103962

Status of Neonatal Pain Assessment and Management in Jordan.

PubMed

Abdel Razeq, Nadin M; Akuma, Akuma O; Jordan, Sue

2016-08-01

Current pain assessment and management in neonates need to be fully described before neonatal pain care can be optimized. This study's purpose was to report neonatal nurses' knowledge, existing pain assessment practice, and pharmacological pain management of neonates in Jordan. A cross-sectional descriptive study was conducted. Eighteen neonatal intensive care units in Jordan were included in the study. One hundred eighty-four neonatal nurses participated. Questionnaires were distributed by and returned to the neonatal intensive care units' managers between June and August 2014. Descriptive and inferential statistics were used to present study results. Of 240 questionnaires distributed, 184 useable responses were returned. Nurses' knowledge regarding neonates' neurological development, nociception, and need for neonatal pain management was suboptimal. The analgesics most commonly used to treat neonatal pain were acetaminophen (52%) and lidocaine (45%). Benzodiazepines, phenobarbitone, and muscles relaxants were also used. Most nurses (54%-97%) reported that pain emanating from most painful procedures was never or rarely treated. Circumcision, lumbar punctures, and chest tube insertion were assigned the highest pain scores (≥9), but were rarely accompanied by analgesia. Pain assessment scales were more likely to be used, and procedural pain was more likely to be treated, in private hospitals than public hospitals. Neonates who require special care still suffer unnecessary pain that could be avoided and managed by following best practice recommendations. Disparities between developed and developing countries in quality of neonatal pain care appear to exist. Resources for education and routine care are needed to address these discrepancies. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Botulinum toxin (BoNT) and back pain.

PubMed

Porta, Mauro; Maggioni, G

2004-02-01

Myofascial pain syndrome is defined as subacute or chronic pain with sensory, motor and autonomic symptoms referred from active trigger points with associated painful dysfunctions. Authors present the usefulness of botulinum toxin A or B (BoNT/A or BoNT/B) injected into target muscles since the toxin is capable of controlling not only the muscular spasm but mostly the pain by alternative mechanisms of action, which are discussed. Posology of BoNT, technical aspects and results are presented. BoNT represents an interesting and useful tool for an adequate management of patients with myofascial pain.

Pain affecting procedures in non-resectable pancreatic carcinoma.

PubMed

Plachkov, I; Chernopolski, P; Bozhkov, V; Madjov, R

2013-01-01

Pancreatic cancer is third most common cancer of the gastrointestinal tract in Bulgaria, accouting for 11, 6% in 2008. The leading symptom in patients with pancreatic cancer is the pain. The pain can be related with neoplasms and their metastasis. We should use all kind of resourses for pain relief: conventional drugs (according to the three steps strategy of WHO), interventional or surgical procedures. To present the interventional and surgical techniques in our practice and to share our experience for pain control in patients with nonresectable pancreatic cancer to improve their quality of life. In a seven year period (2004-2011) we performed 59 thoracoscopic splanhnicectomies/30--bilateral/ 4 intraoperative resections of celiac ganglion, 25 CT--control celiac plexus neurolysis and 90 cases pain relief with epidural analgesia. Concerning the quality of life we applied a questionnaire of a spannish medical center " City of Hope" adapted for patients with cancer and the level of pain with visual analogue scale VAS. The long-term duration of the pain relief technique depends on applied technic, of cancer invasion and of the technic itself. The technique with the longest effect are the intraoperative celiac ganglion removal and the bilateral thoracoscopic splanhnicectomy. On the other hand the shortest effect we report the celiac plexus neurolysis, and the epudural analgesia. These data are in correlation with the reduction of the pain shown using VAS thus improving the quality of life. The surgical and interventional methods for control of cancer pain have their own collocation improving the quality of life of these patients. New strategies for the pain control are need in the future.

Energy Savings Potential and Research, Development, & Demonstration Opportunities for Commercial Building Heating, Ventilation, and Air Conditioning Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

none,

2011-09-01

This report covers an assessment of 182 different heating, ventilation, and air-conditioning (HVAC) technologies for U.S. commercial buildings to identify and provide analysis on 17 priority technology options in various stages of development. The analyses include an estimation of technical energy-savings potential, description of technical maturity, description of non-energy benefits, description of current barriers for market adoption, and description of the technology’s applicability to different building or HVAC equipment types. From these technology descriptions, are suggestions for potential research, development and demonstration (RD&D) initiatives that would support further development of the priority technology options.

Curriculum Development System for Navy Technical Training.

ERIC Educational Resources Information Center

Butler, Lucius

Documentation for the U.S. Navy's curriculum development system is brought together in this paper, beginning with a description of the Naval Technical Training System. This description includes the Navy Training Plan (NTP) process, which is the current mechanism for introducing new courses; the organization and administration of the system; the…

Development and validation of a brief, descriptive Danish pain questionnaire (BDDPQ).

PubMed

Perkins, F M; Werner, M U; Persson, F; Holte, K; Jensen, T S; Kehlet, H

2004-04-01

A new pain questionnaire should be simple, be documented to have discriminative function, and be related to previously used questionnaires. Word meaning was validated by using bilingual Danish medical students and asking them to translate words taken from the Danish version of the McGill pain questionnaire into English. Evaluative word value was estimated using a visual analog scale (VAS). Discriminative function was assessed by having patients with one of six painful conditions (postherpetic neuralgia, phantom limb pain, rheumatoid arthritis, ankle fracture, appendicitis, or labor pain) complete the questionnaire. We were not able to find Danish words that were reliably back-translated to the English words 'splitting' or 'gnawing'. A simple three-word set of evaluative terms had good separation when rated on a VAS scale ('let' 17.5+/-6.5 mm; 'moderat' 42.7+/-8.6 mm; and 'staerk' 74.9+/-9.7 mm). The questionnaire was able to discriminate among the six painful conditions with 77% accuracy by just using the descriptive words. The accuracy of the questionnaire increased to 96% with the addition of evaluative terms (for pain at rest and with activity), chronicity (acute vs. chronic), and location of the pain. A Danish pain questionnaire that subjects and patients can self-administer has been developed and validated relative to the words used in the English McGill Pain questionnaire. The discriminative ability of the questionnaire among some common painful conditions has been tested and documented. The questionnaire may be of use in patient care and research.

Improving undergraduate medical education about pain assessment and management: A qualitative descriptive study of stakeholders’ perceptions

PubMed Central

Tellier, Pierre-Paul; Bélanger, Emmanuelle; Rodríguez, Charo; Ware, Mark A; Posel, Nancy

2013-01-01

BACKGROUND Pain is one of the most common reasons for individuals to seek medical advice, yet it remains poorly managed. One of the main reasons that poor pain management persists is the lack of adequate knowledge and skills of practicing clinicians, which stems from a perceived lack of pain education during the training of undergraduate medical students. OBJECTIVE: To identify gaps in knowledge with respect to pain management as perceived by students, patients and educators. METHODS: A qualitative descriptive study was conducted. Data were generated through six focus groups with second- and fourth-year medical students, four focus groups with patients and individual semistructured interviews with nine educators. All interviews were audiotaped and an inductive thematic analysis was performed. RESULTS: A total of 70 individuals participated in the present study. Five main themes were identified: assessment of physical and psychosocial aspects of pain; clinical management of pain with pharmacology and alternative therapies; communication and the development of a good therapeutic relationship; ethical considerations surrounding pain; and institutional context of medical education about pain. CONCLUSION: Participating patients, students and pain experts recognized a need for additional medical education about pain assessment and management. Educational approaches need to teach students to gather appropriate information about pain, to acquire knowledge of a broad spectrum of therapeutic options, to develop a mutual, trusting relationship with patients and to become aware of their own biases and prejudice toward patients with pain. The results of the present study should be used to develop and enhance existing pain curricula content. PMID:23985579

Health Services for Management of Chronic Non-Cancer Pain in Kuwait: A Case Study Review

PubMed Central

Lakha, S. Fatima; Pennefather, Peter; Badr, Hanan E.; Mailis-Gagnon, Angela

2016-01-01

The experience of chronic pain is universal, yet pain management services delivered by health professionals vary substantially, depending on the context and patient. This review is a part of a series that has examined the issue of chronic non-cancer pain services and management in different global cities. The review is structured as a case study of the availability of management services for people living with chronic non-cancer pain within the context of the Kuwaiti health systems, and the cases are built from evidence in the published literature identified through a comprehensive review process. The evolution of the organizational structure of the public and private health systems in Kuwait is described. These are discussed in terms of their impact on the delivery of comprehensive chronic pain management service by health professionals in Kuwait. This review also includes a description of chronic pain patient personas to highlight expected barriers as well as compliance issues with services likely to be encountered in Kuwait. The case study analysis and persona descriptions illustrate a need to move beyond pain symptom management towards considering the entire person and his/her individual experience of pain such that health care success is judged by enhancement of patient well-being rather than access to services. A road map for improving integrative chronic pain management in Kuwait is discussed. PMID:26595816

Health Services for Management of Chronic Non-Cancer Pain in Kuwait: A Case Study Review.

PubMed

Lakha, S Fatima; Pennefather, Peter; Badr, Hanan E; Mailis-Gagnon, Angela

2016-01-01

The experience of chronic pain is universal, yet pain management services delivered by health professionals vary substantially, depending on the context and patient. This review is a part of a series that has examined the issue of chronic non-cancer pain services and management in different global cities. The review is structured as a case study of the availability of management services for people living with chronic non-cancer pain within the context of the Kuwaiti health systems, and the cases are built from evidence in the published literature identified through a comprehensive review process. The evolution of the organizational structure of the public and private health systems in Kuwait is described. These are discussed in terms of their impact on the delivery of comprehensive chronic pain management service by health professionals in Kuwait. This review also includes a description of chronic pain patient personas to highlight expected barriers as well as compliance issues with services likely to be encountered in Kuwait. The case study analysis and persona descriptions illustrate a need to move beyond pain symptom management towards considering the entire person and his/her individual experience of pain such that health care success is judged by enhancement of patient well-being rather than access to services. A road map for improving integrative chronic pain management in Kuwait is discussed. © 2015 S. Karger AG, Basel.

“Let’s Talk about OA Pain”: A Qualitative Analysis of the Perceptions of People Suffering from OA. Towards the Development of a Specific Pain OA-Related Questionnaire, the Osteoarthritis Symptom Inventory Scale (OASIS)

PubMed Central

Cedraschi, Christine; Delézay, Sylvie; Marty, Marc; Berenbaum, Francis; Bouhassira, Didier; Henrotin, Yves; Laroche, Françoise; Perrot, Serge

2013-01-01

Introduction Pain is the primary outcome measurement in osteoarthritis, and its assessment is mostly based on its intensity. The management of this difficult chronic condition could be improved by using pain descriptors to improve analyses of painful sensations. This should help to define subgroups of patients based on pain phenotype, for more adapted treatment. This study draws upon patients’ descriptions of their pain, to identify and understand their perception of osteoarthritis pain and to categorize pain dimensions. Methods This qualitative study was conducted with representative types of patients suffering from osteoarthritis. Two focus groups were conducted with a sample of 14 participants, with either recent or chronic OA, at one or multiple sites. Focus groups were semi-structured and used open-ended questions addressing personal experiences to explore the experiences of patients with OA pain and the meanings they attributed to these pains. Results Two main points emerged from content analyses: -A major difficulty in getting patients to describe their osteoarthritis pain: perception that nobody wants to hear about it; necessity to preserve one’s self and social image; notion of self-imposed stoicism; and perception of osteoarthritis as a complex, changing, illogical disease associated with aging. -Osteoarthritis pains were numerous and differed in intensity, duration, depth, type of occurrence, impact and rhythm, but also in painful sensations and associated symptoms. Based on analyses of the verbatim interviews, seven dimensions of OA pain emerged: pain sensory description, OA-related symptoms, pain variability profile, pain-triggering factors, pain and physical activity, mood and image, general physical symptoms. Summary In osteoarthritis, pain analysis should not be restricted to intensity. Our qualitative study identified pain descriptors and defined seven dimensions of osteoarthritis pain. Based on these dimensions, we aim to develop a specific questionnaire on osteoarthritis pain quality for osteoarthritis pain phenotyping: the OsteoArthritis Symptom Inventory Scale (OASIS). PMID:24244589

Attribution of Responsibility and Hiring Recommendations for Job Applicants with Low Back Pain.

ERIC Educational Resources Information Center

Bordieri, James E.; And Others

1988-01-01

Supervisors and managers (N=108) reviewed cover letter and resume of job applicant with low back pain (source of which was systematically manipulated) and job description for simulated position. Found that, regardless of qualifications and source of injury, participants made more negative hiring recommendations for applicants with pain than for…

Why does Acute Postwhiplash Injury Pain Transform into Chronic Pain Multimodal Assessment of Risk Factors and Predictors of Pain Chronification

DTIC Science & Technology

2016-10-19

data acquisition. iii. We determined working procedures with the Technion genetic lab. iv. We exercised data transfer between our site and the MRI ... MRI protocols and training of the technical staff. viii. A meeting of the study investigators was held during the world pain conference in Japan in...participated in the study. 20 subjects had withdrawn their consent mainly due to MRI scanner availability and scheduling issues, or excluded from the

MCFire model technical description

Treesearch

David R. Conklin; James M. Lenihan; Dominique Bachelet; Ronald P. Neilson; John B. Kim

2016-01-01

MCFire is a computer program that simulates the occurrence and effects of wildfire on natural vegetation, as a submodel within the MC1 dynamic global vegetation model. This report is a technical description of the algorithms and parameter values used in MCFire, intended to encapsulate its design and features a higher level that is more conceptual than the level...

IDEA Technical Report No. 2. Description of Data Base, 1976-77.

ERIC Educational Resources Information Center

Cashin, William E.; Slawson, Hugh M.

The data and computational procedures used by the IDEA system at Kansas State University (during the 1976-77 academic year) to interpret ratings of teacher performance are described in this technical report. The computations for each of the seven parts (evaluation, course description, students' self ratings, methods, additional questions,…

IDEA Technical Report No. 3. Description of Data Base, 1977-78.

ERIC Educational Resources Information Center

Cashin, William E.; Slawson, Hugh M.

The data and computational procedures used by the IDEA System during the 1977-78 academic year at Kansas State University to interpret ratings of teacher performance are described in this technical report. The computations for each of the seven parts (evaluation, course description, students' self-ratings, methods, additional questions, diagnostic…

[Pain in undernourished children: the mother's perception].

PubMed

Barbosa, Larissa Coelho; Martins, Mariana Cavalcante; Silva, Vanessa Aghata Guimarães da; Carvalho, Quitéria Clarice Magalhães

2005-01-01

This qualitative study aimed to identify how mothers perceive pain in their undernourished children. Semistructured interviews were realized at the Institute for the Prevention of Malnutrition and Exceptionality--IPREDE (Fortaleza-Ceará-Brazil). Participants were mothers who accompanied their undernourished children. Data analysis revealed the following categories: Coming to the Institution; Pain description and How to take care of the pain. Society needs to take actions, in respect of citizens' rights and culture, with a view to reverting this picture of pain in undernourished children.

Shin splints--a literature review.

PubMed

Bates, P

1985-09-01

"Shin splints" is not a specific diagnosis. It is merely a descriptive term that describes chronic exertional shin pain in an athlete. The evidence seems clear that shin splint pain has many different causes and this reflects the variation in the anatomy. It would be preferable to describe shin splint pain by location and aetiology, for example, lower medial tibial pain due to periostitis or upper lateral tibial pain due to elevated compartment pressure. This would aid communication between physicians and also direct therapy more accurately.

Referred Pain Patterns Provoked on Intra-Pelvic Structures among Women with and without Chronic Pelvic Pain: A Descriptive Study

PubMed Central

Butler, Stephen; Peterson, Magnus; Eriksson, Margaretha

2015-01-01

Objectives To describe referred pain patterns provoked from intra-pelvic structures in women with chronic pelvic pain (CPP) persisting after childbirth with the purpose to improve diagnostics and give implications for treatment. Materials and Methods In this descriptive and comparative study 36 parous women with CPP were recruited from a physiotherapy department waiting list and by advertisements in newspapers. A control group of 29 parous women without CPP was consecutively assessed for eligibility from a midwifery surgery. Inclusion criterion for CPP was: moderate pain in the sacral region persisting at least six months after childbirth confirmed by pelvic pain provocation tests. Exclusion criteria in groups with and without CPP were: persistent back or pelvic pain with onset prior to pregnancy, previous back surgery and positive neurological signs. Pain was provoked by palpation of 13 predetermined intra-pelvic anatomical landmarks. The referred pain distribution was expressed in pain drawings and described in pain maps and calculated referred pain areas. Results Pain provoked by palpation of the posterior intra-pelvic landmarks was mostly referred to the sacral region and pain provoked by palpation of the ischial and pubic bones was mostly referred to the groin and pubic regions, with or without pain referred down the ipsilateral leg. The average pain distribution area provoked by palpation of all 13 anatomical landmarks was 30.3 mm² (19.2 to 53.7) in women with CPP as compared to 3.2 mm² (1.0 to 5.1) in women without CPP, p< 0.0001. Conclusions Referred pain patterns provoked from intra-pelvic landmarks in women with CPP are consistent with sclerotomal sensory innervation. Magnification of referred pain patterns indicates allodynia and central sensitization. The results suggest that pain mapping can be used to evaluate and confirm the pain experience among women with CPP and contribute to diagnosis. PMID:25793999

[Ambulatory laparoscopic cholecystectomy by minilaparoscopy versus traditional multiport ambulatory laparoscopic cholecystectomy. Prospective randomized trial].

PubMed

Planells Roig, Manuel; Arnal Bertomeu, Consuelo; Garcia Espinosa, Rafael; Cervera Delgado, Maria; Carrau Giner, Miguel

2016-02-01

Difference analysis of ambulatorization rate, pain, analgesic requirements and daily activities recovery in patients undergoing laparoscopic cholecystectomy with standard multiport access (CLMP) versus a minilaparoscopic, 3mm size, technique. Prospective randomized trial of 40 consecutive patients undergoing laparoscopic cholecystectomy. Comparison criteria included predictive ultrasound factors of difficult cholecystectomy, previous history of complicated biliary disease and demographics. Results are analyzed in terms of ambulatorization rate, pain, analgesic requirements, postoperative recovery, technical difficulty, hemorrhage intensity, overnight stay, readmission rate and total or partial conversion. Both procedures were similar in surgery time, technical score and hemorrhage score. MLC was associated with similar ambulatorization rate, 85%, and over-night stay 15%, with only 15% partial conversion rate. MLC showed less postoperative pain (P=.026), less analgesic consumption (P=.006) and similar DAR (P=.879). MLC is similar to CLMP in terms of ambulatorization with less postoperative pain and analgesic requirements without differences in postoperative recovery. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Prescribing for pain--how do nurses contribute? A national questionnaire survey.

PubMed

Stenner, Karen; Carey, Nicola; Courtenay, Molly

2012-12-01

To provide information on the profile and practice of nurses in the UK who prescribe medication for pain. Pain is widely under-reported and under-treated and can have negative consequences for health and psychosocial well-being. Indications are that nurses can improve treatment and access to pain medications when they prescribe. Whilst nurses working in many practice areas treat patients with pain, little is known about the profile, prescribing practice or training needs of these nurses. A descriptive questionnaire survey. An online questionnaire was used to survey 214 nurses who prescribed for pain in the UK between May and July 2010. Data were analysed using descriptive statistics and non-parametric tests. Half the participants (50%) worked in primary care, 32% in secondary care and 14% worked across care settings. A range of services were provided, including general practice, palliative care, pain management, emergency care, walk-in-centres and out-of-hours. The majority (86%) independently prescribed 1-20 items per week. Non-opioid and weak opioids analgesics were prescribed by most (95%) nurses, whereas fewer (35%) prescribed strong opioids. Training in pain had been undertaken by 97% and 82% felt adequately trained, although 28% had problems accessing training. Those with specialist training prescribed a wider range of pain medications, were more likely to prescribe strong opioids and were more often in pain management roles. Nurses prescribe for pain in a range of settings with an emphasis on the treatment of minor ailments and acute pain. A range of medications are prescribed, and most nurses have access to training. The nursing contribution to pain treatment must be acknowledged within initiatives to improve pain management. Access to ongoing training is required to support nurse development in this area of practice to maximise benefits. © 2012 Blackwell Publishing Ltd.

Dutch Dataset Pain Rehabilitation in daily practice: Content, patient characteristics and reference data.

PubMed

Köke, A J A; Smeets, R J E M; Schreurs, K M; van Baalen, B; de Haan, P; Remerie, S C; Schiphorst Preuper, H R; Reneman, M F

2017-03-01

No core set of measurement tools exists to collect data within clinical practice. Such data could be useful as reference data to guide treatment decisions and to compare patient characteristics or treatment results within specific treatment settings. The Dutch Dataset Pain Rehabilitation was developed which included the six domains of the IMMPACT core set and three new domains relevant in the field of rehabilitation (medical consumption, patient-specific goals and activities/participation). Between 2010 and 2013 the core set was implemented in 32 rehabilitation facilities throughout the Netherlands. A total of 8200 adult patients with chronic pain completed the core set at first consultation with the rehabilitation physician. Adult patients (18-90 years) suffering from a long history of pain (38% >5 years) were referred. Patients had high medical consumption and less than half were working. Although patients were referred with diagnosis of low back pain or neck or shoulder pain, a large group (85%) had multisite pain (39% 2-5 painful body regions; 46% >5 painful body regions). Scores on psychosocial questionnaires were high, indicating high case complexity of referred patients. Reference data for subgroups based on gender, pain severity, pain locations and on pain duration are presented. The data from this clinical core set can be used to compare patient characteristics of patients of other treatment setting and/or scientific publications. As treatment success might depend on case complexity, which is high in the referred patients, the advantages of earlier referral to comprehensive multidisciplinary treatment were discussed. A detailed description of case complexity of patients with chronic pain referred for pain rehabilitation. Insight in case complexity of patients within subgroups on the basis of gender, pain duration, pain severity and pain location. These descriptions can be used as reference data for daily practice in the field of pain rehabilitation and can be used to evaluate, monitor and improve rehabilitation care in care settings nationwide as well as internationally. © 2016 European Pain Federation - EFIC®.

A case of occipital neuralgia in the greater and lesser occipital nerves treated with neurectomy by using transcranial Doppler sonography: technical aspects.

PubMed

Jung, Sang Jin; Moon, Seong Keun; Kim, Tae Young; Eom, Ki Seong

2011-03-01

Occipital neuralgia is usually defined as paroxysmal stabbing pain in the greater or lesser occipital nerve (GON or LON) distribution. In occipital neuralgia patients, surgical considerations are carefully taken into account if medical management is ineffective. However, identification of the occipital artery by palpation in patients with thick necks or small occipital arteries can be technically difficult. Therefore, we established a new technique using transcranial Doppler (TCD) sonography for more accurate and rapid identification. The patient was a 64-year-old man who had undergone C1-C3 screw fixation and presented with intractable stabbing pain in the bilateral GON and LON distributions. In cases in which pain management was performed using medication, physical therapy, nerve block, or radiofrequency thermocoagulation, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed occipital neurectomy of the bilateral GON and LON by using TCD sonography, which helped detect the greater occipital artery easily. After the operation, the patient's headache disappeared gradually, although he had discontinued all medication except antidepressants. We believe that this new technique of occipital neurectomy via a small skin incision performed using TCD sonography is easy and reliable, has a short operative time, and provides rapid pain relief.

A Case of Occipital Neuralgia in the Greater and Lesser Occipital Nerves Treated with Neurectomy by Using Transcranial Doppler Sonography: Technical Aspects

PubMed Central

Jung, Sang Jin; Moon, Seong Keun; Kim, Tae Young

2011-01-01

Occipital neuralgia is usually defined as paroxysmal stabbing pain in the greater or lesser occipital nerve (GON or LON) distribution. In occipital neuralgia patients, surgical considerations are carefully taken into account if medical management is ineffective. However, identification of the occipital artery by palpation in patients with thick necks or small occipital arteries can be technically difficult. Therefore, we established a new technique using transcranial Doppler (TCD) sonography for more accurate and rapid identification. The patient was a 64-year-old man who had undergone C1-C3 screw fixation and presented with intractable stabbing pain in the bilateral GON and LON distributions. In cases in which pain management was performed using medication, physical therapy, nerve block, or radiofrequency thermocoagulation, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed occipital neurectomy of the bilateral GON and LON by using TCD sonography, which helped detect the greater occipital artery easily. After the operation, the patient's headache disappeared gradually, although he had discontinued all medication except antidepressants. We believe that this new technique of occipital neurectomy via a small skin incision performed using TCD sonography is easy and reliable, has a short operative time, and provides rapid pain relief. PMID:21390179

[Pain experience of nursing students and the methods used to cope with pain].

PubMed

Uzunçakmak, Tuğba; Kılıç, Mahmut

2017-07-01

This study aimed to determine the pain experience of nursing students and the methods used to cope with it. This descriptive study was conducted at the nursing department. Sampling was not used. The study was completed with 264 students. Data were collected using the questionnaire that was prepared by the researchers. Descriptive statistics and chi-square test were used for data analysis. Of all students, 76.1% (84.1%, females; 56.0%, males) who participated in this study had pain. The most experienced pain was headache (52.3%), stomachache (42.4%), and low back pain (33%); these were more prevalent in females than in males. The use of medication (42.9% in males and 47.8% in females) was higher than the other methods for pain treatment. Students who stayed in the dormitory were more likely to use drugs (58.5%), whereas those not staying in the dormitory were more likely to use non-drug methods (47.4%). Students who paid attention to feeding behavior used more medication (80%) than who did not pay attention (44.1%; p<0.05). Students were mostly applied to health institutions owing to pain, they used drugs for headache, and the pain affected their daily life activities and resulted in them being absent on school days. In conclusion, considering the adverse effects of medications, it is recommended that students should be informed regarding reliable traditional nonpharmacological methods for coping with pain and should be encouraged to use such methods.

A descriptive feasibility study to evaluate scheduled oral analgesic dosing at home for the management of postoperative pain in preschool children following tonsillectomy.

PubMed

Sutters, Kimberly A; Holdridge-Zeuner, Danielle; Waite, Steven; Paul, Steven M; Savedra, Marilyn C; Lanier, Brent; Mahoney, Karla; Miaskowski, Christine

2012-03-01

The purpose of this study, in a sample of preschool children (ages 3-5 years; N = 47), was to evaluate the feasibility of scheduled analgesic dosing following outpatient tonsillectomy in order to optimize pain management. Parents were instructed to give their child acetaminophen with hydrocodone (167 mg/5 mL) every 4 hours around the clock for the first 3 days following surgery. Parents recorded ratings of their child's pain with/without swallowing using the Faces, Legs, Activity, Cry, and Consolability (FLACC) behavioral pain scale, pain relief ratings, and severity of analgesic side effects in a home diary. Audiotaped interviews were conducted with parents to document descriptions of their experiences in managing their child's pain at home. Mean FLACC scores with/without swallowing were less than two at each measurement time and pain relief scores increased over time. Total analgesic dose decreased, and the number of missed doses increased over the first 3 days after surgery. Moderate-to-severe daytime sedation, nausea, vomiting, and constipation were reported by parents. Study results suggest that acetaminophen with hydrocodone is effective in relieving preschool children's pain following tonsillectomy and that parental adherence to a scheduled analgesic regimen decreases over time. Time-contingent dosing was associated with moderate to severe side effects and should be addressed in discharge teaching with parents. Findings provide insight into parents' perspective of pain management at home following tonsillectomy and methods for relieving their child's pain. Wiley Periodicals, Inc.

A comparison of buffered lidocaine versus ELA-Max before peripheral intravenous catheter insertions in children.

PubMed

Luhmann, Janet; Hurt, Sarah; Shootman, Mario; Kennedy, Robert

2004-03-01

Peripheral intravenous catheter (PIV) insertion is a common, painful experience for many children in the pediatric emergency department. Although local anesthetics such as injected buffered lidocaine have been shown to be effective at reducing pain and anxiety associated with PIV insertion, they are not routinely used. ELA-Max, a topical local anesthetic, has the advantage of needle-free administration but has not been compared with buffered lidocaine for PIV insertion. To compare the reduction of pain and anxiety during PIV insertion provided by subcutaneous buffered 1% lidocaine or topical ELA-Max in children. A randomized trial in children 4 to 17 years old undergoing PIV insertion with 22-gauge catheters was conducted. Children received either buffered lidocaine or ELA-Max. Buffered lidocaine was administered by using 30-gauge needles to inject 0.1 to 0.2 mL subcutaneously just before PIV insertion. ELA-Max was applied to the skin and occluded with Tegaderm 30 minutes before PIV insertion. Self-reported Visual Analog Scale (VAS) questionnaires (rating on a scale of 1-10; 1 = no pain, anxiety) were completed by patients and their parents before PIV insertion to assess baseline perceptions about pain and anxiety associated with PIV insertion and immediately after PIV insertion to assess pain and anxiety associated with the experience. After PIV insertion, the nurse who inserted the PIV also completed a VAS questionnaire assessing technical difficulty and satisfaction with the local anesthesia. A blinded observer also completed a VAS questionnaire to assess pain and anxiety associated with the PIV insertion. Data were analyzed by using chi2 and t tests. Sixty-nine subjects were enrolled, and questionnaires were competed by all (mean age: 12.1 +/- 4.5 years; 61% female). There were no differences for buffered lidocaine and ELA-Max groups in age, gender, race, prior IV experience, or baseline pain and anxiety. There were no significant differences between buffered lidocaine and ELA-Max in mean pain and anxiety after PIV insertion by patient, parent, and blinded observer ratings. Nurse ratings of technical difficulty, number of PIV-insertion attempts, and satisfaction with local anesthesia also were not significantly different for buffered lidocaine and ELA-Max groups. ELA-Max provided similar pain and anxiety reduction during PIV insertion in children compared with injected buffered lidocaine. Technical difficulty and satisfaction by nurses inserting the PIV also were similar.

Self-reported prevalence, description and management of pain in adults with haemophilia: methods, demographics and results from the Pain, Functional Impairment, and Quality of life (P-FiQ) study.

PubMed

Witkop, M; Neff, A; Buckner, T W; Wang, M; Batt, K; Kessler, C M; Quon, D; Boggio, L; Recht, M; Baumann, K; Gut, R Z; Cooper, D L; Kempton, C L

2017-07-01

Haemophilia is characterized by frequent haemarthrosis, leading to acute/chronic joint pain. To assess self-reported prevalence, description and management of pain in adult males with mild-to-severe haemophilia and history of joint pain/bleeding. Participants completed a pain survey and five patient-reported outcome instruments assessing pain, functional impairment and health-related quality of life (HRQoL). Of 381 participants enrolled, median age was 34 years; 77% had haemophilia A, 71% had severe disease and 65% were overweight/obese. Many (56%) were not receiving routine infusions; 30% never received routine infusions. During the prior 6 months, 20% experienced acute pain, 34% chronic pain and 32% both acute/chronic pain. Subjects with both acute/chronic pain (vs. none, acute or chronic) were more likely to be depressed (30% vs. 0-15%), obese (35% vs. 20-29%) and have lower HRQoL (mean EQ-5D visual analog scale, 69 vs. 83-86) and function (median overall Hemophilia Activities List, 60 vs. 88-99). Most common analgesics used for acute/chronic pain during the prior 6 months were acetaminophen (62%/55%) and non-steroidal anti-inflammatory drugs (34%/49%); most common non-pharmacologic strategies were ice (65%/33%) and rest (51%/33%). Hydrocodone-acetaminophen was the most common opioid for both acute/chronic pain (30%); other long-acting opioids were infrequently used specifically for chronic but not acute pain (morphine, 7%; methadone, 6%; fentanyl patch, 2%). Patients with chronic pain, particularly those with both acute/chronic pain, frequently experience psychological issues, functional disability and reduced HRQoL. Treatment strategies for acute pain (e.g. routine infusions to prevent bleeding) and for chronic pain (e.g. long-acting opioids) may be underused. © 2017 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

Cryoablation of Osteoid Osteoma in the Pediatric and Adolescent Population.

PubMed

Whitmore, Morgan J; Hawkins, C Matthew; Prologo, J David; Marshall, Kelley W; Fabregas, Jorge A; Yim, Douglas B; Monson, David; Oskouei, Shervin V; Fletcher, Nicholas D; Williams, Roger S

2016-02-01

To evaluate the technical feasibility and clinical efficacy of osteoid osteoma (OO) cryoablation in a large, pediatric/adolescent cohort. An electronic medical record and imaging archive review was performed to identify all cryoablations performed for OOs between 2011 and 2015 at a single tertiary care pediatric hospital. The subsequent analysis included 29 patients with suspected OOs treated by cryoablation (age range, 3-18 y; mean age, 11.3 y; 17 boys; 12 girls). Conventional CT guidance was used in 22 procedures; cone-beam CT guidance was used in 7 procedures. Follow-up data were obtained via a standardized telephone questionnaire (23/29 patients; 79.3%) and clinical notes (5/29 patients; 17.2%). One patient was lost to follow-up. Technical success was achieved in 100% of patients (29/29). Immediate clinical success (cessation of pain and nonsteroidal antiinflammatory drug [NSAID] use within 1 mo after the procedure) was achieved in 27/28 patients (96.4%). Short-term clinical success (cessation of pain and NSAID use for > 3 mo after the procedure) was achieved in 24/25 patients (96%). Long-term clinical success (cessation of pain and NSAID use for > 12 mo after the procedure) was achieved in 19/21 patients (90.5%). Median pain scale score before the procedure was 10 (range, 5-10); median pain scale score after the procedure was 0 (range, 0-8; P < .0001). There were 6 minor complications (21%) and no major complications. Image-guided cryoablation is a technically feasible, clinically efficacious therapeutic option for children and adolescents with symptomatic OO. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Parents' perspective of their journey caring for a child with chronic neuropathic pain.

PubMed

Gaughan, Veronica; Logan, Deirdre; Sethna, Navil; Mott, Sandra

2014-03-01

When a child has chronic pain, it affects the parents. Their response and how it is factored into their lives and family function was the phenomenon of interest that drove this study. The available literature was sparse, especially when the pain etiology was neuropathic. The purpose of this study was to describe the parents' perception of the pain journey from the initial occurrence of their child's pain through the labyrinth of treatment options to successful outcome, to gain a better understanding of parental beliefs about pain, and to learn how parental attitudes and behaviors relate to children's response to treatment for chronic pain. Qualitative descriptive design was used to better understand the phenomenon from those who were the experts because they had experienced it. Parents whose child was enrolled in a pain rehabilitation program participated in open-ended interviews. The children/adolescents were 8-18 years old and diagnosed with complex regional pain syndrome or a related chronic pain condition. During data immersion, the investigators uncovered the pervasive underlying themes of suffering and disempowerment. In addition, the multiple meaning elements were grouped into three categories and supportive subcategories labeled as follows: parent distress, with subcategories schism in parenting, searching, and disabled parenting; and lack of control, with the subcategories family/community, fear, and empowerment. The voices of parents were heard in their description of the exhausting and difficult journey in search of pain relief for their child. Their comments provided insight into how they defined the child's pain and their related parental role. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Patients' perception of Parkinson's disease-associated pain following initiation of rotigotine: a multicenter non-interventional study.

PubMed

Timmermann, Lars; Oehlwein, Christian; Ransmayr, Gerhard; Fröhlich, Holger; Will, Edgar; Schroeder, Hanna; Lauterbach, Thomas; Bauer, Lars; Kassubek, Jan

2017-01-01

To evaluate Parkinson's disease (PD)-associated pain as perceived by the patients (subjective characterization), and how this may change following initiation of rotigotine transdermal patch. SP1058 was a non-interventional study conducted in routine clinical practice in Germany and Austria in patients experiencing PD-associated pain (per the physician's assessment). Data were collected at baseline (ie, before rotigotine initiation) and at a routine visit after ≥25 days (-3 days allowed) of treatment on a maintenance dose of rotigotine (end of study [EoS]). Pain perception was assessed using the 12-item Pain Description List of the validated German Pain Questionnaire (each item ranked 0 = 'not true' to 3 = 'very true'). Primary effectiveness variable: change from baseline to EoS in the sum score of the 4 'affective dimension' items of the Pain Description List. Secondary effectiveness variables: change from baseline to EoS in Unified Parkinson's Disease Rating Scale (UPDRS) II, III, and II+III scores, and Parkinson's Disease Questionnaire (PDQ-8) total score (PD-related quality-of-life). Other variables included scores of the eight 'sensory dimension' items of the Pain Description List. Of 93 enrolled patients (mean [SD] age: 71.1 [9.0] years; male: 48 [52%]), 77 (83%) completed the study, and 70 comprised the full analysis set. The mean (SD) change from baseline in the sum score of the four 'affective dimension' items was -1.3 (2.8) indicating a numerical improvement (baseline: 3.9 [3.4]). In the 'sensory dimension', pain was mostly perceived as 'pulling' at baseline (49/70 [70%]); 'largely true'/'very true'). Numerical improvements were observed in all UPDRS scores (mean [SD] change in UPDRS II+III: -5.3 [10.5]; baseline: 36.0 [15.9]), and in PDQ-8 total score (-2.0 [4.8]; baseline: 10.7 [5.9]). Adverse drug reactions were consistent with dopaminergic stimulation and transdermal administration. The perception of the 'affective dimension' of PD-associated pain numerically improved in patients treated with rotigotine. ClinicalTrials.gov identifier: NCT01606670; https://clinicaltrials.gov/ct2/show/NCT01606670?term=NCT01606670&rank=1.

Dental Fitness Class 3 Treatment Needs: A Report of Consultation

DTIC Science & Technology

1992-10-20

services of the Defense Technical Information Center (per DOD Instruction 5200.21) may purchase copies directly from the following: Defense Technical ...All other requests for these reports will be directed to the fowing: :9 U.S. Department of Commerce i’-? National Technical Information Services (NTIS...oral malignancies. 12 Temporomandibular joint disorders - myofascial pain dysfunction; dislocation, subluxation or other associated conditions. 13

Painful lumbosacral melorheostosis treated by fusion.

PubMed

Robertson, Peter A; Don, Angus S; Miller, Mary V

2003-06-15

A case report of low back pain associated with a diagnosis of melorheostosis of the lumbosacral spine. To describe a rare presentation of melorheostosis and subsequent successful surgical treatment. Melorheostosis is a rare condition and spinal pain has not been described in association with the condition. A patient with disabling low back pain and suspected melorheostosis of the lumbosacral spine responded favorably to diagnostic facet joint blocks. Treatment was lumbosacral fusion and biopsy of the abnormal bone. The densely sclerotic bone presented technical difficulties requiring modification of surgical technique. Dramatic pain and disability reduction occurred following lumbosacral fusion. Histologic examination was consistent with melorheostosis. Melorheostosis rarely causes severe low back pain that can respond favorably to fusion surgery.

A closer look: Alternative pain management practices by heart failure patients with chronic pain.

PubMed

McDonald, Deborah Dillon; Soutar, Christina; Chan, Maria Agudelo; Afriyie, Angela

2015-01-01

To describe alternative non-pharmaceutical non-nutraceutical pain self-management strategies used by people with heart failure (HF) in order to reduce chronic non-cardiac pain. Little is known about alternative pain self-treatments used by HF patients with chronic pain. A cross-sectional descriptive design was used with 25 hospitalized HF patients who had chronic pain and used at least one alternative pain treatment. Pain intensity, pain interference with function, and current pain treatments were measured with the Brief Pain Inventory. Alternative treatments included walking, stretching, use of heat and cold. Five patients used evidence-based pain treatments for their chronic pain conditions. Patients reported moderate pain intensity and pain interference with activity. Patients with HF and chronic pain use few alternative pain treatments. Screening for chronic pain and referral to Integrative Medicine and/or Palliative care for a pain management consult might reduce the added burden of pain in people with HF. Copyright © 2015 Elsevier Inc. All rights reserved.

48 CFR 2052.215-71 - Project officer authority.

Code of Federal Regulations, 2012 CFR

2012-10-01

... of the work description. (3) Review and, where required by the contract, approve technical reports... subject to the technical direction of the NRC project officer. The term technical direction is defined to include the following: (1) Technical direction to the contractor which shifts work emphasis between areas...

48 CFR 2052.215-71 - Project officer authority.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of the work description. (3) Review and, where required by the contract, approve technical reports... subject to the technical direction of the NRC project officer. The term technical direction is defined to include the following: (1) Technical direction to the contractor which shifts work emphasis between areas...

48 CFR 2052.215-71 - Project officer authority.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of the work description. (3) Review and, where required by the contract, approve technical reports... subject to the technical direction of the NRC project officer. The term technical direction is defined to include the following: (1) Technical direction to the contractor which shifts work emphasis between areas...

48 CFR 2052.215-71 - Project officer authority.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of the work description. (3) Review and, where required by the contract, approve technical reports... subject to the technical direction of the NRC project officer. The term technical direction is defined to include the following: (1) Technical direction to the contractor which shifts work emphasis between areas...

Shin splints--a literature review.

PubMed Central

Bates, P

1985-01-01

"Shin splints" is not a specific diagnosis. It is merely a descriptive term that describes chronic exertional shin pain in an athlete. The evidence seems clear that shin splint pain has many different causes and this reflects the variation in the anatomy. It would be preferable to describe shin splint pain by location and aetiology, for example, lower medial tibial pain due to periostitis or upper lateral tibial pain due to elevated compartment pressure. This would aid communication between physicians and also direct therapy more accurately. Images p132-a PMID:3907743

Medical Surveillance Monthly Report (MSMR). Volume 22, Number 12, December 2015

DTIC Science & Technology

2015-12-01

veterans in whom chronic pain may be comorbid with, and exacerbated by, post-traumatic stress disorder (PTSD), depression, or traumatic brain...unspecifi ed 51 780.52 Insomnia , unspecifi ed 46 723.1 Cervicalgia Other chronic pain Chronic pain syndrome No. ICD-9code Description No. ICD-9 code...without myelopathy 982 719.45 Pain in joint involving pelvic region and thigh 205 309.81 Post-traumatic stress disorder 961 722.52 Degeneration of

Pain, Sleep Disturbance, and Quality of Life Among Palestinian Patients Diagnosed with Cancer.

PubMed

Dreidi, Mu'taz M; Hamdan-Mansour, Ayman M

2016-12-01

The objective of this descriptive study is to explore the relationships between pain, sleep disturbance, and quality of life among Palestinian patients diagnosed with cancer in the West Bank. A cross-sectional, descriptive-correlational design was used to collect data from 184 patients with cancer. The quality of life questionnaire, visual analogue pain scale, and physical health status were used in data collection. The results showed that the mean score for pain was 5, the best functioning was for cognitive scale (M = 75, SD = 29), the worst symptoms experienced by patients was appetite loss (M = 47, SD = 35), a moderate global health status (M = 53, SD = 27), and the mean for sleep disturbance was 43 (SD = 35). Pain and sleep disturbance showed high negative correlations with functional scales of quality of life and positive with symptom scales. The findings showed that the co-occurrence of pain and sleep disturbance was negatively correlated with quality of life (QoL) and positively with symptom scales. The regression analysis revealed that pain and sleep disturbance accounted for a significant proportion of variance in the QoL (p < 0.001), and the highest proportion was in predicting global health status (41.9 %). The findings of this study give evidence about the importance of assessing pain and sleep quality among Palestinian patients with cancer.

The Marshall Engineering Thermosphere (MET) Model. Volume 1; Technical Description

NASA Technical Reports Server (NTRS)

Smith, R. E.

1998-01-01

Volume 1 presents a technical description of the Marshall Engineering Thermosphere (MET) model atmosphere and a summary of its historical development. Various programs developed to augment the original capability of the model are discussed in detail. The report also describes each of the individual subroutines developed to enhance the model. Computer codes for these subroutines are contained in four appendices.

NATO Scientific and Technical Information Service (NSTIS): functional description. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Molholm, K.N.; Blados, W.N.; Bulca, C.

1987-08-01

This report provides a functional description of the requirements for a NATO Scientific and Technical Information Service (NSTIS). The user requirements and much of the background information in this report were derived primarily from interviews with more than 60 NATO Headquarters staff members between 2 March and 25 March 1987. In addition, representatives of the Supreme Headquarters Applied Powers Europe (SHAPE) Technical Centre (STC), the Supreme Allied Commander Atlantic (Anti-Submarine Warfare Research) Centre (SACLANTCEN), the NATO Communications and Information Systems Agency (NACISA), The Advisory Group for Aerospace Research and Development (AGARD), the U.S. Defense Technical Information Center (DTIC), and themore » Technical Documentation Center for the Armed Forces in the Netherlands (TDCK), were interviewed, either in person or by telephone.« less

An exploration of Singaporean parental experiences in managing school-aged children's postoperative pain: a descriptive qualitative approach.

PubMed

Lim, Siew Hoon; Mackey, Sandra; Liam, Joanne Li Wee; He, Hong-Gu

2012-03-01

To enhance understanding of the experience of parents in managing their children's postoperative pain in Singapore. Parents play a significant role in their hospitalised child's postoperative pain care. Their active involvement may contribute to accurate pain assessment and effective pain management for their child. However, there is a lack of in-depth research exploring the experience of parents involved in their children's postoperative pain management. This study adopted a descriptive qualitative approach, which is situated in the interpretive paradigm. Semi-structured interviews were conducted to collect data from 14 parents whose children were hospitalised in one of the three paediatric surgical wards in a hospital in Singapore in December 2009. Thematic analysis was used to analyse the data. Three themes were identified: 'Actions used by parents to alleviate their child's postoperative pain', 'Factors influencing parents' management of their child's postoperative pain' and 'Parents' needs in the process of caring for their child's postoperative pain'. Parents used a range of non-pharmacological pain relief interventions for their child. Parental roles and expectations, bond between parent and child, support from nurses, family and own religious beliefs, as well as children's age and maturity level were factors which promoted parental participation, whereas parents' negative feelings, knowledge deficit and nurses' busy schedule were hindering factors. Parents expressed needs for more involvement in their child's care, adequate rest and information support from nurses. This study highlights the importance of involving parents in their child's postoperative pain management. It provides evidence for health care professionals to pay attention to factors that may influence parental participation and, therefore, guide their practice. Nurses need to provide parents with support and education to facilitate their roles and improve their child's postoperative pain management. © 2011 Blackwell Publishing Ltd.

Feasibility of volumetric MRI-guided high intensity focused ultrasound (MR-HIFU) for painful bone metastases.

PubMed

Huisman, Merel; Lam, Mie K; Bartels, Lambertus W; Nijenhuis, Robbert J; Moonen, Chrit T; Knuttel, Floor M; Verkooijen, Helena M; van Vulpen, Marco; van den Bosch, Maurice A

2014-01-01

Magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) has recently emerged as an effective treatment option for painful bone metastases. We describe here the first experience with volumetric MR-HIFU for palliative treatment of painful bone metastases and evaluate the technique on three levels: technical feasibility, safety, and initial effectiveness. In this observational cohort study, 11 consecutive patients (7 male and 4 female; median age, 60 years; age range, 53-86 years) underwent 13 treatments for 12 bone metastases. All patients exhibited persistent metastatic bone pain refractory to the standard of care. Patients were asked to rate their worst pain on an 11-point pain scale before treatment, 3 days after treatment, and 1 month after treatment. Complications were monitored. All data were prospectively recorded in the context of routine clinical care. Response was defined as a ≥2-point decrease in pain at the treated site without increase in analgesic intake. Baseline pain scores were compared to pain scores at 3 days and 1 month using the Wilcoxon signed-rank test. For reporting, the STROBE guidelines were followed. No treatment-related major adverse events were observed. At 3 days after volumetric MR-HIFU ablation, pain scores decreased significantly (p = 0.045) and response was observed in a 6/11 (55%) patients. At 1-month follow-up, which was available for nine patients, pain scores decreased significantly compared to baseline (p = 0.028) and 6/9 patients obtained pain response (overall response rate 67% (95% confidence interval (CI) 35%-88%)). This is the first study reporting on the volumetric MR-HIFU ablation for painful bone metastases. No major treatment-related adverse events were observed during follow-up. The results of our study showed that volumetric MR-HIFU ablation for painful bone metastases is technically feasible and can induce pain relief in patients with metastatic bone pain refractory to the standard of care. Future research should be aimed at standardization of the treatment procedures and treatment of larger numbers of patients to assess treatment effectiveness and comparison to the standard of care.

Feasibility of volumetric MRI-guided high intensity focused ultrasound (MR-HIFU) for painful bone metastases

PubMed Central

2014-01-01

Background Magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) has recently emerged as an effective treatment option for painful bone metastases. We describe here the first experience with volumetric MR-HIFU for palliative treatment of painful bone metastases and evaluate the technique on three levels: technical feasibility, safety, and initial effectiveness. Methods In this observational cohort study, 11 consecutive patients (7 male and 4 female; median age, 60 years; age range, 53–86 years) underwent 13 treatments for 12 bone metastases. All patients exhibited persistent metastatic bone pain refractory to the standard of care. Patients were asked to rate their worst pain on an 11-point pain scale before treatment, 3 days after treatment, and 1 month after treatment. Complications were monitored. All data were prospectively recorded in the context of routine clinical care. Response was defined as a ≥2-point decrease in pain at the treated site without increase in analgesic intake. Baseline pain scores were compared to pain scores at 3 days and 1 month using the Wilcoxon signed-rank test. For reporting, the STROBE guidelines were followed. Results No treatment-related major adverse events were observed. At 3 days after volumetric MR-HIFU ablation, pain scores decreased significantly (p = 0.045) and response was observed in a 6/11 (55%) patients. At 1-month follow-up, which was available for nine patients, pain scores decreased significantly compared to baseline (p = 0.028) and 6/9 patients obtained pain response (overall response rate 67% (95% confidence interval (CI) 35%–88%)). Conclusions This is the first study reporting on the volumetric MR-HIFU ablation for painful bone metastases. No major treatment-related adverse events were observed during follow-up. The results of our study showed that volumetric MR-HIFU ablation for painful bone metastases is technically feasible and can induce pain relief in patients with metastatic bone pain refractory to the standard of care. Future research should be aimed at standardization of the treatment procedures and treatment of larger numbers of patients to assess treatment effectiveness and comparison to the standard of care. PMID:25309743

77 FR 20369 - Applications for New Awards; Centers for Independent Living-Training and Technical Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-04

... Education ACTION: Notice. Overview Information Centers for Independent Living--Training and Technical.... Funding Opportunity Description Purpose of Program The purpose of the Training and Technical Assistance grant under the Centers for Independent Living program is to provide training and technical assistance...

Unresolved Technical Issues in Fair Interest Measurement.

ERIC Educational Resources Information Center

Cole, Nancy S.

The problem of sex differences in interest measurement involves many technical issues and procedures. The purpose of this paper is to provide a description of the technical problems involved in construction, scoring, and interpretation of interest measures as related to sex differences and to suggest guidelines within these technical issues which…

47 CFR 79.3 - Video description of video programming.

Code of Federal Regulations, 2011 CFR

2011-10-01

... description per calendar quarter, either during prime time or on children's programming; (2) Television... technical capability necessary to pass through the video description, unless using the technology for... video description per calendar quarter during prime time or on children's programming, on each channel...

47 CFR 79.3 - Video description of video programming.

Code of Federal Regulations, 2010 CFR

2010-10-01

... description per calendar quarter, either during prime time or on children's programming; (2) Television... technical capability necessary to pass through the video description, unless using the technology for... video description per calendar quarter during prime time or on children's programming, on each channel...

A DESCRIPTIVE FEASIBILITY STUDY TO EVALUATE SCHEDULED ORAL ANALGESIC DOSING AT HOME FOR THE MANAGEMENT OF POSTOPERATIVE PAIN IN PRESCHOOL CHILDREN FOLLOWING TONSILLECTOMY

PubMed Central

Sutters, Kimberly A.; Holdridge-Zeuner, Danielle; Waite, Steven; Paul, Steven M.; Savedra, Marilyn C.; Lanier, Brent; Mahoney, Karla; Miaskowski, Christine

2012-01-01

Objectives The purpose of this study, in a sample of preschool children (ages 3 to 5 years; N=47), was to evaluate the feasibility of scheduled analgesic dosing following outpatient tonsillectomy in order to optimize pain management. Methods Parents were instructed to give their child acetaminophen with hydrocodone (167mg/5ml) every 4 hours around-the-clock for the first 3 days following surgery. Parents recorded ratings of their child’s pain with/without swallowing using the Faces, Legs, Activity, Cry, and Consolability (FLACC) behavioral pain scale, pain relief ratings, and severity of analgesic side effects in a home diary. Audiotaped interviews were conducted with parents to document descriptions of their experiences in managing their child’s pain at home. Results Mean FLACC scores with/without swallowing were less than 2 at each measurement time and pain relief scores increased over time. Total analgesic dose decreased and the number of missed doses increased over the first 3 days after surgery. Moderate-to-severe daytime sedation, nausea, vomiting, and constipation were reported by parents. Discussion Study results suggest that acetaminophen with hydrocodone is effective in relieving preschool children’s pain following tonsillectomy, and that parental adherence to a scheduled analgesic regimen decreases over time. Time-contingent dosing was associated with moderate to severe side effects, and should be addressed in discharge teaching with parents. Findings provide insight into parents’ perspective of pain management at home following tonsillectomy and methods for relieving their child’s pain. PMID:22313591

Crew Transportation Technical Standards and Design Evaluation Criteria

NASA Technical Reports Server (NTRS)

Lueders, Kathryn L.; Thomas, Rayelle E. (Compiler)

2015-01-01

Crew Transportation Technical Standards and Design Evaluation Criteria contains descriptions of technical, safety, and crew health medical processes and specifications, and the criteria which will be used to evaluate the acceptability of the Commercial Providers' proposed processes and specifications.

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 χ2 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. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Innovations in interventional pain management of chronic spinal pain.

PubMed

Manchikanti, Laxmaiah; Boswell, Mark V; Hirsch, Joshua A

2016-09-01

Interventional pain management dates back to 1901, with significant innovations, which include the definition, literature synthesis, pathophysiology, and technical interventions. Interventional pain management and interventional techniques include neural blockade, neural ablative procedures, spinal cord and peripheral nerve stimulation, intrathecal drug delivery systems, minimally invasive lumbar decompression (MILD®), percutaneous endoscopic spinal decompression, and regenerative medicine. In addition, advances are also related to the evidence synthesis of comparative effectiveness research. Expert commentary: Multiple innovations in interventional pain management and potential innovations may reduce costs and improve care and outcomes with proper evidence synthesis and application of principles of evidence-based medicine. Innovations in interventional pain management in managing chronic spinal pain depend on extensive research and appropriate evidence synthesis. Innovations should be developed in conjunction with health care policy based on principles of evidence-based medicine.

RASSP Benchmark 4 Technical Description.

DTIC Science & Technology

1998-01-09

be carried out. Based on results of the study, an implementation of all, or part, of the system described in this benchmark technical description...validate interface and timing constraints. The ISA level of modeling defines the limit of detail expected in the VHDL virtual prototype. It does not...develop a set of candidate architectures and perform an architecture trade-off study. Candidate proces- sor implementations must then be examined for

Research Notes - An Introduction to Openness and Evolvability Assessment

DTIC Science & Technology

2016-08-01

importance of different business and technical characteristics that combine to achieve an open solution. The complexity of most large-scale systems of...process characteristic)  Granularity of the architecture (size of functional blocks)  Modularity (cohesion and coupling)  Support for multiple...Description)  OV-3 (Operational Information Exchange Matrix)  SV-1 (Systems Interface Description)  TV-1 ( Technical Standards Profile). Note that there

A descriptive account of New Zealand mothers' responses to open-ended questions on their breast feeding experiences.

PubMed

Manhire, Kathleen M; Hagan, Annette E; Floyd, Susan A

2007-12-01

To describe the breast feeding experiences of mothers in New Zealand. Descriptive, qualitative study. After a previous quantitative analysis of a questionnaire, the open-ended responses by the women were examined using a thematic analysis approach. Hawke's Bay, New Zealand. 153 primiparous and multiparous breast feeding women aged between 20 and 49 years, who had had a caesarean section or vaginal birth between 4 months and 3 years previously. Themes identified during the data analysis are as follows: persistence, determination, confidence and satisfaction; pain and limitation of mothering activities; conflicting advice and professionalism; and others' expectations. Breast feeding experience could be detrimentally affected by physical factors, inconsistent health-professional support and others' expectations. Negative influences, however, were likely to be overcome by persistence, determination, confidence and satisfaction. Implications for midwifery practice from the study iterate the importance of consistency of advice and skills of health professionals, of listening and understanding women's responses to early breast feeding assistance and giving continuous encouragement and support throughout their breast feeding experience. To meet these recommendations, breast feeding education for health professionals needs to include technical expertise and communication skills. Recommendations for further research from this study include investigations into why women commit to breast feeding and an exploration of women's perceptions of midwives' breast feeding support.

30 CFR 777.13 - Reporting of technical data.

Code of Federal Regulations, 2010 CFR

2010-07-01

... descriptions of the methodology used to collect and analyze the data. (b) Technical analyses shall be planned... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Reporting of technical data. 777.13 Section 777... PROGRAMS GENERAL CONTENT REQUIREMENTS FOR PERMIT APPLICATIONS § 777.13 Reporting of technical data. (a) All...

76 FR 16785 - Meeting for Software Developers on the Technical Specifications for Common Formats for Patient...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

... Software Developers on the Technical Specifications for Common Formats for Patient Safety Data Collection... designed as an interactive forum where PSOs and software developers can provide input on these technical... updated event descriptions, forms, and technical specifications for software developers. As an update to...

A Case Study of Technical Assistance to Demonstration Programs for Young Handicapped Children. Part I.

ERIC Educational Resources Information Center

Behr, Shirley K.; And Others

The interim report presents an evaluation of TADS (Technical Assistance Development System) through case studies of TADS technical assistance to the staffs of two demonstration programs for preschool handicapped children and their families. Purposes of the study included obtaining indepth descriptions of the technical assistance process to…

Myofascial low back pain treatment.

PubMed

Sharan, Deepak; Rajkumar, Joshua Samuel; Mohandoss, Mathankumar; Ranganathan, Rameshkumar

2014-09-01

Myofascial pain is a common musculoskeletal problem, with the low back being one of the commonest affected regions. Several treatments have been used for myofascial low back pain through physical therapies, pharmacologic agents, injections, and other such therapies. This review will provide an update based on recently published literature in the field of myofascial low back pain along with a brief description of a sequenced, multidisciplinary treatment protocol called Skilled Hands-on Approach for the Release of myofascia, Articular, Neural and Soft tissue mobilization (SHARANS) protocol. A comprehensive multidisciplinary approach is recommended for the successful management of individuals with myofascial low back pain.

[Structure of pain management facilities in Germany : Classification of medical and psychological pain treatment services-Consensus of the Joint Commission of the Professional Societies and Organizations for Quality in Pain Medicine].

PubMed

Müller-Schwefe, G H H; Nadstawek, J; Tölle, T; Nilges, P; Überall, M A; Laubenthal, H J; Bock, F; Arnold, B; Casser, H R; Cegla, T H; Emrich, O M D; Graf-Baumann, T; Henning, J; Horlemann, J; Kayser, H; Kletzko, H; Koppert, W; Längler, K H; Locher, H; Ludwig, J; Maurer, S; Pfingsten, M; Schäfer, M; Schenk, M; Willweber-Strumpf, A

2016-06-01

On behalf of the Medical/Psychological Pain Associations, Pain Patients Alliance and the Professional Association of Pain Physicians and Psychologists, the Joint Commission of Professional Societies and Organizations for Quality in Pain Medicine, working in close collaboration with the respective presidents, has developed verifiable structural and process-related criteria for the classification of medical and psychological pain treatment facilities in Germany. Based on the established system of graded care in Germany and on existing qualifications, these criteria also argue for the introduction of a basic qualification in pain medicine. In addition to the first-ever comprehensive description of psychological pain facilities, the criteria presented can be used to classify five different levels of pain facilities, from basic pain management facilities, to specialized institutions, to the Centre for Interdisciplinary Pain Medicine. The recommendations offer binding and verifiable criteria for quality assurance in pain medicine and improved pain treatment.

African Americans' Perceptions of Pain and Pain Management: A Systematic Review.

PubMed

Booker, Staja Q

2016-01-01

The purpose of this systematic review is to explore the perceptions of acute, persistent, and disease-specific pain and treatment options held by adult African Americans. Underassessment and undermanagement of pain in African Americans has been well documented; however, the cultural continuum of pain perceptions and their influence on pain assessment and management has not been synthesized. Electronic database searches of the Cumulative Index for Nursing and Allied Health Literature and PubMed, Web-based searches of the pain-specific journals plus a manual search of reference lists identified 41 relevant articles addressing perceptions of pain and/or pain management. Analysis of the literature revealed six themes: (a) meaning of pain, (b) description of pain, (c) coping with pain, (d) impact of pain, (e) patient-provider relationship, and (f) treatment approaches. These findings warrant further research and indicate the need for more precise evaluation of pain in African Americans, highlighting an imperative to incorporate cultural patterns into pain management practice and education. © The Author(s) 2014.

Classifying orofacial pains: a new proposal of taxonomy based on ontology

PubMed Central

NIXDORF, D. R.; DRANGSHOLT, M. T.; ETTLIN, D. A.; GAUL, C.; DE LEEUW, R.; SVENSSON, P.; ZAKRZEWSKA, J. M.; DE LAAT, A.; CEUSTERS, W.

2012-01-01

SUMMARY Propose a new taxonomy model based on ontological principles for disorders that manifest themselves through the symptom of persistent orofacial pain and are commonly seen in clinical practice and difficult to manage. Consensus meeting of eight experts from various geographic areas representing different perspectives (orofacial pain, headache, oral medicine and ontology) as an initial step towards improving the taxonomy. Ontological principles were introduced, reviewed and applied during the consensus building process. Diagnostic criteria for persistent dento-alveolar pain disorder (PDAP) were formulated as an example to be used to model the taxonomical structure of all orofacial pain conditions. These criteria have the advantage of being (i) anatomically defined, (ii) in accordance with other classification systems for the provision of clinical care, (iii) descriptive and succinct, (iv) easy to adapt for applications in varying settings, (v) scalable and (vi) transferable for the description of pain disorders in other orofacial regions of interest. Limitations are that the criteria introduce new terminology, do not have widespread acceptance and have yet to be tested. These results were presented to the greater conference membership and were unanimously accepted. Consensus for the diagnostic criteria of PDAP was established within this working group. This is an initial first step towards developing a coherent taxonomy for orofacial pain disorders, which is needed to improve clinical research and care. PMID:21848527

The frequency of fibromyalgia syndrome and quality of life in hospitalized cancer patients.

PubMed

Eyigor, S; Karapolat, H; Korkmaz, O K; Eyigor, C; Durmaz, B; Uslu, R; Uyar, M

2009-03-01

To explore the frequency of fibromyalgia syndrome (FMS) among hospitalized cancer patients and address the relationships between pain, fatigue and quality of life with regard to the extent of pain, a cross-sectional and descriptive study was carried out in the Oncology Supportive Care Unit on 122 hospitalized cancer patients. Pain, sleep, disease impact (Fibromyalgia Impact Questionnaire), fatigue (Brief Fatigue Inventory), quality of life (Short Form 36 and European Organization for Research on Treatment of Cancer questionnaires Quality of Life-C30) were gathered using standardized measures. Thirteen of the hospitalized cancer patients (10.7%) included in the study were diagnosed with FMS. There were no statistically significant differences among three pain groups with respect to demographic characteristics (P > 0.05). There were significant differences among groups with regard to the presence of metastasis, fatigue, sleep disorder, pain, Brief Fatigue Inventory, Fibromyalgia Impact Questionnaire, most of subscores of Short Form 36 and European Organization for Research on Treatment of Cancer questionnaires Quality of Life-C30 scores (P < 0.05). In the present study, we have calculated the frequency of FMS among patients admitted to the oncology hospital in addition to establishing the relationships between pain, fatigue and quality of life with regard to the extent of pain. We believe that the descriptive data presented in this study would be helpful in future studies and therapeutic approaches.

Classifying orofacial pains: a new proposal of taxonomy based on ontology.

PubMed

Nixdorf, D R; Drangsholt, M T; Ettlin, D A; Gaul, C; De Leeuw, R; Svensson, P; Zakrzewska, J M; De Laat, A; Ceusters, W

2012-03-01

We propose a new taxonomy model based on ontological principles for disorders that manifest themselves through the symptom of persistent orofacial pain and are commonly seen in clinical practice and difficult to manage. Consensus meeting of eight experts from various geographic areas representing different perspectives (orofacial pain, headache, oral medicine and ontology) as an initial step towards improving the taxonomy. Ontological principles were introduced, reviewed and applied during the consensus building process. Diagnostic criteria for persistent dento-alveolar pain disorder (PDAP) were formulated as an example to be used to model the taxonomical structure of all orofacial pain conditions. These criteria have the advantage of being (i) anatomically defined, (ii) in accordance with other classification systems for the provision of clinical care, (iii) descriptive and succinct, (iv) easy to adapt for applications in varying settings, (v) scalable and (vi) transferable for the description of pain disorders in other orofacial regions of interest. Limitations are that the criteria introduce new terminology, do not have widespread acceptance and have yet to be tested. These results were presented to the greater conference membership and were unanimously accepted. Consensus for the diagnostic criteria of PDAP was established within this working group. This is an initial first step towards developing a coherent taxonomy for orofacial pain disorders, which is needed to improve clinical research and care. © 2011 Blackwell Publishing Ltd.

Combined ultrasound and fluoroscopic guidance for radiofrequency ablation of the obturator nerve for intractable cancer-associated hip pain.

PubMed

Stone, Jonathan; Matchett, Gerald

2014-01-01

Management of pain from skeletal metastases is notoriously difficult. Case reports and case series have described radiofrequency ablation of the obturator nerve branches to the femoral head for treatment of intractable hip pain. Ablation of the obturator branches to the femoral head is technically difficult because of bony and vascular anatomy, including close proximity of the femoral vessels. Here we present the case of a 79-year-old woman with intractable right hip pain and inability to ambulate secondary to metastatic non-small cell lung cancer in the femoral head and acetabulum, treated with thermal radiofrequency ablation of the obturator and femoral nerve branches to the femoral head. Ablation of the obturator nerve was done via anterior placement of the radiofrequency needle under combined ultrasound and fluoroscopic guidance, passing the radiofrequency needle between the femoral artery and femoral vein. Real-time ultrasound guidance was used to avoid vascular puncture. Thermal radiofrequency ablation resulted in sustained pain relief, and resumption in the ability of the patient to ambulate. From this case we suggest that an anterior approach to the obturator nerve branches to the femoral head may be technically feasible using combined ultrasound and fluoroscopic guidance to avoid vascular puncture.

Performance/Design Requirements and Detailed Technical Description for a Computer-Directed Training Subsystem for Integration into the Air Force Phase II Base Level System.

ERIC Educational Resources Information Center

Butler, A. K.; And Others

The performance/design requirements and a detailed technical description for a Computer-Directed Training Subsystem to be integrated into the Air Force Phase II Base Level System are described. The subsystem may be used for computer-assisted lesson construction and has presentation capability for on-the-job training for data automation, staff, and…

A Novel Compound Analgesic Cream (Ketamine, Pentoxifylline, Clonidine, DMSO) for Complex Regional Pain Syndrome Patients.

PubMed

Russo, Marc A; Santarelli, Danielle M

2016-01-01

Evidence suggests that complex regional pain syndrome (CRPS) is a manifestation of microvascular dysfunction. Topical combinations of α2-adrenergic receptor agonists or nitric oxide donors with phosphodiesterase or phosphatidic acid inhibitors formulated to treat microvascular dysfunction have been shown to reduce allodynia in a rat model of CRPS-I. Driven by these findings, we assessed the outcomes of CRPS patients treated with a compound analgesic cream (CAC) consisting of ketamine 10%, pentoxifylline 6%, clonidine 0.2%, and dimethyl sulfoxide 6% to 10%. An audit was conducted on 13 CRPS patients who trialed the CAC. A detailed report was compiled for each patient which comprised baseline characteristics, including CRPS description, previous treatments, and pain scores (numerical pain rating scale; 0 to 10). Recorded outcomes consisted of pain scores, descriptive outcomes, and concurrent medications/treatments, for which basic analysis was performed to determine the effectiveness of the CAC. Case reports are presented for 3 patients with varying outcomes. Nine patients (69%) reported pain/symptom reduction (4.4 ± 2.1 vs. 6.3 ± 1.9) with use of the CAC. Six patients reported sustained benefits after 2 months of CAC use, and 2 patients reported complete resolution of pain/symptoms: one had early CRPS-I and the other received a partial CRPS diagnosis. An otherwise medication refractory and intolerant patient found partial benefit with the CAC. These results demonstrate promise for this topical combination as a useful treatment in multimodal therapy for patients with CRPS, with the potential to resolve pain/symptoms in early CRPS patients. © 2015 World Institute of Pain.

A Descriptive Study of a Perioperative Pain Service Program

DTIC Science & Technology

1999-07-28

to the sense of pain (Jaros, 1991) . Reason and analytic deduction blossomed during the Renaissance. Leading the forefront was Renee Descartes , a... Descartes considered to be separate from the body and unaffected by external and mechanical forces. Integration of the mind and body, according to... Descartes , occurred within the pineal gland. Pain, therefore, was a Co-axial Narcotics 17 state of excessive sensory awareness modulated by the mind

What does 'recovery' mean to people with neck pain? Results of a descriptive thematic analysis.

PubMed

Walton, David M; Macdermid, Joy C; Taylor, Todd

2013-01-01

To describe the meaning of being recovered as perceived by people with chronic mechanical neck pain. To determine the way people with neck pain would describe a recovered state a descriptive thematic approach was used. A nominal focus group technique, written reflections, and one-on-one semi-structured interviews were used to collect sufficient data. Data from the focus groups were analyzed both through vote tallying and thematic analysis. Reflections and interviews were analyzed thematically by two independent researchers. Triangulation and member-checking were employed to establish trustworthiness of results. A total of 35 people, primarily females with neck pain of traumatic origin, participated in this study. Thematic analysis identified 6 themes that adequately described the data: absent or manageable symptoms, having the physical capacity one ought to have, participation in life roles, feeling positive emotions, autonomy & spontaneity, and re-establishing a sense of self. Member checking and triangulation suggested data saturation and accuracy of the generated themes. Recovery from neck pain appears to be informed by factors that fit with existing models of health, quality of life and satisfaction. Basing recovery solely on symptom or activity-level measures risks inaccurate estimates of recovery trajectories from traumatic or non-traumatic neck pain.

Factors associated with adequate pain control in hospitalized postsurgical patients diagnosed with cancer.

PubMed

Paice, J A; Mahon, S M; Faut-Callahan, M

1991-12-01

The inadequate management of pain continues to be a significant problem for persons with cancer. Experts suggest that contributing factors include discrepancies in pain assessment, inadequate administration of opiate therapy, and insufficient documentation of the patient's pain experience. This study, part of a multidepartmental investigation into the adequacy of pain management in hospitalized patients, describes the pain experience of surgical oncology patients. Its correlational ex post facto design (n = 34) was guided by Loeser's model of pain. Randomly selected surgical oncology patients were interviewed using a structured format. The patient's primary nurse and physician simultaneously completed brief assessments of their perceptions of the patient's pain intensity. Data were analyzed using descriptive and correlational statistics, and implications for nursing practice and future nursing research are discussed.

Chronic Pain: Content Validation of Nursing Diagnosis in Slovakia and the Czech Republic.

PubMed

Zeleníková, Renáta; Maniaková, Lenka

2015-10-01

The main purpose of the study was to validate the defining characteristics and related factors of the nursing diagnosis "chronic pain" in Slovakia and the Czech Republic. This is a descriptive study. The validation process involved was based on Fehring's Diagnostic Content Validity Model. Three defining characteristics (reports pain, altered ability to continue previous activities, and depression) were classified as major by Slovak nurses, and one defining characteristic (reports pain) was classified as major by Czech nurses. The results of the study provide guidance in devising strategies of pain assessment and can aid in the formulation of accurate nursing diagnoses. The defining characteristic "reports pain" is important for arriving at the nursing diagnosis "chronic pain." © 2014 NANDA International, Inc.

Pain sensitisation and the risk of poor outcome following physiotherapy for patients with moderate to severe knee osteoarthritis: protocol for a prospective cohort study

PubMed Central

O'Leary, Helen; Smart, Keith M; Moloney, Niamh A; Blake, Catherine; Doody, Catherine M

2015-01-01

Introduction Pain is the dominant symptom of knee osteoarthritis (OA), and recent evidence suggests factors outside of local joint pathology, such as pain sensitisation, can contribute significantly to the pain experience. It is unknown how pain sensitisation influences outcomes from commonly employed interventions such as physiotherapy. The aims of this study are, first, to provide a comprehensive description of the somatosensory characteristics of people with pain associated with knee OA. Second, we will investigate if indicators of pain sensitisation in patients with knee osteoarthritis are predictive of non-response to physiotherapy. Methods and analysis This is a multicentre prospective cohort study with 140 participants. Eligible patients with moderate to severe symptomatic knee osteoarthritis will be identified at outpatient orthopaedic and rheumatology clinics. A baseline assessment will provide a comprehensive description of the somatosensory characteristics of each participant by means of clinical examination, quantitative sensory testing, and validated questionnaires measuring pain and functional capacity. Participants will then undergo physiotherapy treatment. The primary outcome will be non-response to physiotherapy on completion of the physiotherapy treatment programme as defined by the Osteoarthritis Research Society International treatment responder criteria. A principal component analysis will identify measures related to pain sensitisation to include in the predictive model. Regression analyses will explore the relationship between responder status and pain sensitisation while accounting for confounders. Ethics and dissemination This study has been approved by St James’ Hospital/AMNCH Research Ethics Committee and by the St Vincent's Healthcare Group Ethics and Medical Research Committee. The results will be presented at international conferences and published in a peer review journal. Trial registration number NCT02310945. PMID:26059523

Pain sensitisation and the risk of poor outcome following physiotherapy for patients with moderate to severe knee osteoarthritis: protocol for a prospective cohort study.

PubMed

O'Leary, Helen; Smart, Keith M; Moloney, Niamh A; Blake, Catherine; Doody, Catherine M

2015-06-09

Pain is the dominant symptom of knee osteoarthritis (OA), and recent evidence suggests factors outside of local joint pathology, such as pain sensitisation, can contribute significantly to the pain experience. It is unknown how pain sensitisation influences outcomes from commonly employed interventions such as physiotherapy. The aims of this study are, first, to provide a comprehensive description of the somatosensory characteristics of people with pain associated with knee OA. Second, we will investigate if indicators of pain sensitisation in patients with knee osteoarthritis are predictive of non-response to physiotherapy. This is a multicentre prospective cohort study with 140 participants. Eligible patients with moderate to severe symptomatic knee osteoarthritis will be identified at outpatient orthopaedic and rheumatology clinics. A baseline assessment will provide a comprehensive description of the somatosensory characteristics of each participant by means of clinical examination, quantitative sensory testing, and validated questionnaires measuring pain and functional capacity. Participants will then undergo physiotherapy treatment. The primary outcome will be non-response to physiotherapy on completion of the physiotherapy treatment programme as defined by the Osteoarthritis Research Society International treatment responder criteria. A principal component analysis will identify measures related to pain sensitisation to include in the predictive model. Regression analyses will explore the relationship between responder status and pain sensitisation while accounting for confounders. This study has been approved by St James' Hospital/AMNCH Research Ethics Committee and by the St Vincent's Healthcare Group Ethics and Medical Research Committee. The results will be presented at international conferences and published in a peer review journal. NCT02310945. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

STARLAB UV-optical telescope facility, volume 1

NASA Technical Reports Server (NTRS)

1979-01-01

The STARLAB accomplishments to date include both the feasibility definition and detailed design study efforts on critical subsystems. Topics of discussion for this report include: (1) STARLAB capabilities; (2) scientific programs; (3) STARLAB technical description; (4) STARLAB Phase B studies; and (5) technical conclusions Technical recommendations.

Low back pain functional disability in athletes; conceptualization and initial development of a questionnaire.

PubMed

Zamani, Elham; Kordi, Ramin; Nourian, Ruhollah; Noorian, Negin; Memari, Amir Hossein; Shariati, Mohammad

2014-12-01

Low Back Pain (LBP) is one of the most prevalent causes of disability not only in the general population but also in athletes. Despite a large number of self-reported back specific disability questionnaires, there is no specific, well documented, outcome measure for athletes suffering from back pain. This study aimed to identify the main descriptive themes representing functional disability in athletes due to LBP. We conducted a qualitative study using in-depth interviews to characterize the experiences of athletes with LBP. Twenty athletes with LBP were recruited and the main descriptive elements of their LBP related disability were extracted. Then a preliminary questionnaire using these themes was proposed. The main disability indicators were pain intensity; stretching exercises, strengthening exercises, sport specific skills, back range of motion (ROM), sitting, walking, sleep patterns, self-care, and recreational activities, fear of pain and avoidance behavior, and changes in sexual activity. The findings of this study suggest that apart from non-sports items, some sport related items should be included in the assessment of LBP disability levels in athletes. Our results have also been organized as a preliminary LBP disability questionnaire for athletes.

Low Back Pain Functional Disability in Athletes; Conceptualization and Initial Development of a Questionnaire

PubMed Central

Zamani, Elham; Kordi, Ramin; Nourian, Ruhollah; Noorian, Negin; Memari, Amir Hossein; Shariati, Mohammad

2014-01-01

Background: Low Back Pain (LBP) is one of the most prevalent causes of disability not only in the general population but also in athletes. Despite a large number of self-reported back specific disability questionnaires, there is no specific, well documented, outcome measure for athletes suffering from back pain. Objectives: This study aimed to identify the main descriptive themes representing functional disability in athletes due to LBP. Patients and Methods: We conducted a qualitative study using in-depth interviews to characterize the experiences of athletes with LBP. Twenty athletes with LBP were recruited and the main descriptive elements of their LBP related disability were extracted. Then a preliminary questionnaire using these themes was proposed. Results: The main disability indicators were pain intensity; stretching exercises, strengthening exercises, sport specific skills, back range of motion (ROM), sitting, walking, sleep patterns, self-care, and recreational activities, fear of pain and avoidance behavior, and changes in sexual activity. Conclusions: The findings of this study suggest that apart from non-sports items, some sport related items should be included in the assessment of LBP disability levels in athletes. Our results have also been organized as a preliminary LBP disability questionnaire for athletes. PMID:25741417

An investigation of wing buffeting response at subsonic and transonic speeds: Phase 1: F-111A flight data analysis. Volume 1: Summary of technical approach, results and conclusions

NASA Technical Reports Server (NTRS)

Benepe, D. B.; Cunningham, A. M., Jr.; Dunmyer, W. D.

1978-01-01

The structural response to aerodynamic buffet during moderate to high-g maneuvers at subsonic and transonic speeds was investigated. The investigation is reported in three volumes. This volume presents a summary of the investigation with a complete description of the technical approach, description of the aircraft, its instrumentation, the data reduction procedures, results and conclusion.

48 CFR 14.201-6 - Solicitation provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-21, Descriptive Literature, in invitations for bids if (i) descriptive literature is required to evaluate the technical acceptability of an offered product and (ii) the required information will not be... possibility exists that the contracting officer may waive the requirement for furnishing descriptive...

48 CFR 14.201-6 - Solicitation provisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-21, Descriptive Literature, in invitations for bids if (i) descriptive literature is required to evaluate the technical acceptability of an offered product and (ii) the required information will not be... possibility exists that the contracting officer may waive the requirement for furnishing descriptive...

48 CFR 14.201-6 - Solicitation provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-21, Descriptive Literature, in invitations for bids if (i) descriptive literature is required to evaluate the technical acceptability of an offered product and (ii) the required information will not be... possibility exists that the contracting officer may waive the requirement for furnishing descriptive...

48 CFR 14.201-6 - Solicitation provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-21, Descriptive Literature, in invitations for bids if (i) descriptive literature is required to evaluate the technical acceptability of an offered product and (ii) the required information will not be... possibility exists that the contracting officer may waive the requirement for furnishing descriptive...

48 CFR 14.201-6 - Solicitation provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-21, Descriptive Literature, in invitations for bids if (i) descriptive literature is required to evaluate the technical acceptability of an offered product and (ii) the required information will not be... possibility exists that the contracting officer may waive the requirement for furnishing descriptive...

Astronomical Book Trek: Astronomy Books of 1983.

ERIC Educational Resources Information Center

Fraknoi, Andrew

1984-01-01

Presents an annotated list of technical and non-technical astronomy books. Topic areas of non-technical books include general astronomy, amateur astronomy, computers and astronomy, history of astronomy, pseudoscience, space exploration, physics and astronomy, and textbooks. Each entry includes author, title, description, source, and current cost.…

Nurses' reported thinking during medication administration.

PubMed

Eisenhauer, Laurel A; Hurley, Ann C; Dolan, Nancy

2007-01-01

To document nurses' reported thinking processes during medication administration before and after implementation of point-of-care technology. Semistructured interviews and real-time tape recordings were used to document the thinking processes of 40 nurses practicing in inpatient care units in a large tertiary care teaching hospital in the northeastern US. Content analysis resulted in identification of 10 descriptive categories of nurses' thinking: communication, dose-time, checking, assessment, evaluation, teaching, side effects, work arounds, anticipating problem solving, and drug administration. Situations requiring judgment in dosage, timing, or selection of specific medications (e.g., pain management, titration of antihypertensives) provided the most explicit data about nurses' use of critical thinking and clinical judgment. A key element was nurses' constant professional vigilance to ensure that patients received their appropriate medications. Nurses' thinking processes extended beyond rules and procedures and were based on patient data and interdisciplinary professional knowledge to provide safe and effective care. Identification of thinking processes can help nurses to explain the professional expertise inherent in medication administration beyond the technical application of the "5 rights."

Detailed Design Documentation, without the Pain

NASA Astrophysics Data System (ADS)

Ramsay, C. D.; Parkes, S.

2004-06-01

Producing detailed forms of design documentation, such as pseudocode and structured flowcharts, to describe the procedures of a software system:(1) allows software developers to model and discuss their understanding of a problem and the design of a solution free from the syntax of a programming language,(2) facilitates deeper involvement of non-technical stakeholders, such as the customer or project managers, whose influence ensures the quality, correctness and timeliness of the resulting system,(3) forms comprehensive documentation of the system for its future maintenance, reuse and/or redeployment.However, such forms of documentation require effort to create and maintain.This paper describes a software tool which is currently being developed within the Space Systems Research Group at the University of Dundee which aims to improve the utility of, and the incentive for, creating detailed design documentation for the procedures of a software system. The rationale for creating such a tool is briefly discussed, followed by a description of the tool itself, a summary of its perceived benefits, and plans for future work.

First Chance Network and Technical Assistance

ERIC Educational Resources Information Center

Trohanis, Pascal L.

1973-01-01

Article seeks to cover the following topics: an overview of First Chance; a description of TADS (Technical Assistance Development System); and a discussion of the organization's Media and Information division. (Author)

Study of Navy Enlisted Attrition: Race, Ethnicity, and Type of Occupation

DTIC Science & Technology

2008-09-01

technical job. Further research is recommended to explore these results and to suggest approaches that might assist in lowering attrition rates...technical job than to a technical one; in contrast, most minorities are far more likely to attrite when serving in a technical job. Further research is... HIGH QUALITY (HQ) STATUS ..........................33 IV. RESULTS ................................................35 A. DESCRIPTIVE SUMMARY OF THE

[Which rehabilitation for which low back pain?].

PubMed

Poiraudeau, S; Lefèvre-Colau, M M; Mayoux-Benhamou, M A; Revel, M

2000-10-15

Many rehabilitation technics for low back pain are available. Their aims are short time pain decrease, muscular strengthening in flexion or extension, increased hip and lumbar spine mobility, improved lumbar and pelvic proprioceptive sensibility, improved general fitness. During the past ten years, studies meeting widely accepted validity and applicability for therapeutic trials have addressed the clinical efficacy of rehabilitation in low back pain patients. Most studies assessing the back school approach have found no benefit. Spinal extension and flexion programs have yielded short-time improvements, without difference between the two methods. There is now strong evidence that functional restoration programs provide long-term benefits including better social and occupational outcomes.

A Study on Technical High School Teachers' Views Concerning Corporal Punishment

ERIC Educational Resources Information Center

Tas, Said

2016-01-01

Corporal punishment is defined as inflicting pain on body of someone who presents undesired behavior or does not present expected behavior. In the developed world, experiencing information society, corporal punishment is still in the agenda in educational system in Turkey. In this study, it was aimed to determine technical high school teachers'…

Pain and functional imaging.

PubMed Central

Ingvar, M

1999-01-01

Functional neuroimaging has fundamentally changed our knowledge about the cerebral representation of pain. For the first time it has been possible to delineate the functional anatomy of different aspects of pain in the medial and lateral pain systems in the brain. The rapid developments in imaging methods over the past years have led to a consensus in the description of the central pain responses between different studies and also to a definition of a central pain matrix with specialized subfunctions in man. In the near future we will see studies where a systems perspective allows for a better understanding of the regulatory mechanisms in the higher-order frontal and parietal cortices. Also, pending the development of experimental paradigms, the functional anatomy of the emotional aspects of pain will become better known. PMID:10466155

Distraction arthrodesis of the sacroiliac joint: 2-year results of a descriptive prospective multi-center cohort study in 171 patients.

PubMed

Fuchs, Volker; Ruhl, Benjamin

2018-01-01

The aim of the given study was to evaluate the long-term outcomes of patients undergoing sacroiliac joint (SIJ) distraction arthrodesis to treat SIJ-related pain. Descriptive prospective multi-center cohort study involving 20 hospitals in Germany. Between January 2011 and June 2012, 171 patients with chronic SIJ pain underwent indirect arthrodesis of the SIJ using a distraction implant. The patients were questioned prior to surgery, 6-weeks, and 3-, 6-, 12- and 24-months postoperatively. Overall patient satisfaction was surveyed along with pain medication intake, the Million Visual Analogue Scale (MVAS), Oswestry Disability Index (ODI), Short-form McGill Pain Questionnaire (SF-MPQ), 12-Item Short-Form Health Survey (SF-12), Visual Analogue Scale (VAS) and a pain drawing. Bony fusion of the SIJ was evaluated using X-ray and computed tomography (CT). A majority of patients (73%) reported to feel better or much better 24 months post-surgery, 49% of the patients reduced their pain medication intake. The MVAS dropped from 63 to 36%, the ODI improved from 51 to 33%, the SF-MPQ decreased from 50 to 31%, the SF-12 physical component summary rose from 22 to 41%, the mental component summary increased from 40 to 55%, and pain as measured by the VAS decreased from 74 to 37 points (all comparisons p < 0.001). In the follow-up CT scans 31% of the patients showed SIJ fusion. SIJ distraction arthrodesis has shown satisfactory outcomes in patients with SIJ-related pain for all scores reported in the surveys, accompanied by increased functionality.

[Not Available].

PubMed

Ulbricht, O

1996-01-01

This article sets out to explore the perception of pain during outbreaks of the plague in the early modern period. On the basis of the recent doubts about the mind/body dualism, it holds that both kinds of pain should be investigated and be seen as a whole. In the majority of the autobiographical sources the article relies on, there is no description of pain itself. Instead visual signs and its quantitative dimensions are given: the number of buboes and the length of the illness. This can partly be explained by the perspective of the sources but also points to a more general attitude prevailing at that time. However, that there is no description of pain is a statement which has to be qualified, particularly for those sources which describe the treatment of the buboes by the surgeons. Christian religion was the force that strongly influenced the perception of pain. It gave a meaning to suffering and it made quite a number of the sick concentrate on their duty as Christians and on the death and afterlife, thus partly disregarding pain, in particular when they had done penance and taken Holy Communion before. However, it sometimes also caused doubts about sinful behaviour before the plague. Pain however was aggravated by the way society and the authorities acted or were perceived to act. The pain of separation, and a feeling of loneliness and discrimination were connected with being infected. The article closes with some remarks on plague and gender. The fear of the plague and the plague itself cannot have meant the same to men and women, it argues.

Computer Simulation for Pain Management Education: A Pilot Study.

PubMed

Allred, Kelly; Gerardi, Nicole

2017-10-01

Effective pain management is an elusive concept in acute care. Inadequate knowledge has been identified as a barrier to providing optimal pain management. This study aimed to determine student perceptions of an interactive computer simulation as a potential method for learning pain management, as a motivator to read and learn more about pain management, preference over traditional lecture, and its potential to change nursing practice. A post-computer simulation survey with a mixed-methods descriptive design was used in this study. A college of nursing in a large metropolitan university in the Southeast United States. A convenience sample of 30 nursing students in a Bachelor of Science nursing program. An interactive computer simulation was developed as a potential alternative method of teaching pain management to nursing students. Increases in educational gain as well as its potential to change practice were explored. Each participant was asked to complete a survey consisting of 10 standard 5-point Likert scale items and 5 open-ended questions. The survey was used to evaluate the students' perception of the simulation, specifically related to educational benefit, preference compared with traditional teaching methods, and perceived potential to change nursing practice. Data provided descriptive statistics for initial evaluation of the computer simulation. The responses on the survey suggest nursing students perceive the computer simulation to be entertaining, fun, educational, occasionally preferred over regular lecture, and with potential to change practice. Preliminary data support the use of computer simulation in educating nursing students about pain management. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

77 FR 41132 - Air Quality Implementation Plans; Alabama; Attainment Plan for the Alabama Portion of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-12

... modeling demonstration should include supporting technical analyses and descriptions of all relevant....5 and NO X . The attainment demonstration includes: Technical analyses that locate, identify, and... modeling analysis is a complex technical evaluation that began with selection of the modeling system. The...

Technical Education and Resource Material.

ERIC Educational Resources Information Center

Mills, Marie T.

New approaches and many technical innovations will be required by the junior college to meet the increasing educational needs of technical occupations. A first is information on which the prospective student can base an intelligent choice of occupation. For this he must have a precise job description to determine whether the career fits his…

9 CFR 351.5 - Conditions of eligibility for certification service; review of applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... technical animal fat, and a written description of the shipping, receiving, and inventory records maintained... PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION CERTIFICATION OF TECHNICAL ANIMAL FATS FOR...”); and such source materials will be rendered at the plant into technical animal fat eligible for export...

76 FR 35231 - Notice of Proposed Information Collection for Public Comment; McKinney-Vento Technical Assistance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... Information Collection for Public Comment; McKinney-Vento Technical Assistance Narrative, Matrices, and... Narrative, Matrices, and Reporting Requirements. Description of the need for the information proposed: McKinney- Vento Technical Assistance (MV-TA) Narrative, Matrices, and Reporting Requirements will allow the...

Mobile communications satellite antenna flight experiment definition

NASA Technical Reports Server (NTRS)

Freeland, Robert E.

1987-01-01

Results of a NASA-sponsored study to determine the technical feasibility and cost of a Shuttle-based flight experiment specifically intended for the MSAT commercial user community are presented. The experiment will include demonstrations of technology in the areas of radio frequency, sensing and control, and structures. The results of the structural subsystem study summarized here include experiment objective and technical approach, experiment structural description, structure/environment interactions, structural characterization, thermal characterization, structural measurement system, and experiment functional description.

Content validation of the nursing diagnosis acute pain in the Czech Republic and Slovakia.

PubMed

Zeleníková, Renáta; Žiaková, Katarína; Čáp, Juraj; Jarošová, Darja

2014-10-01

The main purpose of the study was to validate the defining characteristics of the nursing diagnosis acute pain in the Czech Republic and Slovakia. This is a descriptive study. The validation process involved was based on Fehring's diagnostic content validity model. Four defining characteristics were classified as major by Slovak nurses and eight defining characteristics were classified as major by Czech nurses. Validation of the nursing diagnosis acute pain in the Czech and Slovak sociocultural context has shown that nurses prioritize characteristics that are behavioral in nature as well as patients' verbal reports of pain. Verbal reports of pain and behavioral indicators are important for arriving at the nursing diagnosis acute pain. © 2014 NANDA International, Inc.

Ipsilateral shoulder pain in patients following lung resection in the decubitus position.

PubMed

Bando, Takae; Kondo, Kazuya; Onishi, Chiemi; Kajiura, Koichiro; Takizawa, Hiromitsu; Yamada, Kazuyo; Sato, Hiromi; Imai, Yoshie

2018-03-01

To examine the frequency, influencing factors and clinical course of shoulder pain in patients following lung resection. Thoracoscopes have been introduced in the surgical treatment of lung cancer and allow for less invasive surgery with a minimal incision. However, decubitus position-related shoulder pain on the operated side has not yet been investigated. A longitudinal descriptive study. Patients who underwent lung resection in the decubitus position. Patients were interviewed 2 days before surgery and once daily for 5 days after surgery. Interview items included background data, the concomitant use of epidural anaesthesia, operative duration, the presence of preoperative shoulder stiffness (excluding shoulder pain), type of surgery and site of operation. The intensity of pain was approximately 5 on an 11-point numerical rating scale. Descriptive statistics on patient backgrounds were obtained using SPSS Statistics 22 for Windows. Of the 74 patients who underwent lung resection in a decubitus position, 30 (40.5%) developed shoulder pain on the operated side. The highest rating occurred 1 day after surgery and decreased over time. The following two factors were found to influence shoulder pain on the operated side: operative duration (Z = -2.63; p = .01) and the presence of preoperative shoulder stiffness (excluding shoulder pain) (χ 2  = 4.16; p = .04). This study demonstrated that approximately 40% of patients who underwent lung resection in the decubitus position developed shoulder pain. The presence of postoperative shoulder pain was related to both the duration of the operation and to the presence of preoperative shoulder stiffness. Although the shoulder pain resolves within 4 days, it causes the patient additional discomfort and distress. Therefore, further research is needed on positioning for thoracotomy in order to investigate ways to reduce or eliminate this complication of lung surgery. © 2017 John Wiley & Sons Ltd.

Differences in Neural Mechanosensitivity Between Patients with Chronic Nonspecific Neck Pain With and Without Neuropathic Features. A Descriptive Cross-Sectional Study.

PubMed

López-de-Uralde-Villanueva, Ibai; Beltran-Alacreu, Hector; Fernández-Carnero, Josué; Gil-Martínez, Alfonso; La Touche, Roy

2016-01-01

To assess differences in neural mechanosensitivity between patients with chronic nonspecific neck pain with and without neuropathic features (NF and No-NF, respectively). Descriptive, cross-sectional study. A primary care center, a hospital physiotherapy outpatient department, and a university campus. Chronic nonspecific neck pain patients classified by the self-completed leeds assessment of neuropathic symptoms and signs pain scale (S-LANSS; 49 patients with NF [S-LANSS ≥ 12] and 50 patients with No-NF [S-LANSS < 12]) and a healthy control group (n = 48). The primary measurements were the mechanosensitivity of the median nerve and cervical region, specifically the assessment of the onset of symptoms and submaximal pain intensity according to the upper limb neural test 1 (ULNT1) for the median nerve and the modified passive neck flexion test (MPNFT) for the cervical region; secondary measurements included pain intensity, neck disability, kinesiophobia, and pain catastrophizing. Statistically significant differences between the NF and No-NF groups were found with respect to the onset of symptoms of ULNT1 (-15.11 [-23.19 to -7.03]) and MPNFT (-6.58 [-11.54 to -1.62]), as well as the outcomes of the visual analogue scale (Mean difference [95% Confidence Interval]; 7.12 [1.81-12.42]) and neck disability index (3.72 [1.72-5.71]). Both chronic nonspecific neck pain groups showed statistically significant differences compared with the control group for all outcomes assessed (P < 0.01) except for the onset of symptoms of ULNT1 in the No-NF group. The findings of this study suggest that chronic nonspecific neck pain patients with NF have greater neural mechanosensitivity, pain intensity, and neck disability than those with No-NF. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government employees and is in the public domain in the US.

Expert clinical reasoning and pain assessment in mechanically ventilated patients: A descriptive study.

PubMed

Gerber, Anne; Thevoz, Anne-Laure; Ramelet, Anne-Sylvie

2015-02-01

Pain assessment in mechanically ventilated patients is challenging, because nurses need to decode pain behaviour, interpret pain scores, and make appropriate decisions. This clinical reasoning process is inherent to advanced nursing practice, but is poorly understood. A better understanding of this process could contribute to improved pain assessment and management. This study aimed to describe the indicators that influence expert nurses' clinical reasoning when assessing pain in critically ill nonverbal patients. This descriptive observational study was conducted in the adult intensive care unit (ICU) of a tertiary referral hospital in Western Switzerland. A purposive sample of expert nurses, caring for nonverbal ventilated patients who received sedation and analgesia, were invited to participate in the study. Data were collected in "real life" using recorded think-aloud combined with direct non-participant observation and brief interviews. Data were analysed using deductive and inductive content analyses using a theoretical framework related to clinical reasoning and pain. Seven expert nurses with an average of 7.85 (±3.1) years of critical care experience participated in the study. The patients had respiratory distress (n=2), cardiac arrest (n=2), sub-arachnoid bleeding (n=1), and multi-trauma (n=2). A total of 1344 quotes in five categories were identified. Patients' physiological stability was the principal indicator for making decision in relation to pain management. Results also showed that it is a permanent challenge for nurses to discriminate situations requiring sedation from situations requiring analgesia. Expert nurses mainly used working knowledge and patterns to anticipate and prevent pain. Patient's clinical condition is important for making decision about pain in critically ill nonverbal patients. The concept of pain cannot be assessed in isolation and its assessment should take the patient's clinical stability and sedation into account. Further research is warranted to confirm these results. Copyright © 2014. Published by Elsevier Ltd.

Multimodal Analgesia in Breast Surgical Procedures: Technical and Pharmacological Considerations for Liposomal Bupivacaine Use

PubMed Central

Newman, Martin I.; Seeley, Neil; Hutchins, Jacob; Smith, Kevin L.; Mena, Gabriel; Selber, Jesse C.; Saint-Cyr, Michel H.; Gadsden, Jeffrey C.

2017-01-01

Enhanced recovery after surgery is a multidisciplinary perioperative clinical pathway that uses evidence-based interventions to improve the patient experience as well as increase satisfaction, reduce costs, mitigate the surgical stress response, accelerate functional recovery, and decrease perioperative complications. One of the most important elements of enhanced recovery pathways is multimodal pain management. Herein, aspects relating to multimodal analgesia following breast surgical procedures are discussed with the understanding that treatment decisions should be individualized and guided by sound clinical judgment. A review of liposomal bupivacaine, a prolonged-release formulation of bupivacaine, in the management of postoperative pain following breast surgical procedures is presented, and technical guidance regarding optimal administration of liposomal bupivacaine is provided. PMID:29062649

Rib fracture repair: indications, technical issues, and future directions.

PubMed

Nirula, Raminder; Diaz, Jose J; Trunkey, Donald D; Mayberry, John C

2009-01-01

Rib fracture repair has been performed at selected centers around the world for more than 50 years; however, the operative indications have not been established and are considered controversial. The outcome of a strictly nonoperative approach may not be optimal. Potential indications for rib fracture repair include flail chest, painful, movable rib fractures refractory to conventional pain management, chest wall deformity/defect, rib fracture nonunion, and during thoracotomy for other traumatic indication. Rib fracture repair is technically challenging secondary to the human rib's relatively thin cortex and its tendency to fracture obliquely. Nonetheless, several effective repair systems have been developed. Future directions for progress on this important surgical problem include the development of minimally invasive techniques and the conduct of multicenter, randomized trials.

Slipping rib syndrome: a place for sonography in the diagnosis of a frequently overlooked cause of abdominal or low thoracic pain.

PubMed

Meuwly, Jean-Yves; Wicky, Stephan; Schnyder, Pierre; Lepori, Domenico

2002-03-01

To describe the sonographic appearance of a poorly recognized cause of low thoracic or upper abdominal pain. Three sonographic descriptions of slipping rib syndrome are presented. The 3 patients had abnormal mobility of a cartilaginous rib, which could slip over an adjacent rib during abdominal muscle contraction. Slipping rib syndrome should be considered in patients with histories of upper abdominal or low thoracic pain of unknown origin. We suggest that high-resolution sonography of the costal margin should be added to abdominal sonography in cases of nonspecific abdominal pain.

Nurses' provision of parental guidance regarding school-aged children's postoperative pain management: a descriptive correlational study.

PubMed

He, Hong-Gu; Klainin-Yobas, Piyanee; Ang, Emily Neo Kim; Sinnappan, Rajammal; Pölkki, Tarja; Wang, Wenru

2015-02-01

Involving parents in children's pain management is essential to achieve optimal outcomes. Parents need to be equipped with sufficient knowledge and information. Only a limited number of studies have explored nurses' provision of parental guidance regarding the use of nonpharmacologic methods in children's pain management. This study aimed to examine nurses' perceptions of providing preparatory information and nonpharmacologic methods to parents, and how their demographics and perceived knowledge adequacy of these methods influence this guidance. A descriptive correlational study using questionnaire surveys was conducted to collect data from a convenience sample of 134 registered nurses working in seven pediatric wards of two public hospitals in Singapore. Descriptive statistics, independent-samples t test, and multiple linear regression were used to analyze the data. Most nurses provided various types of cognitive information to parents related to their children's surgery, whereas information about children's feelings was less often provided. Most nurses provided guidance to parents on positioning, breathing technique, comforting/reassurance, helping with activities of daily living, relaxation, and creating a comfortable environment. Nurses' provision of parental guidance on preparatory information and nonpharmacologic methods was significantly different between subgroups of age, education, parent or not, and perceived knowledge adequacy of nonpharmacologic methods. Nurses' perceived knowledge adequacy was the main factor influencing their provision of parental guidance. More attention should be paid to nurses who are younger, have less working experience, and are not parents. There is a need to educate nurses about nonpharmacologic pain relief methods to optimize their provision of parental guidance. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Pediatric-Collaborative Health Outcomes Information Registry (Peds-CHOIR): A Learning Health System to Guide Pediatric Pain Research and Treatment

PubMed Central

Bhandari, Rashmi P.; Feinstein, Amanda B.; Huestis, Samantha E.; Krane, Elliot J.; Dunn, Ashley L.; Cohen, Lindsey L.; Kao, Ming C.; Darnall, Beth D.; Mackey, Sean C.

2016-01-01

The pediatric adaptation of the Collaborative Health Outcomes Information Registry (Peds-CHOIR) is a free, open source, flexible learning health care system (LHS) that meets the call by the Institute of Medicine (IOM) for the development of national registries to guide research and precision pain medicine. This report is a technical account of the first application of Peds-CHOIR with three aims: to 1) describe the design and implementation process of the LHS; 2) highlight how the clinical system concurrently cultivates a research platform rich in breadth (e.g., clinic characteristics) and depth (e.g., unique patient and caregiver reporting patterns); and 3) demonstrate the utility of capturing patient-caregiver dyad data in real time, with dynamic outcomes tracking that informs clinical decisions and delivery of treatments. Technical, financial, and systems-based considerations of Peds-CHOIR are discussed. Cross-sectional, retrospective data from patients with chronic pain (N = 352; 8 – 17 years; M = 13.9 years) and their caregivers are reported, including NIH Patient Reported Outcomes Measurement Information System (PROMIS) domains (mobility, pain interference, fatigue, peer relations, anxiety and depression) and the Pain Catastrophizing Scale. Consistent with the literature, analyses of initial visits revealed impairments across physical, psychological and social domains. Patients and caregivers evidenced agreement in observable variables (mobility); however, caregivers consistently endorsed greater impairment regarding internal experiences (pain interference, fatigue, peer relations, anxiety, depression) than patients’ self-report. A platform like Peds-CHOIR highlights predictors of chronic pain outcomes on a group level and facilitates individually tailored treatment(s). Challenges of implementation and future directions are discussed. PMID:27280328

Prevalence and characteristics of orofacial pain in university students.

PubMed

Smiljic, Sonja; Savic, Sladjana; Stevanovic, Jasmina; Kostic, Mirjana

2016-01-01

This cross-sectional study investigated the characteristics and prevalence of orofacial pain, and its associations with sociodemographic characteristics, in 319 university students: 188 second-year students in the Medical Faculty and 131 students in the Faculty of Technical Sciences at the University of Kosovska Mitrovica. A specially designed questionnaire was used to assess the prevalence and characteristics of pain. Among the 319 students, 101 (32%) reported previous orofacial pain, and pain was more frequent among women (P < 0.05). Logistic regression revealed that gender was an important predictor of pain and that the risk for pain development among women was 1.8 times that among men. Place of residence and relationship status were not associated with frequency of orofacial pain. The regions with the highest pain prevalences were the temporal region (7%; 95% confidence interval, 4-10%) and the region around the eye (6%; 95% confidence interval, 4-9%). The first episode of orofacial pain was less than 3 months previously in 59% of the participants, and 39% of students had sought professional medical help. (J Oral Sci 58, 7-13, 2016).

Love at First Sight: Psychoanalytic Psychotherapy with an Adolescent Boy with Severe Physical Disabilities

ERIC Educational Resources Information Center

Pozzi, Maria E.

2005-01-01

The content of this paper reflects the title but it expands upon the technical issues encountered right from the beginning of the assessment. These technical difficulties include the management of physical pain during sessions and the request by the patient for physical interventions as well as contact. The problem of discrimination in the setting…

Effects of Leadership Styles in Technical and Vocational Students, UTHM

ERIC Educational Resources Information Center

Razak, Nur Afifah Binti Abdul; Hamidon, Nur Izeanty Binti

2015-01-01

Effective leadership helps our nation through times become a developed country. This study was undertaken to investigate the effects of leadership style among students in Technical and Vocational at University Tun Hussein Onn Malaysia. Descriptive study carried out to evaluate student leadership. The study sample consisted of 319 Technical and…

The NASA/MSFC global reference atmospheric model: 1990 version (GRAM-90). Part 1: Technical/users manual

NASA Technical Reports Server (NTRS)

Justus, C. G.; Alyea, F. N.; Cunnold, D. M.; Jeffries, W. R., III; Johnson, D. L.

1991-01-01

A technical description of the NASA/MSFC Global Reference Atmospheric Model 1990 version (GRAM-90) is presented with emphasis on the additions and new user's manual descriptions of the program operation aspects of the revised model. Some sample results for the new middle atmosphere section and comparisons with results from a three dimensional circulation model are provided. A programmer's manual with more details for those wishing to make their own GRAM program adaptations is also presented.

THE ORIGIN OF THE CONCEPT OF NEUROPATHIC PAIN IN EARLY MEDIEVAL PERSIA (9TH-12TH CENTURY CE).

PubMed

Heydari, Mojtaba; Shams, Mesbah; Hashempur, Mohammad Hashem; Zargaran, Arman; Dalfardi, Behnam; Borhani-Haghighi, Afshin

2015-01-01

Neuropathic pain is supposed to be a post-renaissance described medical entity. Although it is often believed that John Fothergill (1712-1780) provided the first description of this condition in 1773, a review of the medieval Persian medical writings will show the fact that neuropathic pain was a medieval-originated concept. "Auojae Asab" [Nerve-originated Pain] was used as a medical term in medieval Persian medical literature for pain syndromes which etiologically originated from nerves. Physicians like Rhazes (d. 925 CE), Haly Abbas (d. 982 CE), Avicenna (d. 1037 CE), and Jorjani (d. 1137 CE) have discussed multiple aspects of nerve-originated pain including its classification, etiology, differentiating characteristics, different qualities, and pharmacologic and non-pharmacologic treatments. Recognizing medieval scholars' views on nerve-originated pain can lighten old historical origins of this concept.

Do women and providers value the same features of contraceptive products? Results of a best-worst stated preference experiment.

PubMed

Weisberg, Edith; Bateson, Deborah; Knox, Stephanie; Haas, Marion; Viney, Rosalie; Street, Deborah; Fiebig, Denzil

2013-06-01

To determine how women and physicians rate individual characteristics of contraceptives. Discrete choice experiments are used in health economics to elicit preferences for healthcare products. A choice experiment uses hypothetical scenarios to determine which individual factors influence choice. Women and general practitioners (GPs) were shown individual characteristics of contraceptives, not always matching existing methods, and chose the best and worst features. Two hundred women, mean age 36, 71% using contraception, were presented with descriptions of 16 possible methods and asked to indicate their preference for individual characteristics. One hundred and sixty-two GPs, mostly women, also completed 16 descriptions. Longer duration of action was most favoured by both, followed by lighter periods with less pain or amenorrhoea. The least attractive features for women were heavier and more painful periods, high cost, irregular periods, low efficacy (10% failure) and weight gain of 3 kg. GPs ranked a 10% pregnancy rate as least attractive followed by heavy painful periods and a 5% failure rate. Women and GPs differed in their ranking of contraceptive characteristics. Long duration of use, high efficacy, minimal or no bleeding without pain, were preferred by both. Very undesirable were heavy periods especially with pain, and low efficacy.

The phenomenon of hand holding as a coping strategy in adolescents experiencing treatment-related pain.

PubMed

Weekes, D P; Kagan, S H; James, K; Seboni, N

1993-01-01

The purpose of this study was to understand the phenomenon of hand holding as a coping strategy used by adolescents to deal with treatment-related pain. The convenience sample consisted of 20 adolescents whose ages were 11 to 19 years: 10 had cancer and 10 had renal disease (this served as the comparison group). Using a descriptive design, a semistructured interview was conducted with each adolescent. To supplement and support interview data, structured observations were conducted as adolescents underwent painful treatments (eg, blood draws, shunt placement, peripheral chemotherapy, lumbar punctures, and bone marrow aspirations). Data were analyzed using descriptive statistics and qualitative analytic techniques similar to those delineated by Strauss and Corbin. The results of this study indicated that subjects in both the cancer and the renal disease group perceived hand holding to be a very effective coping strategy in ameliorating treatment-related pain. Overwhelmingly the patients preferred to hold their mother's hand. When the mother was unavailable, they preferred to hold a specific nurse's hand. Hand holding functioned to reduce tension associated with impending treatments, as a source of distraction, and as a source of security. Accordingly, adolescents' subjective experience of treatment-related pain was reduced when they felt more secure, less tense, and were distracted.

75 FR 4136 - Pipeline Safety: Requests for Special Permit

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... technical analysis or other supporting documentation provided by the requestor, including a description of...: Kay McIver by telephone at (202) 366-0113; or, e-mail at [email protected] . Technical: Steve Nanney...

Effects of Guided Imagery on Postoperative Outcomes in Patients Undergoing Same-Day Surgical Procedures: A Randomized, Single-Blind Study

DTIC Science & Technology

2010-06-01

2O0O;9Ot3):706-712. 20. Bertrand P, Maye J. A description of the indices of heart rate variabil- ity in orofacial pain paticnis. Bcihcsda, MD: National...neck proce- dures were randomly assigned into 2 groups for this single-blind investigation. Anxiety and baseline pain levels were documented...control group patients received no intervention. Data were collected on pain and nar- cotic consumption at 7- and 2-hour postoperative inter- vals. In

ANNUAL REPORT, JULY 1, 1957

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1958-10-31

The progress and trends of research are presented along with a description of operational, service, end administrative activities. Some scientific and technical details are given on research programs in the physical sciences, life sciences, and engineering, however, more complete technical information is available in quarterly progress reports, BNL technical reports, and scientific and technical periodicals. A bibliography of these publications is appended. (For preceding period see BNL-426.) (D.E.B.)

Curriculum Programs in Action, Their Administration and Evaluation; Report of a Conference Devoted to Description, Demonstration, and Evaluative Discussions of Innovative Programs in Vocational-Technical Education.

ERIC Educational Resources Information Center

San Francisco State Coll., CA. Center for Technological Education.

The presentation, review and evaluation of innovative vocational-technical curriculums in operation was the major function of a San Francisco conference sponsored jointly by the Center for Technical Education at San Francisco State College and the Center for Studies in Vocational and Technical Education at the University of Wisconsin. Major…

Reconceptualizing Pain through Patient-Centered Care in the Complementary and Alternative Medicine Therapeutic Relationship.

PubMed

Agarwal, Vinita

2018-06-05

The study aim was to understand the patient description of the therapeutic relationship with their CAM provider in the context of pain self-management. Because pain is a subjective state, its assessment depends on patient perception of and response to pain. For nurses to provide empathetic and compassionate care, there is a need to explicate patient perceptions of the therapeutic relationship to (re)conceptualize models of patient-centered care. Inductive qualitative content analysis of patient interviews was conducted to identify how patients described therapeutic relationship themes and understand self-management of pain. Participants were individuals working with a CAM practitioner and solicited through purposive and snowball sampling in collaboration with the practitioners from the mid-Atlantic region of the United States in 2016 (N=13). Verbatim transcriptions of audio-recorded semi-structured in-depth interviews (430 single-spaced pages approximately) were content analyzed. Patients described the therapeutic relationship with the provider as a (a) giver, who was "in-tune" with their sense of self to support self-affirmation through empathetic listening and (b) guide, who connected the mind and body through their practice to support self-reflective learning. This description of the CAM therapeutic relationship advances understandings of readjustment of patient relationship with pain through the provider's empathetic listening and connecting the mind and the body to support patient self-affirmation of pain experiences and self-reflective learning. The findings illuminate how a feminist standpoint contributes to understandings of the therapeutic relationship that centers patient subjectivity and co-construction of meaning-making processes to support self-management of pain. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

TIM Version 3.0 beta - Technical Description and User's Guidance

EPA Pesticide Factsheets

Provides technical information on version 3.0 of the Terrestrial Investigation Model (TIM v.3.0). Describes how TIM derives joint distributions of exposure and toxicity to calculate the risk of mortality to birds.

7 CFR 245.6 - Application, eligibility and certification of children for free and reduced price meals and free...

Code of Federal Regulations, 2010 CFR

2010-01-01

...) General requirements—content of application and descriptive materials. Each local educational agency, as... to the distribution of applications and descriptive materials in paper form as provided for in this... requirements in this section and with technical assistance and guidance provided by FNS. Descriptive materials...

7 CFR 245.6 - Application, eligibility and certification of children for free and reduced price meals and free...

Code of Federal Regulations, 2011 CFR

2011-01-01

...) General requirements—content of application and descriptive materials. Each local educational agency, as... to the distribution of applications and descriptive materials in paper form as provided for in this... requirements in this section and with technical assistance and guidance provided by FNS. Descriptive materials...

Attitudes of veterinary nurses to the assessment of pain and the use of pain scales.

PubMed

Coleman, D L; Slingsby, L S

2007-04-21

In April 2004, a questionnaire was distributed to veterinary nurses across the UK to assess their attitudes towards the assessment and management of pain in practice. During the six-week collection period, a total of 541 questionnaires were returned, of which 24 (4.25 per cent) were discounted due to completion errors. Overall, the pain scores for procedures involving dogs were higher than those for cats; the veterinary nurses' pain scores were higher for all procedures than those of veterinary surgeons in a previous study. Both veterinary nurses and veterinary surgeons were primarily involved with monitoring pain postoperatively, and 96 per cent of veterinary nurses felt that their knowledge of pain management could be enhanced; 8.1 per cent of the practices used a formal pain scoring system, with the simple descriptive scale most commonly used; 80.3 per cent of the veterinary nurses agreed that a pain scale was a useful clinical tool.

Using Pictures to Assess Pain Location in Children.

PubMed

Mesko, Phyllis J; Eliades, Aris Beoglos

2018-06-01

This study uses the Pain Area Locator (PAL) tool, a picture communication aid with body and medical equipment icons, to identify pain location in postoperative pediatric patients and assesses discrepancies between nurses' pain location assessment and pain location identified using the PAL tool. This descriptive study used a quantitative, comparative design, with a convenience sample of pediatric postoperative patients undergoing same-day surgeries at a free-standing, acute care, Magnet designated pediatric hospital. The child's pain location was assessed by asking the child to point to one of the 12 pictures on the PAL tool of where they hurt. All 41 (100%) of the postoperative children in the study demonstrated ability to use the PAL tool. The child identified a pain location in 34 assessments (83%) when the nurse documented no pain location. This investigation expands on previous evidence supporting that children can use the PAL tool to identify the pain location postoperatively. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2017-09-11

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

Yergason's Test: Discrepancies in Description and Implications for Diagnosing Biceps Subluxation

ERIC Educational Resources Information Center

Pettitt, Robert W.; Sailor, Scott R.; Lentell, Gary; Tanner, Cary; Murray, Steven R.

2008-01-01

Yergason described the case of a woman with bicipital pain that was confirmed with isolated forearm supination. Since publication of this respective case report in 1931, orthopedic assessment textbooks have provided a wide range of descriptions for Yergason's Test and what a positive sign implicates. Vast differences in hand placement, along with…

Residential Energy Consumption Survey (RECS): Household screener survey, 1979-1980, household characteristics and annualized consumption

NASA Astrophysics Data System (ADS)

Windell, P.

1981-08-01

This document provides basic information and technical specifications necessary for using the machine-readable magnetic tape containing data from the Household Screener Survey of the Residential Energy Consumption Survey (RECS). Included in this document are an overview of the RECS and a brief description of the Household Screener Survey. The next section contains technical specifications for reading the tape and descriptions of the contents of each of the files contained on the tape. The remaining four sections are devoted to technical topics of special interest to users of the data. Appended to this document are copies of the fieldwork instruments used in the survey and a listing of the contents of a portion of the SPSS labels information.

A Descriptive Study of Body Pain and Work-Related Musculoskeletal Disorders Among Latino Farmworkers Working on Sweet Potato Farms in Eastern North Carolina.

PubMed

Kearney, Gregory D; Allen, Daniel L; Balanay, Jo Anne G; Barry, Paul

2016-01-01

Agricultural work is a physically demanding occupation. The purpose of this project was to describe the prevalence of work-related musculoskeletal disorders (WMSDs) and self-reported pain among Latino farmworkers who work extensively hand harvesting sweet potatoes. Data were obtained from a cross-sectional survey of farmworkers (N = 120) in eastern North Carolina. Univariate and bivariate analyses were used to describe personal, work characteristics, and self-reported pain associated with musculoskeletal injuries. Overall, 79% of farmworkers reported any type of pain or discomfort. The highest reported areas of pain were in the back (66%) and shoulder areas (31%). Younger participants experienced more shoulder pain (P = .04) than older workers, and working more than 5 years as a farmworker was significantly associated with back pain (P = .01). Interventions aimed at administrative and engineering controls for reducing risk factors that contribute to WMSDs are warranted.

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints.

PubMed

Friedrichsdorf, Stefan J; Giordano, James; Desai Dakoji, Kavita; Warmuth, Andrew; Daughtry, Cyndee; Schulz, Craig A

2016-12-10

Primary pain disorders (formerly "functional pain syndromes") are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition "chronic-on-acute pain." We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy.

Radiofrequency denervation of the hip joint for pain management: case report and literature review.

PubMed

Gupta, Gaurav; Radhakrishna, Mohan; Etheridge, Paul; Besemann, Markus; Finlayson, Robert J

2014-01-01

A 55-year-old male presented with severe pain and functional limitations as a result of left hip osteoarthritis. He had failed multiple treatments while waiting for a hip arthroplasty, including physical therapy, medications, and various intra-articular injections. Thermal radiofrequency lesioning of the obturator and femoral articular branches to the hip joint was offered in the interim. To our knowledge, this is the first report to describe an inferior-lateral approach for lesioning the obturator branch, the clinical application of successive lesions to increase denervation area, and outcomes in a patient receiving a second treatment with previously good results. To discuss relevant and technical factors for this specific case, we reviewed previous literature on hip joint radiofrequency and critically evaluated previous anatomic studies in the context of radiofrequency. The first treatment provided significant benefit for a period of 6 months. A second treatment was employed providing only mild to moderate benefit until his joint replacement surgery 4 months later. Literature review revealed studies of low quality secondary to small sample sizes, patient selection methodology, inclusion of patients with heterogenous etiologies for pain, variable needle placement techniques, and lack of measurement of functional outcomes. Case report and low quality studies in existing literature. Hip joint radiofrequency denervation is a promising avenue for adjunctive treatment of hip pain. Further cadaveric studies are required to clarify a multitude of technical parameters. Once these are well defined, future clinical studies should consider pain, functional, and economic outcomes in their design.

Strategic Control Algorithm Development : Volume 2A. Technical Report.

DOT National Transportation Integrated Search

1974-08-01

The technical report presents a detailed description of the strategic control functional objectives, followed by a presentation of the basic strategic control algorithm and how it evolved. Contained in this discussion are results of analyses that con...

Strategic Control Algorithm Development : Volume 2B. Technical Report (Concluded)

DOT National Transportation Integrated Search

1974-08-01

The technical report presents a detailed description of the strategic control functional objectives, followed by a presentation of the basic strategic control algorithm and how it evolved. Contained in this discussion are the results of analyses that...

Special Feature: Teaching about High Tech.

ERIC Educational Resources Information Center

Kopf, Michael; And Others

1992-01-01

Includes four articles: "Virtual Reality" (Kopf), description of its uses in computer-assisted design, architecture, and technical training; "SME (Society of Manufacturing Engineers) Robotics Contest Opens Doors to Future" (Wagner); "Superconductivity" (Canady), description of classroom demonstrations and experiments;…

Descriptive Chemistry in High School Curriculum.

ERIC Educational Resources Information Center

Rajan, Raj G.

1983-01-01

Discusses incorporation of descriptive chemistry and scientific/technical writing at the high school level. After discussing the periodic table, each student prepares a paper discussing the history, atomic data, occurring/extraction/purification, properties, and uses of an element. (JN)

H-Coal Pilot Plant Phase II construction, Catlettsburg, Kentucky. Final construction management report, December 1976-February 1980. [February, 1977 to approximately January, 1980

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1983-03-01

This report covers the H-Coal Pilot Plant facility located in Catlettsburg, Kentucky. The authorization for this project was under DOE contract No. DE-AC05-78ET11052, formally ET-78-C-01-3224. Badger Plants, Inc. carried out the construction management of this facility. The estimated total cost is $147,265,013. A brief process/technical description of the Pilot Plant covers subjects such as objectives, capacity, expected life, etc. A brief technical description of each processing unit, including its purpose in the overall operations of the plant is given. A general description of the organizational history of the project is given. Current overall organization and a description of the responsibilitiesmore » of each participant are included. Badger Plant's organization at manager level is shown.« less

Orofacial pain of cardiac origin: Review literature and clinical cases

PubMed Central

Garcia-Vicente, Laia; Jané-Salas, Enric; Estrugo-Devesa, Albert; Chimenos-Küstner, Eduardo; Roca-Elias, Josep

2012-01-01

The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments. Key words:Orofacial pain, ischemic heart disease, heterotopic pain, odontalgia. PMID:22322488

White Cancer Patients’ Perception of Gender and Ethnic Differences in Pain Experience

PubMed Central

Im, Eun-Ok

2008-01-01

Not considering cancer patients’ own views and experience with pain, especially gender and ethnic differences in their cancer pain experience, was reported to be a major contributor to the miscommunication that frequently results in inadequate cancer pain management. The purpose of this study was to explore white cancer patients’ perception of gender and ethnic differences in pain experience through an online forum. This was a descriptive qualitative study among 29 white cancer patients based on a feminist approach. Nine topics related to cancer pain experience were used. The data were analyzed using thematic analysis: 5 themes were identified. First, the participants perceived that pain accompanies cancer throughout the diagnosis and treatment process. Second, the specific characteristics of the participants’ individual culture and its view of pain and cancer could result in different cancer pain experience even among white cancer patients. Third, the participants complained that women’s pain was not taken seriously by health care providers. Fourth, the participants reported highly individualized pain experience with emotional pain. Finally, the participants wanted to have a control of their own pain management process. Based on the findings, implications for nursing research and practice are proposed. PMID:17135816

Public perception of the terms "cosmetic," "plastic," and "reconstructive" surgery.

PubMed

Hamilton, Grant S; Carrithers, Jeffrey S; Karnell, Lucy H

2004-01-01

To investigate potential differences in perception of the terms "cosmetic," "plastic," and "reconstructive" as descriptors for surgery. An anonymous questionnaire was offered to subjects over 18 years of age throughout the Unites States via the Internet and in person. The multiple-choice survey measured variables including permanence, risk, expense, recovery, reversibility, pain, technical difficulty, and surgeon training. The questionnaire also included several open-ended questions to capture qualitative perceptions. Semantic differential data were analyzed to measure statistical significance. For most variables--permanence, risk, recovery, reversibility, pain, and surgeon training--the 216 subjects had significantly lower mean responses for cosmetic surgery than those for plastic or reconstructive surgery (P < .002). Overall, the results of this study support the authors' hypothesis that there is a significant difference in perception of cosmetic surgery and plastic or reconstructive surgery. Cosmetic surgery is perceived to be more temporary and less technically difficult than plastic or reconstructive surgery. In addition, cosmetic surgery is believed to be associated with less risk, shorter recovery time, and less pain. Subjects also thought that cosmetic surgeons required significantly less training than plastic or reconstructive surgeons.

Parental behaviour in paediatric chronic pain: a qualitative observational study.

PubMed

Dunford, Emma; Thompson, Miles; Gauntlett-Gilbert, Jeremy

2014-10-01

Parental behaviour appears to influence the adjustment of children with chronic pain. However, research in this area has failed to produce consistent evidence. Studies have tended to rely on self-report measures derived from adult pain populations. This qualitative, observational research provides descriptive data of parental behaviour in a clinical environment. A qualitative observational study was made of parents and adolescents in a physically stressful setting. Modified grounded theory was used to analyse verbal and non-verbal behaviours. Eight parent-adolescent dyads seeking treatment for chronic pain were videoed during physical exercise sessions. Verbal and non-verbal behaviours were recorded and transcribed. Four overarching categories emerged: 'monitoring', 'protecting', 'encouraging' and 'instructing'. These often had both verbal and non-verbal aspects. Within these categories, more precise behavioural groups were also identified. This research identifies categories of parental behaviour that were derived directly from observation, rather than imposed on the basis of results from different populations. Four categories of behaviour were derived, which clarify and extend dimensions used in existing self-report instruments. Careful description of parental behaviours showed features that past research has neglected, and highlighted potential drawbacks of apparently positive parental actions. © The Author(s) 2013.

Nonmalignant chronic pain evaluation in the Turkish population as measured by the McGill Pain Questionnaire.

PubMed

Oksuz, Ergun; Mutlu, Esra Tuba; Malhan, Simten

2007-09-01

The purpose of this study was to explore how Turkish nonmalignant pain patients described their pain and how the language of pain used by Turkish patients compares to the language found in common pain assessment tools. Pain is influenced by a combination of ethnic, cultural, psychological, and social variants. In the Turkish language, six words are central to pain-like experiences: ağri (pain), aci (suffering), sizi (aching), sanci (colic), istirap (agony), and dert (torture). We assessed discriminant characteristics of the Turkish translation of the McGill Pain Questionnaire (MPQ). Chronic clinical nonmalignant pain patients (n = 319, 35.7% males, 64.3% females) were questioned with the Turkish translation of the MPQ. Pain symptoms were categorized as headache (33.5%), musculoskeletal pain (33.2%), visceral pain (18.8%), and low back pain (14.5%). The visceral pain group had the highest mean value in the evaluative subscale (2.6 +/- 1.9). Descriptions used for sensory subscale included throbbing, sharp, aching, and tingling, while affective subscale words included tiring, suffocating, sickening, cruel, and wretched. In all pain groups, frequently chosen words for the miscellaneous subscale were nagging and penetrating. Pain descriptors were identified for each type of pain. This is, to our knowledge, the first assessment of the Turkish translation of the MPQ in nonmalignant pain patients.

FY 1991 RDT&E Descriptive Summaries

DTIC Science & Technology

1990-01-01

OF PROJECT : The Defense Sciences program element provides the technical foundation for long-term improvements in military equiment...DESCRIPTION OF PROJECT : Develop the fundamental technology in advanced digital structures and network concepts for smaller, more powerful, less expensive...DESCRIPTION OF PROJECT : The 1985 Defense Science Board (DSB) noted that the United States was behind and failing further behind in armor and

Repositioning the Facilities in Technical College Workshops for Efficiency: A Case Study of North Central Nigeria

ERIC Educational Resources Information Center

Umar, Ibrahim Y.; Ma'aji, Abdullahi S.

2010-01-01

This article focuses on assessing the facilities in Government Technical College workshops in the context of a developing country. A descriptive survey design was adopted. Two research questions and a hypothesis were formulated to guide the study. A 35-item questionnaire was developed based on the National Board for Technical Education (NBTE)…

Applying a Lifespan Developmental Perspective to Chronic Pain: Pediatrics to Geriatrics.

PubMed

Walco, Gary A; Krane, Elliot J; Schmader, Kenneth E; Weiner, Debra K

2016-09-01

An ideal taxonomy of chronic pain would be applicable to people of all ages. Developmental sciences focus on lifespan developmental approaches, and view the trajectory of processes in the life course from birth to death. In this article we provide a review of lifespan developmental models, describe normal developmental processes that affect pain processing, and identify deviations from those processes that lead to stable individual differences of clinical interest, specifically the development of chronic pain syndromes. The goals of this review were 1) to unify what are currently separate purviews of "pediatric pain," "adult pain," and "geriatric pain," and 2) to generate models so that specific elements of the chronic pain taxonomy might include important developmental considerations. A lifespan developmental model is applied to the forthcoming Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society Pain Taxonomy to ascertain the degree to which general "adult" descriptions apply to pediatric and geriatric populations, or if age- or development-related considerations need to be invoked. Copyright © 2016. Published by Elsevier Inc.

Management of vaso-occlusive pain in children with sickle cell disease.

PubMed

Jacob, Eufemia; Miaskowski, Christine; Savedra, Marilyn; Beyer, Judith E; Treadwell, Marsha; Styles, Lori

2003-04-01

A descriptive, longitudinal design was used to evaluate the pain management strategies used in children with sickle cell disease who were experiencing pain during a vaso-occlusive episode. A list of the medications (name, amount, mode of delivery, and frequency) prescribed and administered for pain management for each participant was recorded on the Medication Quantification Scale Worksheet, starting from day 1 of hospitalization to the day of discharge. Children were asked once each evening to provide three separate ratings of how much the pain medication helped them during the day, evening, and night using a 0-to-10 rating scale. Using patient-controlled analgesia (PCA), children self-administered only 35% of the analgesic medications that were prescribed and reported little pain relief. No significant relationships were found between changes in pain relief scores and the amount of analgesics administered. Clinicians need to monitor the amount of analgesics delivered in relationship to pain relief and assist children to titrate PCA administration of analgesics to achieve optimal pain control, or to advocate for changes in the PCA regimen when children cannot assume control of pain management.

Systematic mechanism-orientated approach to chronic pancreatitis pain.

PubMed

Bouwense, Stefan A W; de Vries, Marjan; Schreuder, Luuk T W; Olesen, Søren S; Frøkjær, Jens B; Drewes, Asbjørn M; van Goor, Harry; Wilder-Smith, Oliver H G

2015-01-07

Pain in chronic pancreatitis (CP) shows similarities with other visceral pain syndromes (i.e., inflammatory bowel disease and esophagitis), which should thus be managed in a similar fashion. Typical causes of CP pain include increased intrapancreatic pressure, pancreatic inflammation and pancreatic/extrapancreatic complications. Unfortunately, CP pain continues to be a major clinical challenge. It is recognized that ongoing pain may induce altered central pain processing, e.g., central sensitization or pro-nociceptive pain modulation. When this is present conventional pain treatment targeting the nociceptive focus, e.g., opioid analgesia or surgical/endoscopic intervention, often fails even if technically successful. If central nervous system pain processing is altered, specific treatment targeting these changes should be instituted (e.g., gabapentinoids, ketamine or tricyclic antidepressants). Suitable tools are now available to make altered central processing visible, including quantitative sensory testing, electroencephalograpy and (functional) magnetic resonance imaging. These techniques are potentially clinically useful diagnostic tools to analyze central pain processing and thus define optimum management approaches for pain in CP and other visceral pain syndromes. The present review proposes a systematic mechanism-orientated approach to pain management in CP based on a holistic view of the mechanisms involved. Future research should address the circumstances under which central nervous system pain processing changes in CP, and how this is influenced by ongoing nociceptive input and therapies. Thus we hope to predict which patients are at risk for developing chronic pain or not responding to therapy, leading to improved treatment of chronic pain in CP and other visceral pain disorders.

Handbook of sensor technical characteristics

NASA Astrophysics Data System (ADS)

Tanner, S.

1982-07-01

Space and terrestrial applications remote sensor systems are described. Each sensor is presented separately. Information is included on its objectives, description, technical characteristics, data products obtained, data archives location, period of operation, and measurement and potential derived parameters. Each sensor is cross indexed.

Solid Waste Program technical baseline description

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carlson, A.B.

1994-07-01

The system engineering approach has been taken to describe the technical baseline under which the Solid Waste Program is currently operating. The document contains a mission analysis, function analysis, system definition, documentation requirements, facility and project bases, and uncertainties facing the program.

76 FR 50807 - Data Collection Available for Public Comments and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-16

... development organizations (MDOs) to (1) Provide training and technical assistance to disadvantages and very... providing technical assistance to disadvantage and very-low income entrepreneurs. Information collected is... for Investment in Microentrepreneurs)''. Description of Respondents: Small Disadvantage Businesses...

Handbook of sensor technical characteristics

NASA Technical Reports Server (NTRS)

Tanner, S.

1982-01-01

Space and terrestrial applications remote sensor systems are described. Each sensor is presented separately. Information is included on its objectives, description, technical characteristics, data products obtained, data archives location, period of operation, and measurement and potential derived parameters. Each sensor is cross indexed.

The Extravehicular Mobility Unit (EMU): Proven hardware for Satellite Servicing

NASA Technical Reports Server (NTRS)

1982-01-01

A general technical description of the extravehicular mobility unit (EMU) is given. The description provides a basis for understanding EMU mobility capabilities and the environments a payload is exposed to in the vicinity of an EMU.

[Clinical pattern of patients cared for at pain clinic by first time].

PubMed

Covarrubias-Gómez, Alfredo; Guevara-López, Uriah; Lara-Solares, Argelia; Tamayo-Valenzuela, Antonio C; Salinas-Cruz, Jorge; Torres-González, Rubén

2008-01-01

Epidemiological studies about frequency and prevalence of chronic pain in Mexico are scarce. However, it has been documented that chronic pain is a frequent complain in general population and mainly in older adults. It influences physical patient capacity and it impacts social health services with its expensive cost. Our objective was to identify the clinical pattern of patients attending at a Pain Clinic by first time. We conducted a descriptive-retrospective study, in a five years period, with patients attending a Pain Clinic by first time. We collected demographic data and information about the cause of pain (malignant vs. non-malignant etiology), its intensity by visual analogue scale (VAS), and type (somatic, visceral, neuropathic and mixed). 1453 clinical records were analyzed. Women were more affected; the average age was 59 +/- 16 years; non-malignant pain and neuropathic pain were more frequent; the intensity average was 6 +/- 2, and it increases with age. It is necessary to generate epidemiological studies to fundament health policies regarding the management of these patients.

Feasibility of a mobile and web-based intervention to support self-management in outpatients with cancer pain.

PubMed

Hochstenbach, Laura M J; Zwakhalen, Sandra M G; Courtens, Annemie M; van Kleef, Maarten; de Witte, Luc P

2016-08-01

Cancer pain is a prevalent and distressing symptom. To enhance self-management in outpatients, a multi-component intervention was developed, integrating patient self-management and professional care through healthcare technology. This article describes feasibility of the intervention in everyday practice. Patients with moderate to severe cancer pain (n = 11) and registered nurses specialized in pain and palliative care (n = 3) participated in a four-week study. The intervention involved daily monitoring, graphical feedback, education, and advice by means of a mobile application for patients and a web application for nurses. Learnability, usability and desirability were measured in patients with a 20-item questionnaire (1-5 scale), higher scores indicating better feasibility. Patients' adherence was based on completion rates from server logs. Single semi-structured interviews with patients and a focus group interview with nurses provided insight into experiences. Questionnaire findings confirmed learnability (4.8), usability (4.8) and desirability (4.6) of the application for patients. Average completion rates were 76.8% for pain monitoring, 50.4% for medication monitoring and 100% for education sessions. Interviews revealed that patients were pleased with the simplicity of the mobile application and appreciated different components. Nurses agreed upon the added value and were mostly positive about the possibilities of the web application. Patients and nurses provided ideas for improvements relating to the content and technical performance of the intervention. Study results demonstrate feasibility of the intervention in everyday practice. Provided that content-related and technical adjustments are made, the intervention enables patients with cancer pain to practice self-management and nurses to remotely support these patients. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laborda, Alicia, E-mail: alaborda@unizar.es; Medrano, Joaquin, E-mail: oauieao@gmail.com; Blas, Ignacio de, E-mail: deblas@unizar.es

PurposeThis study was designed to evaluate the clinical outcome and patients' satisfaction after a 5 year follow-up period for pelvic congestion syndrome (PCS) coil embolization in patients who suffered from chronic pelvic pain that initially consulted for lower limb venous insufficiency.MethodsA total of 202 patients suffering from chronic pelvic pain were recruited prospectively in a single center (mean age 43.5 years; range 27-57) where they were being treated for lower limb varices. Inclusion criteria were: lower limb varices and chronic pelvic pain (>6 months), >6 mm pelvic venous caliber in ultrasonography, and venous reflux or presence of communicating veins. Bothmore » ovarian and hypogastric veins were targeted for embolization. Pain level was assessed before and after embolotherapy and during follow-up using a visual analog scale (VAS). Technical and clinical success and recurrence of leg varices were studied. Patients completed a quality questionnaire. Clinical follow-up was performed at 1, 3, and 6 months and every year for 5 years.ResultsTechnical success was 100 %. Clinical success was achieved in 168 patients (93.85 %), with complete disappearance of symptoms in 60 patients (33.52 %). Pain score (VAS) was 7.34 {+-} 0.7 preprocedural versus 0.78 {+-} 1.2 at the end of follow-up (P < 0.0001). Complications were: groin hematoma (n = 6), coil migration (n = 4), and reaction to contrast media (n = 1). Twenty-three cases presented abdominal pain after procedure. In 24 patients (12.5 %), there was recurrence of their leg varices within the follow-up. The mean degree of patients' satisfaction was 7.4/9.ConclusionsCoil embolization of PCS is an effective and safe procedure, with high clinical success rate and degree of satisfaction.« less

Canine ovariectomy by hybrid or total natural orifice transluminal endoscopic surgery: technical feasibility study and pain assessment.

PubMed

Linhares, Marcella Teixeira; Feranti, João Pedro Scussel; Coradini, Gabriela Pesamosca; Martins, Letícia Reginato; Martins, Arthur Rodrigues; Sarturi, Vanessa Zanchi; Gavioli, Felipe Baldissarella; Machado Silva, Marco Augusto; de Ataíde, Michelli Westphal; Teixeira, Luciana Gonçalves; Brun, Maurício Veloso

2018-06-13

To compare technical feasibility, surgical time, surgical complications, and postoperative pain in ovariectomy (OVE) by hybrid and total natural orifice transluminal endoscopic surgery (NOTES). Prospective randomized clinical trial. Sixteen healthy and sexually intact bitches. Dogs were randomly assigned to the hybrid NOTES group (HNG; n = 8) and the total NOTES group (TNG; n = 8) to compare surgical time, pain scores and complications. Pain was assessed by using the visual analog scale (VAS) and the Melbourne pain scale (MPS). Surgical time did not differ between the experimental groups (HNG = 46.3 ± 18.5 minutes, TNG = 54.6 ± 31.1 minutes). Exteriorization of the ovaries through the vaginal wound was the major difficulty. Complications were minor in both groups and occurred intraoperatively only in the HNG, and in both groups post operatively. No dogs required rescue analgesia in the intraoperative or postoperative period. There were no differences in VAS or MPS scores between the groups for any surgical times except for the VAS assessment at 72 hours after extubation (HNG = 1.1 ± 0.3, TNG = 0.7 ± 0.4, P = .0221). Both NOTES techniques were comparable for canine OVE, with no requirement for additional analgesia in the postoperative periods. It was not possible to determine whether there was a clear advantage of one technique rather than the other. The minimally invasive techniques proposed for laparoscopic OVE are feasible for dogs with low pain scores and low rates of complications for both groups. © 2018 The American College of Veterinary Surgeons.

Percutaneous Vertebroplasty for Pain Management in Patients with Multiple Myeloma: Is Radiofrequency Ablation Necessary?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Orgera, Gianluigi; Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com; Matteoli, Marco

PurposeThis study was designed to investigate the added role of radiofrequency ablation (RFA) to vertebroplasty on the pain management of patients with multiple myeloma (MM).MethodsThirty-six patients (51–82 years) with vertebral localization of MM were randomly divided into two groups: 18 patients (group A) who underwent RFA and then vertebroplasty, and 18 patients (group B) who underwent only vertebroplasty. Primary endpoints were technical success and pain relief score rate measured by the visual analogue pain scores (VAS) and Roland–Morris Questionnaire (RMQ); secondary endpoint was the amount of administered analgesia. Survival and complications were compared.ResultsTechnical success was 100 % in both groups. The VASmore » score (at 24 h and 6 weeks postprocedure) decreased in equal manner for both groups from a mean of 9.1–3.4 and 2.0 for group A and from a mean of 9.3–3.0 and 2.3 for group B; RMQ mean score was 19.8 for group A and 19.9 for group B and decreased to a mean of 9.6 and 8.2 for group A and 9.5 and 8.7 for group B. The amount of medication was equally decreased in the two groups. No statistically significant difference was noted. No major complication occurred and two patients died from other causes.ConclusionsThe use of percutaneous vertebroplasty alone appears to be effective for the pain management of the patients with vertebral involvement of multiple myeloma. The use of RFA that includes cost and time does not offer any clear added benefit on the midterm pain management of such patients.« less

Description of movement quality in patients with low back pain: A qualitative study as a first step to a practical definition.

PubMed

van Dijk, Margriet J H; Smorenburg, Nienke T A; Visser, Bart; Nijhuis-van der Sanden, Maria W G; Heerkens, Yvonne F

2017-03-01

As a first step to formulate a practical definition for movement quality (MQ), this study aims to explore how Dutch allied health care professionals (AHCPs) describe MQ of daily life activities in patients with low back pain (LBP). In this qualitative cross-sectional digital survey study, Dutch AHCPs (n = 91) described MQ in open text (n = 91) and with three keywords (n = 90). After exploratory qualitative content analysis, the ICF linking rules (International Classification of Functioning, Disability and Health) were applied to classify MQ descriptions and keywords. The identified meaningful concepts (MCs) of the descriptions (274) and keywords (239) were linked to ICF codes (87.5% and 80.3%, respectively), Personal factors (5.8% and 5.9%, respectively), and supplementary codes (6.6% and 13.8%, respectively). The MCs were linked to a total of 31 ICF codes, especially to b760 'control of voluntary movement functions', b7602 'coordination of voluntary movements', d4 'Mobility', and d230 'carry out daily routine'. Negative and positive formulated descriptions elucidated different MQ interpretations. Descriptions of MQ given by Dutch AHCPs in patients with LBP cover all ICF components. Coordination and functional movements are seen as the most elementary concepts of MQ. Variation in MQ descriptions and interpretations hinders defining MQ and indicates the necessity of additional steps.

The health-seeking behaviours of first-time mothers with persistent pelvic girdle pain after childbirth in Ireland: A descriptive qualitative study.

PubMed

Wuytack, Francesca; Curtis, Elizabeth; Begley, Cecily

2015-11-01

to explore the health-seeking behaviours of primiparous women with pelvic girdle pain persisting for more than three months post partum. a descriptive qualitative design involving face-to-face semi-structured interviews following institutional ethical approval. Transcripts were analysed using thematic analysis. an urban hospital in Ireland. a purposive sample of 23 consenting first-time mothers with pelvic girdle pain persisting for at least three months post partum. 'they didn't ask, I didn't tell' was a key theme, which included emerging categories of a perceived lack of follow-up post partum, and feeling ignored by healthcare professionals. The theme 'Seeking advice and support' describes women's role of talking to others, and triggers and barriers to getting help. 'Coping strategies' was the third theme emerging from the interviews, whereby participants described different strategies they used to deal with their symptoms, although many expressed uncertainty about what to do or who to see. our findings show the importance of appropriate information and follow-up care for women with pelvic girdle pain and highlight barriers they encounter in seeking help. They also question the duration of postnatal care as participants felt that postnatal care was stopped too early. The findings may assist maternity care providers in addressing mothers' expectations and needs related to persistent pelvic girdle pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Shoulder-Fired Weapons with High Recoil Energy: Quantifying Injury and Shooting Performance

DTIC Science & Technology

2004-05-01

USARIEM TECHNICAL REPORT T04-05 SHOULDER-FIRED WEAPONS WITH HIGH RECOIL ENERGY: QUANTIFYING INJURY AND SHOOTING PERFORMANCE...ACKNOWLEDGMENTS The authors would like to thank the following individuals for their assistance in preparing this technical report: Robert Mello... myofascial and other musculoskeletal pain is considered abnormal if the anatomical site is 2 kg/cm2 lower relative to a normal control point, such as

Combination acetabular radiofrequency ablation and cementoplasty using a navigational radiofrequency ablation device and ultrahigh viscosity cement: technical note.

PubMed

Wallace, Adam N; Huang, Ambrose J; Vaswani, Devin; Chang, Randy O; Jennings, Jack W

2016-03-01

Percutaneous radiofrequency ablation and cementoplasty is an alternative palliative therapy for painful metastases involving axial load-bearing bones. This technical report describes the use of a navigational radiofrequency probe to ablate acetabular metastases from an anterior approach followed by instillation of ultrahigh viscosity cement under CT-fluoroscopic guidance. The tumor ablation databases of two institutions were retrospectively reviewed to identify patients who underwent combination acetabular radiofrequency ablation and cementoplasty using the STAR Tumor Ablation and StabiliT Vertebral Augmentation Systems (DFINE; San Jose, CA). Pre-procedure acetabular tumor volume was measured on cross-sectional imaging. Pre- and post-procedure pain scores were measured using the Numeric Rating Scale (10-point scale) and compared. Partial pain improvement was categorically defined as ≥ 2-point pain score reduction. Patients were evaluated for evidence of immediate complications. Electronic medical records were reviewed for evidence of delayed complications. During the study period, 12 patients with acetabular metastases were treated. The median tumor volume was 54.3 mL (range, 28.3-109.8 mL). Pre- and post-procedure pain scores were obtained from 92% (11/12) of the cohort. The median pre-procedure pain score was 8 (range, 3-10). Post-procedure pain scores were obtained 7 days (82%; 9/11), 11 days (9.1%; 1/11) or 21 days (9.1%; 1/11) after treatment. The median post-treatment pain score was 3 (range, 1-8), a statistically significant difference compared with pre-treatment (P = 0.002). Categorically, 73% (8/11) of patients reported partial pain relief after treatment. No immediate symptomatic complications occurred. Three patients (25%; 3/12) were discharged to hospice within 1 week of treatment. No delayed complications occurred in the remaining 75% (9/12) of patients during median clinical follow-up of 62 days (range, 14-178 days). Palliative percutaneous acetabular radiofrequency ablation and cementoplasty can be feasibly performed from an anterior approach using a navigational ablation probe and ultrahigh viscosity cement instilled under CT-fluoroscopic guidance.

Does Age Affect the Relationship Between Pain and Disability? A Descriptive Study in Individuals Suffering From Chronic Low Back Pain.

PubMed

Houde, Francis; Cabana, François; Léonard, Guillaume

2016-01-01

Previous studies have revealed a weak to moderate relationship between pain and disability in individuals suffering from low back pain (LBP). However, to our knowledge, no studies have evaluated if this relationship is different between young and older adults. The objective of this descriptive, cross-sectional study was to determine whether the relationship between LBP intensity and physical disability is different between young and older adults. Pain intensity (measured with a visual analog scale) and physical disability scores (measured with the Oswestry Disability Index) were collected from the medical files of 164 patients with LBP. Separate Pearson correlation coefficients were calculated between these 2 variables for young (mean age 40 ± 6 years, n = 82) and older (62 ± 9 years, n = 82) individuals and a Fisher r-to-z transformation was used to test for group differences in the strength of the relationship. Linear regression analyses were also performed to determine whether the slope of the association was different between the 2 groups. A significant and positive association was found between pain intensity and disability for both young and older individuals. However, the correlation was stronger in the young group (r = 0.66; P < .01) than in the older group (r = 0.44; P < .01) (Fisher Z = 2.03; P < .05). The linear regression model also revealed that the slope of the relationship was steeper in the young group (P < .05). Although both young and older individuals showed a significant association between pain intensity and disability, the relationship between these 2 variables was more tenuous in older individuals than in young patients. Future research is essential to identify the factors underlying this age-related difference.

Computer mouse use predicts acute pain but not prolonged or chronic pain in the neck and shoulder.

PubMed

Andersen, J H; Harhoff, M; Grimstrup, S; Vilstrup, I; Lassen, C F; Brandt, L P A; Kryger, A I; Overgaard, E; Hansen, K D; Mikkelsen, S

2008-02-01

Computer use may have an adverse effect on musculoskeletal outcomes. This study assessed the risk of neck and shoulder pain associated with objectively recorded professional computer use. A computer programme was used to collect data on mouse and keyboard usage and weekly reports of neck and shoulder pain among 2146 technical assistants. Questionnaires were also completed at baseline and at 12 months. The three outcome measures were: (1) acute pain (measured as weekly pain); (2) prolonged pain (no or minor pain in the neck and shoulder region over four consecutive weeks followed by three consecutive weeks with a high pain score); and (3) chronic pain (reported pain or discomfort lasting more than 30 days and "quite a lot of trouble" during the past 12 months). Risk for acute neck pain and shoulder pain increased linearly by 4% and 10%, respectively, for each quartile increase in weekly mouse usage time. Mouse and keyboard usage time did not predict the onset of prolonged or chronic pain in the neck or shoulder. Women had higher risks for neck and shoulder pain. Number of keystrokes and mouse clicks, length of the average activity period, and micro-pauses did not influence reports of acute or prolonged pain. A few psychosocial factors predicted the risk of prolonged pain. Most computer workers have no or minor neck and shoulder pain, few experience prolonged pain, and even fewer, chronic neck and shoulder pain. Moreover, there seems to be no relationship between computer use and prolonged and chronic neck and shoulder pain.

Headache and co-morbid pains associated with TMD pain in adolescents.

PubMed

Nilsson, I-M; List, T; Drangsholt, M

2013-09-01

This case-control study evaluated the association of headache and other co-morbid pain with temporomandibular disorder (TMD) pain in adolescents and explored the temporal co-variance of headache and TMD pain. In a population-based sample of 12- to 19-year-olds, 350 patients with self-reported TMD pain and 350 healthy age- and sex-matched individuals were mailed questionnaires. Descriptive statistics, 95% CI, and OR analyses--logistic regression models with TMD pain as the outcome variable and adjusted for age and gender--were used for the analysis of individuals' responses. Headache, whether defined as once a week or more (OR = 6.6) or as moderate or severe (categorical), was significantly related to TMD pain. Severe headache (vs. mild) showed stronger associations with TMD (OR = 10.1) than between moderate and mild headache (OR = 5.5). Neck (OR = 4.0) and back (OR = 2.6) pain was also significantly related to TMD pain. When participants were grouped according to headache onset and TMD pain, the highest association between headache and TMD pain was found in the subgroup "Headache onset before TMD pain" (OR 9.4). In conclusion, headache appears to be independently and highly associated with TMD pain in adolescents. Neck pain and somatic complaints were also significantly associated with TMD pain. Headache seems to precede TMD pain in many adolescents with pain.

The NASA scientific and technical information system: Its scope and coverage

NASA Technical Reports Server (NTRS)

1988-01-01

A general description of the subject areas covered in the NASA scientific and technical information system is presented. In addition, it establishes subject-based selection criteria for guiding decisions related to the addition of new documents to the NASA collection.

Salivary Alpha-Amylase Correlates with Subjective Heat Pain Perception.

PubMed

Wittwer, Amrei; Krummenacher, Peter; La Marca, Roberto; Ehlert, Ulrike; Folkers, Gerd

2016-06-01

Self-reports of pain are important for an adequate therapy. This is a problem with patients and infants who are restricted in providing an accurate verbal estimation of their pain. Reliable, real-time, economical, and non-invasive physiological correlates might contribute to a more comprehensive description of pain. Salivary alpha-amylase constitutes one candidate biomarker, which reflects predominantly sympathetic nervous system alterations under stressful conditions and can be measured non-invasively. The current study investigated the effects of acute heat pain on salivary alpha-amylase activity. Heat pain tolerance was measured on the non-dominant forearm. Participants completed visual analog scales on pain intensity and unpleasantness. Saliva samples were collected directly after pain induction. Twenty-seven healthy volunteers were recruited for this study. While salivary alpha-amylase levels correlated positively with intensity and unpleasantness ratings in response to acute heat pain stimuli, there was no corresponding association with pain tolerance. Salivary alpha-amylase is suggested to be an indirect physiologic correlate of subjective heat pain perception. Future studies should address the role of salivary alpha-amylase depending on the origin of pain, the concerned tissue, and other pain assessment methods. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Children in pain: recurrent back pain, abdominal pain, and headache in children and adolescents in a four-year-period.

PubMed

van Gessel, Hester; Gassmann, Jennifer; Kröner-Herwig, Birgit

2011-06-01

To analyze the development of recurrent pain in 3 body locations in children and adolescents (baseline age, 9 to 14 years) in a 4-year period. In a large population-based longitudinal epidemiological study data was collected through annual postal questionnaires (longitudinal, n = 2025). Descriptive statistics and generalized estimating equations were used. Girls were more likely to report recurrent pain, demonstrated a steeper development during the 4-year period, and reported multiple pain more often than boys. Younger children reported less recurrent pain, but displayed a steeper trend of increasing prevalence rates as they grew older. Older children illustrated a more stable development of recurrent pain and reported multiple pain more often. Disability experienced because of recurrent pain was related strongest to pain intensity. Stable patterns of pain were related to higher intensity and disability reports. The children experienced headache as the most disabling of the 3 pains. The results show that boys and girls report recurrent pain in different patterns in the years. To identify risk factors, analysis should be performed separately for boys and girls. Furthermore, it is recommended to include children before the age of 9 years in a prevention study. Copyright © 2011 Mosby, Inc. All rights reserved.

Is the experience of pain in patients with temporomandibular disorder associated with the presence of comorbidity?

PubMed

Visscher, Corine M; van Wesemael-Suijkerbuijk, Erin A; Lobbezoo, Frank

2016-10-01

The aim of this study was to explore the association between the presence of comorbidities and the pain experience in individual patients with temporomandibular disorder (TMD). This clinical trial comprised 112 patients with TMD pain. For all participants the presence of the following comorbid factors was assessed: pain in the neck; somatization; impaired sleep; and depression. Pain experience was evaluated using the McGill Pain Questionnaire (MPQ). For each subject the TMD-pain experience was assessed for three dimensions - sensory, affective, and evaluative - as specified in the MPQ. The association between comorbid factors and these three dimensions of TMD-pain experience was then evaluated using linear regression models. Univariable regression analyses showed that all comorbid factors, except for one factor, were positively associated with the level of pain, as rated by the sensory description of pain, the affective component of pain, and the evaluative experience of pain. The multivariable regression analyses showed that for all MPQ dimensions, depression showed the strongest associations with pain experience. It was found that in the presence of comorbid disorders, patients with TMD experience elevated levels of TMD pain. This information should be taken into consideration in the diagnostic process, as well as in the choice of treatment. © 2016 Eur J Oral Sci.

Continuous subcutaneous infusion of ketorolac in cancer neuropathic pain unresponsive to opioid and adjuvant drugs. A case report.

PubMed

Ripamonti, C; Ticozzi, C; Zecca, E; Rodriguez, C H; De Conno, F

1996-01-01

Ketorolac is a new non-steroidal anti-inflammatory drug (NSAID) having a potent nonopioid analgesic activity. Administered by continuous subcutaneous infusion (CSI), its analgesic efficacy has been documented in the treatment of somatic and visceral cancer pain whilst it has been shown to be ineffective in the treatment of neuropathic pain. Here is a description of a cancer patient with neuropathic pain unresponsive to anticonvulsant or antidepressant drugs administered in association or not with oral opioids but who was successfully treated with ketorolac alone via CSI. Furthermore, the analgesia lasted over 75 days of treatment without any significant renal and gastric side effects.

The Unkindest Cut of All: Portrayals of Pain and Surgery in the Tracy Latimer Case

ERIC Educational Resources Information Center

Janz, Heidi L.

2009-01-01

The paper examines the language used to describe pain and surgery in the trials and the media discussions of the killing of Tracy Latimer by her father. Descriptions of proposed surgical procedures, that were planned before Tracy was killed, exaggerate the intrusiveness of surgeries to be performed so as to suggest that surgery would be worse than…

Targeted Muscle Reinnervation for Transradial Amputation: Description of Operative Technique.

PubMed

Morgan, Emily N; Kyle Potter, Benjamin; Souza, Jason M; Tintle, Scott M; Nanos, George P

2016-12-01

Targeted muscle reinnervation (TMR) is a revolutionary surgical technique that, together with advances in upper extremity prostheses and advanced neuromuscular pattern recognition, allows intuitive and coordinated control in multiple planes of motion for shoulder disarticulation and transhumeral amputees. TMR also may provide improvement in neuroma-related pain and may represent an opportunity for sensory reinnervation as advances in prostheses and haptic feedback progress. Although most commonly utilized following shoulder disarticulation and transhumeral amputations, TMR techniques also represent an exciting opportunity for improvement in integrated prosthesis control and neuroma-related pain improvement in patients with transradial amputations. As there are no detailed descriptions of this technique in the literature to date, we provide our surgical technique for TMR in transradial amputations.

Monitored Geologic Repository Project Description Document

DOE Office of Scientific and Technical Information (OSTI.GOV)

P. M. Curry

2001-01-30

The primary objective of the Monitored Geologic Repository Project Description Document (PDD) is to allocate the functions, requirements, and assumptions to the systems at Level 5 of the Civilian Radioactive Waste Management System (CRWMS) architecture identified in Section 4. It provides traceability of the requirements to those contained in Section 3 of the ''Monitored Geologic Repository Requirements Document'' (MGR RD) (YMP 2000a) and other higher-level requirements documents. In addition, the PDD allocates design related assumptions to work products of non-design organizations. The document provides Monitored Geologic Repository (MGR) technical requirements in support of design and performance assessment in preparing formore » the Site Recommendation (SR) and License Application (LA) milestones. The technical requirements documented in the PDD are to be captured in the System Description Documents (SDDs) which address each of the systems at Level 5 of the CRWMS architecture. The design engineers obtain the technical requirements from the SDDs and by reference from the SDDs to the PDD. The design organizations and other organizations will obtain design related assumptions directly from the PDD. These organizations may establish additional assumptions for their individual activities, but such assumptions are not to conflict with the assumptions in the PDD. The PDD will serve as the primary link between the technical requirements captured in the SDDs and the design requirements captured in US Department of Energy (DOE) documents. The approved PDD is placed under Level 3 baseline control by the CRWMS Management and Operating Contractor (M and O) and the following portions of the PDD constitute the Technical Design Baseline for the MGR: the design characteristics listed in Table 1-1, the MGR Architecture (Section 4.1), the Technical Requirements (Section 5), and the Controlled Project Assumptions (Section 6).« less

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

PubMed Central

Friedrichsdorf, Stefan J.; Giordano, James; Desai Dakoji, Kavita; Warmuth, Andrew; Daughtry, Cyndee; Schulz, Craig A.

2016-01-01

Primary pain disorders (formerly “functional pain syndromes”) are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition “chronic-on-acute pain.” We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy. PMID:27973405

The Challenge of the Future. Future Trends in Adult and Continuing Technical and Vocational Education. An International Symposium (Berlin, Germany, October 16-20, 1995).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Hamburg (Germany). Inst. for Education.

This report on an international symposium on the strengthening of the development and improvement of vocational education begins with a description of UNEVOC, the International Project on Technical and Vocational Education. Section 2 presents discussions of the following topics: adult and continuing technical and vocational education and its…

MACCIS 2.0 - An Architecture Description Framework for Technical Infostructures and Their Enterprise Environment

DTIC Science & Technology

2004-06-01

Viewpoint Component Viewpoint View Architecture Description of Enterprise or Infostructure View Security Concern Business Security Model Business...security concern, when applied to the different viewpoints, addresses both stakeholders, and is described as a business security model or component...Viewpoint View Architecture Description of Enterprise or Infostructure View Security Concern Business Security Model Business Stakeholder IT Architect

Lower back pain and absenteeism among professional public transport drivers.

PubMed

Kresal, Friderika; Roblek, Vasja; Jerman, Andrej; Meško, Maja

2015-01-01

Drivers in public transport are subjected to lower back pain. The reason for the pain is associated with the characteristics of the physical position imposed on the worker while performing the job. Lower back pain is the main cause of absenteeism among drivers. The present study includes 145 public transport drivers employed as professional drivers for an average of 14.14 years. Analysis of the data obtained in the study includes the basic descriptive statistics, χ(2) test and multiple regression analysis. Analysis of the incidence of lower back pain showed that the majority of our sample population suffered from pain in the lower back. We found that there are no statistically significant differences between the groups formed by the length of service as a professional driver and incidence of lower back pain; we were also interested in whether or not the risk factors of lower back pain affects the absenteeism of city bus drivers. Analysis of the data has shown that the risk factors of pain in the lower part of the spine do affect the absenteeism of city bus drivers.

Painful Hashimoto's thyroiditis: myth or reality?

PubMed

Rotondi, M; Capelli, V; Locantore, P; Pontecorvi, A; Chiovato, L

2017-08-01

Neck pain is a common complain, being in most cases due to non-thyroidal causes. However, a minority of patients suffer from painful thyroid diseases. Among them, sub-acute thyroiditis (SAT) is the most frequent one. Rare thyroid-related causes of neck pain include hemorrhage within a thyroid nodule as well as Riedel's thyroiditis and suppurative thyroiditis. In the last 30 years, a few cases of a painful variant of Hashimoto's thyroiditis (HT) have been described. Biochemical, ultrasound, and histologic features were clearly suggestive for HT in all of the published cases and definitely ruled out the diagnosis of SAT. While sound descriptions of painful HT are present in the literature, it is important to emphasize that only 20 cases were reported from the year 2000 until now. The condition, however, is clinically relevant because neck pain was reported to be refractory both to steroids and to other analgesic drugs, being thyroidectomy the only effective treatment for pain relief in these patients. This short review analyzes currently available data supporting a role for HT as a rare cause of neck pain.

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

PubMed

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

2017-12-01

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

Frequency and associated risk factors for neck pain among software engineers in Karachi, Pakistan.

PubMed

Rasim Ul Hasanat, Mohammad; Ali, Syed Shahzad; Rasheed, Abdur; Khan, Muhammad

2017-07-01

To determine the frequency of neck pain and its association with risk factors among software engineers. This descriptive, cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from February to March 2016, and comprised software engineers from 19 different locations. Non-probability purposive sampling technique was used to select individuals spending at least 6 hours in front of computer screens every day and having a work experience of at least 6 months. Data were collected using a self-administrable questionnaire. SPSS 21 was used for data analysis. Of the 185 participants, 49(26.5%) had neck pain at the time of data-gathering, while 136(73.5%) reported no pain. However, 119(64.32%) participants had a previous history of neck pain. Other factors like smoking, physical inactivity, history of any muscular pain and neck pain, uncomfortable workstation, and work-related mental stress and insufficient sleep at night, were found to be significantly associated with current neck pain (p<0.05 each). Intensive computer users are likely to experience at least one episode of computer-associated neck pain.

Pain intensity, disability and depression in individuals with chronic back pain1

PubMed Central

Garbi, Márcia de Oliveira Sakamoto Silva; Hortense, Priscilla; Gomez, Rodrigo Ramon Falconi; da Silva, Talita de Cássia Raminelli; Castanho, Ana Carolina Ferreira; Sousa, Fátima Aparecida Emm Faleiros

2014-01-01

OBJECTIVES: to measure the pain intensity, identify the disability and depression levels in people with chronic back pain and to correlate these variables. A cross-sectional, descriptive and exploratory study was undertaken at the Pain Treatment Clinic of the University of São Paulo at Ribeirão Preto Hospital das Clínicas, between February and June 2012, after receiving approval from the Ethics Committee at the University of São Paulo at Ribeirão Preto College of Nursing. METHOD: sixty subjects with chronic back pain participated. The instruments used were: the 11-point Numerical Category Scale, the Roland-Morris Disability Questionnaire and the Beck Depression Inventory. To analyze the data, the arithmetic means, standard deviations and Spearman's correlation coefficient were calculated. RESULTS: the findings show that the participants presented high pain, disability and depression levels. The correlation between pain intensity and disability and between pain intensity and depression was positive and weak and, between disability and depression, positive and moderate. CONCLUSION: the study variables showed moderate and weak indices and the mutual correlations were positive. PMID:25296139

No correlation between stroke specialty and rate of shoulder pain in NCAA men swimmers

PubMed Central

Wymore, Lucas; Reeve, Robert E.; Chaput, Christopher D.

2012-01-01

Purpose: To established an association between shoulder pain and the stroke specialization among NCAA men swimmers. Materials and Methods: All members of the top 25 NCAA men's swim teams were invited to complete the survey. Eleven teams with a total of 187 participants completed the study survey. The teams were mailed surveys that included multiple choice questions regarding their primary stroke and their incidence of shoulder pain. Additionally, the survey included questions about risk factors including distance trained, type of equipment, weight training, and stretching. Results: The analysis showed that there was no significant difference in the rates of shoulder pain among the four strokes and individual medley specialists. The other risk factors did not show a significant correlation with shoulder pain. Conclusions: This study found no significant correlation between stroke specialty and shoulder pain in male collegiate swimmers. Level of Evidence: Level 3. Clinical Relevance: Descriptive epidemiology study. PMID:23204760

Study on the relationship between backpack use and back and neck pain among adolescents.

PubMed

Navuluri, Neelima; Navuluri, Ramesh B

2006-12-01

A descriptive correlation study was conducted in Hobbs, New Mexico, USA, to find the relationship between backpack use and back and neck pain among adolescent boys and girls. A higher percentage of girls than boys rated their pain as being moderate to extremely strong. The correlation between pain and backpack weight per body mass index among girls was positive and significant, but negative and non-significant among boys. The correlation between pain and backpack weight was positive and non-significant among both boys and girls. The correlation between pain and each of the variables of backpack weight per body weight, backpack weight per height, and backpack weight per body surface area was negative and non-significant among boys, but positive and non-significant among girls. Gender-based research studies with additional variables and safe backpack use education in schools are recommended.

Effective management of low back pain: it’s time to accept the evidence

PubMed Central

Manga, Pran; Angus, Douglas E; Swan, William R

1993-01-01

Low back pain is a ubiquitous and economically costly problem. Unfortunately, the clinical management of low back pain is not yet well understood. Chiropractic management of back pain, long the black sheep of back care, has undergone a transition and is now a more respected and understood alternative to conservative medical care, itself under increased scrutiny due to unsatisfactory outcomes and unacceptable iatrogenic side effects. The substantial amount of clinical and related research on the effectiveness of manipulation for low back pain is summarized here from a larger study, divided into randomized control trials, case-control trials, meta-analyses and descriptive studies. The chiropractic management of low back pain is found to be a more effective way of dealing with this medical, social and economic problem. It is suggested that greater utilization of chiropractors be encouraged such that the “right people are doing the right things at the right time”.

Dr. Wernher Von Braun

NASA Technical Reports Server (NTRS)

1999-01-01

Dr. Thomas Paine, Deputy Administrator of the National Aeronautics and Space Administration, examines an ordinary man's shoe outfitted for use in the Saturn I workshop. Pictured from the left in the Saturn I workshop mockup are William Brooksbank, propulsion and vehicle engineering laboratory; Dr. Paine; Dr. Wernher Von Braun, Marshall Center director; Colonel Clare F. Farley, Executive Officer in the Office Of The Administrator; and Charles J. Donlan, Deputy Associate Administrator for Manned Space Flight, Technical. the shoe Dr. Paine is holding has a unique fastener built into the sole to allow an astronaut to move about on the workshop floor and to remain in one position if he desires.

Dimensioning of painful procedures and interventions for acute pain relief in premature infants 1

PubMed Central

Bonutti, Deise Petean; Daré, Mariana Firmino; Castral, Thaíla Corrêa; Leite, Adriana Moraes; Vici-Maia, Joselaine Aparecida; Scochi, Carmen Gracinda Silvan

2017-01-01

ABSTRACT Objective: to dimension the exposure of premature infants to painful procedures, relating the distribution of the exposure to contextual factors, as well as to describe the pharmacological and non-pharmacological interventions health professionals use during the first two weeks of the infant’s hospitalization at two neonatal services. Method: descriptive-exploratory study in which the professionals registered the painful procedures and pain relief interventions on a specific form in the patient file. Results: the daily average of the 89 premature infants was 5.37 painful procedures, corresponding to 6.56 during the first week of hospitalization and 4.18 during the second week (p<0.0001). The most frequent procedures were nasal/oral (35.85%) and tracheal aspirations (17.17%). The children under invasive ventilation were the most exposed to painful procedures (71.2%). Only 44.9% of the painful procedures received some intervention for the purpose of pain relief, the most frequent being sucrose (78.21%) and continuing sedation (19.82%). Conclusion: acute pain was undertreated at these neonatal services, recommending greater sensitization of the team for the effective use of the existing protocol and implementation of other knowledge transfer strategies to improve neonatal pain management.

Qualitative and quantitative aspects of pain in lateral posterior thoracotomy patients.

PubMed

Xavier, Thaiza Teixeira; Torres, Gilson de Vasconcelos; da Rocha, Vera Maria

2006-01-01

Descriptive study that proposed to compare the qualitative and quantitative behavior of the pain in lateral posterior thoracotomy patients. The sample was consisted of 18 individuals with an average age of 44 years. The instruments used were physiotherapy evaluation form, numerical pain scale and McGill questionnaire for pain. The pain on the numerical pain scale was considered moderate(5) for both sexes. The descriptors of the McGill questionnaire choosen by the patients with higher frequency were: in the sensorial component, beat4, pointed1, shock2, final and pull2; in the afetive component, tired1, bored1, punishald1 and miserable1 and in the evaluative component was flat. The characteristics of pain in the sensorial group were more evidents on male group. No significant statistical difeferences were observed between quantitative answers concerning pain between the men and women. On the qualitative aspects , was observed an predominancy of the same descriptors of pain in afetive component for both sexes. Pain intensity was categorized as moderate. No significant statistical difference were observed between the pain on the post-operatory lateral posterior thoracotomy. These data demonstrate a necessity for an analysis with a larger study group.

Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care.

PubMed

Luckett, Tim; Davidson, Patricia M; Green, Anna; Boyle, Frances; Stubbs, John; Lovell, Melanie

2013-08-01

Cancer pain is a common, burdensome problem, which is not well managed despite evidence-based guidelines. To develop insights for managing barriers and optimizing facilitators to adult cancer pain assessment and management within a comprehensive framework of patient care. We undertook a systematic review and synthesis of qualitative studies. Medline, PsycINFO, Embase, AMED, CINAHL, and Sociological Abstracts were searched from May 20 to 26, 2011. To be included, the articles had to be published in a peer-reviewed journal since 2000; written in English; and report original qualitative studies on the perspectives of patients, their significant others, or health care providers. Article quality was rated using the checklist of Kitto et al. Thematic synthesis followed a three-stage approach using Evidence for Policy and Practice Information and Co-ordinating Centre-Reviewer 4 software: 1) free line-by-line coding of "Results," 2) organization into "descriptive" themes, and 3) development of "analytical" themes informative to our objective. At Stage 3, a conceptual framework was selected from the peer-reviewed literature according to prima facie "fit" for descriptive themes. Of 659 articles screened, 70 met the criteria, reporting 65 studies with 48 patient, 19 caregiver, and 21 health care provider samples. Authors rarely reported reflexivity or negative cases. Mead and Bower's model of patient-centered care accommodated 85% of the descriptive themes; 12% more related to the caregiver and service/system factors. Three themes could not be accommodated. Findings highlight the need to integrate patient/family education within improved communication, individualize care, use more nonpharmacological strategies, empower patients/families to self-manage pain, and reorganize multidisciplinary roles around patient-centered care and outcomes. These conclusions require validation via consensus and intervention trials. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Atmospheric turbulence simulation for Shuttle orbiter

NASA Technical Reports Server (NTRS)

Tatom, F. B.; Smith, S. R.

1979-01-01

An improved non-recursive model for atmospheric turbulence along the flight path of the Shuttle Orbiter is developed which provides for simulation of instantaneous vertical and horizontal gusts at the vehicle center-of-gravity, and also for simulation of instantaneous gust gradients. Based on this model the time series for both gusts and gust gradients are generated and stored on a series of magnetic tapes. Section 2 provides a description of the various technical considerations associated with the turbulence simulation model. Included in this section are descriptions of the digital filter simulation model, the von Karman spectra with finite upper limits, and the final non recursive turbulence simulation model which was used to generate the time series. Section 2 provides a description of the various technical considerations associated with the turbulence simulation model. Included in this section are descriptions of the digial filter simulation model, the von Karman spectra with finite upper limits, and the final non recursive turbulence simulation model which was used to generate the time series. Section 3 provides a description of the time series as currently recorded on magnetic tape. Conclusions and recommendations are presented in Section 4.

DEVELOPMENT OF INTERNATIONAL STANDARDS FOR AIR QUALITY MONITORING AND CONTROL

EPA Science Inventory

This report presents a description of the activities and accomplishments of the American Society for Testing and Materials' U. S. Technical Advisory Group (TAG) to the International Standards Organization's Technical Committee 146 on Air Quality. The purpose of the TAG is to re...

ECOS E-MATRIX Methane and Volatile Organic Carbon (VOC) Emissions Best Practices Database

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parisien, Lia

2016-01-31

This final scientific/technical report on the ECOS e-MATRIX Methane and Volatile Organic Carbon (VOC) Emissions Best Practices Database provides a disclaimer and acknowledgement, table of contents, executive summary, description of project activities, and briefing/technical presentation link.

Workshop: The Technical Requirements for Image-Guided Therapy (Focus: Spinal Cord and Spinal Column)

DTIC Science & Technology

2000-02-01

degenerative disease, spondylosis , ligamental ossification, fractures, tumors, and other causes. Compression is a painful condition that may require...series of 7000 patients who underwent lumbar disk surgery, Long indicates three reasons for failed surgery: 1. Failure of the patient to meet the...validated outcomes measures in the lumbar area, is used for a 70-year-old patient with osteoarthritis of the knees and low back pain as well as problems

47 CFR 22.401 - Description and purposes of developmental authorizations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... authorizations. 22.401 Section 22.401 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Developmental Authorizations § 22.401 Description and purposes of... technical suitability of antenna locations for stations in the Public Mobile Services; (b) Experimentation...

47 CFR 22.401 - Description and purposes of developmental authorizations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... authorizations. 22.401 Section 22.401 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Developmental Authorizations § 22.401 Description and purposes of... technical suitability of antenna locations for stations in the Public Mobile Services; (b) Experimentation...

49 CFR 572.71 - General description.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.71 General description. (a) The representative 6-year-old dummy consists of a drawings and specifications package that contains the following materials: (1) Technical drawings, specifications, and the parts list...

Assessment of patient satisfaction with pain management in small community inpatient and outpatient settings.

PubMed

Corizzo, C C; Baker, M C; Henkelmann, G C

2000-09-01

To describe patient outcomes (e.g., pain intensity and relief, satisfaction, expectations) and analgesic practices of healthcare providers for inpatients and outpatients in community hospital settings. Descriptive, correlational, and random sampling. Three community-based institutions in southeast Louisiana. 114 inpatients and outpatients with cancer-related or acute postoperative pain. Inpatients (n = 68) mostly were women and younger than 60 years of age. Outpatients (n = 46) mostly were men and older than 60 years of age. Both groups were predominantly well-educated and Caucasian. Subjects completed a modified version of the American Pain Society's Patient Satisfaction Survey. Researchers completed a chart audit tool reviewing analgesic prescriptive and administrative practices. Weak to moderately strong correlations existed for the relationships between the satisfaction variables and the pain intensity, pain relief, and expectation variables for all subjects. Satisfaction with current pain intensity was correlated most strongly with pain intensity and relief scores. Higher pain intensity and relief were related to lower satisfaction with current pain intensity. Regardless of setting or pain type, subjects experienced significant amounts of pain during a 24-hour period. Patient expectations for experiencing high levels of pain were realized, but expectations for significant pain relief were not. Institutional pain management programs that approach pain from a multidimensional perspective need to be developed. Continued education for healthcare professionals and patients is a vital part of this process.

'It feels like someone is hammering my feet': understanding pain and its management from the perspective of people with multiple sclerosis.

PubMed

Harrison, Anthony M; Bogosian, Angeliki; Silber, Eli; McCracken, Lance M; Moss-Morris, Rona

2015-04-01

Pain affects around 63% of people with multiple sclerosis (pwMS). Biomedical treatments demonstrate limited efficacy. More research is needed to understand pain from the individual's perspective in order to better inform a patient-centred approach that improves engagement, self-management and outcome. The objective of this paper is to explore pwMS' experience and responses to pain, and their perspectives on pain management. Twenty-five in-depth, semi-structured telephone interviews were conducted. Interviews were audiotaped, transcribed and analysed using an inductive thematic analysis approach with elements of grounded theory. Key themes included vivid descriptions of pain and beliefs that pain is unpredictable, a sign of damage and may worsen. Anger was a common emotional response. Two dominant pain management themes emerged: one related to pain reduction and another to acceptance. Those focusing on pain reduction appeared to engage in cycles in which they struggled with symptoms and experienced continued distress. Findings identify pain-related beliefs, emotional reactions and disparate pain-management attitudes. All may influence pwMS' responses to pain and what they ask of their clinicians. Uncovering pwMS' personal beliefs about pain, and introducing a broader biopsychosocial understanding of pain in the clinical context, may provide opportunities to rectify potentially unhelpful management choices and enhance pain acceptance. © The Author(s), 2014.

A Child's Concept of Pain: An International Survey of Pediatric Pain Experts.

PubMed

Pate, Joshua W; Hush, Julia M; Hancock, Mark J; Moseley, G Lorimer; Butler, David S; Simons, Laura E; Pacey, Verity

2018-01-15

A child's 'concept of pain' refers to how they understand what pain actually is, what function pain serves, and what biological processes are thought to underpin it. We aimed to determine pediatric pain experts' opinions of: (1) the importance and usefulness of assessing a child's concept of pain in clinical and/or research settings; (2) the usefulness of the content of items within currently published adult-targeted resources for assessing a child's concept of pain; and (3) important domains of a child's concept of pain to assess. Forty-nine pediatric pain experts (response rate = 75.4%) completed an online survey. Descriptive statistics and frequency of responses were analyzed. Experts from all included disciplines reported that assessing a child's concept of pain is important and useful both clinically and in a research setting (>80% reported very or extremely useful for each item). Experts considered that the content of 13 items from currently published adult-targeted resources was useful, but the wording was too complex for children aged 8-12 years. Experts considered that all seven of the proposed domains of a child's concept of pain was important to assess. The findings can be used to inform the development of an assessment tool for a child's concept of pain.

The Association of Musculoskeletal Pain with Bone Mineral Density in Patients with Parkinson's Disease.

PubMed

Choi, Seong-Min; Kim, Byeong C; Jung, Hyun-Jung; Yoon, Geum-Jin; Kang, Kyung Wook; Choi, Kang-Ho; Lee, Seung-Han; Park, Man-Seok; Kim, Myeong-Kyu; Cho, Ki-Hyun

2017-01-01

Pain and osteoporosis are common in Parkinson's disease (PD), and lower bone mineral density (BMD) or osteoporosis may be associated with an increased risk of reporting to have pain in the general population. The aim of this study was to determine whether there is an association between the pain subtypes and the BMD in patients with PD. We included 162 PD patients. Pain was assessed using the patients' descriptions, a structured interview, a detailed neurologic examination, and the Visual Analogue Scale. BMD was measured using dual energy X-ray absorptiometry scans. Of the 162 PD patients, 120 had chronic pain, while 42 reported no pain. The most prevalent type of pain was musculoskeletal, followed by radicular/neuropathic, dystonic, and central. PD patients with musculoskeletal pain had a lower BMD than PD patients without pain. Multivariate regression analysis showed that the low BMD of the lumbar spine, hip, and femoral neck were related to old age, female gender, low MBI, and the presence of musculoskeletal pain. PD patients with musculoskeletal pain have low BMD and are at risk for developing osteoporosis. If a PD patient has musculoskeletal pain and other risk factors related to low BMD, clinicians should consider screening for osteoporosis. © 2017 S. Karger AG, Basel.

Patient attitudes regarding healthcare utilization and referral: a descriptive comparison in African- and Caucasian Americans with chronic pain.

PubMed Central

Green, Carmen R.; Baker, Tamara A.; Ndao-Brumblay, S. Khady

2004-01-01

The purpose of this study was to evaluate healthcare utilization and referral patterns for pain management services in a racially and ethnically diverse population. A study-specific mail survey was directed at African- (N=324) and Caucasian Americans (N=300) receiving chronic pain treatment at a tertiary care pain center to address their healthcare access, referral, and utilization patterns. Overall, 46% (N=286) responded, with the majority of respondents being Caucasian Americans (57%) and women (68%). The majority (58%) reported asking their physicians to refer them to a pain physician. African Americans were more likely to report that chronic pain was a major reason for financial problems. They made significantly more visits to the emergency room for pain care. African Americans agreed more that ethnicity and culture affected access to healthcare and pain management. They also tended to agree more than Caucasian Americans that pain medication could not control pain. These results demonstrate significant differences in healthcare utilization, access, and attitudes amongst African- and Caucasian Americans receiving chronic pain management. In light of the socioeconomic and health consequences of chronic pain, these results suggest the need for further studies addressing variability in pain care access and utilization in diverse populations. PMID:14746352

Successful endoscopic removal of a rare, large impacted pancreatic duct stone using grasping forceps: A case report with video.

PubMed

Liu, Qin; Wang, Yiping; Zeng, Hongze; Hu, Bing

2018-04-01

As a main complication of chronic pancreatitis (CP), pancreatic duct stones (PDSs) are often associated with ductal obstruction resulting in increasing intraductal and parenchymal pressure and long-lasting pain. There are many methods for removing PDSs. However, for large stones, it is technically difficult to remove them entirely by endoscopic retrograde cholangiopancreatography (ERCP). A 57-year-old man presented with a chief complaint of severe epigastric pain radiating to his back 3 or 4 times annually for 2 years. The abdominal computed tomography scan revealed dilation of the proximal pancreatic duct with an irregular high-density calcification shadow located at the head of the pancreas. A pancreatic stent was placed initially by ERCP to relieve epigastric pain and alleviate symptom. Repeated ERCP was subsequently performed 2 months later to extract the impacted large pancreatic stone. By using grasping forceps, the huge coralloid stone (272 × 0 mm) was successfully extracted in an en bloc manner. Then, a 7-French × 5 cm plastic pancreatic stent was placed for 2 weeks. The patient was free of any pancreatic pain during the 2-year follow-up. Generally, for large or impacted pancreatic stones, endoscopic removal is technically difficult to achieve. Pancreatic stenting can be an effective method of alleviating abdominal pain and facilitating subsequent endoscopic lithoextraction. Extraction of large stones with grasping forceps can be an alternative approach instead of extracorporeal shock wave lithotripsy or surgery when stones are impacted at the papilla's orifice and partially protruding into the duodenal lumen.

Systematic mechanism-orientated approach to chronic pancreatitis pain

PubMed Central

Bouwense, Stefan AW; de Vries, Marjan; Schreuder, Luuk TW; Olesen, Søren S; Frøkjær, Jens B; Drewes, Asbjørn M; van Goor, Harry; Wilder-Smith, Oliver HG

2015-01-01

Pain in chronic pancreatitis (CP) shows similarities with other visceral pain syndromes (i.e., inflammatory bowel disease and esophagitis), which should thus be managed in a similar fashion. Typical causes of CP pain include increased intrapancreatic pressure, pancreatic inflammation and pancreatic/extrapancreatic complications. Unfortunately, CP pain continues to be a major clinical challenge. It is recognized that ongoing pain may induce altered central pain processing, e.g., central sensitization or pro-nociceptive pain modulation. When this is present conventional pain treatment targeting the nociceptive focus, e.g., opioid analgesia or surgical/endoscopic intervention, often fails even if technically successful. If central nervous system pain processing is altered, specific treatment targeting these changes should be instituted (e.g., gabapentinoids, ketamine or tricyclic antidepressants). Suitable tools are now available to make altered central processing visible, including quantitative sensory testing, electroencephalograpy and (functional) magnetic resonance imaging. These techniques are potentially clinically useful diagnostic tools to analyze central pain processing and thus define optimum management approaches for pain in CP and other visceral pain syndromes. The present review proposes a systematic mechanism-orientated approach to pain management in CP based on a holistic view of the mechanisms involved. Future research should address the circumstances under which central nervous system pain processing changes in CP, and how this is influenced by ongoing nociceptive input and therapies. Thus we hope to predict which patients are at risk for developing chronic pain or not responding to therapy, leading to improved treatment of chronic pain in CP and other visceral pain disorders. PMID:25574079

Space station systems analysis study. Part 3: Documentation. Volume 4: Supporting research and technology report

NASA Technical Reports Server (NTRS)

1977-01-01

A brief description of recommended supporting research and technology items resulting from the space station analysis study is provided. Descriptions include the title; the status with respect to the state of the art; the justification; the technical plan including objectives and technical approach; resource requirements categorized by manpower, specialized facilities, and funding in 1977 dollars; and also the target schedule. The goal is to provide high confidence in the solutions for the various functional system development problems, and to do so within a time period compatible with the overall evolutionary space construction base schedule.

An overlooked complication of the inguinal hernia repair: Dysejaculation

PubMed Central

Yılmaz, Hüseyin

2018-01-01

The objective of this study was to investigate the rate of post-herniorrhaphy dysejaculation in the current literature. A comprehensive search of PubMed, Medline, Google Scholar, and Google databases was performed using the keywords “groin hernia and chronic pain,” “inguinal hernia and chronic pain,” “dysejaculation,” and “ejaculatory pain.” The eligible studies were evaluated in terms of ejaculatory pain and surgical technique used. Ten studies with 122 patients were eligible for the analysis. The rate of ejaculatory pain for a total of 5521 patients was found to be 2.2%. The incidence of postoperative ejaculatory pain was found to be 2.1% following laparoscopic techniques and 1.1 % following open repair. Open techniques were not related to the increased frequency of dysejaculation. Sufficient data could not be obtained from the studies for the ejaculatory pain, and thus, no statistical evaluation was performed. Dysejaculation is a common cause of postoperative morbidity after inguinal hernia repair. Attention to technical details of the primary operation may reduce the incidence of dysejaculation. PMID:29756096

National Institute of Neurological Disorders and Stroke

MedlinePlus

... All News Technical Assistance Webinar for the BRAIN Initiative Diversity K99/R00 Tuesday, June 12, 2018 | Online ... View All Events Director's Corner The NIH HEAL Initiative and Pain Research Thursday, June 21, 2018 At ...

Pain control methods in use and perceived effectiveness by patients with Ehlers-Danlos syndrome: a descriptive study.

PubMed

Arthur, Karen; Caldwell, Karen; Forehand, Samantha; Davis, Keith

2016-01-01

The purpose of this study was to assess the pain control methods in use by patients who have Ehlers-Danlos Syndrome (EDS), a group of connective tissue disorders, and their perceived effectiveness. This descriptive study involved 1179 adults diagnosed with EDS who completed an anonymous on-line survey. The survey consisted of demographics information, the Patient Reported Outcomes Measurement Information System (PROMIS) Pain-Behavior, PROMIS Pain-Interference, and Neuro QOL Satisfaction with Social Roles and Activities scales, as well as a modified version of the Pain Management Strategies Survey. Respondents reported having to seek out confirmation of their EDS diagnosis with multiple healthcare providers, which implies the difficulty many people with EDS face when trying to gain access to appropriate treatment. Patients with EDS experience higher levels of pain interference and lower satisfaction with social roles and activities compared to national norms. Among the treatment modalities in this study, those perceived as most helpful for acute pain control were opioids, surgical interventions, splints and braces, avoidance of potentially dangerous activities and heat therapy. Chronic pain treatments rated as most helpful were opioids, splints or braces and surgical interventions. For methods used for both acute and chronic pain, those perceived as most helpful were opioids, massage therapies, splints or braces, heat therapy and avoiding potentially dangerous activities. EDS is a complex, multi-systemic condition that can be difficult to diagnose and poses challenges for healthcare practitioners who engage with EDS patients in holistic care. Improved healthcare provider knowledge of EDS is needed, and additional research on the co-occurring diagnoses with EDS may assist in comprehensive pain management for EDS patients. Ehlers-Danlos Syndrome (EDS) is a group of connective tissue disorders associated with defective production of collagen, which can dramatically reduce musculoskeletal functioning by symptoms of joint laxity and frequent dislocations eventually leading to disability. Respondents to an on-line survey reported having to seek out confirmation of their EDS diagnosis with multiple physicians, which implies the difficulty many people with EDS face when trying to gain access to appropriate treatment. Participants with EDS reported the most helpful methods for managing acute pain were opioids, surgical interventions, splints and braces, heat therapy, nerve blocks and physical therapy, while chronic pain was treated most effectively with opioids, heat therapy, splints or braces and surgical interventions.

[Effectiveness of education based on neuroscience in the treatment of musculoskeletal chronic pain].

PubMed

Cuenda-Gago, J D; Espejo-Antunez, L

2017-07-01

Chronic pain is one of the most frequent health, economic and social problems. Given this, numerous approaches have been described, one of which is pain neuroscience education. To examine the effectiveness of pain neuroscience education in the treatment of musculoskeletal disorders with chronic pain and to explore the impact of specific aspects of the technique on its effectiveness. Relevant studies published between 2000 and 2015 were identified by searching PubMed, Scopus and Web of Science. Studies identified by electronic searches were screened against a set of pre-defined inclusion criteria. PEDro and SIGN scales were used to evaluate the methodological quality of the included studies. Ten studies were included in this systematic review. The main outcomes that were measured were pain, disability, neurophysiology pain test, attitudes and beliefs, fear-avoidance beliefs, self-care, kinesiophobia, quality of life and algometry. The results suggest that pain neuroscience education is effective in the short term and medium/long term for pain relief, either alone or combined with multimodal treatment. It was also effective in normalizing cognitions about pain, fear-avoidance beliefs, and self-care. Despite some evidence for a positive effect in the short and medium/long term, the heterogeneity in the technical aspects used does not allow the obtaining of conclusive results.

Writing a technical note.

PubMed

Ng, K H; Peh, W C G

2010-02-01

A technical note is a short article giving a brief description of a specific development, technique or procedure, or it may describe a modification of an existing technique, procedure or device applicable to medicine. The technique, procedure or device described should have practical value and should contribute to clinical diagnosis or management. It could also present a software tool, or an experimental or computational method. Technical notes are variously referred to as technical innovations or technical developments. The main criteria for publication will be the novelty of concepts involved, the validity of the technique and its potential for clinical applications.

Teaching Leadership in Technical Programs at Community Colleges

ERIC Educational Resources Information Center

DeBlauw, Amanda L.; Daugherty, Jenny L.

2017-01-01

This descriptive study explored how community colleges are teaching leadership in technical programs. Leadership education curricular offerings were identified via a survey and selected programs reviewed. 68 Deans, Directors, or Chairpersons of a Business, Management, or Technology program completed the survey, representing 61 community colleges.…

Fox Valley Technical Institute Economic Development Plan.

ERIC Educational Resources Information Center

Fox Valley Technical Inst., Appleton, WI.

Designed as an operating blueprint for Fox Valley Technical Institute's (FVTI's) economic development efforts, this guide incorporates the necessary operation procedures, descriptions, and resources for those involved in FVTI's effort to assist existing businesses to expand and to attract new businesses to the area. Introductory material describes…

Proximal opening wedge osteotomy with wedge-plate fixation compared with proximal chevron osteotomy for the treatment of hallux valgus: a prospective, randomized study.

PubMed

Glazebrook, Mark; Copithorne, Peter; Boyd, Gordon; Daniels, Timothy; Lalonde, Karl-André; Francis, Patricia; Hickey, Michael

2014-10-01

Hallux valgus with an increased intermetatarsal angle is usually treated with a proximal metatarsal osteotomy. The proximal chevron osteotomy is commonly used but is technically difficult. This study compares the proximal opening wedge osteotomy of the first metatarsal with the proximal chevron osteotomy for the treatment of hallux valgus with an increased intermetatarsal angle. This prospective, randomized multicenter (three-center) study was based on the clinical outcome scores of the Short Form-36, the American Orthopaedic Foot & Ankle Society forefoot questionnaire, and the visual analog scale for pain, activity, and patient satisfaction. Subjects were assessed prior to surgery and at three, six, and twelve months postoperatively. Surgeon preference was evaluated based on questionnaires and the operative times required for each procedure. No significant differences were found for any of the patients' clinical outcome measurements between the two procedures. The proximal opening wedge osteotomy was found to lengthen, and the proximal chevron osteotomy was found to shorten, the first metatarsal. The intermetatarsal angles improved (decreased) significantly, from 14.8° ± 3.2° to 9.1° ± 2.9 (mean and standard deviation) after a proximal opening wedge osteotomy and from 14.6° ± 3.9° to 11.3° ± 4.0° after a proximal chevron osteotomy (p < 0.05 for both). Operative time required for performing a proximal opening wedge osteotomy is similar to that required for performing a proximal chevron osteotomy (mean and standard deviation, 67.1 ± 16.5 minutes compared with 69.9 ± 18.6 minutes; p = 0.510). Opening wedge and proximal chevron osteotomies have comparable radiographic outcomes and comparable clinical outcomes for pain, satisfaction, and function. The proximal opening wedge osteotomy lengthens, and the proximal chevron osteotomy shortens, the first metatarsal. The proximal opening wedge osteotomy was subjectively less technically demanding and was preferred by the orthopaedic surgeons in this study. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Acute pain in children and adults with sickle cell disease: management in the absence of evidence-based guidelines.

PubMed

Field, Joshua J; Knight-Perry, Jessica E; Debaun, Michael R

2009-05-01

Acute, vaso-occlusive pain is the most characteristic complication of sickle cell disease (SCD). Although there has been rigorous work examining the pathogenesis of vaso-occlusion, fewer studies have focused on approaches to the clinical management of acute pain. In this review, we will examine the epidemiology and management strategies of acute pain events and we will identify limitations in the best available studies. Most acute pain events in adults with SCD are managed at home without physician contact. Prior descriptions of the natural history of pain episodes from the Cooperative Study of Sickle Cell Disease relied on physician contact, limiting the generalizability of these findings to current practice. Patient-controlled analgesia has replaced on-demand therapy to become the standard for management of severe pain events in children and adults with SCD requiring hospital admission. Unfortunately, most clinical practice guidelines for the management of acute pain are not based on randomized clinical trials. As a result, our practice of pain management is primarily limited to expert opinion and inferences from observational studies. Additional clinical trials in management of acute pain in children and adults with SCD are critical for the development of evidence-based guidelines.

A subtype based analysis of urological chronic pelvic pain syndrome in men.

PubMed

Davis, Seth N P; Binik, Yitzchak M; Amsel, Rhonda; Carrier, Serge

2013-07-01

The current conceptualization of urological chronic pelvic pain syndrome in men recognizes a wide variety of pain, psychosocial, sexual and urological symptoms and markers that may contribute to decreased quality of life. Unfortunately, this syndrome is difficult to clearly define and treat due to heterogeneous symptom profiles. We systematically describe these heterogeneous symptoms and investigated whether they could be subtyped into distinct syndromes. A total of 171 men diagnosed with urological chronic pelvic pain syndrome completed validated questionnaires, a structured genital pain interview, digital pain threshold testing and urological assessment. Pain interview results are systematically presented as descriptive information. We used k-means cluster analysis to define subtypes. Seven homogenous, distinct clusters were defined, each with a remarkably different symptom presentation. These clusters were described and related to previous hypotheses of urological chronic pelvic pain syndrome etiology. These clusters may represent distinct subtypes of urological chronic pelvic pain syndrome that can be used to guide treatment more effectively. Defining subtypes may also improve our understanding of the underlying mechanisms of urological chronic pelvic pain syndrome. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Advanced reactor site feasibility evaluation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haynes, Mark; Owens, Martin; Southworth, Finis

The report provides a description of the project, summarizes the methodology and results for each task of the project, and ends with the overall project conclusions and recommendations. In addition, the report contains a descriptive index of the technical reports generated during the course of the project.

FINAL PROJECT REPORT - EVALUATION AND TESTING OF HTGR REACTOR BUILDING RESPONSE TO DEPRESSURIZATION ACCIDENTS

DOE Office of Scientific and Technical Information (OSTI.GOV)

ALLIANCE LIMITED, NGNP INDUSTRY

This report provides a description of the project, summarizes each phase of the project, and ends with project conclusions. In addition, the report contains a descriptive index of the technical reports generated during the course of the project.

49 CFR 572.141 - General description.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 3-year-Old Child Crash Test Dummy, Alpha Version § 572.141 General description. (a) The Hybrid III 3-year-old child dummy is described by the following materials: (1) Technical drawings and specifications package 210-0000 (refer to...

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

PubMed

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

2015-10-01

Research supports using nonverbal pain behaviors to identify pain in persons with dementia. It is unknown whether variations exist among ethnic groups in the expression of nonverbal pain behaviors in this special population. The purpose of this descriptive study was to examine ethnic differences in the presentation and intensity of nonverbal pain behaviors among African American, Caucasian, and Hispanic older adults with dementia when screened for pain by certified nursing assistants. Six certified nursing assistants were trained to review and score 28 video recordings of subjects with dementia for nonverbal pain behaviors using the Non-Communicative Patient's Pain Assessment Instrument. Chi-square was used to examine differences among ethnic groups with regard to the display of nonverbal pain behaviors, and ANOVA was used to evaluate differences in the intensity of overall pain across ethnic groups. Of the 168 assessments, pain words (28%), pain noises (29.8%), and pain faces (28%) were observed most often as indicators of pain. Rubbing, bracing, and restlessness were rarely noted. Chi-square analysis revealed ethnic differences in the expression of pain words (χ(2) = 19.167, p < .001). No significant differences were noted across ethnic groups with regards to overall pain intensity. These findings are the first to examine ethnic differences in nonverbal pain behaviors for older adults with dementia. However, future work should examine assessment tendencies of providers in a larger, more diverse sample. Copyright © 2015 American Society for Pain Management Nursing. All rights reserved.

A Descriptive Study of a Perioperative Pain Service Program

DTIC Science & Technology

1999-10-01

the Renaissance. Leading the forefront was Renee Descartes , a French mathematician. He described nerves as hollow tubes through which fine threads...Sensations had to interact with the mind or soul, which Descartes considered to be separate from the body and unaffected by external and mechanical...forces. Integration of the mind and body, according to Descartes , occurred within the pineal gland. Pain, therefore, was a Co-axial Narcotics 17 state

Chiropractic and CAM utilization: a descriptive review.

PubMed

Lawrence, Dana J; Meeker, William C

2007-01-22

To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

Pain treatment and its cost in old people with dementia: a descriptive analysis from the Registry of Dementias of Girona (ReDeGi).

PubMed

Calvó-Perxas, Laia; López-Pousa, Secundino; Turró-Garriga, Oriol; de Eugenio, Rosa; Linares, Marta; Fernández, Maria Del Mar; Castellanos, Mar; Casas, Isabel; Turón-Estrada, Antoni; Casadevall, Teresa; Coromina, Joan; Vilalta-Franch, Joan; Garre-Olmo, Josep

2013-05-01

Pain prevalence is high among elderly people, and equally prevalent in those with dementia. The aim of this study was to describe the use analgesics, as well as the cost of these treatments in old people with dementia. We used a cross-sectional design using 1186 cases registered by the Registry of Dementias of Girona from 2007 to 2008. All drugs were categorized following the Anatomic Therapeutic Chemical classification and grouped according to the World Health Organization (WHO) analgesic ladder steps. Descriptive statistical methods were used. Analgesics were prescribed to 78.6% (95% CI, 76.2-81.0) of the registered cases. Of them, 80.6% (95% CI, 78.0-83.2) were treated following step 1 of the WHO analgesic ladder, 16.8% (95% CI, 14.4-19.3) following step 2 and 2.6% (95% CI, 1.5-3.6) following step 3. Pain treatment in old people with dementia had a cost of 42.1 € per patient and year, with no significant differences depending on the subtype of dementia. The use of analgesics in our sample was not associated to age or to dementia severity, which are themselves risk factors for increased pain. Moreover, no differences were detected depending on the subtype of dementia.

Mechanism, Assessment and Management of Pain in Chronic Pancreatitis: Recommendations of a Multidisciplinary Study Group

PubMed Central

Anderson, Michelle A; Akshintala, Venkata; Albers, Kathryn M; Amann, Stephen T.; Belfer, Inna; Brand, Randall; Chari, Suresh; Cote, Greg; Davis, Brian M.; Frulloni, Luca; Gelrud, Andres; Guda, Nalini; Humar, Abhinav; Liddle, Rodger A.; Slivka, Adam; Gupta, Rachelle Stopczynski; Szigethy, Eva; Talluri, Jyothsna; Wassef, Wahid; Wilcox, C Mel; Windsor, John; Yadav, Dhiraj; Whitcomb, David C.

2015-01-01

Description Pain in patients with chronic pancreatitis (CP) remains the primary clinical complaint and source of poor quality of life. However, clear guidance on evaluation and treatment is lacking. Methods Pancreatic Pain working groups reviewed information on pain mechanisms, clinical pain assessment and pain treatment in CP. Levels of evidence were assigned using the Oxford system, and consensus was based on GRADE. A consensus meeting was held during PancreasFest 2012 with substantial post-meeting discussion, debate, and manuscript refinement. Results Twelve discussion questions and proposed guidance statements were presented. Conference participates concluded: Disease Mechanism: Pain etiology is multifactorial, but data are lacking to effectively link symptoms with pathologic feature and molecular subtypes. Assessment of Pain: Pain should be assessed at each clinical visit, but evidence to support an optimal approach to assessing pain character, frequency and severity is lacking. Management: There was general agreement on the roles for endoscopic and surgical therapies, but less agreement on optimal patient selection for medical, psychological, endoscopic, surgical and other therapies. Conclusions Progress is occurring in pain biology and treatment options, but pain in patients with CP remains a major problem that is inadequately understood, measured and managed. The growing body of information needs to be translated into more effective clinical care. PMID:26620965

Parents' Voice in Managing the Pain of Children with Cancer during Palliative Care.

PubMed

Mariyana, Rina; Allenidekania, Allenidekania; Nurhaeni, Nani

2018-01-01

Pain experienced by children can adversely affect their growth and development. Pain is a major health problem for cancer patients and remains an unresolved problem. To know how the experiences of mothers managing their children's pain during palliative care following cancer diagnosis. Pain experienced by children can adversely affect their growth and development. Using qualitative methods within a descriptive phenomenological approach, in-depth interviews were conducted with parents (mostly mothers) of eight children diagnosed with cancer. The data were collected using the snowball sampling method. Participants experienced in managing the pain of children with cancer. Analysis of the results identified 8 themes: the dimensions of pain experienced by children undergoing palliative care; mothers' physical and psychological responses; mothers' emotional responses; barriers encountered by mothers when taking care of their child at home; mothers' interventions to reduce their child's pain; mothers' efforts to distract their child from pain; giving encouragement when the child is in pain; and mothers' efforts and prayers to make their child comfort. It can be concluded that the child's pain is the main cause of mothers' stress and pressure and also affects the daily lives of mothers and children. Along with the most effective intervention, nurses need to provide mothers and children with adequate information about cancer pain.

A Child’s Concept of Pain: An International Survey of Pediatric Pain Experts

PubMed Central

Hush, Julia M.; Hancock, Mark J.; Moseley, G. Lorimer; Butler, David S.; Pacey, Verity

2018-01-01

A child’s ‘concept of pain’ refers to how they understand what pain actually is, what function pain serves, and what biological processes are thought to underpin it. We aimed to determine pediatric pain experts’ opinions of: (1) the importance and usefulness of assessing a child’s concept of pain in clinical and/or research settings; (2) the usefulness of the content of items within currently published adult-targeted resources for assessing a child’s concept of pain; and (3) important domains of a child’s concept of pain to assess. Forty-nine pediatric pain experts (response rate = 75.4%) completed an online survey. Descriptive statistics and frequency of responses were analyzed. Experts from all included disciplines reported that assessing a child’s concept of pain is important and useful both clinically and in a research setting (>80% reported very or extremely useful for each item). Experts considered that the content of 13 items from currently published adult-targeted resources was useful, but the wording was too complex for children aged 8–12 years. Experts considered that all seven of the proposed domains of a child’s concept of pain was important to assess. The findings can be used to inform the development of an assessment tool for a child’s concept of pain. PMID:29342976

Helicopter winchmens' experiences with pain management in challenging environments.

PubMed

van der Velde, J; Linehan, L; Cusack, S

2013-02-01

We conducted a survey of Irish Coast Guard Search and Rescue Helicopter winchmen to establish if their pain management scope of practice was adequate for their working environment. We surveyed 17 SAR personnel. 88% of winchmen have experienced scenarios where they were unable to reduce pain scores below 6/10. In seeking solutions within current Irish Prehospital Clinical Practice Guidelines, repeated descriptions of operations in extreme weather and sea conditions were given which were entirely incompatible with the dexterity required to break a glass ampoule and draw up solution, let alone site an intravenous (IV) line or administer a drug via intramuscular (IM) injection. Irish Coast Guard Search and Rescue Helicopter winchmen encounter polytrauma patients in extreme pain in uniquely challenging environments. Novel solutions to pain management within this tightly governed system are urgently required.

Fatigue and pain related to internet usage among university students.

PubMed

Dol, Kim Sang

2016-04-01

[Purpose] This study was performed to assess fatigue and pain levels related to internet usage among university students. The dominant regions of fatigue and pain in the body were examined, as well as differences in fatigue and pain levels among students. [Subjects and Methods] The study used a descriptive survey and a convenience sample of 378 students from a single university. The data were collected from January 1 to June 31, 2015. Fatigue and pain levels were measured using a visual analog scale. [Results] The average reported by the participants 4.7 and 3.7 levels of fatigue and pain, respectively. The regions with the highest fatigue scores were the eyes, followed by the neck, and shoulders. The regions with the highest pain scores were the neck, followed by the shoulders, and the waist. The results show that participants' fatigue and pain levels depended on the duration of their internet use per day. [Conclusion] These findings indicate that control of internet usage time is needed to maintain the well-being of university students who use the internet.

Intrathecal Analgesia and Palliative Care: A Case Study

PubMed Central

Salins, Naveen S; Crawford, Gregory B

2010-01-01

Intrathecal analgesia is an interventional form of pain relief with definite advantages and multiple complications. Administration of intrathecal analgesia needs a good resource setting and expertise. Early complications of intrathecal analgesia can be very distressing and managing these complications will need a high degree of knowledge, technical expertise and level of experience. Pain control alone cannot be the marker of quality in palliative care. A holistic approach may need to be employed that is more person and family oriented. PMID:20859471

Mini-open lateral retroperitoneal lumbar spine approach using psoas muscle retraction technique. Technical report and initial results on six patients.

PubMed

Aghayev, Kamran; Vrionis, Frank D

2013-09-01

The main aim of this paper was to report reproducible method of lumbar spine access via a lateral retroperitoneal route. The authors conducted a retrospective analysis of the technical aspects and clinical outcomes of six patients who underwent lateral multilevel retroperitoneal interbody fusion with psoas muscle retraction technique. The main goal was to develop a simple and reproducible technique to avoid injury to the lumbar plexus. Six patients were operated at 15 levels using psoas muscle retraction technique. All patients reported improvement in back pain and radiculopathy after the surgery. The only procedure-related transient complication was weakness and pain on hip flexion that resolved by the first follow-up visit. Psoas retraction technique is a reliable technique for lateral access to the lumbar spine and may avoid some of the complications related to traditional minimally invasive transpsoas approach.

Percutaneous endoscopic intra-annular subligamentous herniotomy for large central disc herniation: a technical case report.

PubMed

Lee, Sang-Ho; Choi, Kyung-Chul; Baek, Oon Ki; Kim, Ho Jin; Yoo, Seung-Hwa

2014-04-01

Technical case report. To describe the novel technique of percutaneous endoscopic herniotomy using a unilateral intra-annular subligamentous approach for the treatment of large centrally herniated discs. Open discectomy for large central disc herniations may have poor long-term prognosis due to heavy loss of intervertebral disc tissue, segmental instability, and recurrence of pain. Six consecutive patients who presented with back and leg pain, and/or weakness due to a large central disc herniation were treated using percutaneous endoscopic herniotomy with a unilateral intra-annular subligamentous approach. The patients experienced relief of symptoms and intervertebral disc spaces were well maintained. The annular defects were noted to be in the process of healing and recovery. Percutaneous endoscopic unilateral intra-annular subligamentous herniotomy was an effective and affordable minimally invasive procedure for patients with large central disc herniations, allowing preservation of nonpathological intradiscal tissue through a concentric outer-layer annular approach.

76 FR 11414 - Defense Federal Acquisition Regulation Supplement; Independent Research and Development Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-02

... Acquisition Regulation Supplement; Independent Research and Development Technical Descriptions (DFARS Case... (DFARS) to require contractors to report independent research and development (IR&D) projects generating... the address shown below on or before May 2, 2011, to be considered in the formation of the final rule...

Student Flow Model SFM-IA: System Documentation. Technical Report 41B. Preliminary Edition.

ERIC Educational Resources Information Center

Busby, John C.; Johnson, Richard S.

Technical specifications, operating procedures, and reference information for the National Center for Higher Education Management Systems' (NCHEMS) Student Flow Model (SFM) computer programs are presented. Included are narrative descriptions of the system and its modules, specific program documentation for each of the modules, system flowcharts,…

Project DIVIDE Instrument Development. Technical Report # 0810

ERIC Educational Resources Information Center

Ketterlin-Geller, Leanne; Jung, Eunju; Geller, Josh; Yovanoff, Paul

2008-01-01

In this technical report, we describe the development of cognitive diagnostic test items that form the basis of the diagnostic system for Project DIVIDE (Dynamic Instruction Via Individually Designed Environments). The construct underlying the diagnostic test is division of fractions. We include a description of the process we used to identify the…

10 CFR 52.17 - Contents of applications; technical information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... NUCLEAR POWER PLANTS Early Site Permits § 52.17 Contents of applications; technical information. (a) For..., and thermal power level of the facilities, or range of possible facilities, for which the site may be... forth the requirements for quality assurance programs for nuclear power plants. The description of the...

10 CFR 52.17 - Contents of applications; technical information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... NUCLEAR POWER PLANTS Early Site Permits § 52.17 Contents of applications; technical information. (a) For..., and thermal power level of the facilities, or range of possible facilities, for which the site may be... forth the requirements for quality assurance programs for nuclear power plants. The description of the...

10 CFR 52.17 - Contents of applications; technical information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... NUCLEAR POWER PLANTS Early Site Permits § 52.17 Contents of applications; technical information. (a) For..., and thermal power level of the facilities, or range of possible facilities, for which the site may be... forth the requirements for quality assurance programs for nuclear power plants. The description of the...

10 CFR 52.17 - Contents of applications; technical information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... NUCLEAR POWER PLANTS Early Site Permits § 52.17 Contents of applications; technical information. (a) For..., and thermal power level of the facilities, or range of possible facilities, for which the site may be... forth the requirements for quality assurance programs for nuclear power plants. The description of the...

Vocational-Technical Marine Career Opportunities in Texas.

ERIC Educational Resources Information Center

Hollin, Dewayne

Presented are background information and descriptions of jobs in various Texas marine industries, as well as a summary of the training required for particular positions. Since the emphasis is upon vocational-technical training for immediate job placement, most opportunities discussed require a high school diploma and some on-the-job education.…

Apprenticeship and CETA Technical Assistance Guide.

ERIC Educational Resources Information Center

Employment and Training Administration (DOL), Washington, DC.

Intended to encourage CETA (Comprehensive Employment and Training Act) prime sponsors and apprenticeship program sponsors to integrate their activities, this technical assistance guide demonstrates many ways the two can unite at the local level to train and place people for employment. A general description of CETA is provided explaining the shift…

Technical assessment of PSSC-supported experiments and demonstrations

NASA Technical Reports Server (NTRS)

1978-01-01

A description of CTS and ATS short-term and long-term satellite demonstration supported through usage of a satellite communication ground station complex is presented. User assessments about the programmatic impact of their demonstrations and experiments were summarized. The technical planning and coordination process involved in satellite utilization is also presented.

76 FR 31356 - Notice of Proposed Information Collection for Public Comment; Technical Assistance Experience...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-31

... Matrices AGENCY: Office of the Community Planning and Development. ACTION: Notice of proposed information..., Expertise, and Awards Received Matrices. Description of the need for the information proposed: The Technical Assistance Experience, Expertise, and Awards Received Matrices will allow the Office of Special Needs...

47 CFR 22.401 - Description and purposes of developmental authorizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... technical suitability of antenna locations for stations in the Public Mobile Services; (b) Experimentation leading to the potential development of a new Public Mobile Service or technology; or, (c) Stations... CARRIER SERVICES PUBLIC MOBILE SERVICES Developmental Authorizations § 22.401 Description and purposes of...

Minnesota Department of Education Agricultural Education Program Descriptions 01.0000-01.9095

ERIC Educational Resources Information Center

Minnesota Department of Education, 2004

2004-01-01

This document provides a brief compilation of descriptions of agricultural education programs linked to Career and Technical Education (CTE) initiative in Minnesota. Agriculture Exploration courses focus on the animal sciences, plant sciences, natural resource sciences, agricultural business and marketing, and leadership development. Agribusiness…

Treatment Seeking and Self-Constructed Explanations of Pain and Pain Management Strategies Among Adolescents with Temporomandibular Disorder Pain.

PubMed

Nilsson, Ing-Marie; Willman, Ania

2016-01-01

To explore adolescents' explanations of their temporomandibular disorder (TMD) pain, their pain management strategies for TMD pain, and their treatment-seeking behavior. One-on-one interviews were conducted with 21 adolescents aged 15 to 19 years who had TMD pain and followed a semistructured interview guide. Subjects were strategically selected from patients referred to an orofacial pain clinic. All participants had been examined and received a pain diagnosis based on the Research Diagnostic Criteria for TMD. The interviews focused on the adolescents' experiences of TMD pain, their strategies for handling pain, and how they seek care. The interviews were recorded, transcribed verbatim, and analyzed using qualitative manifest content analysis. Qualitative manifest content analysis revealed two categories: (1) self-constructed explanations, with three subcategories (situation-based explanatory model, physical/biologic model, and psychological explanatory model); and (2) pain management strategies, with four subcategories (social support, treatment, relaxation/rest, and psychological strategies). Adolescents used physical activities and psychological and pharmacologic treatment to manage pain. Reasons for seeking treatment were to be cured, to obtain an explanation for their pain, and because their symptoms bother others. Adolescents living with TMD pain develop self-constructed explanations and pain management strategies. With access to these descriptions, dentists can be better prepared to have a dialogue with their adolescent patients about their own explanations of pain, the nature of pain, and in which situations the pain appears. Dentists can also explore adolescent patients' pain management strategies and perhaps also suggest new treatment strategies at an earlier stage.

Intraarticular Pulsed Radiofrequency to Treat Refractory Lumbar Facet Joint Pain in Patients with Low Back Pain.

PubMed

Chang, Min Cheol; Cho, Yun-Woo; Ahn, Da Hyun; Do, Kyung Hee

2018-04-01

Many treatment techniques have been used for refractory lumbar facet joint pain; however, their efficacy has been controversial. In this study, we investigated the clinical efficacy and safety of intra-articular pulsed radiofrequency for the treatment of refractory lumbar facet joint pain in patients with low back pain. Twenty patients with refractory lumbar facet joint pain were recruited, and each patient was treated via intra-articular pulsed radiofrequency. The treatment effects were measured with a numerical rating scale, and the technical accuracy of intra-articular pulsed radiofrequency treatment was evaluated independently by 2 radiologists. Any adverse events or complications also were checked. We performed intra-articular pulsed radiofrequency treatment at 48 levels of the lumbar facet joints in 20 patients (5 men and 15 women; mean age, 64.50 ± 10.65 years) with refractory lumbar facet joint pain. Pain scores were significantly reduced at 1 month, 3 months, and 6 months after treatment (P < 0.05). The face validity revealed good intraarticular pulsed radiofrequency results in all 20 patients, without any serious adverse effects. Treatment using intra-articular pulsed radiofrequency is an alternative to other techniques in patients with refractory lumbar facet joint pain. Copyright © 2018 Elsevier Inc. All rights reserved.

[Myofascial pain syndrome--frequent occurrence and often misdiagnosed].

PubMed

Pongratz, D E; Späth, M

1998-09-30

Myofascial pain syndrome (MPS) is a very common localized--sometimes also polytopic--painful musculoskeletal condition associated with trigger points, for which, however, diagnostic criteria established in well-designed studies are still lacking. These two facts form the basis for differentiating between MPS and the fibromyalgia syndrome. The difference between trigger points (MPS) and tender points (fibromyalgia) is of central importance--not merely in a linguistic sense. A knowledge of the signs and symptoms typically associated with a trigger point often obviates the need for time-consuming and expensive technical diagnostic measures. The assumption that many cases of unspecific complaints affecting the musculoskeletal system may be ascribed to MPS makes clear the scope for the saving of costs.

Pain Sensitivity Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case Control Study

PubMed Central

Greenspan, Joel D.; Slade, Gary D.; Bair, Eric; Dubner, Ronald; Fillingim, Roger B.; Ohrbach, Richard; Knott, Charlie; Mulkey, Flora; Rothwell, Rebecca; Maixner, William

2011-01-01

Many studies report that people with temporomandibular disorders (TMD) are more sensitive to experimental pain stimuli than TMD-free controls. Such differences in sensitivity are observed in remote body sites as well as in the orofacial region, suggesting a generalized upregulation of nociceptive processing in TMD cases. This large case-control study of 185 adults with TMD and 1,633 TMD-free controls measured sensitivity to painful pressure, mechanical cutaneous, and heat stimuli, using multiple testing protocols. Based on an unprecedented 36 experimental pain measures, 28 showed statistically significantly greater pain sensitivity in TMD cases than controls. The largest effects were seen for pressure pain thresholds at multiple body sites and cutaneous mechanical pain threshold. The other mechanical cutaneous pain measures and many of the heat pain measures showed significant differences, but with lesser effect sizes. Principal component analysis (PCA) of the pain measures derived from 1,633 controls identified five components labeled: (1) heat pain ratings, (2) heat pain aftersensations and tolerance, (3) mechanical cutaneous pain sensitivity, (4) pressure pain thresholds, and (5) heat pain temporal summation. These results demonstrate that, compared to TMD-free controls, chronic TMD cases are more sensitive to many experimental noxious stimuli at extra-cranial body sites, and provides for the first time the ability to directly compare the case-control effect sizes of a wide range of pain sensitivity measures. PMID:22074753

Initiating pain and palliative care outpatient services for the suburban underserved in Montgomery County, Maryland: Lessons learned at the NIH Clinical Center and MobileMed.

PubMed

Aggarwal, Sunil K; Ghosh, Amrita; Cheng, M Jennifer; Luton, Kathleen; Lowet, Peter F; Berger, Ann

2016-08-01

With the ongoing expansion of palliative care services throughout the United States, meeting the needs of socioeconomically marginalized populations, as in all domains of healthcare, continues to be a challenge. Our specific aim here was to help meet some of these needs through expanding delivery of pain and palliative care services by establishing a new clinic for underserved patients and collecting descriptive data about its operation. In November of 2014, the National Institutes of Health Clinical Center's Pain and Palliative Care Service (PPCS) launched a bimonthly offsite pain and palliative care outpatient clinic in collaboration with Mobile Medical Care Inc. (MobileMed), a private not-for-profit primary care provider in Montgomery County, Maryland, serving underserved area residents since 1968. Staffed by NIH hospice and palliative medicine clinical fellows and faculty, the clinic provides specialty pain and palliative care consultation services to patients referred by their primary care healthcare providers. A patient log was maintained, charts reviewed, and referring providers surveyed on their satisfaction with the service. The clinic had 27 patient encounters with 10 patients (6 males, 4 females, aged 23-67) during its first 7 months of operation. The reason for referral for all but one patient was chronic pain of multiple etiologies. Patients had numerous psychosocial stressors and comorbidities. All primary care providers who returned surveys (n = 4) rated their level of satisfaction with the consultation service as "very satisfied" or "extremely satisfied." This brief descriptive report outlines the steps taken and logistical issues addressed to launch and continue the clinic, the characteristics of patients treated, and the results of quality-improvement projects. Lessons learned are highlighted and future directions suggested for the clinic and others that may come along like it.

Low-Dose Ketamine Infusion for Adjunct Management during Vaso-occlusive Episodes in Adults with Sickle Cell Disease: A Case Series.

PubMed

Palm, Nicole; Floroff, Catherine; Hassig, Tanna B; Boylan, Alice; Kanter, Julie

2018-05-23

The optimal management of recurrent painful episodes in individuals living with sickle cell disease (SCD) remains unclear. Currently, the primary treatment for these episodes remains supportive, using fluids and intravenous opioid and anti-inflammatory medications. Few reports have described the use of adjunct subanesthetic doses of ketamine to opioids for treatment of refractory pain in SCD. This article reports a retrospective case series of five patients admitted to the intensive care unit (ICU) with prolonged vaso-occlusive episodes (VOEs). Patients were treated with a continuous-infusion of low-dose ketamine (up to 5 µg/kg/min) after insufficient pain control with opioid analgesic therapy. Outcomes studied included impact on opioid analgesic use, a description of ketamine dosing strategy, and an analysis of adverse events due to opioid or ketamine analgesia. Descriptive statistics are provided. During ketamine infusion, patients experienced a lower reported pain score (mean numeric rating scale [NRS] score 7.2 vs. 6.4), reduced opioid-induced adverse effects, and decreased opioid dosing requirements (median reduction of 90 mg morphine equivalents per patient). The average duration of severe pain during admission prior to ketamine therapy was 8 days. Only one of five patients reported an adverse effect (vivid dreams) secondary to ketamine infusion. The Richmond Agitation Sedation Scale (RASS) was assessed throughout therapy, with only one patient experiencing light drowsiness. Low-dose ketamine infusion may be considered as an adjunct analgesic agent in patients with vaso-occlusive episodes who report continued severe pain despite high-dose opioid therapy, particularly those experiencing opioid-induced adverse effects.

Pain perception of children undergoing nasendoscopy for investigation of voice and resonance disorders.

PubMed

Hay, Imogen; Oates, Jennifer; Giannini, Alessandra; Berkowitz, Robert; Rotenberg, Brian

2009-05-01

The primary objective of this descriptive and correlational study was to determine the level of pain and discomfort perceived by children undergoing nasendoscopy for investigation of voice and resonance disorders. The secondary objective was to explore whether gender, age, previous experience of painful or distressing medical procedures, and previous experience of nasendoscopy influenced the perception of pain during nasendoscopy. Twenty-three children self-reported the degree of pain perceived during nasendoscopy using the Wong-Baker Faces Pain Rating Scale. Parents also used this scale to rate their child's perceived pain. Otolaryngologists and speech pathologists rated the intensity and frequency of observed pain-related behaviors using the Child-Adult Medical Procedure Interaction Scale-Revised and the Procedure Behavior Checklist. Children perceived the procedure, on average, to be moderately painful, as did their parents. Only two children reported perceiving no pain during the procedure. The most frequently observed pain-related behaviors were muscle tension (86.96%), physical resistance (69.57%), requiring physical restraint (60.87%), crying (43.48%), and expressions of verbal pain (39.13%). No significant correlations were found between self-reported pain or observed pain and the variables of age, gender, previous experience of nasendoscopy, and previous experience of painful or distressing medical procedures, although children aged 4-7 years reported significantly more pain than children aged 8-18 years. Most children perceive nasendoscopy to be painful to some degree. This perceived pain occurred in conjunction with several observable pain-related behaviors that have the potential to interfere with the success of the procedure.

Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey.

PubMed

Schmidt, Carsten Oliver; Raspe, Heiner; Pfingsten, Michael; Hasenbring, Monika; Basler, Heinz Dieter; Eich, Wolfgang; Kohlmann, Thomas

2007-08-15

A population-based cross-sectional multiregion postal survey. To provide a descriptive epidemiology of the prevalence and severity of back pain in German adults and to analyze sociodemographic correlates for disabling back pain within and across regions. Back pain is a leading health problem in Germany. However, comprehensive population-based evidence on the severity of back pain is still fragmentary for this country. Despite earlier findings concerning large prevalence differences across regions, systematic explanations remain to be ascertained. Questionnaire data were collected for 9263 subjects in 5 German cities and regions (population-based random samples, postal questionnaire). Point, 1-year, and lifetime prevalence were assessed using direct questions, and graded back pain was determined using the Graded Chronic Pain Scale. Poststratification was applied to adjust for cross-regional sociodemographic differences. Point-prevalence was 37.1%, 1-year prevalence 76.0%, and lifetime prevalence 85.5%. A substantial minority had severe (Grade II, 8.0%) or disabling back pain (Grade III-IV, 11.2%). Subjects with a low educational level reported substantially more disabling back pain. This variable was an important predictor for large cross-regional differences in the burden of back pain. Back pain is a highly prevalent condition in Germany. Disabling back pain in this country may be regarded as part of a social disadvantage syndrome. Educational level should receive greater attention in future cross-regional comparisons of back pain.

[Anxiety and depression in patients with chronic pain: neuropathic and nociceptive].

PubMed

Morales-Vigil, Tania; Alfaro-Ramírez del Castillo, Olga Isabel; Sánchez-Román, Sofía; Guevara-López, Uriah; Vázquez-Pineda, Fernando

2008-01-01

To describe and compare anxiety and depression symptoms between two group patients with neuropathic and nociceptive pain those arrive for first time to a clinic of pain. Non-experimental, exploratory and descriptive design. Seventy-eight patients that arrive the first time to a clinic of pain were evaluated; those patients were divided in two groups: neuropathic pain with 44 patients and nociceptive pain with 34 patients. To evaluate anxiety and depression we use the Anxiety and Depression Scale (HAD), this scale is adapted and validated in Mexico. From the 78 patients in the study, the 76.9% were female and 23.1% were male. The age average was (56.9 +/- 16.8 year-old for neuropathic pain and 63.1 +/- 17.2 year-old for nociceptive pain). The reliability of the scale HAD was evaluated by the Chronbach's alpha analysis with an r = 0.826. There was no significance difference in anxiety and depression between types of pain, but after analyzing all of the patients we found that anxiety was more frequent than depression p < 0.0001. Independently of the algological diagnosis, patients presented almost the same affective symptoms.

Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: a mixed-methods approach.

PubMed

Eaton, Linda H; Meins, Alexa R; Mitchell, Pamela H; Voss, Joachim; Doorenbos, Ardith Z

2015-03-01

To describe evidence-based practice (EBP) beliefs and behaviors of nurses who provide cancer pain management. Descriptive, cross-sectional with a mixed-methods approach. Two inpatient oncology units in the Pacific Northwest. 40 RNs.
 Data collected by interviews and web-based surveys. EBP beliefs, EBP implementation, evidence-based pain management. Nurses agreed with the positive aspects of EBP and their implementation ability, although implementation level was low. They were satisfied with their pain management practices. Oncology nursing certification was associated with innovativeness, and innovativeness was associated with EBP beliefs. Themes identified were (a) limited definition of EBP, (b) varied evidence-based pain management decision making, (c) limited identification of evidence-based pain management practices, and (d) integration of nonpharmacologic interventions into patient care. Nurses' low level of EBP implementation in the context of pain management was explained by their trust that standards of care and medical orders were evidence-based. Nurses' EBP beliefs and behaviors should be considered when developing strategies for sustaining evidence-based pain management practices. Implementation of the EBP process by nurses may not be realistic in the inpatient setting; therefore, hospital pain management policies need to be evidence-based and reinforced with nurses.

Neck pain in children: a retrospective case series.

PubMed

Cox, Jocelyn; Davidian, Christine; Mior, Silvano

2016-09-01

Spinal pain in the paediatric population is a significant health issue, with an increasing prevalence as they age. Paediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning. A retrospective chart review was used to describe chiropractic management of paediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed. Fifty paediatric neck pain patient files were analysed. Patients' age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented. Paediatric mechanical neck pain appears to be successfully managed by chiropractic care. Spinal manipulative therapy appears to benefit paediatric mechanical neck pain resulting from day-today activities with no reported serious adverse events. Results can be used to inform clinical trials assessing effectiveness of manual therapy in managing paediatric mechanical neck pain.

Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.

PubMed

Keefe, Francis J; Main, Chris J; George, Steven Z

2018-05-01

There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity. Since 2011, the interest in PIP seems to be growing, as evidenced by its use in large trials, inclusion in scientific conferences, increasing evidence base, and expansion to other musculoskeletal pain conditions. Primary care physicians and physical therapists have delivered PIP as part of a stratified care approach involving screening and targeting of treatment for people at high risk for continued pain-associated disability. Furthermore, PIP is consistent with recent national priorities emphasizing nonpharmacological pain management options. In this perspective, PIP techniques that range in complexity are described, considerations for implementation in clinical practice are offered, and future directions that will advance the understanding of PIP are outlined.

State Competencies for Writing: Grades K-6. Technical Note.

ERIC Educational Resources Information Center

Lawlor, Joseph

This paper contains descriptions of mandated minimum competency documents from seven states: Florida, Georgia, Louisiana, Michigan, Oklahoma, Tennessee, and Texas. Each description provides a picture of the general nature of the state requirements and a discussion of the specific writing skills requirements. The procedures used to compile a…

State Minimum Competencies for High School Graduation. Technical Note.

ERIC Educational Resources Information Center

Lawlor, Joseph

This paper contains descriptions of mandated minimum competency programs in 13 states: Connecticut, Delaware, Georgia, Hawaii, Idaho, Kansas, Missouri, New Jersey, New York, North Carolina, South Carolina, Texas, and Vermont. Each description provides the skills assessed in the state, the assessment instruments used, and the overall purposes of…

40 CFR 161.160 - Description of materials used to produce the product.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Chemistry Data Requirements § 161.160 Description of materials used to produce the product. The following... composition (and, if requested by the Agency, chemical and physical properties) of the ingredient, including a..., chemical or physical properties) of the starting material, including a copy of all technical specifications...

40 CFR 161.160 - Description of materials used to produce the product.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Chemistry Data Requirements § 161.160 Description of materials used to produce the product. The following... composition (and, if requested by the Agency, chemical and physical properties) of the ingredient, including a..., chemical or physical properties) of the starting material, including a copy of all technical specifications...

40 CFR 161.160 - Description of materials used to produce the product.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Chemistry Data Requirements § 161.160 Description of materials used to produce the product. The following... composition (and, if requested by the Agency, chemical and physical properties) of the ingredient, including a..., chemical or physical properties) of the starting material, including a copy of all technical specifications...

40 CFR 161.160 - Description of materials used to produce the product.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Chemistry Data Requirements § 161.160 Description of materials used to produce the product. The following... composition (and, if requested by the Agency, chemical and physical properties) of the ingredient, including a..., chemical or physical properties) of the starting material, including a copy of all technical specifications...

Systems Development at the Grom Hayes Library.

ERIC Educational Resources Information Center

Yother, Larry W.

1987-01-01

Details the "painful" history, development, and progress of a "home-grown" library automation system at the Hartford State Technical College; describes several of the most common activities generated from menus; and looks at future prospects of the system. (Author/CLB)

Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

PubMed

Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

2016-01-01

Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Retrospective study. This study was conducted at the imaging department of a 1,409 bed university hospital. Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Some of the limitations of our study include that it represents a single institution. The low number of infiltrations included in this study, for this guidance procedure, is another bias. This ultrasound-guided infiltration technique appears to be feasible, safe, non-ionizing, and fast when targeting the greater occipital nerve in its intermediate portion. This imaging guidance modality should be used in routine clinical practice. Greater occipital nerve, infiltration, ultrasound guidance, corticosteroids, occipital neuralgia, craniofacial pain syndrome.

Technical information report: Plasma melter operation, reliability, and maintenance analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hendrickson, D.W.

1995-03-14

This document provides a technical report of operability, reliability, and maintenance of a plasma melter for low-level waste vitrification, in support of the Hanford Tank Waste Remediation System (TWRS) Low-Level Waste (LLW) Vitrification Program. A process description is provided that minimizes maintenance and downtime and includes material and energy balances, equipment sizes and arrangement, startup/operation/maintence/shutdown cycle descriptions, and basis for scale-up to a 200 metric ton/day production facility. Operational requirements are provided including utilities, feeds, labor, and maintenance. Equipment reliability estimates and maintenance requirements are provided which includes a list of failure modes, responses, and consequences.

Seeking Chronic Pain Relief: A Hermeneutic Exploration.

PubMed

Smith, Crystal Lederhos; Severtsen, Billie; Vandermause, Roxanne; Barbosa-Leiker, Celestina; Wilson, Marian; Roll, John

2018-06-21

In the United States, chronic pain is experienced by over 39.4 million adults, many of whom are treated with opioid pain medications. This research presents an interpretation of the experience of seeking pain relief for a group of people taking opioid pain medications whose pain is not adequately controlled. A concurrent embedded mixed-methods design was used, including a Heideggerian hermeneutic qualitative approach that focuses on the participants' perceptions as a vehicle for understanding the phenomenon of seeking pain relief with descriptive quantitative data in a supporting role. Thirteen interviews and 15 surveys were analyzed, all of which met the following criteria: (1) self-reported chronic pain (persistent pain lasting a minimum of six months), (2) current use of prescription opioid medications, (3) pain not successfully controlled. The analysis revealed a paradox, which we describe as being lost/finding myself in the health care system. This paradox became the overarching pattern of experience that subsumed several dynamic, overlapping practices described in the patterns: (1) seeking relief as suffering; (2) being classified as an addict but not an addict; (3) living with pain as remembering; and (4) experiencing treatment modalities as fickle possibilities. Explication of and interpretive commentary on these patterns shift the focus from drug seeking to pain relief seeking behaviors in chronic pain sufferers. Such a shift could change the manner in which providers work with chronic pain sufferers to find appropriate treatment modalities. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Barriers to Optimal Pain Management in Aged Care Facilities: An Australian Qualitative Study.

PubMed

Veal, Felicity; Williams, Mackenzie; Bereznicki, Luke; Cummings, Elizabeth; Thompson, Angus; Peterson, Gregory; Winzenberg, Tania

2018-04-01

Up to 80% of residents in aged care facilities (ACFs) experience pain, which is often suboptimally managed. The purpose of this study was to characterize pain management in ACFs and identify the barriers to optimal pain management. This exploratory descriptive qualitative study used semistructured interviews in five Southern Tasmania, Australian ACFs. Interviewees included 23 staff members (18 nurses and 5 facility managers) and were conducted from September to November 2015. Interviews included questions about how pain was measured or assessed, what happened if pain was identified, barriers to pain management, and potential ways to overcome these barriers. Interviewees noted that there were no formal requirements regarding pain assessment at the ACFs reviewed; however, pain was often informally assessed. Staff noted the importance of adequate pain management for the residents' quality of life and employed both nonpharmacologic and pharmacologic techniques to reduce pain when identified. The barriers to optimal pain management included difficulty identifying and assessing pain, residents' resistance to reporting pain and/or taking medications, and communication barriers between the nursing staff and GPs. Staff interviewed were dedicated to managing residents' pain effectively; however, actions in a number of areas could improve resident outcomes. These include a more consistent approach to documenting pain in residents' progress notes and improving nurse-GP communications to ensure that new or escalating pain is identified and expedient changes can be made to the resident's management. Additionally, resident, family, nurse, and carer education, conducted within the facilities on a regular basis, could help improve the pain management of residents. Copyright © 2017. Published by Elsevier Inc.

How adolescents experience and cope with pain in daily life: a qualitative study on ways to cope and the use of over-the-counter analgesics

PubMed Central

Lagerløv, Per; Rosvold, Elin Olaug; Holager, Tanja; Helseth, Sølvi

2016-01-01

Objective The aim of this study was to describe how different adolescents experience and manage pain in their daily life, with a focus on their use of over-the-counter analgesics. More specifically, the aim was to explore different patterns among the adolescents in pain descriptions, in the management of pain, in relationships with others, and in their daily life. Design Qualitative semistructured interviews on experiences with pain, pain management and involvement of family and friends during pain. Pain and stress management strategies and attachment theory will be in focus for interpretations. Participants and setting 25 participants aged 15–16-years from six different junior high schools, both genders, with and without immigrant background were interviewed at their local schools in Norway. Results We identified 4 groups of adolescents with similarities in attitudes and management strategies to pain: ‘pain is manageable’, ‘pain is communicable’, ‘pain is inevitable’ and ‘pain is all over’. The participants within each group differed in how they engaged their parents in pain; how they perceived, communicated and managed pain; and how they involved emotions and used over-the-counter analgesics. Conclusions The adolescents’ different involvement with the family during pain related to their pain perception and management. Knowledge of the different ways of approaching pain is important when supporting adolescents and may be a subject for further research on the use of over-the-counter analgesics in the family. PMID:26932141

Technical books and monographs. 1979 compilation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This booklet lists technical books and monographs published since the issuance of Technical Books and Monographs, 1978 Catalog, a bibliography of books and monographs sponsored by the US Department of Energy (DOE) or by one of the earlier organizations that were brought together to form DOE. In general, information for each published book, and for each book in press when known, includes title, author and author affiliation, publisher and publication date, page count, size of book, price, availability information if the book is not available from the publisher, Library of Congress card number, International Standard Book Number (ISBN), a briefmore » descriptive statement concerning the book, and a list or a description of the contents. The books and monographs are grouped under twelve subject categories: general reference, biology and medicine, chemistry, computers and mathematics, energy, engineering and instrumentation, environment, health and safety, isotope separation, metallurgy and materials, physics, and reactors. (RWR)« less

Epicrania Fugax.

PubMed

Cuadrado, María Luz; Guerrero, Angel L; Pareja, Juan A

2016-04-01

Epicrania fugax (EF) is a primary headache of recent description. EF essentially consists of brief paroxysms of pain describing a linear or zigzag trajectory across the surface of one hemicranium, commencing and terminating in the territories of different nerves. The pain of forward EF originates in a particular area of the occipital, parietal or temporal regions and moves anteriorly, whereas the pain of backward EF originates in the frontal area, the eye or the nose and moves posteriorly. Some patients have ocular or nasal autonomic accompaniments, and some have triggers. Between attacks, many patients have continuous or intermittent pain and/or tenderness at the stemming area. Pain frequency is extremely variable and some patients have spontaneous remissions. Preventive therapy is required when the paroxysms are frequent and non-remitting. Neuromodulators, indomethacin, amitryptiline, nerve anesthetic blockades, and trochlear steroid injections have been used in different cases, with partial or complete response.

Comparison of pain response after subcutaneous injection of two maropitant formulations to beagle dogs.

PubMed

Deckers, Nynke; Ruigrok, Catharina A; Verhoeve, Hans Peter; Lourens, Nicky

2018-01-01

The antiemetic maropitant, with metacresol as preservative (Cerenia, Zoetis), has been associated with pain after subcutaneous injection in dogs and cats. Recently, a generic formulation containing benzyl alcohol was authorised (Prevomax, Le Vet). Benzyl alcohol is reported to have local anaesthetic properties and reduce injection pain. This study compared local pain after subcutaneous injection of the two maropitant formulations, administered at approximately 4°C and 25°C, to dogs. Thirty-two healthy beagle dogs were enrolled into a blinded, randomised, cross-over study. Dogs received subcutaneous injections of maropitant injection containing metacresol as preservative and maropitant injection containing benzyl alcohol as preservative, both at approximately 4°C and 25°C, with at least three days in between treatments. Injection pain was evaluated by two blinded observers using a visual analogue scale immediately after injection and a simple descriptive scale at two minutes after injection. In healthy beagle dogs, subcutaneous injection of maropitant with benzyl alcohol is significantly less painful than injection of maropitant with metacresol.

Association between composites of selected motion palpation and pain provocation tests for sacroiliac joint disorders.

PubMed

Soleimanifar, Manijeh; Karimi, Noureddin; Arab, Amir Massoud

2017-04-01

The sacroiliac joint (SIJ) has been implicated as a potential source of low back and buttock pain. Several types of motion palpation and pain provocation tests are used to evaluate SIJ dysfunction. The purpose of this study was to investigate the relationship between motion palpation and pain provocation tests in assessment of SIJ problems. This study is Descriptive Correlation. 50 patients between the ages of 20 and 65 participated. Four motion palpation tests (Sitting flexion, Standing flexion, Prone knee flexion, Gillet test) and three pain provocation tests (FABER, Posterior shear, Resisted abduction test) were examined. Chi-square analysis was used to assess the relationship between results of the individuals and composites of these two groups of tests. No significant relationship was found between these two groups of tests. It seems that motion palpation tests assess SIJ dysfunction and provocative tests assessed SIJ pain which do not appear to be related. Copyright © 2016 Elsevier Ltd. All rights reserved.

Racial discrimination's influence on smoking rates among American Indian Alaska Native two-spirit individuals: does pain play a role?

PubMed

Johnson-Jennings, Michelle D; Belcourt, Annie; Town, Matthew; Walls, Melissa L; Walters, Karina L

2014-11-01

High rates of racial discrimination and non-ceremonial tobacco smoking exist among American Indian/Alaska Native (AIAN) Two-Spirit/LGBT (Lesbian, Gay, Bisexual, Transgender) populations. The authors examined whether or not pain mediates between racial discrimination and smoking among Two-Spirits. Two-Spirit adults (n=447) from seven urban U.S. locations were surveyed during the HONOR project. The Indigenist stress coping model was used as framework in which to conduct descriptive, bivariate and regression analyses. A majority of the participants reported smoking (45.2%) and pain (57%). Pain was found to mediate the association between racial discrimination and smoking. Racial discrimination appears to be a significant factor influencing tobacco smoking and health behaviors within Two-Spirit populations. Effective tobacco cessation and/or prevention planning for Two-Spirits and others who experience frequent racial discrimination, stress, and trauma should also consider the influence of pain. Pain may serve as the embodiment of discrimination, and this possibility requires future research

Prevalence of neck pain and headaches: impact of computer use and other associative factors.

PubMed

Smith, L; Louw, Q; Crous, L; Grimmer-Somers, K

2009-02-01

Headaches and neck pain are reported to be among the most prevalent musculoskeletal complaints in the general population. A significant body of research has reported a high prevalence of headaches and neck pain among adolescents. Sitting for lengthy periods in fixed postures such as at computer terminals may result in adolescent neck pain and headaches. The aim of this paper was to report the association between computer use (exposure) and headaches and neck pain (outcome) among adolescent school students in a developing country. A cross-sectional study was conducted and comprehensive description of the data collection instrument was used to collect the data from 1073 high-school students. Headaches were associated with high psychosocial scores and were more common among girls. We found a concerning association between neck pain and high hours of computing for school students, and have confirmed the need to educate new computer users (school students) about appropriate ergonomics and postural health.

The pain experience of inpatients in a teaching hospital: revisiting a strategic priority.

PubMed

Jabusch, Kimberly M; Lewthwaite, Barbara J; Mandzuk, Lynda L; Schnell-Hoehn, Karen N; Wheeler, Barbara J

2015-02-01

For hospital executives and clinicians to improve pain management, organizations must examine the current pain experience of in-patients beyond simply measuring patient satisfaction. The aim of this study was to quantify the prevalence of pain among adult in-patients and the degree of interference pain had on daily activities. A descriptive, cross-sectional study was undertaken in a 530 bed tertiary care, teaching hospital in central Canada. A convenience sample (N = 88) of adult medical-surgical patients completed the Short Form-Brief Pain Inventory survey. Pain prevalence was 70.4%. The mean pain severity score was 3.76 (standard deviation, SD = 2.88) and mean pain interference score on daily activities was 4.56 (SD = 3.93). The most frequently identified site of pain was the lower extremities (n = 15, 28%). Women had higher mean scores on pain "right now" compared to men (p < 0.05). The sample majority (n = 81) indicated hospital staff asked about the presence of pain. Seventy-nine percent (n = 57) reported hospital staff "always" did everything they could to help manage pain. Eighty-four percent (n = 61) selected "always" or "usually" to describe their ability to be involved in deciding pain treatments. The mean pain relief score from treatments was 61% (SD = 34.79). Significant positive correlations were found between pain intensity ratings and pain interference on all daily activities (p < 0.001). Pain prevalence remains high with a significant relationship between pain and activities of daily living. The study provides baseline data to direct future initiatives at improving pain management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

BIOPHYSICAL EVALUATION OF INDIVIDUAL COMPONENT LEVELS AND SELECTED CONFIGURATIONS OF THE UNITED STATES MARINE CORPS COLD-WEATHER CLOTHING ENSEMBLE

DTIC Science & Technology

2018-01-02

TECHNICAL REPORT NO. T18-01 DATE January 2018 BIOPHYSICAL EVALUATION OF INDIVIDUAL COMPONENT...USARIEM TECHNICAL REPORT T18-01 BIOPHYSICAL EVALUATION OF INDIVIDUAL COMPONENT LEVELS AND...OF TABLES Table Page Table 1. Clothing and individual equipment descriptions ................................................. 3 Table 2. Surface

Local/State Bilingual Project. 1981-82 Final Technical Report. Appendixes.

ERIC Educational Resources Information Center

Austin Independent School District, TX. Office of Research and Evaluation.

The 1981-82 Local/State Bilingual Program Technical Report addresses the evaluation questions of the Local/State Bilingual Program Evaluation Design. It is organized into six appendixes. Each appendix reports the information collected by a specific measure. Each appendix consists of (1) an instrument description, (2) purpose of the measure, (3)…

From Industry to Teaching: The Quality Instruction Program at Hocking Technical College.

ERIC Educational Resources Information Center

Moran, Ralph; And Others

This presentation on Hocking Technical College's (HTC's) Quality Instruction Program (QIP) provides a program description and comments from three HTC faculty members who have been involved in the program in various ways. Recognizing that many faculty members are hired on the basis of their industrial credentials rather than their teaching…

Financing Options for Home Care for Children with Chronic Illness and Severe Disability. Technical Assistance Manual.

ERIC Educational Resources Information Center

Ellison, Marsha Langer; And Others

This manual is intended to accompany technical assistance efforts aimed at improving selected states' home health care programs for children with chronic illness and severe disability. Summary descriptions of funding sources are presented, including purpose, eligibility guidelines, and services covered, as well as additional information as…

Technical Notes on the Multifactor Method of Elementary School Closing.

ERIC Educational Resources Information Center

Puleo, Vincent T.

This report provides preliminary technical information on a method for analyzing the factors involved in the closing of elementary schools. Included is a presentation of data and a brief discussion bearing on descriptive statistics, reliability, and validity. An intercorrelation matrix is also examined. The method employs 9 factors that have a…

Technical and Vocational Education and Training (TVET): Understanding the Nigerian Experience

ERIC Educational Resources Information Center

Dike, Victor Ebipuruonwu

2013-01-01

The descriptive mixed-methods study explores and describes the challenges and prospects of the growth and development of technical and vocational education and training (TVET) schools and science-based technology education in Nigeria. It is not understood how Nigerians in the United States perceive the impacts of governmental policies on education…

Accessing technical data bases using STDS: A collection of scenarios

NASA Technical Reports Server (NTRS)

Hardgrave, W. T.

1975-01-01

A line by line description is given of sessions using the set-theoretic data system (STDS) to interact with technical data bases. The data bases contain data from actual applications at NASA Langley Research Center. The report is meant to be a tutorial document that accompanies set processing in a network environment.

Career-Technical Students in Baccalaureate Programs: Predictors of the Intent to Persist and Satisfaction with Educational Pathways

ERIC Educational Resources Information Center

Uranis, Julie

2015-01-01

This research explores the intersections of descriptive attributes, expectations, and influences (independent variables) and the degree to which they predict the intent to persist and satisfaction (dependent variables) of students enrolled in career-technical programs at four-year institutions. Little research exists for this population, and…

Brokering Boundaries: Literacy Change Agents at Work

ERIC Educational Resources Information Center

VanDeusen-MacLeod, Elizabeth A.

2009-01-01

The purpose of this mixed-method descriptive case study is to investigate the role technical assistance providers within the context of one state's large-scale literacy grant program. This study provides an in-depth examination of one state's technical assistance providers known as Reading First Facilitators (RFF) through the study of a group of…

A Critical Review of the Technical Characteristics of Current Preschool Screening Batteries

ERIC Educational Resources Information Center

Emmons, Michael R.; Alfonso, Vincent C.

2005-01-01

The current review provides a summary and evaluation of the technical characteristics of five preschool screening batteries, including the Brigance Screens, DIAL-3, ESI-R, ESP, and FirstSTEP. These norm-referenced instruments were selected on the basis of their commercial availability, description as a screening instrument, and ability to assess…

77 FR 53903 - Notice of Proposed Information Collection for Public Comment: OneCPD Technical Assistance and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

... Information Collection for Public Comment: OneCPD Technical Assistance and Capacity Building Needs Assessment... Needs Assessment. Description of the need for the information proposed: The OneCPD Needs Assessment will... to identify trends in TA needs across grantees and assist in prioritizing the development of tools...

Abstracts of BESRL Research Publications, FY 1969.

ERIC Educational Resources Information Center

Brown, Emma E.

Publications abstracted include Technical Research Reports 1156 and 1157, Technical Research Notes 199 through 210, Research Studies 68-4 through 68-6 and 69-1 through 6910, and Research Memorandums 68-8 through 68-13. Included are descriptions of 19 Work Units covering activities reported in the 33 abstracted publications, a list of regular…

The Effects of Pain, Gender, and Age on Sleep/Wake and Circadian Rhythm Parameters in Oncology Patients at the Initiation of Radiation Therapy

PubMed Central

Buffum, David; Koetters, Theresa; Cho, Maria; Macera, Liz; Paul, Steven M.; West, Claudia; Aouizerat, Bradley; Dunn, Laura; Dodd, Marylin; Lee, Kathryn; Cooper, Bruce; Wara, William; Swift, Patrick; Miaskowski, Christin

2010-01-01

To date, no studies have evaluated for differences in subjective and objective measures of sleep disturbance in oncology outpatients with and without pain. This descriptive study recruited 182 patients from two radiation therapy (RT) departments at the time of the patient’s simulation visit. Approximately 38% of the sample reported moderate to severe pain (i.e., worst pain intensity of 6.2 ± 2.4). After controlling for age, patients with pain reported worse sleep quality and more sleep disturbance using the Pittsburgh Sleep Quality Index. With the General Sleep Disturbance Scale, patients with pain reported poorer sleep quality, increased use of sleep medications, and more daytime sleepiness. In addition using an objective measure of sleep disturbance (i.e., actigraphy), significant Gender × Pain interactions were found for sleep onset latency, percentage of time awake at night, wake duration, total sleep time, and sleep efficiency. While no differences were found in female patients, males with pain had worse scores than males without pain. Findings from this study suggest that pain and sleep disturbance are prevalent in oncology outpatients and that a patient’s age and gender need to be considered in any evaluation of the relationship between pain and sleep. Perspective: The effects of pain on subjective and objective sleep parameters appear to be influenced by both patients’ age and gender. PMID:21146465

Evaluation of the Iconic Pain Assessment Tool by a heterogeneous group of people in pain

PubMed Central

Lalloo, Chitra; Henry, James L

2011-01-01

The Iconic Pain Assessment Tool (IPAT) is a novel web-based instrument for the self-report of pain quality, intensity and location in the form of a permanent diary. Originally designed for people with central poststroke pain, the tool is being adapted for a larger, more diverse patient population. The present study aimed to collect evaluative feedback on the IPAT from a heterogeneous sample of individuals with chronic pain. The specific study aims were to evaluate participant comfort with the tool including enjoyment, ease of use and comfort with the electronic medium; to assess perceived value of the tool for communicating pain quality, intensity and location; to gauge participant intent to share their pain diaries with others and use the tool on a regular basis to track their pain over time; to assess the perceived descriptiveness of current IPAT icons and the numerical rating scale; and to identify strengths and weaknesses of the tool to refine the existing prototype. Written and verbal feedback from individuals with a variety of chronic pain conditions (n=23) were collected in the context of these objectives. Overall, the IPAT was positively endorsed by this heterogeneous sample of people in pain. The authors concluded that the IPAT is a user-friendly instrument that has the potential to help people express, document and share their personal experience with chronic pain. PMID:21369536

Video education for critical care nurses to assess pain with a behavioural pain assessment tool: A descriptive comparative study.

PubMed

Björn, Annika; Pudas-Tähkä, Sanna-Mari; Salanterä, Sanna; Axelin, Anna

2017-10-01

To evaluate the impact of video education on critical care nurses' knowledge and skills in using a behavioural pain assessment tool for intensive care patients and to explore the nurses' experiences with video education. Forty-eight nurses in one intensive care unit watched an educational video on the use of the Critical-Care Pain Observation Tool, then assessed pain in two patients with the tool and took a knowledge test. The researcher made parallel pain assessments. Interrater reliability of patients' pain assessment between nurses and the researcher was determined to examine nurses' skills in using the tool after education. Twenty nurses were interviewed about their experiences with the video education. Interviews were analysed with deductive thematic analysis. The knowledge test scores indicated that the nurses learned the principles of how to use the tool. The interrater reliability of pain assessments reached a moderate level of agreement during the painful procedure, with a weighted kappa coefficient value of 0.48, CL [0.37, 0.58]. The nurses perceived video education positively, but requested additional interaction. Video education is useful in teaching the principles of using a pain assessment tool. Additional clinical training is required for nurses to reach adequate skills in using the tool. Copyright © 2017 Elsevier Ltd. All rights reserved.

Streamlining the Evaluation of Low Back Pain in Children

PubMed Central

Auerbach, Joshua D.; Ahn, Jaimo; Zgonis, Miltiadis H.; Reddy, Sudheer C.; Ecker, Malcolm L.

2008-01-01

The workup of low back pain in children often results in overimaging so as not to miss organic back pain. The primary goal of this study was to identify which combination of imaging modalities provides the most sensitive and specific screening protocol for children with low back pain. Medical records from 100 consecutive patients between 2 and 18 years of age presenting with low back pain, without night pain or constitutional symptoms, were evaluated. A hyperextension test combined with a radiograph showed a negative predictive value of 0.81 and sensitivity of 0.90. The addition of a bone scan was highly effective in achieving good negative predictive value and sensitivity. Bone scans had perfect negative predictive value and sensitivity when symptom duration was less than 6 weeks. We identified a set of factors that is highly predictive for distinguishing organic back pain from mechanical back pain. Painless hyperextension combined with negative anteroposterior, lateral, and oblique lumbar radiographs and magnetic resonance images predicts mechanical back pain. For patients with nonneurologic back pain of less than 6 weeks duration, bone scan is the most useful screening test because it is accurate, accessible, inexpensive, and unlikely to require sedation. Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18553213

Pain and behaviour changes in children following surgery.

PubMed

Power, Nina Mary; Howard, Richard F; Wade, Angie M; Franck, Linda S

2012-10-01

To quantify postoperative pain and problematic behaviour (PB) in children at home following day-case (same day admission and discharge) or inpatient (≥1 night in hospital) surgery, to identify factors associated with PB at 2 and 4 weeks after discharge and to determine whether pain is associated with PB after adjustment for other factors. Children scheduled for elective surgery were recruited to a descriptive study involving direct observation and self-report questionnaires. The principal outcomes were pain and PB on the 2nd post-discharge day and after the 1st, 2nd and 4th weeks. 131 parents and their children (aged 2-12years) participated in the study. 93% of children had pain and 73% exhibited PB on day 2 after discharge. The incidence of pain and PB decreased over time, but 25% of children still had pain and 32% PB at week 4. Factors associated with PB were child's previous pain experience, parent and child anxiety and parent's level of education. There was a high incidence of pain and PB persisting for several weeks after surgery in this cohort of children. Previous painful medical experiences and anxiety were important modifiable factors that require further attention from healthcare providers and researchers to potentially improve health and social outcomes for children after surgery.

Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain

PubMed Central

Anderson, Gary C.; John, Mike T.; Ohrbach, Richard; Nixdorf, Donald R.; Schiffman, Eric L.; Truelove, Edmond S.; List, Thomas

2011-01-01

The relationship of the frequency of temple headache to signs and symptoms of temporomandibular disorders (TMD) was investigated in a subset of a larger convenience sample of community TMD cases. The study sample included: 86 painful TMD, non-headache subjects; 309 painful TMD subjects with varied frequency of temple headaches; and 149 subjects without painful TMD or headache for descriptive comparison. Painful TMD included Research Diagnostic Criteria (RDC) diagnoses of myofascial pain, TMJ arthralgia and TMJ osteoarthritis. Mild to moderate intensity temple headaches were classified by frequency using criteria based on the ICHD-II classification of TTH. Outcomes included TMD signs and symptoms (pain duration, pain intensity, number of painful masticatory sites on palpation, mandibular range of motion), PPTs and temple headache resulting from masticatory provocation tests. Trend analyses across the painful TMD groups showed a substantial trend for aggravation of all of the TMD signs and symptoms associated with increased frequency of the temple headaches. In addition, increased headache frequency showed significant trends associated with reduced PPTs and reported temple headache with masticatory provocation tests. In conclusion, these findings suggest that these headaches may be TMD-related, as well as a possible role for peripheral and central sensitization in TMD patients. PMID:21196079

Neonatal nurses' perceptions of pain management.

PubMed

Collados-Gómez, L; Camacho-Vicente, V; González-Villalba, M; Sanz-Prades, G; Bellón-Vaquerizo, B

To describe the perceptions of nurses in neonatal units on pain management, meet the educational profile and describe the use of pain assessment tools and non-pharmacological management for treatment. Cross-sectional descriptive multicentre study, developed during the months of February to September 2015, in the neonatology services of three hospitals at the Community of Madrid, Spain. Data collection was performed through an ad hoc questionnaire on paper or electronically using Survey Monkey platform. The sample consisted of 142 professionals, with a response rate of 55%: 47.9% (68) confirmed they had received specific training in pain management; 39.5% (56) stated that pain is regularly assessed in the unit; only 43.6% reported using validated scales, the most used being the Premature Infant Pain Profile (PIPP). As for the non-pharmacological management, swaddling and non-nutritive sucking it is the most used, followed by sucrose. Intravenous cannulation was identified as the most painful procedure. Pain management is in the process of improvement, because of training and because there is little pain assessment using validated scales. The improvement in the use of non-pharmacological management for the relief of pain in minor procedures is noteworthy. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

Increased pain intensity is associated with greater verbal communication difficulty and increased production of speech and co-speech gestures.

PubMed

Rowbotham, Samantha; Wardy, April J; Lloyd, Donna M; Wearden, Alison; Holler, Judith

2014-01-01

Effective pain communication is essential if adequate treatment and support are to be provided. Pain communication is often multimodal, with sufferers utilising speech, nonverbal behaviours (such as facial expressions), and co-speech gestures (bodily movements, primarily of the hands and arms that accompany speech and can convey semantic information) to communicate their experience. Research suggests that the production of nonverbal pain behaviours is positively associated with pain intensity, but it is not known whether this is also the case for speech and co-speech gestures. The present study explored whether increased pain intensity is associated with greater speech and gesture production during face-to-face communication about acute, experimental pain. Participants (N = 26) were exposed to experimentally elicited pressure pain to the fingernail bed at high and low intensities and took part in video-recorded semi-structured interviews. Despite rating more intense pain as more difficult to communicate (t(25)  = 2.21, p =  .037), participants produced significantly longer verbal pain descriptions and more co-speech gestures in the high intensity pain condition (Words: t(25)  = 3.57, p  = .001; Gestures: t(25)  = 3.66, p =  .001). This suggests that spoken and gestural communication about pain is enhanced when pain is more intense. Thus, in addition to conveying detailed semantic information about pain, speech and co-speech gestures may provide a cue to pain intensity, with implications for the treatment and support received by pain sufferers. Future work should consider whether these findings are applicable within the context of clinical interactions about pain.

Disability pension from back pain among social security beneficiaries, Brazil.

PubMed

Meziat Filho, Ney; Silva, Gulnar Azevedo E

2011-06-01

To describe disability pension from back pain. Descriptive study based on data from the Brazilian Social Security Beneficiary Database and the Social Security Statistics Annual Report in 2007. The incidence rate of disability pension from back pain was estimated according to gender and age by Brazilian states. There were also estimated working days lost due to back pain disability by occupation. Idiopathic back pain was the most common cause of disability among social security pension and accidental retirement. Most pensioners were living in urban areas and were commercial workers. The rate of disability pension from back pain in Brazil was 29.96 per 100,000 beneficiaries. A higher rate was seen among males and older individuals. Rondônia showed the highest rate, four times as high as expected (RR= 4.05) followed by Bahia with a rate about twice as high as expected (RR=2.07). Commercial workers accounted for 96.9% of working days lost due to disability. Back pain was a major cause of disability in 2007 mostly among commercial workers showing great differences between the Brazilian states.

Distress correlates with the degree of chest pain: a description of patients awaiting revascularisation.

PubMed

Bengtson, A; Herlitz, J; Karlsson, T; Hjalmarson, A

1996-03-01

To describe various symptoms other than pain among consecutive patients on the waiting list for possible coronary revascularisation in relation to estimated severity of chest pain. All patients were sent a postal questionnaire for symptom evaluation. All patients in western Sweden on the waiting list in September 1990 who had been referred for coronary angiography or coronary revascularisation (n = 904). 88% of the patients reported chest pain symptoms that limited their daily activities to a greater or lesser degree. Various psychological symptoms including anxiety and depression were strongly associated with the severity of pain (P < 0.001), as were sleep disturbances (P < 0.001), and dyspnoea and various psychosomatic symptoms (P < 0.001). Nevertheless only 44% of the patients reported chest pain as the major disruptive symptom, whereas the remaining 56% reported uncertainty about the future, fear, or unspecified symptoms as being the most disturbing. In a consecutive series of patients on the waiting list for possible coronary revascularisation, half the participants reported that uncertainty and fear were more disturbing than chest pain.

Energygrams: Brief descriptions of energy technology

NASA Astrophysics Data System (ADS)

Simpson, W. F., Jr.

This compilation of technical notes (called Energygrams) is published by the Technical Information Center. Energygrams are usually one-page illustrated bulletins describing DOE technology or data and telling how to obtain the technical reports or other material on which they are based. Frequently a personal contact is given who can provide program information in addition to the data found in the reports. The compilation is organized by subject categories, and, within each category, Energygrams are presented alphabetically by Energygram title.

Descriptive analysis of context evaluation instrument for technical oral presentation skills evaluation: A case study in English technical communication course

NASA Astrophysics Data System (ADS)

Mohamed, Abdullah-Adnan; Asmawi, Adelina; Hamid, Mohd Rashid Ab; Mustafa, Zainol bin

2015-02-01

This paper reports a pilot study of Context Evaluation using a self-developed questionnaire distributed among engineering undergraduates at a university under study. The study aims to validate the self-developed questionnaires used in the Context evaluation, a component in the CIPP Model. The Context evaluation assesses background information for needs, assets, problems and opportunities relevant to beneficiaries of the study in a defined environment. Through the questionnaire, background information for the assessment of needs, assets and problems related to the engineering undergraduates' perceptions on the teaching and learning of technical oral presentation skills was collected and analysed. The questionnaire was developed using 5-points Likert scale to measure the constructs under study. They were distributed to 100 respondents with 79 returned. The respondents consisted of engineering undergraduates studied at various faculties at one technical university in Malaysia. The descriptive analysis of data for each item which makes up the construct for Context evaluation is found to be high. This implied that engineering undergraduates showed high interest in teaching and learning of technical oral presentation skills, thus their needs are met. Also, they agreed that assets and facilities are conducive to their learning. In conclusion, the context evaluation involving needs and assets factors are both considerably important; their needs are met and the assets and facilities do support their technical oral presentation skills learning experience.

Effect of physical therapy management of nonspecific low back pain with exercise addiction behaviors: A case series.

PubMed

Anandkumar, Sudarshan; Manivasagam, Murugavel; Kee, Vivian Tie Suk; Meyding-Lamade, Uta

2018-04-01

This case series describes two patients, aged 35 and 45 years, respectively, who presented with chronic nonspecific low back pain (NSLBP) having exercise addiction (EA) behaviors. Diagnosis of EA was based on clinical findings, exercising patterns and withdrawal symptoms along with high scores in the EA inventory. This report is a potential first-time description of the successful physical therapy management of NSLBP associated with EA utilizing pain neuroscience education (with individualized curriculum), mindfulness, breathing, quota-based reduction in exercises and modification of exercises into social participation, pleasure activities and hobbies. Both the patients were seen once a week, for 8 weeks. At discharge, they were pain-free and fully functional, which was maintained at a six-month follow-up.

Neck and shoulder disorders in medical secretaries. Part II. Ergonomical work environment and symptom profile.

PubMed

Kamwendo, K; Linton, S J; Moritz, U

1991-01-01

Seventy-nine medical secretaries with neck and shoulder pain were included in a study aimed at an in-depth description of the ergonomical work environment and the participant's symptom profile, as well as analysing relationships between ergonomical factors and symptoms. Data were collected by daily ratings, questionnaires, and direct observation. The symptom profile showed low mean daily ratings of perceived fatigue and pain, a low medicine consumption, and few stress symptoms. A mean number of 2.1 undesirable work postures was observed. The correlations between perceived fatigue, pain, and well-being with number of shifts from sitting to standing and time spent typing, were generally small. This study suggests that risk factors for neck and shoulder pain are individual and multifactorial.

Evaluation of Evidence-Based Nursing Pain Management Practice

PubMed Central

Song, Wenjia; Eaton, Linda H.; Gordon, Debra B.; Hoyle, Christine; Doorenbos, Ardith Z.

2014-01-01

Background It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. Aims This study aimed to (a) modify and test an evaluation tool for nursing cancer pain documentation, and (b) describe the frequency and quality of nursing pain documentation in one oncology unit via electronic medical system. Design and Setting A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Methods Medical records were examined for 37 adults hospitalized during April and May of 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. Results The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. Conclusions The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. PMID:26256215

Oak Ridge TNS Program: system description manual

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reid, R.L.; Becraft, W.R.; Brown, T.G.

1979-05-01

This document provides a systems description of the Reference Design for The Next Step (TNS) evolved at Oak Ridge National Laboratory (ORNL) during FY 1978. The description is presented on the basis of 24 individual device and facility systems. Additional information on these systems, the Reference Design, and the FY 1978 Oak Ridge TNS activities can be found in the associated technical memoranda, ORNL/TM-6720 and ORNL/TM-6722--ORNL/TM-6733.

Retirement Forecasting. Technical Descriptions of Cost, Decision and Income Models. Volume 2. Report to the Chairman, Subcommittee on Social Security and Income Maintenance Programs, Committee on Finance, United States Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

This supplementary report identifies and provides individual descriptions and reviews of 71 retirement forecasting models. Composed of appendices, it is intended as a source of more detailed information than that included in the main volume of the report. Appendix I is an introduction. Appendix II contains individual descriptions of 32 models of…

Abdominal wall surgery

MedlinePlus

... Description Your surgery will be done in an operating room in a hospital. You will receive general anesthesia . This will keep you asleep and pain-free during the procedure. The surgery takes 2 to 6 hours. You ...

FAST FLUX TEST FACILITY CONCEPTUAL FACILTY DESIGN DESCRIPTION FOR THE INERT GAS CELL EXAMINATION FACILITY NO. 71

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1968-12-12

The purpose of this Conceptual Facility Design Description (CFDD) is to provide a technical description of the Inert Gas Cell Examination Facility such that agreement with RDT on a Conceptual Design can be reached . The CFDD also serves to establish a common understanding of the facility concept among all responsible FFTF Project parties including the Architect Engineer and Reactor Designer. Included are functions and design requirements, a physical description of the facility, safety considerations, principles of operation, and maintenance principles.

Fatigue, pain, and functional status during outpatient chemotherapy.

PubMed

Siefert, Mary Lou

2010-03-01

To examine the relationship of fatigue and pain with functional status and the pattern of the two symptoms' occurrence over time in individuals with cancer who were receiving outpatient chemotherapy. The aims were to describe the levels of fatigue and pain with functional status and the inter-relationships with each other and with demographic and clinical variables over time. Descriptive, correlational. Outpatient chemotherapy clinic in the New England region of the United States. Total available population of 70 consecutive adult patients with breast cancer (n = 9), colorectal cancer (n = 21), lung cancer (n = 21), or lymphoma (n = 19). Retrospective data were extracted from the medical records; descriptive, correlational, and mixed-modeling methods were used to describe the sample and to examine the relationships of the symptoms and functional status. Fatigue, pain, functional status, and demographic and clinical factors. Fatigue was the most frequently reported symptom; pain was rarely and almost exclusively reported by patients with lung cancer or lymphoma during their early treatments. Fatigue and functional status impairment were highly associated with each other and had similar relationships with the other variables. The patterns and relationships of fatigue and functional status reported by this fairly healthy sample provide useful information to help guide early assessments and nursing interventions for people receiving outpatient chemotherapy. The patterns and severity of symptoms and functional status impairment in people with colorectal cancer or lymphoma warrant further investigation. Targeted exercise interventions for specific outpatient populations should be developed and tested to address specific patterns of symptoms and functional status impairment in individuals with cancer.

Neuropathic pain in the orofacial region: The role of pain history. A retrospective study.

PubMed

Dieb, W; Moreau, N; Chemla, I; Descroix, V; Boucher, Y

2017-06-01

Orofacial neuropathic pain is often difficult to treat, mostly because of still unclear underlying mechanisms. The occurrence of such neuropathic pain varies depending on different factors, of which preexisting preoperative pain seems to be of high importance. The aim of this study was thus to test the hypothesis that prior history of pain could indeed be considered a risk factor for the development of orofacial neuropathic pain in the same region. The study was performed in the dental department of the Groupe Hospitalier Pitié-Salpêtrière (GHPS) in Paris, France. We investigated the presence of prior inflammatory pain before development of orofacial neuropathic pain in 56 patients. For each patient file, the following items were collected: age, gender; medical history; diagnosis; description of the pain (at time of consultation); presence or absence of prior dental treatment; date and type of dental treatment received. 41 patients (73%) of orofacial neuropathic pain patients had a history of pain compatible with an inflammatory condition; 4% (n=2) did not report any prior pain and 23% (n=13) could not remember. Among the patients with documented history of pain prior to neuropathy, 88% (n=36) received surgical treatment; 61%, (n=25) endodontic treatment and 22%, (n=9) restorative treatment. All eventually received endodontic treatment or tooth extraction. These dental treatments are compatible with the hypothesis of prior inflammatory pain in these patients. These results support the hypothesis that prior inflammatory pain could favor the development of orofacial neuropathic pain. Prevention and treatment of inflammatory trigeminal pain may therefore play a key role in preventing future neuropathic pain development. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Pain and Psychological Outcomes After Rehabilitative Treatment for a Woman With Chronic Pelvic Pain With Stage III Cervical Cancer: A Case Report

PubMed Central

Alappattu, Meryl J.

2016-01-01

Background Chronic pelvic pain and sexual dysfunction are adverse effects of treatment of cervical cancer. Surgery and radiation therapies may result in soft tissue pain and dysfunction, including spasms and trigger points of the pelvic floor muscles that result in pain. In addition to physical restrictions, negative mood associated with pain is believed to intensify and prolong the pain experience. Study Design The purpose of this case report was to describe outcomes of pelvic physical therapy in a 58-year-old woman with chronic pelvic pain after medical treatments for cervical cancer. Case Description The patient reported dyspareunia, hip pain, and lower abdominal, pelvic pain, and fatigue with activities lasting greater than 30 minutes. Interventions included pelvic floor massage, dilator use, and patient education. Symptoms were assessed at baseline and completion of physical therapy, using the Female Sexual Function Index, Fear of Pain Questionnaire–III, Pain Catastrophizing Scale, and Numerical Pain Rating Scale. Outcomes The Female Sexual Function Index score decreased from 7.8 to 2.8, the Fear of Pain Questionnaire– III score decreased from 85 to 73, the Pain Catastrophizing Scale score decreased from 18 to 8, and lower abdominal and pelvic pain decreased from 4 of 10 to 0 of 10, while bilateral hip pain remained at 4 of 10. In addition, she exhibited increased tolerance to mechanical pressure, evidenced by progression in size of a vaginal dilator. Discussion These results suggest that pelvic physical therapy may be useful in treating chronic pelvic pain after cervical cancer treatments and may also help decrease the magnitude of negative mood aspects such as pain-related fear and catastrophizing. PMID:27134605

Epidural catheterization with a subcutaneous injection port for the long-term administration of opioids and local anesthetics to treat zoster-associated pain -a report of two cases-

PubMed Central

Min, Bo Mi

2013-01-01

Continuous epidural analgesia has been used for decades to treat acute herpes zoster pain and to prevent postherpetic neuralgia. However, many technical problems can arise during chronic treatment with epidural medications. These complications include catheter dislodgement, infection, injection pain, leakage, and occlusion. Epidural catheter placement utilizing subcutaneous injection port implantation has gained widespread acceptance as a method to overcome such complications. The technique reduces the risk of infection, the most feared complication, compared to the use of a percutaneous epidural catheter. Herein, we present 2 cases in which the continuous thoracic epidural administration of opioids and local anesthetics through an implantable subcutaneous injection port for over 2 months successfully treated zoster-associated pain without any technique- or medication-related complications in patients with risk factors for epidural abscess. PMID:24363852

NASA Deputy Administrator Tours Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

1968-01-01

Pictured from the left, in the Saturn I mockup, are: William Brooksbank, Marshall Space Flight Center (MSFC) Propulsion and Vehicle Engineering Laboratory; Dr. Thomas O. Paine, Deputy Administrator of the National Aeronautics and Space Administration (NASA); Dr. Wernher von Braun, MSFC director; Colonel Clare F. Farley, executive officer of the Office of the Administrator; and Charles J. Donlan, newly appointed deputy associate administrator for Manned Space Flight, technical. The party examined an ordinary man's shoe (held by Paine) outfitted for use in the Saturn I Workshop. The shoe had a unique fastener built into the sole to allow an astronaut to move about the workshop floor and to remain in one position if he desired. Dr. Paine and his party indulged in a two-day tour at the Marshall Space Flight Center getting acquainted with Marshall personnel and programs. It was Paine's first visit to the center since assuming the NASA post on February 1, 1968.

Inputs to Vocational-Technical Education from Occupational Research.

ERIC Educational Resources Information Center

Christal, Raymond E.

The Air Force has developed a data bank which classifies job descriptions into occupational clusters. A retrieval system, also recently developed computes and publishes a consolidated description of the work being performed by any group which can be defined in terms of the background information. Other retrieval programs are available which enable…

75 FR 26193 - Notice of Funds Availability: Inviting Applications for the Technical Assistance for Specialty...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

.... The intended effect of this notice is to solicit applications from the private sector and from... description of relevant dates. FOR FURTHER INFORMATION CONTACT: Entities wishing to apply for funding.... Funding Opportunity Description Authority: The TASC program is authorized by section 3205 of Public Law...

15 CFR Supplement No. 1 to Part 748 - BIS-748P, BIS-748P-A; Item Appendix, and BIS-748P-B; End-User Appendix; Multipurpose Application...

Code of Federal Regulations, 2011 CFR

2011-01-01

... “Tech. Specs.” box with an (X) if you are submitting descriptive literature, brochures, technical... or B. Be specific—vague descriptions such as “research”, “manufacturing”, or “scientific uses” are...

15 CFR Supplement No. 1 to Part 748 - BIS-748P, BIS-748P-A; Item Appendix, and BIS-748P-B; End-User Appendix; Multipurpose Application...

Code of Federal Regulations, 2013 CFR

2013-01-01

... “Tech. Specs.” box with an (X) if you are submitting descriptive literature, brochures, technical... or B. Be specific—vague descriptions such as “research”, “manufacturing”, or “scientific uses” are...

15 CFR Supplement No. 1 to Part 748 - BIS-748P, BIS-748P-A; Item Appendix, and BIS-748P-B; End-User Appendix; Multipurpose Application...

Code of Federal Regulations, 2010 CFR

2010-01-01

... “Tech. Specs.” box with an (X) if you are submitting descriptive literature, brochures, technical... or B. Be specific—vague descriptions such as “research”, “manufacturing”, or “scientific uses” are...

15 CFR Supplement No. 1 to Part 748 - BIS-748P, BIS-748P-A; Item Appendix, and BIS-748P-B; End-User Appendix; Multipurpose Application...

Code of Federal Regulations, 2012 CFR

2012-01-01

... “Tech. Specs.” box with an (X) if you are submitting descriptive literature, brochures, technical... or B. Be specific—vague descriptions such as “research”, “manufacturing”, or “scientific uses” are...

78 FR 5176 - Information Collection Being Reviewed by the Federal Communications Commission Under Delegated...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

.... Frequency of Response: Third party disclosure. Obligation to Respond: Required to obtain or retain benefits..., phone number of the applicant, description of why the STA is needed, description of the operation to be... base and mobile units, power, emission designator, and any other pertinent technical information not...

Critical Competitors. Evaluation of the Bay Area Writing Project. Technical Report.

ERIC Educational Resources Information Center

Thomas, Susan; Watson, Patti

Prepared as part of the evaluation of the Bay Area Writing Project (BAWP), this report compares BAWP to its "critical competitors" (other inservice teacher programs and programs for improving student writing). The BAWP model and ten other program descriptions are presented in identical descriptive formats. Three types of competitors are…

Description of the KEEP Reading Curriculum, 1975-76. Technical Report No. 43.

ERIC Educational Resources Information Center

Au, Kathryn H.

The Kamehameha Early Education Program (KEEP) is a research and development program designed to develop, demonstrate, and disseminate methods for improving the education of Hawaiian and part-Hawaiian children; this report contains a description of the reading curriculum used in the KEEP demonstration school during the 1975-76 school year. The…

Lightning Protection Guidelines for Aerospace Vehicles

NASA Technical Reports Server (NTRS)

Goodloe, C. C.

1999-01-01

This technical memorandum provides lightning protection engineering guidelines and technical procedures used by the George C. Marshall Space Flight Center (MSFC) Electromagnetics and Aerospace Environments Branch for aerospace vehicles. The overviews illustrate the technical support available to project managers, chief engineers, and design engineers to ensure that aerospace vehicles managed by MSFC are adequately protected from direct and indirect effects of lightning. Generic descriptions of the lightning environment and vehicle protection technical processes are presented. More specific aerospace vehicle requirements for lightning protection design, performance, and interface characteristics are available upon request to the MSFC Electromagnetics and Aerospace Environments Branch, mail code EL23.

Pain management in the emergency department and its relationship to patient satisfaction.

PubMed

Downey, La Vonne A; Zun, Leslie S

2010-10-01

Pain is the most common reason due to which patients come to the emergency department (ED). The purpose of this study was to measure the correlation, if any, between pain reduction and the level of satisfaction in patients who presented to the ED with pain as their chief complaint. This study used a randomly selected group of patients who presented to the ED with pain of 4 or more on the Visual Analogue Pain Scale (VAS) as their chief complaint to a level one adult and pediatric trauma center. Instruments that were used in this study were the VAS, Brief Pain Inventory (BPI), and the Medical Interview Satisfaction Scale (MISS). They were administered to patients by research fellows in the treatment rooms. Statistical analysis included frequencies, descriptive, and linear regression. This study was approved by the Internal Review Board. A total of 159 patients were enrolled in the study. All patients were given some type of treatment for their pain upon arrival to the ED. A logistic regression showed a significant relationship to reduction in pain by 40% or more and customer service questions. A reduction in perceived pain levels does directly relate to several indicators of customer service. Patients who experienced pain relief during their stay in the ED had significant increases in distress relief, rapport with their doctor, and intent to comply with given instructions.

Nurse Perceptions of Pain in Pediatric Traumatic Brain Injury: A Pilot Study.

PubMed

McCaa, Robin

2017-01-01

Pain assessment in the pediatric population is challenging because of age, developmental stage, and patient cooperation. Cognitive impairment, impaired communication, and physical disability that may accompany traumatic brain injury (TBI) further complicate pain assessments. A pilot descriptive qualitative research study was conducted to investigate nurse perceptions of pain in pediatric patients diagnosed with TBI. Specifically, this study sought to answer the following questions: a) Is pain accurately assessed in this population? b) Is pain adequately treated in this population? and c) What obstacles exist, if any, to the assessment and treatment of pain? A convenience sample of three registered nurses employed in a pediatric neurosurgery setting participated in this study. Each nurse participated in one individual, semi-structured, face-to-face interview lasting approximately 30 minutes. Interviews were transcribed verbatim and analyzed for common themes. Common themes identified across all interviews were a) challenging assessments; b) limited, although effective, treatments; and c) communication as an area of opportunity for improvement. Implications for practice and policy include a need for more sensitive pain assessment tools to improve the objectivity and accuracy of pain assessment, clarification of care priorities and organization of care from clinical and management perspectives, and additional research in alternative pain treatments for this population. Findings from this study will guide the development of a larger, more comprehensive study, with the aim of improving practice and policy in pain management for this population.

[Differential diagnosis of polyarthritis pain syndrome of the locomotor apparatus].

PubMed

Menninger, H

1998-02-28

Widespread pain syndromes of the musculoskeletal system present to general practitioners, internists, neurologists and orthopedic surgeons every day. The syndromes may result both from organic diseases (inflammatory joint diseases, rheumatic manifestations of organ diseases) as well as dysfunctional syndromes, the latter including mainly biomechanically induced syndromes and fibromyalgia. The approach is predominantly clinically oriented and requires laboratory means or technical procedures only in a limited extend. The duration of history, the recognition of synovitis and of myofascial trigger points or of integumental tender points allow in most patients to achieve appropriate diagnostic criteria.

Thoracic Outlet Syndrome in a Volleyball Player Due to Nonunion of the First Rib Fracture.

PubMed

Puttmann, Kathleen T; Satiani, Bhagwan; Vaccaro, Patrick

2016-11-01

Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Physical therapy had been unsuccessful in relieving the pain, and surgical management was performed with resection of the first rib through a transaxillary approach with complete resolution of symptoms. Inflammation surrounding such fractures may destroy tissue planes, making dissection more technically difficult.

Therapeutic writing and chronic pain: experiences of therapeutic writing in a cognitive behavioural programme for people with chronic pain.

PubMed

Furnes, Bodil; Dysvik, Elin

2012-12-01

To examine the experiences of therapeutic writing from the perspectives of patients attending a chronic pain management programme. Pain is a multifaceted experience. Increased awareness, understanding and gaining new insights are essential aspects of dealing with chronic pain. It is crucial to find powerful ways to cope with chronic pain. Several studies point to writing as a tool for managing such demanding life experiences. Therapeutic writing in a cognitive behavioural approach may be used to facilitate the rehabilitation process. A qualitative study with a descriptive and explorative design including a phenomenological perspective was used. A consecutive sample of 34 outpatients with chronic pain was recruited to an eight-week group-based pain management programme. A therapeutic writing tool was developed and included as part of the homework tasks. Guidelines were used to initiate and guide the therapeutic writing activity. Written reports were collected after completion. Three thematic findings emerged from the analysis: 'increased understanding of chronic pain as a multifaceted experience', 'new insights into managing the chronic pain situation' and 'different performances lead to different experiences with therapeutic writing'. Increased awareness, understanding and new insights are essential to dealing with chronic pain. People with chronic pain need tools and skills for optimal adaptation. Our findings suggest therapeutic writing may strengthen cognitive behavioural therapy by facilitating cognitive restructuring processes. Therapeutic writing may be used as a tool to express individual experiences and to improve adaptation to chronic pain. © 2012 Blackwell Publishing Ltd.

Defining worthwhile and desired responses to treatment of chronic low back pain.

PubMed

Yelland, Michael J; Schluter, Philip J

2006-01-01

To describe patients' perceptions of minimum worthwhile and desired reductions in pain and disability upon commencing treatment for chronic low back pain. Descriptive study nested within a community-based randomized controlled trial on prolotherapy injections and exercises. A total of 110 participants with chronic low back pain. Interventions. Prior to treatment, participants were asked what minimum percentage reductions in pain and disability would make treatment worthwhile and what percentage reductions in pain and disability they desired with treatment. Minimum worthwhile reductions and desired reductions in pain and disability. Median (inter-quartile range) minimum worthwhile reductions were 25% (20%, 50%) for pain and 35% (20%, 50%) for disability. This compared with desired reductions of 80% (60%, 100%) for pain and 80% (50%, 100%) for disability. The internal consistency between pain and disability responses was high (Spearman's coefficient of association of 0.81 and 0.87, respectively). A significant association existed between minimum worthwhile reductions and desired reductions, but no association was found between these two factors and patient age, gender, pain severity or duration, disability, anxiety, depression, response to treatment, or treatment satisfaction. Inquiring directly about patients' expectations of reductions in pain and in disability is important in establishing realistic treatment goals and setting benchmarks for success. There is a wide disparity between the reductions that they regard as minimum worthwhile and reductions that they hope to achieve. However, there is a high internal consistency between reductions in pain and disability that they expect.

Inferior heel pain in soccer players: a retrospective study with a proposal for guidelines of treatment

PubMed Central

Saggini, Raoul; Migliorini, Maurizio; Carmignano, Simona Maria; Ancona, Emilio; Russo, Chiara; Bellomo, Rosa Grazia

2018-01-01

Background The cause of heel pain among soccer players is multifactorial and is related to repetitive microtrauma due to impact forces involving technical moves, but also the playground, the exercise mode, the recovery time, the climatic conditions and the footwear used. Aim To investigate the aetiology of plantar heel pain of soccer players with the objective of proposing an example of guidelines for treatment. Methods We investigated the prevalence and characteristics of inferior heel pain of 1473 professional, semiprofessional and amateur players. All evaluated subjects were submitted to a specific rehabilitation protocol that involved advanced physical therapies and viscoelastic insoles depending on the aetiology of pain. Results Clinical and instrumental examinations revealed that 960 of 1473 athletes had inferior heel pain. These patients were divided into seven groups based on aetiology: sural nerve compression, abductor digiti minimi compression, atrophy and inflammation of the fat pad, plantar fasciitis, stress injury of the heel spur, stress fracture of the heel bone and heel spur. The proposed rehabilitation treatment aims for a reduction of pain and an early return to sports, with excellent results. Conclusions According to what was observed in the present study, related also to the specific treatment of inferior heel pain, and considering the technological progress achieved in recent years, we can now propose an integrated therapeutic approach to treatment of heel pain, properly differentiated according to specific aetiology. PMID:29527319

Thermionic fuel element for the S-prime reactor

NASA Astrophysics Data System (ADS)

Van Hagan, Thomas H.; Drees, Elizabeth A.

1993-01-01

Technical aspects of the thermionic fuel element (TFE) design proposed for the S-PRIME space nuclear power system are discussed. Topics covered include the rational for selecting a multicell TFE approach, a technical description of the S-PRIME TFE and its estimated performance, and the technology readiness of the design, which emphasizes techology maturity and low risk.

Creating Pathways for Low-Skill Adults: Lessons for Community and Technical Colleges from a Statewide Longitudinal Study

ERIC Educational Resources Information Center

Perry, Carol A.

2012-01-01

The purpose of this study was to examine the educational experiences and outcomes of low-skill adults in West Virginia's community and technical colleges, providing a more detailed profile of these students. Data for the variables were obtained from archival databases through a cooperative agreement between state agencies. Descriptive statistics…

A Descriptive Study of the Classroom Instruction Component of the ESEA Title VII Bilingual Education Program. Technical Report.

ERIC Educational Resources Information Center

Cardenas, Rene F.; And Others

The technical report portion of a national survey of bilingual education programs funded under Title VII of the Elementary and Secondary Education Act is presented. The study, conducted during 1979-83, describes the characteristics of the programs' classroom instruction component. Basic project directors and parent advisory committee chairpersons…

Fiscal Year 1986 Technical Objective Document (TOD).

DTIC Science & Technology

1986-03-01

abilties superior to other IR and manual turrets. - START DATE: FY 88 END DATE: FY 90" PROJECT TITLE: COMPOSITE METAL FIRES EE 62:06 JON: 2673XXXX...TECHNOLOGY: FIRE ELEMENT: INTERACTION DESCRIPTION (TECHNICAL OBJECTIVE) Evaluate a new series of agents "BORALONS" capable of extinguishing metal fires and...PROJECT TITLE: COMPOSITE METAL FIRES PE: 63723 JON: 2104XXXX

The Pacific Northwest region vegetation and monitoring system.

Treesearch

Timothy A. Max; Hans T. Schreuder; John W. Hazard; Daniel D. Oswald; John Teply; Jim. Alegria

1996-01-01

A grid sampling strategy was adopted for broad-scale inventory and monitoring of forest and range vegetation on National Forest System lands in the Pacific North-west Region, USDA Forest Service. This paper documents the technical details of the adopted design and discusses alternative sampling designs that were considered. A less technical description of the selected...

Technical Report on Manpower Planning. Technical Group Report No. 7.

ERIC Educational Resources Information Center

Montana Commission on Post-Secondary Education, Helena.

The report is one of a series containing data and recommendations relevant to the task of developing future plans for Montana's post-secondary education. A brief introduction outlines the methods used in gathering information on manpower needs, and is followed by a review and summarization of the data collected, including a description, analysis,…

Technical Assistance and Training from the Document Design Project. Final Report.

ERIC Educational Resources Information Center

American Institutes for Research, Washington, DC.

Contained in this report is a description of the technical assistance and training phase of the Document Design Project, a program funded by the National Institute of Education and intended to address and correct the readability problems posed by public documents. The first section of the report provides background material on the assistance and…

Sociometric Clique Identification. Final Report.

ERIC Educational Resources Information Center

Kadushin, Charles

This report consists of four parts. The first part is a non-technical summary of the basic problem and an attempted solution. The second part is a technical review of the literature and a description of the basic algorithm used in the solution. The third part describes the use of the Sociogram System. The fourth part describes the use of CHAIN, a…

High School Career and Technical Education Participation and Initial College Enrollment: Evidence from Arkansas

ERIC Educational Resources Information Center

Dougherty, Shaun M.

2016-01-01

This paper uses rich administrative data from Arkansas to understand whether and how high school career and technical education (CTE) programs are related to initial enrollment in college after high school. This descriptive work is designed to inform how other state and local policymakers understand the potential role of high school CTE…

Third Progress and Information Report of the Vocational-Technical Education Consortium of States.

ERIC Educational Resources Information Center

Lee, Connie W.; And Others

This description of major activities and accomplishments of the Vocational-Technical Education Consortium of the States (V-TECS) since the second progress report of May, 1975, is designed to provide the reader with a basic understanding of the processes and procedures used by the consortium in achieving its major goal: The production of catalogs…

Upward Mobility Programs in the Service Sector for Disadvantaged and Dislocated Workers. Volume II: Technical Appendices.

ERIC Educational Resources Information Center

Tao, Fumiyo; And Others

This volume contains technical and supporting materials that supplement Volume I, which describes upward mobility programs for disadvantaged and dislocated workers in the service sector. Appendix A is a detailed description of the project methodology, including data collection methods and information on data compilation, processing, and analysis.…

The Impact of Career and Technical Education on Native American Males

ERIC Educational Resources Information Center

Neilson, Brent Alan

2016-01-01

The results of this qualitative descriptive study provide insight into the impact Career and Technical Education has on Native American male students in Northern Arizona. This study was created in response to the lack of research, especially qualitative research in this area. Moreover, it provided Native youth an opportunity to share their stories…

Technical writing practically unified through industry

NASA Technical Reports Server (NTRS)

Houston, L. S.

1981-01-01

General background details in the development of a university level technical writing program, based upon the writing tasks of the student's occupations, are summarized. Objectives and methods for unifying the courses of study with the needs of industry are discussed. Four academic course divisions, Industries Technologies, in which preparation and training are offered are: Animal, Horticulture, Agriculture, and Agricultural Business. Occupational competence is cited as the main goal for these programs in which technical writing is to be practically unified through industry. Course descriptions are also provided.

Pain management at the end of life: A comparative study of cancer, dementia, and chronic obstructive pulmonary disease patients.

PubMed

Romem, Anat; Tom, Sarah E; Beauchene, Michelle; Babington, Lynn; Scharf, Steven M; Romem, Ayal

2015-05-01

Limited data exist concerning the unique pain characteristics of patients with non-cancer terminal diseases referred for inpatient hospice care. To define the unique pain characteristics of patients admitted to an acute inpatient hospice setting with end-stage dementia or chronic obstructive lung disease (or chronic obstructive pulmonary disease) and to compare them to patients with end-stage cancer. Retrospective patient chart review. Demographic, physiological, pain parameters, and medication utilization data were extracted. Associations between pain characteristics, medication utilization, and admission diagnoses were assessed. Analyses included descriptive statistics. In total, 146 patients admitted to an acute inpatient hospice between 1 April 2011 and 31 March 2012 with an underlying primary diagnosis of chronic obstructive pulmonary disease (n = 51), dementia (n = 48), or cancer (n = 47). Pain was highly prevalent in all diagnostic groups, with cancer patients experiencing more severe pain on admission. Cancer patients received a significantly higher cumulative opioid dose compared with dementia and chronic obstructive pulmonary disease patients. Pain control within 24 h of pain onset was achieved in less than half of all patient groups with chronic obstructive pulmonary disease patients the least likely to achieve pain control. Despite the fact that pain is the most common complaint at the end of life, pain management may be suboptimal for some primary diagnoses. Admission diagnosis is the strongest predictor of pain control. Patient with cancer achieve the best pain control, and chronic obstructive pulmonary disease patients are the least likely to have their pain adequately treated. © The Author(s) 2015.

Evaluation of Evidence-based Nursing Pain Management Practice.

PubMed

Song, Wenjia; Eaton, Linda H; Gordon, Debra B; Hoyle, Christine; Doorenbos, Ardith Z

2015-08-01

It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. The aim of this study was to modify and test an evaluation tool for nursing cancer pain documentation, and describe the frequency and quality of nursing pain documentation in one oncology unit via the electronic medical system. A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Medical records were examined for 37 adults hospitalized during April and May 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score ranging from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Nonspecific lower-back pain: surgical versus nonsurgical treatment.

PubMed

Nordin, Margareta; Balagué, Federico; Cedraschi, Christine

2006-02-01

We review evidence-based treatments for patients seeking care for lower-back pain and patients who have been diagnosed with nonspecific lower-back pain. The review is based on selected systematic reviews and national and international guidelines for the treatment of lower-back pain. Additional randomized controlled trials (ie, possibly those not previously included in the latest systematic reviews) were reviewed and added based on recommended procedures for the evaluation of methodological quality (ie, strong, moderate, and weak). In acute nonspecific lower-back pain (0-4 weeks duration of pain) there is moderate to strong evidence that self-care with over-the-counter medication and maintaining activity as tolerated or treatment with a limited number of sessions of manipulative therapy is effective for pain relief. In subacute nonspecific lower-back pain (4-12 weeks duration of pain) there is weak to moderate evidence that a graded activity program including exercises and cognitive behavioral treatment in combination is more efficient than usual care with regard to return to work. There is strong evidence that these programs reduce work absenteeism. In cases of chronic nonspecific lower-back pain (> 12 weeks duration of pain) a variety of treatments are available with limited and similar efficacy on pain and disability reduction. There is moderate evidence that surgery in chronic nonspecific lower-back pain is as effective as cognitive behavioral treatment with regard to pain, function, mood and return to work. Surgical indications for chronic nonspecific lower-back pain remain ill defined. Level V (expert opinion). See the Guidelines for Authors for a complete description of levels of evidence.

Cancer-Related Pain: Prevalence, Severity and Management in a Tertiary Care Center in the Middle East

PubMed Central

Hamieh, Nadine M; Akel, Reem; Anouti, Bilal; Traboulsi, Cindy; Makki, Iman; Hamieh, Lana; Tfayli, Arafat

2018-01-01

Background: Despite pain awareness and the development of treatment guidelines, cancer-related pain assessment and management remain suboptimal. Our objectives were to estimate the prevalence and severity of pain and its interference with daily activities, and evaluate adequacy of treatment in cancer patients in Lebanon. Methods: A total of 400 cancer patients aged 18 and above were interviewed at the American University of Beirut Medical Center surgical and medical oncology floors, outpatient clinics and chemotherapy units from March 2016-February 2017. The subjects covered were socio-demographics, clinical data, and presence of pain in the past month with use of the Brief Pain Inventory questionnaire. Descriptive statistics were conducted using t-test, chi-square and Fischer’s exact tests. Pearson’s correlation coefficients were used to examine relationships between pain severity and pain interference. Logistic regression was employed to determine risk factors for pain. Results: The majority of participants were Lebanese (76.0%), females (62.7%), married (80.2%), of Muslim faith (64.2%), of urban residence (85.8%), and with insurance plans (81.3%). Most had breast cancer (38.8%), were stage 4 (52.7%) and underwent a combination of surgery and systemic therapy (55.1%). The prevalence of pain in the past month was 29.8%. Among patients with pain, the highest proportion had moderate pain (37.8%) and around 46% received inadequate treatment. Conclusion: More awareness about cancer-related pain is needed to improve pain management and encourage referral to palliative care and pain specialists early-on in diagnosis of disease. PMID:29582633

Technology and development requirements for advanced coal conversion systems

NASA Technical Reports Server (NTRS)

1981-01-01

A compendium of coal conversion process descriptions is presented. The SRS and MC data bases were utilized to provide information paticularly in the areas of existing process designs and process evaluations. Additional information requirements were established and arrangements were made to visit process developers, pilot plants, and process development units to obtain information that was not otherwise available. Plant designs, process descriptions and operating conditions, and performance characteristics were analyzed and requirements for further development identified and evaluated to determine the impact of these requirements on the process commercialization potential from the standpoint of economics and technical feasibility. A preliminary methodology was established for the comparative technical and economic assessment of advanced processes.

Aircraft/Air Traffic Management Functional Analysis Model: Technical Description. 2.0

NASA Technical Reports Server (NTRS)

Etheridge, Melvin; Plugge, Joana; Retina, Nusrat

1998-01-01

The Aircraft/Air Traffic Management Functional Analysis Model, Version 2.0 (FAM 2.0), is a discrete event simulation model designed to support analysis of alternative concepts in air traffic management and control. FAM 2.0 was developed by the Logistics Management Institute (LMI) under a National Aeronautics and Space Administration (NASA) contract. This document provides a technical description of FAM 2.0 and its computer files to enable the modeler and programmer to make enhancements or modifications to the model. Those interested in a guide for using the model in analysis should consult the companion document, Aircraft/Air Traffic Management Functional Analysis Model, Version 2.0 Users Manual.

Cognitive behavioural therapy in pain and psychological disorders: Towards a hybrid future.

PubMed

Tang, Nicole K Y

2017-03-08

Cognitive Behavioural Therapy (CBT) is a form of evidence-based talking therapy that emphasises the importance of behaviour and conscious thoughts in shaping our emotional experiences. As pain becomes increasingly accepted as not only a sensory but also an emotional experience, success in using CBT to treat emotional disorders has resulted in the incorporation of cognitive-behavioural principles into the management of chronic pain. Outcomes of CBT-informed interdisciplinary pain management programmes are modest at best, despite rapid methodological improvements in trial design and implementation. Whilst the field searches for new treatment directions, a hybrid CBT approach that seeks to simultaneously tackle pain and its comorbidities shows promise in optimising treatment effectiveness and flexibility. This article provides a brief description of the core characteristics of CBT and the transformation this therapeutic model has brought to our understanding and management of chronic pain. Current evidence on efficacy of CBT for chronic pain is then reviewed, followed by a critical consideration of the advantages and disadvantages of the new hybrid treatment approach that conceptualises and treats chronic pain in connection with its comorbidities. Recent progress made in the area of pain and insomnia is highlighted as an example to project therapeutic innovations in the near future. Copyright © 2017 Elsevier Inc. All rights reserved.

Role of Rehabilitation Medicine and Physical Agents in the Treatment of Cancer-Associated Pain

PubMed Central

Cheville, Andrea L.; Basford, Jeffrey R.

2014-01-01

Purpose To provide an overview of rehabilitation medicine– and physical modality–based approaches to cancer pain management, and to highlight the fact that these approaches are generally used in conjunction and that a majority are focused on minimizing pain during periods of mobility and the performance of activities of daily living. Methods We performed a nonsystematic literature review and provide a description of the current standard of care. Results Rehabilitative and physical modalities used to manage pain can be grouped into four categories: those that modulate nociception, stabilize or unload painful structures, influence physiological processes that indirectly influence nociception, or alleviate pain arising from the overloading of muscles and connective tissues that often occurs after surgery or with sarcopenia in late-stage cancer. Most modalities have been pragmatically refined over the years, and many have an evidence base, although few have been explicitly validated in the oncologic setting. With few exceptions, they are patient controlled and free of adverse effects. Conclusion Physical modalities and rehabilitation medicine offer a range of pain management approaches that may serve as beneficial adjuncts to the conventional systemic and interventional analgesic strategies used to control cancer-related pain. These approaches may be particularly beneficial to patients with movement-associated pain and those who are ambivalent regarding pharmacoanalgesia. PMID:24799472

An Examination of Cultural Values and Pain Management in Foreign-Born Spanish-Speaking Hispanics Seeking Care at a Federally Qualified Health Center.

PubMed

Torres, Calia A; Thorn, Beverly E; Kapoor, Shweta; DeMonte, Colette

2017-11-01

Most studies done with Hispanics illustrate their preference for self-management practices; therefore, examining the factors driving patients to seek medical care for pain management will help elucidate what patients want and need from their doctors for pain management. The aim of the present study was to obtain patients' perspectives and enhance our understanding of the cultural beliefs influencing pain management decisions of foreign-born Spanish-speaking Hispanics with low acculturation. Twenty-four individuals (17 females and 7 males) with self-reported chronic pain completed the study. Participants attended a focus group and shared about pain management practices and their experiences with medical care for pain management. Descriptive data on pain and mood variables were collected to examine how this population compares with the norms reported in the pain literature for Hispanics. Participants reported a preference for pain self-management and noninvasive medical treatments and expressed negative attitudes toward pain medications, although wanting the option of pain medications as a "last resort." Satisfaction with medical care for pain was highly influenced by the participants' expectations and preference for personal, warm, and friendly interactions. Our findings are consistent with previous reports on Hispanics' preference for self-care practices. Perhaps foreign-born Hispanics may rely on self-care practices and delay medical attention for pain management because of their unfamiliarity with the US health care system. Other potential explanations for a reliance on self-care for pain management involve patients having a limited understanding of or access to effective treatment options for chronic pain and negative experiences with US medical providers. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Knowledge and attitudes of pain management among nursing faculty.

PubMed

Voshall, Barbara; Dunn, Karen S; Shelestak, Debra

2013-12-01

A descriptive correlational design was used in this study to examine nursing faculty knowledge and attitudes in pain management. Relationships between age, education level, pain management preparation, length of time practicing as a nurse, length of time teaching nursing, time teaching pain management in the classroom, taught pain guidelines in the classroom, and additional continuing education about pain management were explored. Ninety-six nursing faculty participated from 16 schools of nursing in one Midwestern U.S. region. Findings identified that most of the nursing faculty recalled being taught about pain management in their basic education, but less than one-half felt adequately prepared. Most respondents said that they taught pain management, yet fewer than one-half identified that they used specific pain management guidelines. Faculty demonstrated adequate knowledge of pain assessment, spiritual/cultural issues, and pathophysiology. Areas of weakness were found in medications, interventions, and addiction. Faculty that reported teaching pain management in the classroom and reported more continuing education missed fewer items. Older nursing faculty reported more years of practice, more years of teaching, and more continuing education in pain management than younger faculty. Younger nursing faculty remembered being taught pain management in nursing school and felt more adequately prepared than older nursing faculty. Faculty that reported practicing for longer periods of time felt less prepared in pain management than faculty who practiced for shorter periods of time. More continuing education in pain management may be needed for older nurses to meet the recommendations of the Institute of Medicines' report on relieving pain in the U.S. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Can social media be used as a hospital quality improvement tool?

PubMed

Lagu, Tara; Goff, Sarah L; Craft, Ben; Calcasola, Stephanie; Benjamin, Evan M; Priya, Aruna; Lindenauer, Peter K

2016-01-01

Many hospitals wish to improve their patients' experience of care. To learn whether social media could be used as a tool to engage patients and to identify opportunities for hospital quality improvement (QI), we solicited patients' narrative feedback on the Baystate Medical Center Facebook page during a 3-week period in 2014. Two investigators used directed qualitative content analysis to code comments and descriptive statistics to assess the frequency of selected codes and themes. We identified common themes, including: (1) comments about staff (17/37 respondents, 45.9%); (2) comments about specific departments (22/37, 59.5%); (3) comments on technical aspects of care, including perceived errors and inattention to pain control (9/37, 24.3%); and (4) comments describing the hospital physical plant, parking, and amenities (9/37, 24.3%). A small number (n = 3) of patients repeatedly responded, accounting for 30% (45/148) of narratives. Although patient feedback on social media could help to drive hospital QI efforts, any potential benefits must be weighed against the reputational risks, the lack of representativeness among respondents, and the volume of responses needed to identify areas of improvement. © 2015 Society of Hospital Medicine.

Idiopathic Ophthalmodynia and Idiopathic Rhinalgia: A Prospective Series of 16 New Cases.

PubMed

Pareja, Juan A; Montojo, Teresa; Guerrero, Ángel L; Álvarez, Mónica; Porta-Etessam, Jesús; Cuadrado, María L

2015-01-01

Idiopathic ophthalmodynia and idiopathic rhinalgia were described a few years ago. These conditions seem specific pain syndromes with a distinctive location in the eye or in the nose. We aimed to present a new prospective series in order to verify the consistency of these syndromes. We performed a descriptive study of all patients referred to our regional neurologic clinics from 2010 to 2014 because of facial pain exclusively felt in the eye or in the nose fulfilling the proposed diagnostic criteria for idiopathic ophthalmodynia and idiopathic rhinalgia. There were 9 patients with idiopathic ophthalmodynia and 7 patients with idiopathic rhinalgia, with a clear female preponderance, and a mean age at onset in the fifth decade. The pain was usually moderate and the temporal pattern was generally chronic. Only one patient reported accompaniments (hypersensitivity to the light and to the flow of air in the symptomatic eye). Preventive treatment with amitriptyline, pregabalin, or gabapentin was partially or totally effective. The clinical features of this new series parallels those of the original description, thus indicating that both idiopathic ophthalmodynia and idiopathic rhinalgia have clear-cut clinical pictures with excellent consistency both inter- and intra-individually. © 2015 American Headache Society.

Association of pain, social support and socioeconomic indicators in patients with spinal cord injury in Iran.

PubMed

Khazaeipour, Z; Ahmadipour, E; Rahimi-Movaghar, V; Ahmadipour, F; Vaccaro, A R; Babakhani, B

2017-02-01

Descriptive cross-sectional study. Pain is a prevalent complication of individuals with spinal cord injury (SCI). Our objective was to examine the association between social support, socioeconomic factors and psychosocial factors and pain to develop more effective management strategies. Brain and Spinal Cord Injury Research (BASIR) Center, Tehran University of Medical Sciences, Tehran, Iran. The Persian version of the Brief Pain Inventory was used to measure the pain, and the Multidimensional Scale of Perceived Social Support was used to measure social support through structured face-to-face interviews in SCI individuals. The overall prevalence of pain was 50.7%; 79.3% of individuals had bilateral pain, with lower limbs and back being the most common location. The quality of pain was described as aching (41.4%), tingling (32.9%), pressure (15.7%), coldness (5.7%) and feeling electric shock sensations (4.3%). The frequency of pain in individuals with paraplegia (60.9% vs 45.7%) and incomplete (53.5% vs 52.5%) SCI was higher than with other types of neurological injuries. Patients with a medium level of education had the least pain and those with good economic situation reported higher frequency of having pain (P=0.034). There was no significant relationship between pain and social support. There was a positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P<0.001). These novel findings will inform the development of strategies to manage pain by improving access to health-care facilities and supplies.

Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study.

PubMed

Liu, Justina Y W

2014-05-01

To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. This is a descriptive, exploratory qualitative study. Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. © 2013 John Wiley & Sons Ltd.

Emergency nurses' knowledge, attitude and clinical decision making skills about pain.

PubMed

Ucuzal, Meral; Doğan, Runida

2015-04-01

Pain is the most common reason that patients come to the emergency department. Emergency nurses have an indispensable role in the management of this pain. The aim of this study was to examine emergency nurses' knowledge, attitude and clinical decision-making skills about pain. This descriptive study was conducted in a state and a university hospital between September and October 2012 in Malatya, Turkey. Of 98 nurses working in the emergency departments of these two hospitals, 57 returned the questionnaires. The response rate was 58%. Data were collected using the Demographic Information Questionnaire, Knowledge and Attitude Questionnaire about Pain and Clinical Decision Making Survey. Frequency, percentage, mean and standard deviation were used to evaluate data. 75.4% of participant nurses knew that patients' own statement about their pain was the most reliable indicator during pain assessment. Almost half of the nurses believed that patients should be encouraged to endure the pain as much as possible before resorting to a pain relief method. The results also indicate that most of nurses think that a sleeping patient does not have any pain and pain relief should be postponed as it can influence the diagnosis negatively. It is determined that the pain scale was not used frequently. Only 35.1% of nurses reported keeping records of pain. Despite all the recommendations of substantial past research the results of this study indicate that emergency nurses continue to demonstrate inadequate knowledge, clinical decision-making skills and negative attitudes about pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bullous Complex Regional Pain Syndrome: A description of the clinical and histopathologic features.

PubMed

Ho, J D; Al-Haseni; Smith, S; Bhawan, J; Sahni, D

2018-04-27

Complex regional pain syndrome (CRPS, formerly reflex sympathetic dystrophy) is a poorly understood syndrome occurring most commonly after peripheral trauma.(1) Diagnostic features include pain, autonomic dysregulation, sensory/motor abnormalities and trophic changes involving the affected limb.(1,2) Dermatologic findings include erythema, atrophy, xerosis, erosive disease, and reticulated erythematous patches.(3,4) Exceptionally, blistering has been reported.(5-7) Given its rarity, the clinical and histopathologic findings of bullous CRPS are not well described. We report a case of bullous CRPS in a patient with mycosis fungoides (MF), describing the clinical and histopathologic features of this uncommon entity. This article is protected by copyright. All rights reserved.

Nuclear facility decommissioning and site remedial actions: A selected bibliography: Volume 8

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P.T.; Michelson, D.C.; Knox, N.P.

1987-09-01

The 553 abstracted references on nuclear facility decommissioning, uranium mill tailings management, and site remedial actions constitute the eighth in a series of reports. Foreign and domestic literature of all types - technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions - has been included. The bibliography contains scientific, technical, economic, regulatory, and legal information pertinent to the US Department of energy's remedial action program. Major chapters are Surplus Facilities Management Program, Nuclear Facilities Decommissioning, Formerly Utilized Sites Remedial Action Program, Facilities Contaminated with Naturally Occurring Radionuclides, Uranium Mill Tailings Remedial Action Program,more » Uranium Mill Tailings Management, Technical Measurements Center, and General Remedial Action Program Studies. Chapter sections for chapters 1, 2, 5, and 6 include Design, Planning, and Regulations; Environmental Studies and Site Surveys; Health, Safety, and Biomedical Studies; Decontamination Studies; Dismantlement and Demolition; Site Stabilization and Reclamation; Waste Disposal; Remedial Action Experience; and General Studies. Within these categories, references are arranged alphabetically by first author. Those references having no individual author are listed by corporate affiliation or by publication description. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, and keywords. The appendix contains a list of frequently used acronyms and abbreviations.« less

A Descriptive Study of Head Start Families: FACES Technical Report I.

ERIC Educational Resources Information Center

O'Brien, Robert W.; D'Elio, Mary Ann; Vaden-Kiernan, Michael; Magee, Candice; Younoszai, Tina; Keane, Michael J.; Connell, David C.; Hailey, Linda

Recognizing that families have played an essential role in the Head Start philosophy since the program's inception, the Head Start Family and Child Experiences Survey (FACES) is an effort to develop a descriptive profile of families participating in the Head Start program and services, as well as to develop, test, and refine Program Performance…

Toward the 21st Century: Preparing Proactive Visionary Transformational Leaders for Building Learning Communities. Human Resource Development.

ERIC Educational Resources Information Center

Groff, Warren H.

This package includes a description of Nova University's Human Resource Development (HRD) core seminar and seven doctoral student papers. The description (by Warren Groff) explains how a major curriculum change was made to convert the vocational, technical, and occupational specialization seminar, Personnel-Human Resources Development, to the core…

Descriptive Geometry in Educational Process of Technical University in Russia Today

ERIC Educational Resources Information Center

Voronina, Marianna V.; Tretyakova, Zlata O.; Moroz, Olga N.; Folomkin, Andrey I.

2016-01-01

The relevance of the investigated problem is caused by the need for monitoring the impact of the Unified State Examination (USE) on the level of mathematical culture and the level of geometric literacy of applicants and students of modern engineering universities of Russia. The need to determine the position of Descriptive Geometry in the…

Mozambican Student-Teachers' Perceptions of Developing Their Understanding of Teaching Spatially Dependent Geometry

ERIC Educational Resources Information Center

Dinis da Costa, Daniel

2014-01-01

This article presents student-teachers' perceptions of spatial 3D-descriptive geometry education in Mozambique. To interpret a 3D object through 2D projections and vice-versa requires spatial abilities that are deemed crucial for learning in any spatially dependent discipline such as 3D-descriptive geometry, engineering and technical-vocational…

Concerning Descriptive Standards: A Partnership between Public Archives and Private Collections in Geneva, Switzerland

ERIC Educational Resources Information Center

Roth-Lochner, Barbara; Grange, Didier

2005-01-01

This paper presents the results of a partnership begun in 2002 in the field of archival description between the Geneva City Archives (AVG) and the Manuscripts Department of the Public and University Library of Geneva (BPU). This cooperation has allowed the creation of two computer applications, which share technical and conceptual foundations.…

Recent Scientific Evidence and Technical Developments in Cardiovascular Computed Tomography.

PubMed

Marcus, Roy; Ruff, Christer; Burgstahler, Christof; Notohamiprodjo, Mike; Nikolaou, Konstantin; Geisler, Tobias; Schroeder, Stephen; Bamberg, Fabian

2016-05-01

In recent years, coronary computed tomography angiography has become an increasingly safe and noninvasive modality for the evaluation of the anatomical structure of the coronary artery tree with diagnostic benefits especially in patients with a low-to-intermediate pretest probability of disease. Currently, increasing evidence from large randomized diagnostic trials is accumulating on the diagnostic impact of computed tomography angiography for the management of patients with acute and stable chest pain syndrome. At the same time, technical advances have substantially reduced adverse effects and limiting factors, such as radiation exposure, the amount of iodinated contrast agent, and scanning time, rendering the technique appropriate for broader clinical applications. In this work, we review the latest developments in computed tomography technology and describe the scientific evidence on the use of cardiac computed tomography angiography to evaluate patients with acute and stable chest pain syndrome. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Treatment of comorbid pain and PTSD in returning veterans: a collaborative approach utilizing behavioral activation.

PubMed

Plagge, Jane M; Lu, Mary W; Lovejoy, Travis I; Karl, Andrea I; Dobscha, Steven K

2013-08-01

We explore preliminary clinical effectiveness and feasibility of an intervention utilizing collaborative care components and behavioral activation (BA) to treat comorbid chronic pain and posttraumatic stress disorder (PTSD). Descriptive, including pre- and posttreatment assessment results. Portland Veterans Affairs Medical Center. Fifty-eight Iraq and Afghanistan veterans with chronic pain and PTSD symptoms. Veterans participated in a biopsychosocial evaluation and up to eight BA sessions using a collaborative approach involving primary care, mental health, and other clinicians. A physiatrist assisted the psychologist in providing recommendations to primary care providers. Participants were administered pre- and posttreatment measures of PTSD, pain severity, pain interference, mental health, quality of life, satisfaction, and global ratings of change with the purpose of assessing progress and improving quality. Of the 58 participants, 30 completed treatment. Common recommendations included physical therapy and exercise programs, pain medication or pain medication adjustments, and additional diagnostic workups, such as imaging. Participants who completed the program showed significant improvements on measures of PTSD, pain severity, and pain interference. Improvements were also evident on measures of mental health and quality of life. Overall, participants were satisfied with the program, and on average reported feeling "somewhat better." These findings suggest that a collaborative approach that includes BA is feasible and a potentially effective treatment for comorbid chronic pain and PTSD. Wiley Periodicals, Inc.

Effect of clinic related factors on continuation rates of IUDs.

PubMed

Reading, A E; Goldstuck, N D

1982-01-01

This paper concerns factors relating to the clinic and the way in which the insertion of IUDs is managed from a psychological and technical standpoint. 3 aspects of clinical service are examined: 1) the influence of the psychological state at time of insertion, 2) individual differences in relation to side effects amongst users and the way in which those are influenced by managment techniques, and 3) technical aspects of the insertion of the device. Insertion pain and discomfort may influence subsequent tolerance of the IUD in 3 ways: 1) patient compliance may be enhanced by trouble-free insertion, 2) an unpleasant experience may influence attitudes towards the IUD, and 3) the experience of pain at insertion may reduce subsequent tolerance of discomfort. IUDs increase the amount of menstrual flow which, along with pain, constitute frequent requests for removal. Removal rates for pain and bleeding vary from 0-16.8/100 users. Removal rates for bleeding are also influenced by cultural attitudes. Insertion techniques influence acceptability of IUDs. Also, the incidence of expulsion, pregnancy, and removal declines with increasing age and parity. Discontinuation rates after 24 months were 91% for women below 2nd parity and only 37% for women of 6 or more parity. In the youngest age group the discontinuation rate was 76% compared with 35% in the oldest age group. The timing of IUD insertion and positioning of the IUD influence continuation rates. An implication of these concerns is that IUD insertion procedures may have to become more complex to achieve compatibility between IUD-uterine configurations.

Construct validity and reliability of a real-time multidimensional smartphone app to assess pain in children and adolescents with cancer.

PubMed

Stinson, Jennifer N; Jibb, Lindsay A; Nguyen, Cynthia; Nathan, Paul C; Maloney, Anne Marie; Dupuis, L Lee; Gerstle, J Ted; Hopyan, Sevan; Alman, Benjamin A; Strahlendorf, Caron; Portwine, Carol; Johnston, Donna L

2015-12-01

We evaluated the construct validity (including responsiveness), reliability, and feasibility of the Pain Squad multidimensional smartphone-based pain assessment application (app) in children and adolescents with cancer, using 2 descriptive studies with repeated measures. Participants (8-18 years) undergoing cancer treatment were drawn from 4 pediatric cancer centers. In study 1, 92 participants self-reported their level of pain twice daily for 2 weeks using the Pain Squad app to assess app construct validity and reliability. In study 2, 14 participants recorded their level of pain twice a day for 1 week before and 2 weeks after cancer-related surgery to determine app responsiveness. Participants in both studies completed multiple measures to determine the construct validity and feasibility of the Pain Squad app. Correlations between average weekly pain ratings on the Pain Squad app and recalled least, average, and worst weekly pain were moderate to high (0.43-0.68). Correlations with health-related quality of life and pain coping (measured with PedsQL Inventory 4.0, PedsQL Cancer Module, and Pain Coping Questionnaire) were -0.46 to 0.29. The app showed excellent internal consistency (α = 0.96). Pain ratings changed because of surgery with large effect sizes between baseline and the first week postsurgery (>0.85) and small effect sizes between baseline and the second week postsurgery (0.13-0.32). These findings provide evidence of the construct validity, reliability, and feasibility of the Pain Squad app in children and adolescents with cancer. Use of real-time data capture approaches should be considered in future studies of childhood cancer pain. A video accompanying this abstract is available online as Supplemental Digital Content at http://links.lww.com/PAIN/A169.

Use of a Behavioural Pain Scale to assess pain in ventilated, unconscious and/or sedated patients.

PubMed

Young, Jeanne; Siffleet, Jo; Nikoletti, Sue; Shaw, Thérèse

2006-02-01

Current empirical evidence supports claims that pain in sedated, unconscious Intensive Care Unit (ICU) patients is underrated and under-treated. Given the severity of ICU patients' illness pain management, whilst important, may not be considered a priority and therefore can be easily overlooked. The aim of this study was to validate the Behavioural Pain Scale (BPS) for the assessment of pain in critically ill patients by evaluating facial expressions, upper limb movements and compliance with mechanical ventilation. A prospective, descriptive repeated measures study design was used to assess the validity and reliability of the BPS for assessing pain in critically ill patients undergoing routine painful (repositioning) and non-painful (eye care) procedures. An average of 73% of BPS scores increased (indicating pain) after patients were repositioned, as opposed to 14% after eye care. This increase was statistically significant for repositioning (p < 0.003) but not for eye care (p > 0.3). The odds of an increase in BPS between pre- and post-procedure assessments was more than 25 times higher for repositioning compared with eye care (p < 0.0001), after controlling for analgesics and sedatives. The BPS was found to be a valid and reliable tool in the assessment of pain in the unconscious sedated patient. Results also highlighted that traditional pain indicators, such as fluctuations in haemodynamic parameters, are not always an accurate measure for the assessment of pain in unconscious patients and as such more objective pain assessment measures are essential. Finally, further validation of the BPS and identification of other painful routine procedures is needed to enhance pain management delivery for unconscious patients.

Attitude and Intention Regarding Pain Management among Chinese Nursing Students: A Cross-Sectional Questionnaire Survey.

PubMed

Fang, Liang-Yu; Xu, Yin-Chuan; Lin, Dan-Ni; Jin, Jing-Feng; Yan, Min

2017-08-01

Optimal pain management is a priority in effective nursing care. Lack of sufficient pain knowledge associated with inadequate pain management has been proved. However, the intention, defined as the predictor of behavior, regarding pain management remains unknown. Therefore, the study was to determine the attitude and intention regarding pain management among Chinese nursing students and investigate the underlying determinants and their interactions in terms of intention toward pain management. The Pain Management Survey Questionnaire, comprising the key determinants of the theory of planned behavior-that is, direct attitude, belief-based intention, subjective norm, direct control, and indirect control-was used to collect data from 512 nursing students who undertook clinical rotation in an affiliated hospital of a medical college in China. Data were analyzed using descriptive statistics, independent sample t test, Pearson correlation analysis, or structural equation modeling analysis. Chinese nursing students reported negative attitudes and behavioral intentions toward pain management. Direct control, subjective norm, belief-based attitude, and indirect control independently predicted nursing students' intention to treat patients with pain. Direct control was the strongest predictor. Structural equation modeling analysis further revealed 39.84% of the variance associated with intention that could be explained by determinants of the theory of planned behavior. Additionally, educational school level and previous pain management training had great effects on pain management intention. Overall, this study identified intention as an important factor in effective pain treatment. Chinese nursing students have negative attitudes and insufficient intention to pain management. Therefore, hospitals and universities in China should manage these factors to improve nursing students' practice regarding pain management. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Assessment of chronic post-surgical pain after knee replacement: development of a core outcome set.

PubMed

Wylde, V; MacKichan, F; Bruce, J; Gooberman-Hill, R

2015-05-01

Approximately 20% of patients experience chronic post-surgical pain (CPSP) after total knee replacement (TKR). There is scope to improve assessment of CPSP after TKR, and this study aimed to develop a core outcome set. Eighty patients and 43 clinicians were recruited into a three-round modified Delphi study. In Round 1, participants were presented with 56 pain features identified from a systematic review, structured interviews with patients and focus groups with clinicians. Participants assigned importance ratings, using a 1-9 scale, to individual pain features; those features rated as most important were retained in subsequent rounds. Consensus that a pain feature should be included in the core outcome set was defined as the feature having a rating of 7-9 by ≥70% of both panels (patients and clinicians) and 1-3 by ≤15% of both panels or rated as 7-9 by ≥90% of one panel. Round 1 was completed by 71 patients and 39 clinicians, and Round 3 by 62 patients and 33 clinicians. The final consensus was that 33 pain features were important. These were grouped into an 8-item core outcome set comprising: pain intensity, pain interference with daily living, pain and physical functioning, temporal aspects of pain, pain description, emotional aspects of pain, use of pain medication, and improvement and satisfaction with pain relief. This core outcome set serves to guide assessment of CPSP after TKR. Consistency in assessment can promote standardized reporting and facilitate comparability between studies that address a common but understudied type of CPSP. © 2014 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.

Description of Metopiellus painensis sp. nov. (Coleoptera, Staphylinidae), first troglobitic Pselaphinae from Brazil.

PubMed

Asenjo, Angélico; Ferreira, Rodrigo Lopes; Zampaulo, Robson DE Almeida

2017-05-19

Metopiellus painensis new species, of the Neotropical pselaphine tribe Metopiasini, is described from Pains region, Brasil (Minas Gerais). Major diagnostic features are illustrated and a key to the known species is given.

Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome Type III and Ehlers-Danlos syndrome hypermobility type): Clinical description and natural history.

PubMed

Tinkle, Brad; Castori, Marco; Berglund, Britta; Cohen, Helen; Grahame, Rodney; Kazkaz, Hanadi; Levy, Howard

2017-03-01

The hypermobile type of Ehlers-Danlos syndrome (hEDS) is likely the most common hereditary disorder of connective tissue. It has been described largely in those with musculoskeletal complaints including joint hypermobility, joint subluxations/dislocations, as well as skin and soft tissue manifestations. Many patients report activity-related pain and some go on to have daily pain. Two undifferentiated syndromes have been used to describe these manifestations-joint hypermobility syndrome and hEDS. Both are clinical diagnoses in the absence of other causation. Current medical literature further complicates differentiation and describes multiple associated symptoms and disorders. The current EDS nosology combines these two entities into the hypermobile type of EDS. Herein, we review and summarize the literature as a better clinical description of this type of connective tissue disorder. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Retrobulbar chlorpromazine in management of painful eye in blind or low vision patients.

PubMed

Ortiz, A; Galvis, V; Tello, A; Miro-Quesada, J J; Barrera, R; Ochoa, M

2017-04-01

To evaluate the results of applying retrobulbar chlorpromazine in the management of patients with painful blind eyes or with very poor vision. A retrospective, descriptive review was carried out on the medical records of 33 patients who were treated with a retrobulbar injection of chlorpromazine (25mg) for the management of painful blind eyes in Centro Oftalmológico Virgilio Galvis. Pain control was achieved in 90% of cases (with mean follow-up of 2.1 years). The mean intraocular pressure decreased by 37%. In 7 out of 12 eyes that maintained residual vision, loss of some degree of vision was acknowledged. One patient required an additional cyclodestructive procedure, another one required an absolute alcohol injection, and in an additional case evisceration surgery was necessary to achieve pain control. No serious complications were noted with this therapy. Retrobulbar injection of chlorpromazine is a valid option in painful, blind eye cases (or with very poor vision) with a poor visual prognosis. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of yoga on chronic neck pain: a systematic review of randomized controlled trials

PubMed Central

Kim, Sang-Dol

2016-01-01

[Purpose] The aim of this study was to investigate the effectiveness of yoga in the management of chronic neck pain. [Subjects and Methods] Five electronic databases were searched to identify randomized controlled trials (RCTs) of yoga intervention on chronic neck pain. The trials were published in the English language between January 1966 and December 2015. The Cochrane Risk of Bias Tool was used to assess the quality of the trials. [Results] Three trials were identified and included in this review. A critical appraisal was performed on the trials, and the result indicated a high risk of bias. A narrative description was processed because of the small number of RCTs. Neck pain intensity and functional disability were significantly lower in the yoga groups than in the control groups. [Conclusion] Evidence from the 3 randomly controlled trials shows that yoga may be beneficial for chronic neck pain. The low-quality result of the critical appraisal and the small number of trials suggest that high-quality RCTs are required to examine further the effects of yoga intervention on chronic neck pain relief. PMID:27512290

Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain.

PubMed

Moulin, D E; Kreeft, J H; Murray-Parsons, N; Bouquillon, A I

1991-02-23

To compare the safety and efficacy of subcutaneous and intravenous infusion of opioid analgesics, a randomised, double-blind, crossover trial was carried out in inpatients. 15 patients with severe cancer pain received two 48 h infusions of hydromorphone--one subcutaneously and one intravenously in randomly allocated order. The study was made double-blind by the use of two infusion pumps throughout; during the active subcutaneous infusion the intravenous pump delivered saline and vice versa. Serial measurements of pain intensity, pain relief, mood, and sedation by means of visual analogue scales showed no clinically or statistically significant difference between the two infusion routes. Side-effects were slight, and the mean number of morphine injections for breakthrough pain did not differ significantly between the routes (4.8 [SD 4.5] for intravenous vs 5.3 [5.6] for subcutaneous). Plasma hydromorphone concentrations measured at 24 h and 48 h of infusion showed stable steady-state pharmacokinetics; the mean bioavailability from subcutaneous infusion was 78% of that with intravenous infusion. Because of the simplicity, technical advantages, and cost-effectiveness of continuous subcutaneous opioid infusion into the chest wall or trunk, intravenous opioid infusion for the management of severe cancer pain should be abandoned.

Pulse-dose radiofrequency treatment in pain management-initial experience.

PubMed

Ojango, Christine; Raguso, Mario; Fiori, Roberto; Masala, Salvatore

2018-05-01

Radiofrequency procedures have been used for treating various chronic pain conditions for decades. These minimally invasive percutaneous treatments employ an alternating electrical current with oscillating radiofrequency wavelengths to eliminate or alter pain signals from the targeted site. The aim of the continuous radiofrequency procedure is to increase the temperature sufficiently to create an irreversible thermal lesion on nerve fibres and thus permanently interrupt pain signals. The pulsed radiofrequency procedure utilises short pulses of radiofrequency current with intervals of longer pauses to avert a temperature increase to the level of permanent tissue damage. The goal of these pulses is to alter the processing of pain signals, but to avoid relevant structural damage to nerve fibres, as seen in the continuous radiofrequency procedure. The pulse-dose radiofrequency procedure is a technical improvement of the pulsed radiofrequency technique in which the delivery mode of the current is adapted. During the pulse-dose radiofrequency procedure thermal damage is avoided. In addition, the amplitude and width of the consecutive pulses are kept the same. The method ensures that each delivered pulse keeps the same characteristics and therefore the dose is similar between patients. The current review outlines the pulse-dose radiofrequency procedure and presents our institution's chronic pain management studies.

The 30/20 GHz flight experiment system, phase 2. Volume 2: Experiment system description

NASA Technical Reports Server (NTRS)

Bronstein, L.; Kawamoto, Y.; Ribarich, J. J.; Scope, J. R.; Forman, B. J.; Bergman, S. G.; Reisenfeld, S.

1981-01-01

A detailed technical description of the 30/20 GHz flight experiment system is presented. The overall communication system is described with performance analyses, communication operations, and experiment plans. Hardware descriptions of the payload are given with the tradeoff studies that led to the final design. The spacecraft bus which carries the payload is discussed and its interface with the launch vehicle system is described. Finally, the hardwares and the operations of the terrestrial segment are presented.

Educational Technology Program. Quarterly Technical Summary, Period Ending 31 May 1970.

ERIC Educational Resources Information Center

Frick, Frederick C.

An overview of the Lincoln Training System (LTS) and descriptions of the hardward and software of the LTS-1 and LTS-2 systems are provided. The overall program seeks to develop, test, and evaluate technical aids to vocational training systems. These are appropriate to this field because the high costs need to be reduced and because there are clear…

Pollutant Assessments Group procedures manual: Volume 2, Technical procedures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-03-01

This is volume 2 of the manuals that describes the technical procedures currently in use by the Pollution Assessments Group. This manual incorporates new developments in hazardous waste assessment technology and administrative policy. Descriptions of the equipment, procedures and operations of such things as radiation detection, soil sampling, radionuclide monitoring, and equipment decontamination are included in this manual. (MB)

Physics of Musical Instruments Minicourse, Career Oriented Pre-Technical Physics. Preliminary Edition.

ERIC Educational Resources Information Center

Bullock, Bob; And Others

This minicourse was prepared for use with secondary physics students in the Dallas Independent School District and is one option in a physics program which provides for the selection of topics on the basis of student career needs and interests. This minicourse was aimed at providing students with a knowledge of the technical descriptions of music,…

IDEA Technical Report No. 4. Description of IDEA Standard Form Data Base.

ERIC Educational Resources Information Center

Cashin, William E.; Perrin, Bruce M.

The data and computational procedures used by the IDEA System to generate IDEA Reports from information collected on the Standard Form of the IDEA Survey Form are described in this technical report. The computations for each of the seven parts of the IDEA Report are explained. The data base used for this 1978-79 Kansas State University study…

Using Examinations To Improve Education: A Study in Fourteen African Countries. World Bank Technical Paper Number 165. Africa Technical Department Series.

ERIC Educational Resources Information Center

Kellaghan, Thomas; Greaney, Vincent

A detailed description is presented of the types, functions, performance levels, governance, administration, and funding of public examinations in 14 Sub-Saharan African countries with different educational traditions, based on English, French, or other backgrounds. The countries are: (1) Kenya; (2) Lesotho; (3) Mauritius; (4) Swaziland; (5)…

Technical Training Skills Needs of Youth for Sustainable Job Security in Rice Production in Ebonyi State, Nigeria

ERIC Educational Resources Information Center

Edu, Chukwuma Nwofe; Ogba, Ernest Ituma

2016-01-01

The study identifies technical training skills needs of youth for sustainable job security in rice production in Ebonyi State, Nigeria. This study was carried out in secondary schools in three educational zones in Ebonyi State, Nigeria. Ebonyi state is one of the states in the southeast geopolitical zone in Nigeria. Descriptive survey design was…

A Look at Leadership: An Examination of Career and Technical Administrator Preparation in the United States

ERIC Educational Resources Information Center

Clark, Robert W.; Cole, Belinda

2015-01-01

The study is designed to examine the perceptions of U.S. State Directors of Career and Technical Education (CTE) of the state of administrator preparation programs and the needs for training administrators in CTE. The study used descriptive survey research with a 59 element Likert-type questionnaire. The results of the study, from 26 respondents…

A Description of the Psychological Environment of Students at the Agricultural and Technical College at Delhi.

ERIC Educational Resources Information Center

Bertrami, Anthony

The psychological environment of a college is determined by the inner needs of the students and environmental press, i.e. the stresses, conformity-demanding influence, and rewards of the college. To determine the psychological environment at the Agricultural and Technical College at Delhi, 100 males and 85 females were administered the College…

Nurses' and Nursing Students' Knowledge and Attitudes regarding Pediatric Pain.

PubMed

Ortiz, Mario I; Ponce-Monter, Héctor A; Rangel-Flores, Eduardo; Castro-Gamez, Blanca; Romero-Quezada, Luis C; O'Brien, Jessica P; Romo-Hernández, Georgina; Escamilla-Acosta, Marco A

2015-01-01

Nursing staff spend more time with patients with pain than any other health staff member. For this reason, the nurse must possess the basic knowledge to identify the presence of pain in patients, to measure its intensity and make the steps necessary for treatment. Therefore, a prospective, descriptive, analytical, and cross-sectional study was conducted to investigate the knowledge and attitudes regarding pediatric pain in two different populations. The questionnaire, Pediatric Nurses Knowledge and Attitudes Survey Regarding Pain (PKNAS), was applied to 111 hospital pediatric nurses and 300 university nursing students. The final scores for pediatric nurses and nursing students were 40.1 ± 7.9 and 40.3 ± 7.5, respectively. None of the sociodemographic variables predicted the scores obtained by the participants (P > 0.05). There was a high correlation between the PKNAS scores of pediatric nurses and nursing students (r = 0.86, P < 0.001). It was observed that the degree of knowledge about pain and its treatment was very low in both groups. Due to this deficiency, pain in children remains inadequately managed, which leads to suffering in this population. It is necessary to increase the continued training in this subject in both areas.

Nurses' and Nursing Students' Knowledge and Attitudes regarding Pediatric Pain

PubMed Central

Ponce-Monter, Héctor A.; Rangel-Flores, Eduardo; Castro-Gamez, Blanca; Romero-Quezada, Luis C.; O'Brien, Jessica P.; Romo-Hernández, Georgina; Escamilla-Acosta, Marco A.

2015-01-01

Nursing staff spend more time with patients with pain than any other health staff member. For this reason, the nurse must possess the basic knowledge to identify the presence of pain in patients, to measure its intensity and make the steps necessary for treatment. Therefore, a prospective, descriptive, analytical, and cross-sectional study was conducted to investigate the knowledge and attitudes regarding pediatric pain in two different populations. The questionnaire, Pediatric Nurses Knowledge and Attitudes Survey Regarding Pain (PKNAS), was applied to 111 hospital pediatric nurses and 300 university nursing students. The final scores for pediatric nurses and nursing students were 40.1 ± 7.9 and 40.3 ± 7.5, respectively. None of the sociodemographic variables predicted the scores obtained by the participants (P > 0.05). There was a high correlation between the PKNAS scores of pediatric nurses and nursing students (r = 0.86, P < 0.001). It was observed that the degree of knowledge about pain and its treatment was very low in both groups. Due to this deficiency, pain in children remains inadequately managed, which leads to suffering in this population. It is necessary to increase the continued training in this subject in both areas. PMID:26543643

Discovery and development of tramadol for the treatment of pain.

PubMed

Bravo, Lidia; Mico, Juan Antonio; Berrocoso, Esther

2017-12-01

Tramadol is an opioid drug that, unlike classic opioids, also modulates the monoaminergic system by inhibiting noradrenergic and serotoninergic reuptake. For this reason, tramadol is considered an atypical opioid. These special pharmacological characteristics have made tramadol one of the most commonly prescribed analgesic drugs to treat moderate to severe pain. Areas covered: The aim of this review is to provide a historical description of the biochemistry, pharmacokinetics and particularly, the mechanisms of action of tramadol. In addition, a summary is offered of the analgesic effects of tramadol in a variety of animal models of acute and chronic pain. Finally, clinical studies that demonstrate the efficacy and safety of tramadol in the treatment of pain are also assessed. Expert opinion: The discovery that tramadol combines opioid and monoaminergic effects represented a milestone in the evolution of pain treatment. Given its 'mild effect' on opioid receptors, tramadol induces fewer side effects than classic opioids. Tramadol produces satisfactory analgesia against various types of pain and it is currently approved for the treatment of moderate to severe pain. Thus, the combination of monoamine and opioid mechanisms opens new avenues for the design of innovative analgesics.

Chronic Pain in the School Setting: The Teachers' Point of View.

PubMed

Solé, Ester; Castarlenas, Elena; Sánchez-Rodríguez, Elisabet; Galán, Santiago; de la Vega, Rocío; Jensen, Mark P; Miró, Jordi

2018-01-01

The aims of this study were to (1) examine the reactions of teachers and student teachers to children experiencing pain, (2) identify the most common challenges and potential resources that are associated to dealing with them, and (3) examine whether their responses differed as a function of their experience or sex. Forty teachers and 318 student teachers completed a survey which included descriptive information, a questionnaire that assesses different responses of participants to children who experience pain, and provides a list of problems and resources that participants might encounter and implement, respectively, when dealing with these children. The study participants most often endorsed use of coping and health-promoting responses. Experienced teachers endorsed solicitous responses significantly more often than student teachers. Women reported responding more with solicitous responses than men. Absenteeism and the negative effect of pain on the ability of students to engage in school activities were the most common pain-related challenges mentioned by the study participants overall. The findings emphasize (1) the need for developing guidelines to help teachers to help students experiencing chronic pain, and (2) the importance of including information about pediatric chronic pain in teachers training. © 2018, American School Health Association.

Running injuries and associated factors in participants of ING Taipei Marathon.

PubMed

Chang, Wei-Ling; Shih, Yi-Fen; Chen, Wen-Yin

2012-08-01

To investigate the distribution of lower extremity running injuries and their associated factors. Descriptive and exploratory study. 1004 participants of the 2005 ING Taipei International Marathon. We used a self-developed questionnaire to collect data of previous running injuries and applied multivariate logistic regression modeling to examine relationships between these injuries and associated factors. Of the 893 valid questionnaires, 396 (44.4%) reported having previous lower extremity pain related to running. Knee joint pain was the most common problem (32.5%). Hip pain was associated with the racing group, training duration, and medial arch support. Use of knee orthotics (P = 0.002) and ankle braces (P = 0.007) was related to a higher rate of knee and ankle pain. Participants of the full marathon group who practiced on a synthetic track had a higher incidence of ankle pain. A training duration of >60 min was linked to an increased rate of foot pain (P = 0.003). Our data indicated that running injuries were associated with training duration and use of orthotics. Clinicians can use this information in treating or preventing running associated injuries and pain. Copyright © 2011 Elsevier Ltd. All rights reserved.

[What is the value of pain therapy in the German refined diagnosis-related-groups system?].

PubMed

Meissner, W; Thoma, R; Bauer, M

2006-03-01

The German refined diagnosis-related-groups (G-DRG) system was introduced on 1st January 2003, initially on a voluntary basis and on 1st January 2004 the use of a G-DRG costing for stationary hospital treatment became obligatory. The possibility of a description of acute and chronic pain therapy in the G-DRG system was initially rudimentary and not logically planned and also a fair allotment of proceeds according to resources was not possible. By further development of the G-DRG system, pain therapeutic treatment could be improved in some areas, but in others it still remains unsatisfactory. This article offers a summary of the underlying systematics of the G-DRG system and consideration of chronic and current pain therapy in the G-DRG system 2006. In addition to information on currently available possibilities of a pain therapeutical coding in conformation with the G-DRG system, the tasks which are still outstanding will be outlined.

[Comparison between 2 groups of nursing professionals on the knowledge of pediatric pain].

PubMed

Lobete Prieto, C; Rey Galán, C; Kiza, A H

2015-01-01

To compare infant pain knowledge between a group of nurses who work in a pediatric hospital and one that works in a general hospital. Descriptive study based on the use of a validated questionnaire for assessing the knowledge and attitudes of nurses about pediatric pain (Pediatric Nurses' Knowledge and Attitude Survey Regarding Pain [PNKAS]). PNKAS questionnaire was distributed to the nursing staff of a pediatric hospital and a general hospital and the results were compared. The average score obtained in the pediatric vs. the general hospital was: mean, 51.7% vs. 47.2%, 95% confidence interval, 47.5 to 56% vs. 43.6 to 50.8% (P=.098). There were no differences between the scores in the PNKAS questionnaire between nurses working exclusively with children and nurses working with general population. Training on pediatric pain needs to be improved in nurses caring for sick children. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Engineering directorate technical facilities catalog

NASA Technical Reports Server (NTRS)

Maloy, Joseph E.

1993-01-01

The Engineering Directorate Technical Facilities Catalog is designed to provide an overview of the technical facilities available within the Engineering Directorate at the National Aeronautics and Space Administration (NASA), Lyndon B. Johnson Space Center (JSC) in Houston, Texas. The combined capabilities of these engineering facilities are essential elements of overall JSC capabilities required to manage and perform major NASA engineering programs. The facilities are grouped in the text by chapter according to the JSC division responsible for operation of the facility. This catalog updates the facility descriptions for the JSC Engineering Directorate Technical Facilities Catalog, JSC 19295 (August 1989), and supersedes the Engineering Directorate, Principle test and Development Facilities, JSC, 19962 (November 1984).

Vitamin D status in patients with musculoskeletal pain, fatigue and headache: a cross-sectional descriptive study in a multi-ethnic general practice in Norway.

PubMed

Knutsen, Kirsten Valebjørg; Brekke, Mette; Gjelstad, Svein; Lagerløv, Per

2010-09-01

To investigate vitamin D levels in patients with non-specific musculoskeletal pain, headache, and fatigue. A cross-sectional descriptive study. A health center in Oslo, Norway, with a multi-ethnic population. A total of 572 patients referred by a general practitioner (GP) for an examination of hypovitaminosis D who reported musculoskeletal pain, headache, or fatigue. The patients' native countries were: Norway (n = 249), Europe, America, and South-East Asia (n = 83), and the Middle East, Africa, and South Asia (n = 240). Both genders and all ages were included. Vitamin D levels (25-hydroxyvitamin D) in nmol/L. Hypovitaminosis D (25-hydroxyvitamin D < 50 nmol/L) was found in 58% of patients. One-third of ethnic Norwegians had hypovitaminosis D, while 83% of patients from the Middle East, Africa, and South Asia had hypovitaminosis D with minimal seasonal variation of levels. One in two women from these countries had a vitamin D level below 25 nmol/L. Mean vitamin D level was lower in patients with headaches compared with patients with other symptoms. Some 15% of patients with low (< 50 nmol/L) vitamin D levels reported headaches, compared with 5% of those with normal vitamin D levels. Our study shows a high prevalence of hypovitaminosis D in patients with non-specific musculoskeletal pain, headache, or fatigue for whom the GP had suspected a low vitamin D level. Hypovitaminosis D was not restricted to immigrant patients. These results indicate that GPs should maintain awareness of hypovitaminosis D and refer patients who report headaches, fatigue, and musculoskeletal pain with minimal sun exposure and a low dietary vitamin D intake for assessment.

Long-term neuropsychological effects of opioid use in children: a descriptive literature review.

PubMed

Jain, Gaurav; Mahendra, Vijaita; Singhal, Sarita; Dzara, Kristina; Pilla, Trinadha R; Manworren, Renee; Kaye, Alan D

2014-01-01

Use of opioids in the management of pain and its consequences in children presents a substantial challenge. A significant concern in pediatric pain management is the long-term neuropsychological consequences of opioids. The authors aim to provide a descriptive review of the current literature surrounding the neuropsychological impact of opioid use in children, along with possible extrapolations from their use in adults and animal models. Systematic review of published literature. Various universities in the United States. The electronic review for papers published between January 1992 and December 2012 was conducted using Medline/Pubmed, PsychInfo, CINAHL, the Cochrane Library database, and Google Scholar. Findings assessing pediatric pain patients treated with opioids demonstrated no significant differences in intelligence, behavior, vocabulary, or motor skills. One study reported a decrease in a visuo-constructional ability, which measured higher order executive function. Studies from prenatal illicit opioid exposure found poorer performance on measures of language, verbal ability, mathematics, reading, impulse control, and school readiness skills. The literature from adult prescribed opioid users has mixed results. Some showed impairment in the neuropsychological domains of memory, decision-making, attention, concentration, information processing, psychomotor speed, visual special skills, and hand-eye coordination, while others found no differences or revealed improved perceptual-cognitive status, possibly due to the removal of pain as a stressor. Very few studies looked into the long term neuropsychological and cognitive effects of the opioids in pediatric population. In an attempt to extrapolate from other groups, this review also included literature from adult patients, prenatal opioid exposure, and animal studies. Opioid medications have the potential to produce long-lasting neuropsychological side effects. However, given the negative consequences of untreated pain, the potential benefit may offset their risk. More studies are needed to clarify this complex interaction.

Technical architecture of ONC-approved plans for statewide health information exchange.

PubMed

Barrows, Randolph C; Ezzard, John

2011-01-01

ONC-approved state plans for HIE were reviewed for descriptions and depictions of statewide HIE technical architecture. Review was complicated by non-standard organizational elements and technical terminology across state plans. Findings were mapped to industry standard, referenced, and defined HIE architecture descriptions and characteristics. Results are preliminary due to the initial subset of ONC-approved plans available, the rapid pace of new ONC-plan approvals, and continuing advancements in standards and technology of HIE, etc. Review of 28 state plans shows virtually all include a direct messaging component, but for participating entities at state-specific levels of granularity (RHIO, enterprise, organization/provider). About ½ of reviewed plans describe a federated architecture, and ¼ of plans utilize a single-vendor "hybrid-federated" architecture. About 1/3 of states plan to leverage new federal and open exchange technologies (DIRECT, CONNECT, etc.). Only one plan describes a centralized architecture for statewide HIE, but others combine central and federated architectural approaches.

Technical Architecture of ONC-Approved Plans For Statewide Health Information Exchange

PubMed Central

Barrows, Randolph C.; Ezzard, John

2011-01-01

ONC-approved state plans for HIE were reviewed for descriptions and depictions of statewide HIE technical architecture. Review was complicated by non-standard organizational elements and technical terminology across state plans. Findings were mapped to industry standard, referenced, and defined HIE architecture descriptions and characteristics. Results are preliminary due to the initial subset of ONC-approved plans available, the rapid pace of new ONC-plan approvals, and continuing advancements in standards and technology of HIE, etc. Review of 28 state plans shows virtually all include a direct messaging component, but for participating entities at state-specific levels of granularity (RHIO, enterprise, organization/provider). About ½ of reviewed plans describe a federated architecture, and ¼ of plans utilize a single-vendor “hybrid-federated” architecture. About 1/3 of states plan to leverage new federal and open exchange technologies (DIRECT, CONNECT, etc.). Only one plan describes a centralized architecture for statewide HIE, but others combine central and federated architectural approaches. PMID:22195059

The use of analgesia in mountain rescue casualties with moderate or severe pain.

PubMed

Ellerton, John Alexander; Greene, Mike; Paal, Peter

2013-06-01

To assess the effectiveness of analgesia used in mountain rescue (MR) in casualties with moderate or severe pain. To determine if a verbal numeric pain score is practical in this environment. To describe the analgesic strategies used by MR. Prospective, descriptive study. Fifty-one MR teams in England and Wales. The study period was 1 September 2008 to 31 August 2010. 92 MR casualties with a pain scoreof 4/10 or greater. 38% of casualties achieved a pain reduction of 50% or greater in their initial score at 15 min and 60.2% had achieved this at handover. The initial pain score was 8 (median), reducing to 5 at 15 min and 3 at handover. The mean pain reduction was 2.5 ± 2.4 at 15 min and 3.9 ± 2.5 at handover. 80 casualties (87%) were treated with an opioid and seven had two different opioids administered. Seven main strategies were identified in which the principal agent was entonox, intramuscular opioid, oral analgesia, fentanyl lozenge, intranasal or intravenous opioid. The choice of strategy varied with the skills of the casualty carer. Pain should be assessed using a pain score. When possible, intravenous opioid is the gold standard to achieve early and continuing pain control in patients with moderate or severe pain. Entonox and oral analgesics, as sole agents, have limited use in moderate or severe pain. Intranasal opioid and fentanyl lozenge are effective, and appropriate in MR. Research priorities include bioavailability in different environmental conditions and patient's satisfaction with their pain management.

Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery-A quantitative study with repeated measures.

PubMed

Eriksson, Kerstin; Wikström, Lotta; Fridlund, Bengt; Årestedt, Kristofer; Broström, Anders

2017-11-01

To compare different levels of self-rated pain and determine if they predict anticipated early physical recovery in patients undergoing general and orthopaedic surgery. Previous research has indicated that average self-rated pain reflects patients' ability to recover the same day. However, there is a knowledge gap about the feasibility of using average pain ratings to predict patients' physical recovery for the next day. Descriptive, quantitative repeated measures. General and orthopaedic inpatients (n = 479) completed a questionnaire (October 2012-January 2015) about pain and recovery. Average pain intensity at rest and during activity was based on the Numeric Rating Scale and divided into three levels (0-3, 4-6, 7-10). Three out of five dimensions from the tool "Postoperative Recovery Profile" were used. Because few suffered severe pain, general and orthopaedic patients were analysed together. Binary logistic regression analysis showed that average pain intensity postoperative day 1 significantly predicted the impact on recovery day 2, except nausea, gastrointestinal function and bladder function when pain at rest and also nausea, appetite changes, and bladder function when pain during activity. High pain ratings (NRS 7-10) demonstrated to be a better predictor for recovery compared with moderate ratings (NRS 4-6), day 2, as it significantly predicted more items in recovery. Pain intensity reflected general and orthopaedic patients' physical recovery postoperative day 1 and predicted recovery for day 2. By monitoring patients' pain and impact on recovery, patients' need for support becomes visible which is valuable during hospital stays. © 2017 John Wiley & Sons Ltd.

Exploring novel paths towards protein signatures of chronic pain.

PubMed

Gomez-Varela, David; Schmidt, Manuela

2016-01-01

Pain is a major symptom of many medical conditions and the worldwide number one reason for people to seek medical assistance. It affects the quality of life of patients and poses a heavy financial burden on society with high costs of treatment and lost productivity. Furthermore, the treatment of chronic pain presents a big challenge as pain therapeutics often lack efficacy and exhibit minimal safety profiles. The latter can be largely attributed to the fact that current therapies target molecules with key physiological functions throughout the body. In light of these difficulties, the identification of proteins specifically involved in chronic pain states is of paramount importance for designing selective interventions. Several profiling efforts have been employed with the aim to dissect the molecular underpinnings of chronic pain, both on the level of the transcriptome and proteome. However, generated results are often inconsistent and non-overlapping, which is largely due to inherent technical constraints. A potential solution may be offered by emerging strategies capable of performing standardized and reproducible proteome analysis, such as data-independent acquisition-mass spectrometry (DIA-MS). We have recently demonstrated the applicability of DIA-MS to interrogate chronic pain-related proteome alterations in mice. Based on our results, we aim to provide an overview on DIA-MS and its potential to contribute to the comprehensive characterization of molecular signatures underlying pain pathologies. © The Author(s) 2016.

Depressive Disorder, Anxiety Disorder and Chronic Pain: Multiple Manifestations of a Common Clinical and Pathophysiological Core.

PubMed

Arango-Dávila, Cesar A; Rincón-Hoyos, Hernán G

A high proportion of depressive disorders are accompanied by anxious manifestations, just as depression and anxiety often present with many painful manifestations, or conversely, painful manifestations cause or worsen depressive and anxious expressions. There is increasingly more evidence of the pathophysiological, and neurophysiological and technical imaging similarity of pain and depression. Narrative review of the pathophysiological and clinical aspects of depression and chronic pain comorbidity. Research articles are included that emphasise the most relevant elements related to understanding the pathophysiology of both manifestations. The pathological origin, physiology and clinical approach to these disorders have been more clearly established with the latest advances in biochemical and cellular techniques, as well as the advent of imaging technologies. This information is systematised with comprehensive images and clinical pictures. The recognition that the polymorphism of inflammation-related genes generates susceptibility to depressive manifestations and may modify the response to antidepressant treatments establishes that the inflammatory response is not only an aetiopathogenic component of pain, but also of stress and depression. Likewise, the similarity in approach with images corroborates not only the structural, but the functional and pathophysiological analogy between depression and chronic pain. Knowledge of depression-anxiety-chronic pain comorbidity is essential in the search for effective therapeutic interventions. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Factors indicating need of rehabilitation--occupational therapy among persons with long-term and/or recurrent pain.

PubMed

Müllersdorf, M

2000-12-01

The aim of the study was to elucidate selection criteria for need of rehabilitation/occupational therapy, and to state criteria for participation in occupational therapy, among persons with long-term and/or recurrent pain causing activity limitations or restricting participation in daily life. The study involved 914 persons aged 18-58 years who answered a postal questionnaire concerning demography, pain, occupations in daily life, work, treatments and health care staff visited. The direct method in logistic regression analysis was used to test two models: (1) need of rehabilitation/occupational therapy and (2) participation in occupational therapy. The results for the first model revealed the selection criteria (1) 'feelings of irresolution', (2) 'gnawing/searing pain' and (3) 'use of technical aids'. The odds for need of rehabilitation/occupational therapy were higher for women than for men. The criteria derived from the second model, participation in occupational therapy, were whether (1) the participants had 'used tricks and/or compensated ways to perform tasks', (2) the participants had 'pain in shoulders' and (3) 'changes had been made at work due to health conditions'.

[Design of low-intermediate frequency electrotherapy and pain assessment system].

PubMed

Liang, Chunyan; Tian, Xuelong; Yu, Xuehong; Luo, Hongyan

2014-06-01

Aiming at the single treatment and the design separation between treatment and assessment in electrotherapy equipment, a kind of system including low-intermediate frequency treatment and efficacy evaluation was developed. With C8051F020 single-chip microcomputer as the core and the circuit design and software programming used, the system realized the random switch of therapeutic parameters, the collection, display and data storage of pressure pain threshold in the assessment. Experiment results showed that the stimulus waveform, current intensity, frequency, duty ratio of the system output were adjustable, accurate and reliable. The obtained pressure pain threshold had a higher accuracy (< 0.3 N) and better stability, guiding the parameter choice in the precise electrical stimulation. It, therefore, provides a reliable technical support for the treatment and curative effect assessment.

Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis.

PubMed

Miyamoto, Gisela Cristiane; Lin, Chung-Wei Christine; Cabral, Cristina Maria Nunes; van Dongen, Johanna M; van Tulder, Maurits W

2018-04-20

To investigate the cost-effectiveness of exercise therapy in the treatment of patients with non-specific neck pain and low back pain. Systematic review of economic evaluations. The search was performed in 5 clinical and 3 economic electronic databases. We included economic evaluations performed alongside randomised controlled trials. Differences in costs and effects were pooled in a meta-analysis, if possible, and incremental cost-utility ratios (ICUR) were descriptively analysed. Twenty-two studies were included. On average, exercise therapy was associated with lower costs and larger effects for quality-adjusted life-year (QALY) in comparison with usual care for subacute and chronic low back pain from a healthcare perspective (based on ICUR). Exercise therapy had similar costs and effect for QALY in comparison with other interventions for neck pain from a societal perspective, and subacute and chronic low back pain from a healthcare perspective. There was limited or inconsistent evidence on the cost-effectiveness of exercise therapy compared with usual care for neck pain and acute low back pain, other interventions for acute low back pain and different types of exercise therapy for neck pain and low back pain. Exercise therapy seems to be cost-effective compared with usual care for subacute and chronic low back pain. Exercise therapy was not (more) cost-effective compared with other interventions for neck pain and low back pain. The cost-utility estimates are rather uncertain, indicating that more economic evaluations are needed. PROSPERO, CRD42017059025. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An equine pain face

PubMed Central

Gleerup, Karina B; Forkman, Björn; Lindegaard, Casper; Andersen, Pia H

2015-01-01

Objective The objective of this study was to investigate the existence of an equine pain face and to describe this in detail. Study design Semi-randomized, controlled, crossover trial. Animals Six adult horses. Methods Pain was induced with two noxious stimuli, a tourniquet on the antebrachium and topical application of capsaicin. All horses participated in two control trials and received both noxious stimuli twice, once with and once without an observer present. During all sessions their pain state was scored. The horses were filmed and the close-up video recordings of the faces were analysed for alterations in behaviour and facial expressions. Still images from the trials were evaluated for the presence of each of the specific pain face features identified from the video analysis. Results Both noxious challenges were effective in producing a pain response resulting in significantly increased pain scores. Alterations in facial expressions were observed in all horses during all noxious stimulations. The number of pain face features present on the still images from the noxious challenges were significantly higher than for the control trial (p = 0.0001). Facial expressions representative for control and pain trials were condensed into explanatory illustrations. During pain sessions with an observer present, the horses increased their contact-seeking behavior. Conclusions and clinical relevance An equine pain face comprising ‘low’ and/or ‘asymmetrical’ ears, an angled appearance of the eyes, a withdrawn and/or tense stare, mediolaterally dilated nostrils and tension of the lips, chin and certain facial muscles can be recognized in horses during induced acute pain. This description of an equine pain face may be useful for improving tools for pain recognition in horses with mild to moderate pain. PMID:25082060

Simple neck pain questions used in surveys, evaluated in relation to health outcomes: a cohort study

PubMed Central

2012-01-01

Background The high prevalence of pain reported in many epidemiological studies, and the degree to which this prevalence reflects severe pain is under discussion in the literature. The aim of the present study was to evaluate use of the simple neck pain questions commonly included in large epidemiological survey studies with respect to aspects of health. We investigated if and how an increase in number of days with pain is associated with reduction in health outcomes. Methods A cohort of university students (baseline age 19–25 years) were recruited in 2002 and followed annually for 4 years. The baseline response rate was 69% which resulted in 1200 respondents (627 women, 573 men). Participants were asked about present and past pain and perceptions of their general health, sleep disturbance, stress and energy levels, and general performance. The data were analyzed using a mixed model for repeated measurements and a random intercept logistic model. Results When reporting present pain, participants also reported lower prevalence of very good health, higher stress and sleep disturbance scores and lower energy score. Among those with current neck pain, additional questions characterizing the pain such as duration (categorized), additional pain sites and decreased general performance were associated with lower probability of very good health and higher amounts of sleep disturbance. Knowing about the presence or not of pain explains more of the variation in health between individuals, than within individuals. Conclusion This study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual. PMID:23102060

Simple neck pain questions used in surveys, evaluated in relation to health outcomes: a cohort study.

PubMed

Grimby-Ekman, Anna; Hagberg, Mats

2012-10-26

The high prevalence of pain reported in many epidemiological studies, and the degree to which this prevalence reflects severe pain is under discussion in the literature. The aim of the present study was to evaluate use of the simple neck pain questions commonly included in large epidemiological survey studies with respect to aspects of health. We investigated if and how an increase in number of days with pain is associated with reduction in health outcomes. A cohort of university students (baseline age 19-25 years) were recruited in 2002 and followed annually for 4 years. The baseline response rate was 69% which resulted in 1200 respondents (627 women, 573 men). Participants were asked about present and past pain and perceptions of their general health, sleep disturbance, stress and energy levels, and general performance. The data were analyzed using a mixed model for repeated measurements and a random intercept logistic model. When reporting present pain, participants also reported lower prevalence of very good health, higher stress and sleep disturbance scores and lower energy score. Among those with current neck pain, additional questions characterizing the pain such as duration (categorized), additional pain sites and decreased general performance were associated with lower probability of very good health and higher amounts of sleep disturbance. Knowing about the presence or not of pain explains more of the variation in health between individuals, than within individuals. This study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual.

Nurse prescribing for inpatient pain in the United Kingdom: a national questionnaire survey.

PubMed

Stenner, Karen L; Courtenay, Molly; Cannons, Karin

2011-07-01

Nurses make a valuable contribution to pain services and have the potential to improve the safety and effectiveness of pain management. A recent addition to the role of the specialist pain nurse in the United Kingdom has been the introduction of prescribing rights, however there is a lack of literature about their role in prescribing pain medication. The aim of this study was to develop a profile of the experience, role and prescribing practice of these nurses. A descriptive questionnaire survey. 192 National Health Service public hospital inpatient pain services across the United Kingdom. 161 qualified nurse prescribers were invited to participate, representing 98% of known nurse prescribers contributing to inpatient pain services. The survey was completed in November 2009 by 137 nurses; a response rate of 85%. Compared with nurse prescribers in the United Kingdom in general, participants were highly qualified and experienced pain specialists. Fifty-six percent had qualified as a prescriber in the past 3 years and 22% reported that plans were underway for more nurses to undertake a nurse prescribing qualification. Although all participants worked in inpatient pain services, 35% also covered chronic pain (outpatient) services and 90% treated more than one pain type. A range of pain medications were prescribed, averaging 19.5 items per week. The role contained a strong educational component and contributed to informing organisational policy on pain management. Prescribing was said to improve nurses' ability to promote evidence-based practice but benefits were limited by legislation on prescribing controlled drugs. Findings demonstrate that pain nurses are increasingly adopting prescribing as part of their advanced nurse role. This has implications for the development needs of pain nurses in the United Kingdom and the future role development of nurses in other countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Frequency of pain as a reason for visiting a primary care clinic and its influence on sleep].

PubMed

Calsina-Berna, Agnès; Moreno Millán, Nemesio; González-Barboteo, Jesús; Solsona Díaz, Luis; Porta Sales, Josep

2011-11-01

To determine the frequency of pain as a reason to visit a Primary Care doctor and to investigate the influence of pain on sleep disturbances. Cross-sectional descriptive study. Urban Primary Health Care Centre. The first five patients who came to the primary health care centre with an appointment were included. Those who came with pain were labelled as cases, the others as controls. Socio-demographic variables, background, use of co-analgesics, Pittsburgh Sleep Quality Index (a global PSQI score greater than 5 indicated "poor sleepers"). For the cases, pain intensity was also assessed, chronology and kind of pain, the system affected and treatment. A total of 206 patients were included and 31 excluded. The mean age was 50 years and 56% were women. Pain was the reason for consultation in 39% of the patients, of whom 78% had acute pain, 80% nociceptive, 75% incidental and 71% musculoskeletal. The average VAS score was 4.98. A total of 62% were receiving treatment according to the first step of the WHO pain ladder. Forty-five per cent of patients were categorized as "good sleepers". The multivariate analysis showed that acute pain (P=.022) and pain intensity (P=.035) in men appeared as independent factors of sleep disturbances; in women there were no statistically significant variables. In our study, a high percentage of patients came to the primary health care centre for pain, mainly musculoskeletal. In men, there is a clear relationship between sleep disturbances, pain intensity and acute pain. Further research is needed to study this topic in depth, in order to alleviate pain and improve the sleep quality in our patients. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Abdominal pain in adult sickle cell disease patients: a nigerian experience.

PubMed

Akingbola, T S; Kolude, B; Aneni, E C; Raji, A A; Iwara, K U; Aken'Ova, Y A; Soyannwo, O A

2011-12-01

Abdominal pain is a relatively frequent occurrence in sickle cell disease. The aetiology of abdominal pain in sickle cell disease is often difficult to diagnose clinically. Despite the frequent occurrence, diagnostic dilemma, and the need for an accurate, early diagnosis, abdominal pain in sickle cell disease has not been rigorously studied. We therefore sought to describe the different presentations and patterns of abdominal pain in persons with sickle cell disease. A prospective case series of 20 patients was done in which data was collected on demographic characteristics, hemoglobin electrophoresis patterns, a description of the abdominal pain including sites, severity, and type of pain, packed cell volume and the provisional and final diagnosis. Haemoglobin S patients were 17 in number constituting eightyfive percent (85%) of our study population whilst the rest 3 were Hb S+C. Most patients (70%) had one site of abdominal pain. The pain was mainly colicky or tightening, moderate to severe in nature and, in some cases, associated with vomiting. We did not find any significant difference between the steady state PCV and the PCV during the acute abdominal pain episodes. The final diagnosis showed that only 38.8% of the patients had vasoocclusive crises and the reliability index between the provisional diagnosis and the final diagnosis was 67%. Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vasoocclusive crises. Early diagnosis and prompt treatment can be life saving.

Effect of cryotherapy on arteriovenous fistula puncture-related pain in hemodialysis patients.

PubMed

P B, Sabitha; Khakha, D C; Mahajan, S; Gupta, S; Agarwal, M; Yadav, S L

2008-10-01

Pain during areteriovenous fistula (AVF) cannulation remains a common problem in hemodialysis (HD) patients. This study was undertaken to assess the effect of cryotherapy on pain due to arteriovenous fistula puncture in hemodialysis patients. A convenience sample of 60 patients (30 each in experimental and control groups) who were undergoing hemodialysis by using AVF, was assessed in a randomized control trial. Hemodialysis patients who met the inclusion criteria, were randomly assigned to experimental and control groups using a randomization table. Objective and subjective pain scoring was done on two consecutive days of HD treatment (with cryotherapy for the experimental and without cryotherapy for the control group). The tools used were a questionnaire examining demographic and clinical characteristics, an observation checklist for assessing objective pain behavior, and a numerical rating scale for subjective pain assessment. Descriptive statistics were used as deemed appropriate. Chi square, two-sample and paired t-tests, the Mann Whitney test, Wilcoxon's signed rank test, the Kruskal Wallis test, and Spearman's and Pearson's correlations were used for inferential statistics. We found that the objective and subjective pain scores were found to be significantly (P = 0.001) reduced within the experimental group with the application of cryotherapy. This study highlights the need for adopting alternative therapies such as cryotherapy for effective pain management in hospital settings.

A survey of healthcare providers' knowledge and attitudes regarding pain relief in labor for women in Ethiopia.

PubMed

McCauley, Mary; Stewart, Catriona; Kebede, Birhanu

2017-02-07

To explore healthcare providers' knowledge and attitudes to the need for pain relief for women in labor. A structured questionnaire (n = 200) distributed to healthcare providers working in the obstetric departments, including theatres, of three public hospitals in different settings (rural, peri-urban and urban) in Ethiopia. Descriptive analysis was performed using Excel 2013 and SPSS version 22 for associations. The response rate was 81.5% with 164 questionnaires completed. The majority, 79% of respondents, understood that women can feel moderate to severe pain in labor and 77% were of the opinion that labor pain should be relieved. However, common practices included only supportive measures such as breathing and relaxation exercises, back massage and support from family. The general attitude of healthcare providers is that labor is a natural process, women should be able to cope and that pain relief is not a priority for women in labor. More than half, 52% of healthcare providers had safety concerns with using pharmacological methods to relieve pain in labor. The majority of healthcare providers understand that women suffer significant pain during labor. However, providing effective pain relief is currently not provided as part of routine intra-partum care in Ethiopia.

Exploring how nurses assess, monitor and manage acute pain for adult critically ill patients in the emergency department: protocol for a mixed methods study.

PubMed

Varndell, Wayne; Fry, Margaret; Elliott, Doug

2017-08-01

Many critically ill patients experience moderate to severe acute pain that is frequently undetected and/or undertreated. Acute pain in this patient cohort not only derives from their injury and/or illness, but also as a consequence of delivering care whilst stabilising the patient. Emergency nurses are increasingly responsible for the safety and wellbeing of critically ill patients, which includes assessing, monitoring and managing acute pain. How emergency nurses manage acute pain in critically ill adult patients is unknown. The objective of this study is to explore how emergency nurses manage acute pain in critically ill patients in the Emergency Department. In this paper, we provide a detailed description of the methods and protocol for a multiphase sequential mixed methods study, exploring how emergency nurses assess, monitor and manage acute pain in critically ill adult patients. The objective, method, data collection and analysis of each phase are explained. Justification of each method and data integration is described. Synthesis of findings will generate a comprehensive picture of how emergency nurses' perceive and manage acute pain in critically ill adult patients. The results of this study will form a knowledge base to expand theory and inform research and practice.

Musculoskeletal pain among undergraduate laptop users in a Nigerian University.

PubMed

Obembe, Adebimpe Olayinka; Johnson, Olubusola Esther; Tanimowo, Tolulope Odunayo; Onigbinde, Ayodele Teslim; Emechete, Anne Anthonette

2013-01-01

Musculoskeletal disorder is a significant health problem affecting adults and young people alike. The prevalence of musculoskeletal pain resulting from musculoskeletal disorders is on the increase especially with increased use of laptops. This study determined the prevalence of musculoskeletal pain among undergraduate students of Obafemi Awolowo University (OAU), Ile-Ife who use laptops. This was a cross-sectional study and participants were selected using the non-probability sampling technique. The Boston University Computer and Health Survey questionnaire was self-administered to 400 undergraduate laptop users. Data were analyzed using descriptive statistics of frequency and percentage. Three hundred and seventy six out of 400 copies of administered questionnaires were amenable to data analysis representing a response rate of 94%. Pain in the shoulder was the most reported musculoskeletal complaint from 268 (75.7%) participants. Elbow pain was the least common complaint from 132 (37.3%) participants. The prevalence of musculoskeletal pain was slightly higher among female students 93 (50.3%) of 185 and highest among students aged between 24 and 26 years: 60 (37.5%). In addition, the prevalence of musculoskeletal complaints was highest among those who used single-strap laptop bags 176 (94.1%). There is a high prevalence of musculoskeletal pain among undergraduate laptop users in OAU and shoulder pain was the most commonly reported.

Ultrasound biomicroscopy after palliative surgical procedures for bullous keratopathy: a descriptive comparative study.

PubMed

Paris, Fabiana dos Santos; Gonçalves, Eliana Domingues; Morales, Maira Saad Ávila; Kanecadan, Liliane Andrade Almeida; Campos, Mauro Silveira de Queiroz; Gomes, José Álvaro Pereira; Allemann, Norma; Sato, Elcio Hideo

2014-01-01

To describe quantitative and qualitative features of eyes with advanced bullous keratopathy assessed using ultrasound biomicroscopy, before and after anterior stromal puncture (ASP) or amniotic membrane transplantation (AMT) procedures to relieve chronic pain. The present descriptive comparative study included 40 eyes of 40 patients with chronic intermittent pain due to bullous keratopathy who were randomly assigned to one of the two treatments (AMT or ASP). Ultrasound biomicroscopy (Humphrey, UBM 840, 50 MHz transducer, immersion technique) was used, and a questionnaire about pain intensity was completed preoperatively and postoperatively at days 90 and 180, respectively. Exclusion criteria were age<18 years, presence of concurrent infection, ocular hypertension, and absence of pain. In a 180-day follow-up, the AMT group exhibited mean central corneal thickness (CCT), 899.4 µm preoperatively and 1122.5 µm postoperatively (p<0.001); mean epithelial thickness (ET), 156.4 µm preoperatively and 247.8 µm postoperatively (p<0.001); and mean stromal thickness (ST), 742.9 µm preoperatively and 826.3 µm postoperatively (p=0.005). The ASP group exhibited mean CCT, 756.7 µm preoperatively and 914.8 µm postoperatively (p<0.001); mean ET, 102.1 µm preoperatively and 245.2 µm postoperatively (p<0.001); and mean ST, 654.6 µm preoperatively and 681.5 µm postoperatively (p<0.999). Correlations between CCT and pain intensity in the AMT group (p=0.209 pre- and postoperatively) and the ASP group (p=0.157 preoperatively and p=0.426 at the 180-day follow-up) were not statistically significant. Epithelial and stromal edema, Descemet's membrane folds, epithelial bullae, and the presence of interface fluid were frequently observed qualitative features. CCT increased over time in both groups. The magnitude of CCT did not correlate with pain intensity in the sample studied. The presence of interface fluid was a qualitative feature specifically found in some patients who underwent AMT.

'I am not the kind of woman who complains of everything': illness stories on self and shame in women with chronic pain.

PubMed

Werner, Anne; Isaksen, Lise Widding; Malterud, Kirsti

2004-09-01

In this study, we explore issues of self and shame in illness accounts from women with chronic pain. We focused on how these issues within their stories were shaped according to cultural discourses of gender and disease. A qualitative study was conducted with in-depth interviews including a purposeful sampling of 10 women of varying ages and backgrounds with chronic muscular pain. The women described themselves in various ways as 'strong', and expressed their disgust regarding talk of illness of other women with similar pain. The material was interpreted within a feminist frame of reference, inspired by narrative theory and discourse analysis. We read the women's descriptions of their own (positive) strength and the (negative) illness talk of others as a moral plot and argumentation, appealing to a public audience of health personnel, the general public, and the interviewer: As a plot, their stories attempt to cope with psychological and alternative explanations of the causes of their pain. As performance, their stories attempt to cope with the scepticism and distrust they report having been met with. Finally, as arguments, their stories attempt to convince us about the credibility of their pain as real and somatic rather than imagined or psychological. In several ways, the women negotiated a picture of themselves that fits with normative, biomedical expectations of what illness is and how it should be performed or lived out in 'storied form' according to a gendered work of credibility as woman and as ill. Thus, their descriptions appear not merely in terms of individual behaviour, but also as organized by medical discourses of gender and diseases. Behind their stories, we hear whispered accounts relating to the medical narrative about hysteria; rejections of the stereotype medical discourse of the crazy, lazy, illness-fixed or weak woman.

Turkish Nurses' Use of Nonpharmacological Methods for Relieving Children's Postoperative Pain.

PubMed

Çelebioğlu, Ayda; Küçükoğlu, Sibel; Odabaşoğlu, Emel

2015-01-01

The experience of pain is frequently observed among children undergoing surgery. Hospitalization and surgery are stressful experiences for those children. The research was conducted to investigate and analyze Turkish nurses' use of nonpharmacological methods to relieve postoperative pain in children. The study was cross-sectional and descriptive. The study took place at 2 hospitals in eastern Turkey. Participants were 143 nurses whose patients had undergone surgical procedures at the 2 hospitals. The researchers used a questionnaire, a checklist of nonpharmacological methods, and a visual analogue scale (VAS) to collect the data. To assess the data, descriptive statistics and the χ² test were used. Of the 143 nurses, 73.4% initially had applied medication when the children had pain. Most of the nurses (58.7%) stated the children generally experienced a middle level of postoperative pain. The most frequent practices that the nurses applied after the children's surgery were (1) "providing verbal encouragement" (90.2%), a cognitive-behavioral method; (2) "a change in the child's position" (85.3%), a physical method; (3) "touch" (82.5%), a method of emotional support; and (4) "ventilation of the room" (79.7%), a regulation of the surroundings. Compared with participants with other educational levels, the cognitive-behavioral methods were the ones most commonly used by the more educated nurses (P < .05): (1) encouraging patients with rewards, (2) helping them think happy thoughts, (3) helping them use their imaginations, (4) providing music, and (5) reading books. Female nurses used the following methods more than the male nurses did (P < .05): (1) providing encouragement with rewards, (2) helping patients with deep breathing, (3) keeping a desired item beside them, (4) changing their positions, and (5) ventilating the room. Undergoing surgery is generally a painful experience for children. Nurses most commonly use cognitive-behavioral methods in the postoperative care of their pediatric patients after surgery.

An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study

PubMed Central

2017-01-01

Background Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes’ additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes’ self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained. Objective The aim of this study was to perform a 4-week pilot study and (1) evaluate the monitoring feasibility and system usability of a novel eHealth application for self-reported SRIIPS and (2) report preliminary data on SRIIPS. Methods An eHealth application for routine collection of data from athletes was developed and adapted to Paralympic athletes. A 4-week pilot study was performed where Paralympic athletes (n=28) were asked to weekly self-report sport exposure, training load, general well-being, pain, sleep, anxiety, and possible SRIIPS. The data collection was followed by a poststudy use assessment survey. Quantitative data related to the system use (eg, completed self-reports, missing responses, and errors) were analyzed using descriptive statistics. The qualitative feasibility and usability data provided by the athletes were condensed and categorized using thematic analysis methods. Results The weekly response rate was 95%. The athletes were of the opinion that the eHealth application was usable and feasible but stated that it was not fully adapted to Paralympic athletes and their impairments. For example, it was difficult to understand how a new injury or illness should be identified when the impairment was involved. More survey items related to the impairments were requested, as the athletes perceived that injuries and illnesses often occurred because of the impairment. Options for description of multifactorial incidents including an injury, an illness, and the impairment were also insufficient. Few technical issues were encountered, but athletes with visual impairment reported usability difficulties with the speech synthesizer. An incidence rate of 1.8 injuries and 1.7 illnesses per 100 hours of athlete exposure were recorded. The weekly pain prevalence was 56% and the impairment contributed to 20% of the reported incidents. Conclusions The novel eHealth-based application for self-reported SRIIPS developed and tested in this pilot study was generally feasible and usable. With some adaptation to accommodate Paralympic athletes’ prerequisites and improved technical support for athletes with visual impairment, this application can be recommended for use in prospective studies of SRIIPS. Trial Registration ClinicalTrials.gov NCT02788500; https://clinicaltrials.gov/ct2/show/NCT02788500 (Archived by WebCite at http://www.webcitation.org/6v56OqTeP) PMID:29187343

Back pain was less explained than leg pain: a cross-sectional study using magnetic resonance imaging in low back pain patients with and without radiculopathy.

PubMed

Jensen, Ole Kudsk; Nielsen, Claus Vinther; Sørensen, Joan Solgaard; Stengaard-Pedersen, Kristian

2015-12-03

Cross-sectional studies have shown associations between lumbar degenerative manifestations on magnetic resonance imaging (MRI) and low back pain (LBP). Disc herniations and other degenerative manifestations, however, frequently occur in asymptomatic individuals. The purpose of this cross-sectional study was to analyze for associations between pain intensity and degenerative manifestations and other pain variables in patients for whom prognostic factors have been published previously. Included were 141 consecutive patients with and without radiculopathy, all sick-listed 1-4 months due to low back pain and subsequently examined by MRI of the lumbar spine. Using different methods of grouping the degenerative manifestations, linear regression analyses were performed with the intensity of back + leg pain, back pain and leg pain as dependent variables covering actual pain and pain the preceding 2 weeks. The clinical classification into +/- radiculopathy was established before and independently of the standardised description of MRI findings. Radiculopathy was present in 43 % of the patients. Pain was best explained using rank-ordered degenerative manifestations on MRI. Back pain and leg pain were differently associated, and back pain was less explained than leg pain in the multivariate analyses (15 % vs. 31 % of the variation). Back pain intensity was higher in patients with type 1 Modic changes and in some patients with nerve root touch, but was not associated with disc herniations. Leg pain intensity was well explained by disc herniations causing MRI nerve root compromise and radiculopathy. In patients with radiculopathy, nerve root touch caused as much leg pain as nerve root displacement or compression. High intensity zones and osteophytes were not associated with back pain, but only associated with leg pain in patients with radiculopathy. Tender points explained some of the back pain, and widespread pain explained leg pain in some of the patients without radiculopathy. Back pain was associated with type 1 Modic changes, nerve root touch and tender points, whereas leg pain was associated with osteophytes, HIZ, disc herniation, all sorts of MRI nerve root compromise, radiculopathy and widespread pain.

Epidemiology and management of painful procedures in children in Canadian hospitals

PubMed Central

Stevens, Bonnie J.; Abbott, Laura K.; Yamada, Janet; Harrison, Denise; Stinson, Jennifer; Taddio, Anna; Barwick, Melanie; Latimer, Margot; Scott, Shannon D.; Rashotte, Judith; Campbell, Fiona; Finley, G. Allen

2011-01-01

Background Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management. Methods We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ2) analyses. Results Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered. Interpretation For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of hospital unit. PMID:21464171

Pain locations in the postoperative period after cardiac surgery: Chronology of pain and response to treatment.

PubMed

Roca, J; Valero, R; Gomar, C

Postoperative pain after cardiac surgery (CS) can be generated at several foci besides the sternotomy. Prospective descriptive longitudinal study on the chronological evolution of pain in 11 sites after CS including consecutive patients submitted to elective CS through sternotomy. The primary endpoints were to establish the main origins of pain, and to describe its chronological evolution during the first postoperative week. Secondary endpoints were to describe pain characteristics in the sternotomy area and to correlate pain intensity with other variables. Numerical Pain Rating Scale from 0 to 10 at rest and at movement on postoperative days 1, 2, 4 and 6. Numerical Pain Rating Scale>3 was considered moderate pain. Statistical analysis consisted in Mann-Whitney U-test, a Chi-squared, a Fisher exact text and Pearson's correlations. Forty-seven patients were enrolled. In 4 of 11 locations pain was reported as Numerical Pain Rating Scale>3 (sternotomy, oropharynx, saphenectomy and musculoskeletal pain in the back and shoulders). Maximum intensity of pain on postoperative days 1 and 2 was reported in the sternotomy area, while on postoperative days 4 and 6 it was reported at the saphenectomy. Pain at rest and at movement differed considerably in the sternotomy, saphenectomy and oropharynx. Pain at back and shoulders and at central venous catheter entry were not influenced by movement. Pain in the sternotomy was mainly described as oppressive. Patients with arthrosis and younger patients presented higher intensity of pain (P=.004; P=.049, respectively). Four locations were identified as the main sources of pain after CS: sternotomy, oropharynx, saphenectomy, and back and shoulders. Pain in different focuses presented differences in chronologic evolution and was differently influenced by movement. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

20 CFR 220.61 - Informing the examining physician or psychologist of examination scheduling, report content and...

Code of Federal Regulations, 2011 CFR

2011-04-01

... help the Board determine the nature, severity, duration of the impairment, and residual functional capacity. Pertinent points in the claimant's medical history, such as a description of chest pain, will...

Office of Exploration: Exploration studies technical report. Volume 2: Studies approach and results

NASA Technical Reports Server (NTRS)

Roberts, Barney B.; Bland, Dan

1988-01-01

The NASA Office of Exploration has been tasked with defining and recommending alternatives for an early 1990's national decision on a focused program of human exploration of the solar system. The Mission Analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report describes the process that has been developed in a case study approach. The four case studies that were developed in FY88 include: (1) human expedition to Phobos; (2) human expeditions to Mars; (3) lunar observatory; and (4) lunar outpost to early Mars evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work. Volume 2 describes the case study process, the technical results of each of the case studies, and opportunities for additional study. Included in the discussion of each case study is a description of the mission key features and profile. Mission definition and manifesting are detailed, followed by a description of the mission architecture and infrastructure. Systems concepts for the required orbital nodes, transportation systems, and planetary surface systems are discussed. Prerequisite implementation plans resulting from the synthesized case studies are described and in-depth assessments are presented.

Department of the Air Force Justification of Estimates for Fiscal Year 1983 Submitted to Congress February 1982. Aircraft Procurement, Missile Procurement, Other Procurement

DTIC Science & Technology

1982-02-01

SUPPORT EQUIP. .1 TOTAL 2 1.4 190 4.5 82 2.1 274 8.c METTHOD OF IIIPLE14ENTATIOI: IIUSTALLATION -. DEPOT/FIELD TEAl! LEAD TI:.E - 9 ,,O,|TIS * LESS THAN...Mobility Equipmnent 287 97.14 427 Scientific /Technical Intelligence 292 5.6 4128 Air Force Technical Application Center* 295 15.8 � Photo Processing...Line Item: 292 Nomenclature: Scientific /Technical Lnteliigerce Mission/Description: Thic program provide. data reduction, photo processing. and printing

The "Hoover" (vacuum cleaner) technique for calcifying tendonitis deposits excision and removal of the calcific debris.

PubMed

Ehud, Atoun; Ehud, Rath; Alexander, Van Tongel; Ali, Narvani; Giusseppe, Sforza; Ofer, Levy

2012-07-01

A new technical tip for the improvement of the arthroscopic treatment of symptomatic calcifying tendinitis is described. Arthroscopic excision of calcifying tendonitis may result with multiple minute calcific debris in the subacromial bursa, causing severe post operative pain due to chemical irritation of the bursa. We suggest the use of a bladeless shaver barrel as a "Hoover" (vacuum cleaner) for arthroscopic clearance of these miniature calcific debris from the subacromial space after resection of the major deposits. The use of this technique resulted in good clinical outcome with improved post operative pain.

Automatic Requirements Specification Extraction from Natural Language (ARSENAL)

DTIC Science & Technology

2014-10-01

designers, implementers) involved in the design of software systems. However, natural language descriptions can be informal, incomplete, imprecise...communication of technical descriptions between the various stakeholders (e.g., customers, designers, imple- menters) involved in the design of software systems...the accuracy of the natural language processing stage, the degree of automation, and robustness to noise. 1 2 Introduction Software systems operate in

77 FR 40129 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing of Rule Change, as Modified by...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-06

... Delete Obsolete Text and To Clarify and Update the Description of the Allocation of Market and Limit... Orders in the Allocation of Orders in Closing Transactions, and (4) Making Other Technical and Conforming... delete obsolete text and to clarify and update the description of the allocation of market and limit...

77 FR 40133 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing of Rule Change, as...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-06

... Obsolete Text and To Clarify and Update the Description of The Allocation of Market and Limit Interest in... Allocation of Orders in Closing Transactions, and (4) Making Other Technical and Conforming Changes June 29... description of the allocation of market and limit interest in opening and reopening transactions, (3) amend...

77 FR 51596 - Self-Regulatory Organizations; New York Stock Exchange LLC; NYSE MKT LLC; Order Granting Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-24

...--Equities to Delete Obsolete Text and to Clarify and Update the Description of The Allocation of Market and...) Making Other Technical and Conforming Changes August 17, 2012. I. Introduction On June 15, 2012, New York... description of the allocation of market and limit interest in opening and reopening transactions, (3) amend...

Research and Technology

NASA Technical Reports Server (NTRS)

1990-01-01

Johnson Space Center (JSC) accomplishments in new and advanced concepts during 1989 are highlighted. This year, reports are grouped in sections, Medical Science, Solar System Sciences, Space Transportation Technology, and Space Systems Technology. Summary sections describing the role of JSC in each program are followed by descriptions of significant tasks. Descriptions are suitable for external consumption, free of technical jargon, and illustrated to increase ease of comprehension.

A data science approach to candidate gene selection of pain regarded as a process of learning and neural plasticity.

PubMed

Ultsch, Alfred; Kringel, Dario; Kalso, Eija; Mogil, Jeffrey S; Lötsch, Jörn

2016-12-01

The increasing availability of "big data" enables novel research approaches to chronic pain while also requiring novel techniques for data mining and knowledge discovery. We used machine learning to combine the knowledge about n = 535 genes identified empirically as relevant to pain with the knowledge about the functions of thousands of genes. Starting from an accepted description of chronic pain as displaying systemic features described by the terms "learning" and "neuronal plasticity," a functional genomics analysis proposed that among the functions of the 535 "pain genes," the biological processes "learning or memory" (P = 8.6 × 10) and "nervous system development" (P = 2.4 × 10) are statistically significantly overrepresented as compared with the annotations to these processes expected by chance. After establishing that the hypothesized biological processes were among important functional genomics features of pain, a subset of n = 34 pain genes were found to be annotated with both Gene Ontology terms. Published empirical evidence supporting their involvement in chronic pain was identified for almost all these genes, including 1 gene identified in March 2016 as being involved in pain. By contrast, such evidence was virtually absent in a randomly selected set of 34 other human genes. Hence, the present computational functional genomics-based method can be used for candidate gene selection, providing an alternative to established methods.

The dorsal anterior cingulate cortex is selective for pain: Results from large-scale reverse inference

PubMed Central

Lieberman, Matthew D.; Eisenberger, Naomi I.

2015-01-01

Dorsal anterior cingulate cortex (dACC) activation is commonly observed in studies of pain, executive control, conflict monitoring, and salience processing, making it difficult to interpret the dACC’s specific psychological function. Using Neurosynth, an automated brainmapping database [of over 10,000 functional MRI (fMRI) studies], we performed quantitative reverse inference analyses to explore the best general psychological account of the dACC function P(Ψ process|dACC activity). Results clearly indicated that the best psychological description of dACC function was related to pain processing—not executive, conflict, or salience processing. We conclude by considering that physical pain may be an instance of a broader class of survival-relevant goals monitored by the dACC, in contrast to more arbitrary temporary goals, which may be monitored by the supplementary motor area. PMID:26582792

Postoperative pain and its impact on quality of life for hip-fractured older people over 12 months after hospital discharge.

PubMed

Shyu, Yea-Ing Lotus; Chen, Mei-Ling; Chen, Min-Chi; Wu, Chi-Chuan; Su, Juin-Yih

2009-03-01

To describe pain severity and pain interference and to explore the impact of pain severity on postoperative health-related quality of life of older people during their first year after discharge for hip surgery in Taiwan. Few studies have examined the impact of pain on postoperative quality of life for hip-fractured older persons. A descriptive, correlational design was used for this longitudinal study. Pain intensity, pain interference and quality of life were investigated prospectively for 87 elders within 12 months after discharge for hip surgery at a medical centre in Taiwan. Pain intensity and pain interference were measured by items from the Bodily Pain scale of the Medical Outcomes Study Short Form-36, Taiwan version. Quality of life dimensions were measured by all instrument scales, except bodily pain. Moderate to severe pain was reported by 41.3% and 24(.)8% of subjects at one and 12 months following discharge, respectively. Pain interference with life was reported as quite a bit or extreme by 31.1% of subjects at 12 months after discharge. Subjects who reported moderate/severe pain at one month after discharge experienced declines in general health (p = 0.03) and vitality (p = 0.02) from 6-12 months after discharge. Around a quarter of hip-fractured older persons experienced moderate to very severe pain and quite a bit to severe pain interference from six months to one year after discharge. Furthermore, pain experienced during the first month after discharge significantly impacted quality of life throughout the year following discharge, even after controlling for covariates. Nurses must pay attention and intervene with long-term postoperative pain in hip-fractured elders to prevent further declines in physically related outcomes. The findings of this study can be used to develop effective pain-management strategies for hip-fractured older patients.

A study of National Health Service management of chronic osteoarthritis and low back pain.

PubMed

Hart, Oliver R; Uden, Ruth M; McMullan, James E; Ritchie, Mark S; Williams, Timothy D; Smith, Blair H

2015-04-01

To describe treatment and referral patterns and National Health Service resource use in patients with chronic pain associated with low back pain or osteoarthritis, from a Primary Care perspective. Osteoarthritis and low back pain are the two commonest debilitating causes of chronic pain, with high health and social costs, and particularly important in primary care. Understanding current practice and resource use in their management will inform health service and educational requirements and the design and optimisation of future care. Multi-centre, retrospective, descriptive study of adults (⩾18 years) with chronic pain arising from low back pain or osteoarthritis, identified through primary care records. Five general practices in Scotland, England (two), Northern Ireland and Wales. All patients with a diagnosis of low back pain or osteoarthritis made on or before 01/09/2006 who had received three or more prescriptions for pain medication were identified and a sub-sample randomly selected then consented to an in-depth review of their medical records (n=264). Data on management of chronic pain were collected retrospectively from patients' records for three years from diagnosis ('newly diagnosed' patients) or for the most recent three years ('established' patients). Patients received a wide variety of pain medications with no overall common prescribing pattern. GP visits represented the majority of the resource use and 'newly diagnosed' patients were significantly more likely to visit their GP for pain management than 'established' patients. Although 'newly diagnosed' patients had more referrals outside the GP practice, the number of visits to secondary care for pain management was similar for both groups. This retrospective study confirmed the complexity of managing these causes of chronic pain and the associated high resource use. It provides an in-depth picture of prescribing and referral patterns and of resource use.

Cultural Adaptation and Psychometric Evaluation of the Spanish Version of the Nursing Outcome "Pain Control" in Primary Care Patients with Chronic Pain.

PubMed

Bellido-Vallejo, José Carlos; Pancorbo-Hidalgo, Pedro Luis

2017-10-01

The control of chronic pain is a major challenge for patients and health care professionals. To culturally adapt the Nursing Outcomes Classification outcome "Pain control" (PC) to the Spanish health care setting and to analyze its psychometric properties and sensitivity to change. A study of three stages was designed: (1) Translation and cultural adaptation by translation-back-translation method, (2) content validation by a group of experts, and (3) observational-longitudinal study in patients with chronic pain. Patient sampling was nonprobabilistic, and participants completed forms and questionnaires and responded to a question on pain. Statistical analysis included descriptive analysis, content validity index (for global PC and each indicator), principal component analysis, Spearman's test, Cronbach's α, Cohen's κ coefficient, and Wilcoxon range test. The new Spanish version of "Pain control" was semantically equivalent to the original, with a mean content validity index of 0.96. The clinical study included 88 patients with long-term pain, and the mean (standard deviation) interval between assessments (baseline and final) was 29.33 (8.05) days. Thirteen indicators were organized into two components. There was divergent but not convergent validity with the Change Pain Scale and Brief Pain Inventory. Between-observer agreement was κ = 0.48 and internal consistency was α = 0.85. No differences were found between mean baseline and final scores. The Spanish version of "Pain control," culturally adapted and structured in two components (13 indicators), is useful to assess and monitor pain control in patients with chronic pain. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Basic science of pain.

PubMed

DeLeo, Joyce A

2006-04-01

The origin of the theory that the transmission of pain is through a single channel from the skin to the brain can be traced to the philosopher and scientist René Descartes. This simplified scheme of the reflex was the beginning of the development of the modern doctrine of reflexes. Unfortunately, Descartes' reflex theory directed both the study and treatment of pain for more than 330 years. It is still described in physiology and neuroscience textbooks as fact rather than theory. The gate control theory proposed by Melzack and Wall in 1965 rejuvenated the field of pain study and led to further investigation into the phenomena of spinal sensitization and central nervous system plasticity, which are the potential pathophysiologic correlates of chronic pain. The processing of pain takes place in an integrated matrix throughout the neuroaxis and occurs on at least three levels-at peripheral, spinal, and supraspinal sites. Basic strategies of pain control monopolize on this concept of integration by attenuation or blockade of pain through intervention at the periphery, by activation of inhibitory processes that gate pain at the spinal cord and brain, and by interference with the perception of pain. This article discusses each level of pain modulation and reviews the mechanisms of action of opioids and potential new analgesics. A brief description of animal models frames a discussion about recent advances regarding the role of glial cells and central nervous system neuroimmune activation and innate immunity in the etiology of chronic pain states. Future investigation into the discovery and development of novel, nonopioid drug therapy may provide needed options for the millions of patients who suffer from chronic pain syndromes, including syndromes in which the pain originates from peripheral nerve, nerve root, spinal cord, bone, muscle, and disc.

Pain relief at the end of life: nurses' experiences regarding end-of-life pain relief in patients with dementia.

PubMed

Brorson, Hanna; Plymoth, Henrietta; Örmon, Karin; Bolmsjö, Ingrid

2014-03-01

Patients with dementia receive suboptimal palliative care, and this patient group is at risk to have pain at the end of life. Because communicative impairments are common in this patient group, nurses play an important caregiver role in identifying, assessing, and relieving patients' pain. This study aimed to describe nurses' experiences regarding end-of-life pain relief in patients with dementia. This descriptive exploratory qualitative study was based on seven semistructured interviews. Burnard's content analysis inspired the data analysis. Two main categories were identified: (1) nurses' experience of difficulties concerning pain relief and (2) nurses' experience of resources concerning pain relief. Nurses experienced difficulties, such as feeling of powerlessness because of difficulties in obtaining adequate prescriptions for analgesics, ethical dilemmas, feeling of inadequacy because analgesia did not have the desired effect, and a feeling of not being able to connect with the patient. Factors, including knowledge about the patient, professional experience, utilization of pain assessment tools, interpersonal relationships, and interprofessional cooperation, served as resources and enabled end-of-life pain relief. The results of this study highlight the complexity of pain relief in patients with dementia at the end of life from a nursing perspective. The inability of patients with dementia to verbally communicate their pain makes them a vulnerable patient group, dependent on their caregivers. Knowing the life story of the patient, professional experience, teamwork based on good communication, and use of a pain assessment tool were reported by the nurses to improve pain relief at the end of life for patients with dementia. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping.

PubMed

van Randeraad-van der Zee, Carlijn H; Beurskens, Anna J H M; Swinkels, Raymond A H M; Pool, Jan J M; Batterham, Roy W; Osborne, Richard H; de Vet, Henrica C W

2016-05-01

To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

Health care professionals' pain narratives in hospitalized children's medical records. Part 1: pain descriptors.

PubMed

Rashotte, Judy; Coburn, Geraldine; Harrison, Denise; Stevens, Bonnie J; Yamada, Janet; Abbott, Laura K

2013-01-01

Although documentation of children's pain by health care professionals is frequently undertaken, few studies have explored the nature of the language used to describe pain in the medical records of hospitalized children. To describe health care professionals' use of written language related to the quality and quantity of pain experienced by hospitalized children. Free-text pain narratives documented during a 24 h period were collected from the medical records of 3822 children (0 to 18 years of age) hospitalized on 32 inpatient units in eight Canadian pediatric hospitals. A qualitative descriptive exploration using a content analysis approach was used. Pain narratives were documented a total of 5390 times in 1518 of the 3822 children's medical records (40%). Overall, word choices represented objective and subjective descriptors. Two major categories were identified, with their respective subcategories of word indicators and associated cues: indicators of pain, including behavioural (e.g., vocal, motor, facial and activities cues), affective and physiological cues, and children's descriptors; and word qualifiers, including intensity, comparator and temporal qualifiers. The richness and complexity of vocabulary used by clinicians to document children's pain lend support to the concept that the word 'pain' is a label that represents a myriad of different experiences. There is potential to refine pediatric pain assessment measures to be inclusive of other cues used to identify children's pain. The results enhance the discussion concerning the development of standardized nomenclature. Further research is warranted to determine whether there is congruence in interpretation across time, place and individuals.

Patients' perceptions and responses to procedural pain: results from Thunder Project II.

PubMed

Puntillo, K A; White, C; Morris, A B; Perdue, S T; Stanik-Hutt, J; Thompson, C L; Wild, L R

2001-07-01

Little is known about the painfulness of procedures commonly performed in acute and critical care settings. To describe pain associated with turning, wound drain removal, tracheal suctioning, femoral catheter removal, placement of a central venous catheter, and nonburn wound dressing change and frequency of use of analgesics during procedures. A comparative, descriptive design was used. Numeric rating scales were used to measure pain intensity and procedural distress; word lists, to measure pain quality. Data were obtained from 6201 patients: 176 younger than 18 years and 5957 adults. Mean pain intensity scores for turning and tracheal suctioning were 2.80 and 3.00, respectively (scale, 0-5), for 4- to 7-year-olds and 52.0 and 28.1 (scale, 0-100) for 8- to 12-year-olds. For adolescents, mean pain intensity scores for wound dressing change, turning, tracheal suctioning, and wound drain removal were 5 to 7 (scale, 0-10); mean procedural distress scores were 4.83 to 6.00 (scale, 0-10). In adults, mean pain intensity scores for all procedures were 2.65 to 4.93 (scale, 0-10); mean procedural distress scores were 1.89 to 3.47 (scale, 0-10). The most painful and distressing procedures were turning for adults and wound care for adolescents. Procedural pain was often described as sharp, stinging, stabbing, shooting, and awful. Less than 20% of patients received opiates before procedures. Procedural pain varies considerably and is procedure specific. Because procedures are performed so often, more individualized attention to preparation for and control of procedural pain is warranted.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien; Department of Interventional Radiology, Nouvel Hôpital Civil

ObjectivesThe purpose of this study is to discuss technical aspects and rationales of magnetic resonance (MR)-guided cryoablation (CA) of Morton’s neuroma (MN); preliminary clinical experience is also retrospectively reviewed.MethodsProcedures were performed under local anaesthesia on an outpatient basis. Lesion size and location, procedural (technical success, procedural time, complications) and clinical outcomes (patient satisfaction according to a four-point scale, residual pain according to a 0–10 visual analogue scale and instances of “stump neuroma”) were assessed via chart review and cross-sectional telephone survey after the 20th case.ResultsTwenty patients (15 female, 5 male; mean age 50.3 years) were included; 24 MN (mean size 12.7 mm)more » were treated. Technical success was 100 %. Mean procedural time was 40.9 ± 10.4 min (range 35–60). One minor complication (superficial cellulitis) was reported (4.2 %). Follow-up (mean 19.7 months) was available for 18/24 MN. Patient satisfaction on a per-lesion basis was as follows: “completely satisfied” in 77.7 %, “satisfied with minor reservations” in 16.6 % and “satisfied with major reservations” in 5.7 % of cases. Mean pain score at last follow-up post-CA was 3.0. No instances of “stump neuroma” were reported.ConclusionsMR-guided CA of MN is a novel therapy which appears technically feasible. Clinical advantages of the procedure are high patient satisfaction, reduced risk of “stump neuroma” syndrome and good patient tolerance on an outpatient basis. Further, prospective studies are needed to confirm these encouraging results.« less

Experience of Adults and Children in Hospitals

ERIC Educational Resources Information Center

Rokach, Ami; Parvini, Maneli

2011-01-01

This review article examines the experience, in general but especially, of hospitalised children. The technical, environmental and social aspects of a hospital are described. Being hospitalised, especially for a child, could be a terrifying and painful experience. This experience has been described and closely examined with the aim of helping…

Growing Pains: An Evaluation of the SUCCEED Coalition.

ERIC Educational Resources Information Center

Brawner, Catherine E.; Serow, Robert C.

The SUCCEED coalition, one of the NSF Engineering Education Coalitions, was founded on a vision in which all engineering graduates will possess not only highly developed technical skills, but also the attitudes and awareness needed to prosper in the contemporary workplace. This vision manifested itself within SUCCEED by the development of…

Evaluation of Routine Atmospheric Sounding Measurements using Unmanned Systems (ERASMUS): Final Technical Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

de Boer, Gijs; Lawrence, Dale; Palo, Scott

2017-03-29

This final technical report details activities undertaken as part of the referenced project. Included is information on the preparation of aircraft for deployment to Alaska, summaries of the three deployments covered under this project, and a brief description of the dataset and science directions pursued. Additionally, we provide information on lessons learned, publications, and presentations resulting from this work.

Outcomes of an Independent Review and Guidelines for the Implementation of a Program Review Model. Volume II. Technical Report.

ERIC Educational Resources Information Center

Carvell Education Managment Planning, Inc., Los Angeles, CA.

The second part of a report on a comprehensive review of the credit instructional programs offered by Pasadena City College (PCC), this volume contains a technical description of the data collection and assembly procedures used in the program review and provides guidelines for the implementation of the program review model. The first section…

Ammunition Cost Research Study

DTIC Science & Technology

1976-06-01

LIBRARY TECHNICAL REPORT Gerald W. Kalal Patrick J. Gannon COST ANALYSIS DIVISION (DRSAR-CPE) HEADQUARTERS, U.S. ARMY ARMAMENT COMMAND ROCK ISLAND... Kalal trick J. Gannon COST ANALYSIS DIVISION (DRSAR-CPE) HEADQUARTERS, U.S. ARMY ARMAMENT COMMAND ROCK ISLAND, ILLINOIS 61201 I UNCLASSIFIED...4. DESCRIPTIVE NOTES (Type ot report and Inclusive date») Technical Report 8- AU THOR(S> (flral name, middle Initial, laat name) Gerald W. Kalal

User's Guide to Computing High School Graduation Rates. Volume 2. Technical Report: Technical Evaluation of Proxy Graduation Indicators. NCES 2006-605

ERIC Educational Resources Information Center

Seastrom, Marilyn M.; Chapman, Chris; Stillwell, Robert; McGrath, Daniel; Peltola, Pia; Dinkes, Rachel; Xu, Zeyu

2006-01-01

This report consists of two volumes, the first takes an in-depth look at the various graduation indicators, with a description of the computational formulas, the data required for each indicator, the assumptions underlying each formula, the strengths and weaknesses of each indicator, and a consideration of the conditions under which each indicator…

"Who Stays and Who Leaves?" Findings from a Three-Part Study of Teacher Turnover in NYC Middle Schools. Technical Appendices

ERIC Educational Resources Information Center

Marinell, William H.; Coca, Vanessa M.; Arum, Richard; Goldstein, Jennifer; Kemple, James; Pallas, Aaron; Bristol, Travis; Buckley, Clare; Scallon, Amy; Tanner, Barbara

2013-01-01

The technical appendices presented in this document correspond to the synthesis report, "'Who Stays and Who Leaves?' Findings from a Three-Part Study of Teacher Turnover in NYC Middle Schools." The appendices include: (1) Description of Data Source and Samples; (2) Methods; and (3) Who Are the Middle School Teachers in NYC? [The…

The Accounting Class as Accounting Firm: A Model Program for Developing Technical and Managerial Skills

ERIC Educational Resources Information Center

Docherty, Gary

1976-01-01

One way to bring the accounting office into the classroom is to conduct the class as a "company." Such a class is aimed at developing students' technical and managerial skills, as well as their career awareness and career goals. Performance goals, a course description, and overall objectives of the course are given and might serve as a model.…

9 CFR 2.31 - Institutional Animal Care and Use Committee (IACUC).

Code of Federal Regulations, 2013 CFR

2013-01-01

...; (xi) Methods of euthanasia used must be in accordance with the definition of the term set forth in 9... discomfort and pain to animals; and (5) A description of any euthanasia method to be used. [54 FR 36147...

9 CFR 2.31 - Institutional Animal Care and Use Committee (IACUC).

Code of Federal Regulations, 2012 CFR

2012-01-01

...; (xi) Methods of euthanasia used must be in accordance with the definition of the term set forth in 9... discomfort and pain to animals; and (5) A description of any euthanasia method to be used. [54 FR 36147...

9 CFR 2.31 - Institutional Animal Care and Use Committee (IACUC).

Code of Federal Regulations, 2011 CFR

2011-01-01

...; (xi) Methods of euthanasia used must be in accordance with the definition of the term set forth in 9... discomfort and pain to animals; and (5) A description of any euthanasia method to be used. [54 FR 36147...

Microvascular Decompression for Trigeminal Neuralgia: Technical Refinement for Complication Avoidance.

PubMed

Tomasello, Francesco; Esposito, Felice; Abbritti, Rosaria V; Angileri, Filippo F; Conti, Alfredo; Cardali, Salvatore M; La Torre, Domenico

2016-10-01

Microvascular decompression (MVD) represents the most effective and safe surgical option for the treatment of trigeminal neuralgia since it was first popularized by Jannetta 50 years ago. Despite several advances, complications such as cerebellar and vascular injury, hearing loss, muscular atrophy, cerebrospinal fluid (CSF) leak, postoperative cutaneous pain, and sensory disturbances still occur and may negatively affect the outcome. We propose some technical nuances of the surgical procedure that were used in our recent series. We used a novel hockey stick-shaped retromastoid skin incision, preserving the major nerves of the occipital and temporal areas. Microsurgical steps were performed without the use of retractors. CSF leakage was prevented with a watertight dural closure and multilayer osteodural reconstruction. The refined surgical steps were perfected in the last consecutive 15 cases of our series. In these cases we did not record any cutaneous pain, sensory disturbances, or CSF leakage. The average diameter of the craniectomy was 18 mm. No patient reported major complications related to the intradural microsurgical maneuvers. In all cases the neurovascular conflict was found and solved with a good outcome in terms of pain disappearance. Our minimally invasive approach was demonstrated to guarantee an optimal exposure of the cerebellopontine angle and minimize the rate of complications related to skin incision and muscular dissection, microsurgical steps, and closure. Copyright © 2016 Elsevier Inc. All rights reserved.

Chronic pain in the newborn: toward a definition.

PubMed

van Ganzewinkel, Christ-jan; Anand, Kanwaljeet J S; Kramer, Boris W; Andriessen, Peter

2014-11-01

Chronic pain is poorly addressed in neonatal pain research. We aimed at contributing to define the concept of chronic pain in the newborn. We designed a Web-based, 3-round Delphi survey. We invited an international panel of experts (health care providers and parents) in the fields of neonatology and neonatal pain to participate. In the first round, participants (n=189) answered 3 open-ended questions: (1) define chronic pain in your own words, (2) what are the possible causes, and (3) which signs and symptoms are used to diagnose chronic pain? The answers were categorized and summarized into 437 statements, which were valued by the participants (n=189) on a 5-point Likert scale. In the second round, the remaining participants (n=72) were asked to reflect on 65 selected statements with a mode or median ≥4 or mean ≥3.75. These threshold values provided the opportunity to reach consensus in the following round. In the third round, the remaining participants (n=33) were provided with the group and individual responses. This process resulted in 23 statements with mode, mean, and median of ≥4, on which the participants reached consensus. Although several etiologic factors were defined, no useful diagnostic criterion could be identified. The survey resulted in a description of chronic pain in the newborn. Identifying chronic pain is clinically relevant because it interferes with growth, prolongs hospitalization, leads to altered pain perception, and impairs cognitive and behavioral development.

48 CFR 36.202 - Specifications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... technical societies. (c) When brand name or equal descriptions are necessary, specifications must clearly identify and describe the particular physical, functional, or other characteristics of the brand-name items...

Bruxism: A Literature Review

PubMed Central

Reddy, S Varalakshmi; Kumar, M Praveen; Sravanthi, D; Mohsin, Abdul Habeeb Bin; Anuhya, V

2014-01-01

Parafunctional activities associated with the stomatognathic system include lip and cheek chewing, nail biting, and teeth clenching. Bruxism can be classified as awake or sleep bruxism. Patients with sleep bruxism are more likely to experience jaw pain and limitation of movement, than people who do not experience sleep bruxism. Faulty occlusion is one of the most common causes of bruxism that further leads to temporomandibular joint pain. Bruxism has been described in various ways by different authors. This article gives a review of the literature on bruxism since its first description. PMID:25628497