Medicine and Health Sciences Commons^™

Children’S Cancer Pain In A World Of The Opioid Epidemic: Challenges And Opportunities, Michelle Fortier, Sun Yang, Michael T. Phan, Daniel Tomaszewski, Brooke N. Jenkins, Zeev N. Kain

Psychology Faculty Articles and Research

The opioid crisis in the United States has grown at an alarming rate. Children with cancer are at high risk for pain, and opioids are a first‐line treatment in this population. Accordingly, there is an urgent need to optimize pain management in children with cancer without contributing to the opioid crisis. This report details opportunities for this optimization, including clinical practice guidelines, comprehensive approaches to pain management, mobile health, and telemedicine. It is vital to balance appropriate use of analgesics with efforts to prevent misuse in order to reduce unnecessary suffering and minimize unintended harms.

Genetic Variations In The Dopamine Reward System Influence Exercise Reinforcement And Tolerance For Exercise Intensity, Kyle D. Flack, Christopher Pankey, Kelsey Elise Ufholz, Luann Johnson, James N. Roemmich

Dietetics and Human Nutrition Faculty Publications

Background: Exercise is a reinforcing behavior and finding exercise highly reinforcing is characteristic of habitual exercisers. Genotypes related to dopamine metabolism moderate the reinforcing value of behaviors, but genetic moderators of exercise reinforcement have not been established.

Purpose: Determine whether singular nucleotide polymorphisms (SNPs) that moderate central reward pathways and pain neurotransmission are associated with exercise reinforcement, tolerance for exercise intensity, and usual physical activity.

Methods: Adults (n = 178) were measured for the reinforcing value of exercise relative to sedentary activities (RRV_exercise), minutes of moderate-to-vigorous physical activity (MVPA) and completed the Preference for and Tolerance …

Wheelchair Propulsion For Everyday Manual Wheelchair Users: Repetition Training And Machine Learning-Based Monitoring, Pin-Wei Chen

Arts & Sciences Electronic Theses and Dissertations

Upper limb pain and injuries are prevalent among manual wheelchair users and can restrict their participation and daily activities. Due to the high repetition and force in wheelchair propulsion, chronic wheelchair propulsion has been linked to the risk of upper limb pain and injury. Prevention of upper limb pain and injury is a high priority in wheelchair-related research. Decades of research in wheelchair propulsion biomechanics have led to clinical practice guidelines (CPG). Unfortunately, a decade after the publication of the CPG, CPG-recommended propulsion is still uncommon. Hence, for the first aim, a randomized controlled trial pilot study with two groups …

Effects Of Ketamine Versus Morphine In The Treatment Of Acute Pain In The Emergency Department, Dakoda Farrington, Amber Knowlton

Physician Assistant Capstones, 2016 to 2019

No abstract provided.

Postpartum Pains, Lakea Youngblood

Capstones

The Academy once again came under fire. This time for banning a commercial that advertised a postpartum support. People all over the country became enraged. The Academy seemed more friendly to movies about murder than postpartum, in alignment with the sexist ideas that have been pervasive in this country since its foundations. This short documentary pushes back against this narrative and the silence around postpartum by showing the realities of it through a woman’s journey.

The film is a personal documentary about myself. After having my first child, I found myself traumatized and scarred by the pains of postpartum. Because …

Concurrent Discitis And A Spinal Epidural Abscess Following Transforaminal Epidural Steroid Injection Arising From An Unlikely Bacterial Species, Adlai Pappy Ii, Vinita Singh Md

Anesthesiology

No abstract provided.

Treatment Of Phantom Limb Pain And Knee Flexion Contracture Due To Transtibial Amputation: A Case Study, Kristin Smead, Donna Leigel

Miami, Fall 2019

This case study evaluated the effectiveness of a combination of visual mirror therapy for phantom limb pain desensitization in conjunction with a physical therapy regimen of therapeutic exercise, short-wave diathermy, and gait training in a 66-year-old male with left lower extremity amputation.

Through a combination of mirror therapy, short-wave diathermy over the hamstring musculature, and therapeutic exercise, the patient displayed an overall improvement in left lower limb knee flexion contracture and a reduction in perceived phantom limb pain.The patient can now tolerate full weight bearing through this extremity from an improved fit of the prosthesis socket. Throughout the course of …

Pain, Functional Disability, And Their Association In Juvenile Fibromyalgia Compared To Other Pediatric Rheumatic Diseases., Mark Connelly, Jennifer E Weiss, Carra Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Severe pain and impairments in functioning are commonly reported for youth with juvenile fibromyalgia. The prevalence and impact of pain in other diseases commonly managed in pediatric rheumatology comparatively have been rarely systematically studied. The objective of the current study was to determine the extent to which high levels of pain and functional limitations, and the strength of their association, are unique to youth with juvenile primary fibromyalgia syndrome/JPFS) relative to other pediatric rheumatic diseases.

METHODS: Using data from 7753 patients enrolled in the multinational Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry, we compared the levels and …

Latent Effects Of Stress On Delayed Modulation Of Chronic Low Back Pain: Case Series, Roger Allen Phd, Pt, Anna Chang Spt, Catherine Mooney-Myers Spt, Lauren Gallison

Physical Therapy Research Symposium

Purpose: The purpose of the study was to investigate the temporal relationship between psychogenic stress and perceived intensity of chronic low back pain (LBP). LBP was chosen as a pilot condition prefacing a larger research effort to determine which variants of chronic pain may manifest latent psychogenic modulation based on previous studies of neuropathic pain conditions.

Methods: The study consisted of five subjects, one male and four females, ranging from 19-32 years old and chronicity of pain ranging from 5 months to 6+ years since diagnosis. Over 12-15 weeks, participants completed daily visual analog pain, stress, and pain-related function scales. …

The Use Of Ibuprofen And Our Knowledge About It, Dafina Krasniqi, Engjell Thaqi, Donika Berisha, Gentian Bibaj, Fjolla Kryeziu

UBT International Conference

Ibuprofen is a medication in the nonsteroidal anti-inflammatory drug class that is used for treating pain, fever, and inflammation. It can be used by mouth or intravenous. It typically begins working within an hour. Usual adult dose for pain or fever is 200 to 400 mg orally every 4 to 6 hours as needed. Side effects include nausea, dyspepsia, diarrhea, constipation, gastrointestinal ulceration/bleeding, headache, dizziness, rash, salt and fluid retention, and high blood pressure. Infrequent side effects include esophageal ulceration, heart failure, high blood levels of potassium, kidney …

Importance Of Psychological Support In Pain Management In Terminal Patients, Ariola Panteqi, Armela Garpi Bejko

UBT International Conference

Pain is unpleasant sensation, suffering or distress of the body or mind. This feeling impairs active life and and make you feel tired and tense. Pain often accompanies terminal patients affecting all aspects of life. In the cancer population, its prevalence is over 75% for those with advanced disease (Dahlia Rizk, 2017.). Techniques mainly used in Albania for pain management are those with medications, ranging from mild to severe such as morphine or other opiate family medications.

The purpose of this research is to investigate the services offered to terminal patients in Albania, in terms of pain management. …

Epidemiology Of Chronic Pain In Ukraine: Findings From The World Mental Health Survey, Anna Xu, Elizabeth Hilton, Riley Arkema, Nathan L. Tintle, Luralyn M. Helming

Faculty Work Comprehensive List

Chronic pain can pose a serious challenge in everyday life for many individuals globally, especially in developing countries, but studies explicitly exploring risk factors of chronic pain beyond demographic characteristics using survey data have been scarce. To address this problem, this study analyzed World Health Organization data on chronic pain in Ukraine to explore demographic, psychological, and treatment perception-related risk factors to chronic pain. We replicated previous reports of older age, female sex, married status, inadequate financial resources, and comorbidity of other physical conditions as significant demographic risk factors for chronic pain diagnosis but not necessarily for severe pain. We …

Determining The Effectiveness Of Core Strengthening Exercise Therapies In Treating Nonspecific Low Back Pain: A Critically Appraised Topic, Amanda King, Andrea Cripps

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO: Nonspecific low back pain is a condition which impacts athletes of all calibers and sports. It has been found that a total of 68% of top athletes from multiple sports have been affected by nonspecific low back pain at some point in their career. Clinicians have discussed that tight hamstrings and weak core muscles are a major cause of nonspecific low back pain. A myriad of program exist to reduce nonspecific low back pain caused from hamstring tightness, however a standardized rehabilitation protocol for strengthening the core muscles to reduce nonspecific low back pain is not as well …

Pain Management In Dementia Patients In Nursing Homes, Tiffany Kneuss, Kelsey Weisenburger, Hannah Stewart, Kelly Reilly Kroustos

Pharmacy and Wellness Review

Pain in the elderly, especially those with dementia, is often undertreated and misdiagnosed by health care professionals in the long-term care setting. Communication barriers in patients with cognitive impairment force pain assessment to rely heavily on subjective interpretation of behavioral factors due to the inability of patients to self-report pain symptoms. It is important for clinicians to develop a standard method of identifying and assessing signs of pain in patients with dementia in order to appropriately treat those experiencing discomfort. Patients with dementia who present with a sudden onset of behavioral changes should receive a comprehensive evaluation that includes a …

Special Considerations In Pediatric Burn Patients Regarding Drug Dosage And Administration, Kelsey Lindsley, Maureen Moynihan, Angela Chu, Kristen Yaeger, Karen L. Kier

Pharmacy and Wellness Review

Pediatric burn patients are a high-risk patient population to treat. These patients have altered physiologic function as a result of the burn injury, in addition to their smaller size and developing bodies. This creates unique challenges during treatment. Accommodations for these patients are made through unique drug dosages and routes of administration. When treating pediatric burn patients, properly assessing and treating pain promptly and effectively is of utmost importance. Nurses who utilize accurate and appropriate pain assessment scales will provide the best treatment of pain. Proper assessment allows the patient to receive the correct analgesic regime, ensuring a faster and …

Welfare Challenges Influence The Complexity Of Movement: Fractal Analysis Of Behaviour In Zebrafish, Anthony G. Deakin, Joseph W. Spencer, Andrew R. Cossins, Iain S. Young, Lynne U. Sneddon

Lynne Sneddon, PhD

The ability to assess welfare is an important refinement that will ensure the good condition of animals used in experimentation. The present study investigated the impact of invasive procedures on the patterns of movement of zebrafish (Danio rerio). Recordings were made before and after fin clipping, PIT tagging and a standard pain test and these were compared with control and sham handled zebrafish. The fractal dimension (FD) from the 3D trajectories was calculated to determine the effect of these treatments on the complexity of movement patterns. While the FD of zebrafish trajectories did not differ over time in either the …

Reduction In Activity By Noxious Chemical Stimulation Is Ameliorated By Immersion In Analgesic Drugs In Zebrafish, Javier Lopez-Luna, Qussay Al-Jubouri, Waleed Al-Nuaimy, Lynne U. Sneddon

Lynne Sneddon, PhD

Research has recently demonstrated that larval zebrafish show similar molecular responses to nociception to those of adults. Our study explored whether unprotected larval zebrafish exhibited altered behaviour after exposure to noxious chemicals and screened a range of analgesic drugs to determine their efficacy to reduce these responses. This approach aimed to validate larval zebrafish as a reliable replacement for adults as well as providing a high-throughput means of analysing behavioural responses. Zebrafish at 5 days postfertilization were exposed to known noxious stimuli: acetic acid (0.01%, 0.1% and 0.25%) and citric acid (0.1%, 1% and 5%). The behavioural response of each …

Teaching An Old Pain Medicine Society New Tweets: Integrating Social Media Into Continuing Medical Education., Kellie M Jaremko, Eric S Schwenk, Amy C S Pearson, Jonathan Hagedorn, Ankeet D Udani, Gary Schwartz, Nabil M Elkassabany, Anne Snively, Edward R Mariano

Department of Anesthesiology Faculty Papers

No abstract.

Quantifying The Outcomes Of A Virtual Reality (Vr)-Based Gamified Neck Rehabilitation, Shahan Salim

Electronic Thesis and Dissertation Repository

Neck pain is a major global public health concern and adds a significant financial burden to both the healthcare system as well as people suffering from it. Additionally, it presents measurement and evaluation challenges for clinicians as well as adherence challenges and treatment barriers for the patients. We have developed a virtual reality (VR)-based video game that can be used to capture outcomes that may aid in the assessment and treatment of neck pain. We investigated: (i) performance metrics of overall accuracy, accuracy based on movement difficulty, duration, and total envelope of movement; (ii) stability across sessions; (iii) accuracy across …

Burden Of Disease In Pediatric Patients With Hypophosphatasia: Results From The Hpp Impact Patient Survey And The Hpp Outcomes Study Telephone Interview., Eric T. Rush, Scott Moseley, Anna Petryk

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Hypophosphatasia (HPP) is a rare, inherited, metabolic bone disease caused by deficient tissue-non-specific isoenzyme of alkaline phosphatase activity that manifests as a broad range of signs/symptoms, including bone mineralization defects and systemic complications. The burden of disease is poorly characterized, particularly in children. This study aimed to characterize the patient-reported burden of disease among children with HPP using two survey instruments: the HPP Impact Patient Survey (HIPS) and the HPP Outcomes Study Telephone interview (HOST).

METHODS: Between September 2009 and June 2011, pediatric patients (aged younger than 18 years) with HPP were recruited to participate in the study via …

Effects Of Toothache On The Educational And Social Status Of Children, Mehmet S. Dogan, Ahmet Aras, Osman Atas, Abdullah E. Karaali, Ayse Gunay, Haluk M. Akbaba, Izzet Yavuz

Makara Journal of Health Research

Background: Untreated tooth cavities and the resulting toothaches have significant effects on children’s social and psychological development. The aim of this study was to evaluate the impact of toothache on children’s educational and social activities. Methods: For this retrospective study, we issued a 15-question survey to the parents of 515 children between ages of 5–16 years in Diyarbakır, Turkey. The chi-square test was used to test the strength of the relationship between two variables (p ≤ 0.05). Results: 318 (61.7%) parents reported having difficulty in feeding their children, 94 (18.3%) left a game due to toothache, 173 (33.6%) had school …

Demographic, Clinical, And Treatment Characteristics Of The Juvenile Primary Fibromyalgia Syndrome Cohort Enrolled In The Childhood Arthritis And Rheumatology Research Alliance Legacy Registry., Jennifer E. Weiss, Kenneth N. Schikler, Alexis D. Boneparth, Mark Connelly, Carra Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: To describe the demographic, clinical, and treatment characteristics of youth diagnosed with juvenile primary fibromyalgia syndrome (JPFS) who are seen in pediatric rheumatology clinics.

METHODS: Information on demographics, symptoms, functioning, and treatments recommended and tried were obtained on patients with JPFS as part of a multi-site patient registry (the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry). Data were summarized using descriptive statistics. In a subset of patients completing registry follow-up visits, changes in symptoms, pain, and functioning were evaluated using growth modeling.

RESULTS: Of the 201 patients with JPFS enrolled in the registry, most were Caucasian/White (85%), non-Hispanic …

Decreasing Musculoskeletal Injuries Among Operating Room Personnel Through The Use Of Anti-Fatigue Mats., Hannah Raake

Doctor of Nursing Practice Papers

Work-related musculoskeletal disorders (WRMDs) are a common occurrence among operating room (OR) personnel due to certain job requirements including standing in a static position for long periods of time. The American Association of Operating Room Nurses (AORN) ergonomic guidelines support interventions (anti-fatigue mats, shoe in-soles, etc.) aimed at decreasing the rates of WRMDs among OR personnel. A 3-month pre- and post-intervention trial was established at one Southern Indiana hospital to assess the efficacy of anti-fatigue mats in the OR theatre. Two anti-fatigue mats were placed in each OR, cardiovascular operating room (CVOR), and endoscopy room for use with each case. …

Role Of Heart Rate Variability Biofeedback In Cognitive Performance, Chronic Pain, And Related Symptoms, James P. Winstead

Theses and Dissertations

Over-modulation of the sympathetic nervous system and reduced heart rate variability (HRV) are commonly overlooked components of pain, poor cognition (decreased attention, recall, and cognitive processing), depression, stress, and fatigue. HRV Biofeedback (HRVB) training induces HRV coherence to balance the autonomic system. Paced breathing (~6 breaths/minute) increases HRV coherence. This randomized, controlled intervention trial tested the hypothesis that HRVB would improve HRV coherence, pain (severity, interference, and catastrophizing), cognitive performance, and reduce depressive, stress, and fatigue symptoms and pain medication use in veterans. Participants were randomized to previously established HRVB or control protocols. Each participant completed a Baseline Assessment, 6 …

Comparative Study Between Intrahemorrhoidal Diode Laser Treatment And Milligan-Morgan Hemorrhoidectomy, Alla A. Alsisy, Ibrahim Ei Salem, Yahia M. Alkhateep

Menoufia Medical Journal

Objective The aim of this study was to compare between intrahemorrhoidal diode laser coagulation with Milligan–Morgan (MM) hemorrhoidectomy. Background Because of the increased number of patients suffering from hemorrhoids and increased complications of MM hemorrhoidectomy, using intrahemorrhoidal diode laser therapy in this study was proved to be beneficial in terms of being easily used, noninvasive, nontoxic, painless, and highly effective. Patients and methods This study included 60 patients with symptomatic hemorrhoids of grades II and III. Thirty patients were treated with intrahemorrhoidal diode laser coagulation and the remaining were treated with MM hemorrhoidectomy. We measured operative time, postoperative pain, complications, …

The Endocannabinoid System In Migraine: From Bench To Pharmacy And Back., Cristina Tassorelli, Rosaria Greco, Stephen D. Silberstein

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: Migraine is a common, highly disabling disorder. Its treatment involves acute and preventive therapy. Many of available preventive medications are not well tolerated, which results in poor compliance and limited effectiveness. Cannabinoids have been proposed for the treatment of migraine but their efficacy and tolerability are controversial.

RECENT FINDINGS: Cannabinoids modulate functions and activity of signaling pathways that have a key role in pain control. Growing preclinical evidence and initial clinical findings suggest that modulation of the endocannabinoid system, via endogenous or exogenous cannabinoids may be relevant for migraine via multiple mechanisms.

SUMMARY: The endocannabinoid system qualifies …

Enhancing Chronic Pain Management Motivational Interview Among Lower Back Pain Patients, Melissa L. Hines-Antico

Doctor of Nursing Practice Final Manuscripts

Purpose: Untreated chronic pain is a nationwide epidemic affect individual physically, psychologically, and financially. Low back pain is the most common subset of chronic pain. Restricted clinic time and a focus on procedural/prescriptive methods for managing pain prohibits patient education regarding self-care, and formation of a relationship with the provider.

Design: Article review yielded 20 articles that supported the use of motivational interviewing for chronic pain in lower back pain patients. They were evaluated for their strength of evidence on a scale of 1-6. One article was ranked level I as a meta-analysis, and six were ranked as level II …

Remifentanil Patient Controlled Analgesia Use In Laboring Women: A Feasibility Pilot Project, Joshua Aaron Carr

Doctor of Nursing Practice Final Manuscripts

Labor pain is a significant source of anxiety for most pregnant women. Parturients who are excluded from epidural analgesia (EA), the most common and most effective technique to reduce this pain, deserve access to the next best choice. Remifentanil patient controlled analgesia (RPCA), due to its fast onset, short half-life and demonstrated effect at reducing pain and boosting satisfaction is the next best option when compared to EA. Adoption of this strategy represents an opportunity to help bring this evidence based technique into a mainstream health system. This project reports on the first stage of a pilot project to bring …

Pilot Implementation Of A Comprehensive Pain Assessment In An Oncology Clinic, Lauren Botta

Doctor of Nursing Practice Final Manuscripts

Purpose/Aims: This project implemented an algorithmic approach to assess pain, functionality, and psychosocial states in newly diagnosed cancer patients. This was accomplished through utilization of a validated pain assessment tool. The tool’s purpose was to identify high-risk patients for Emergency Department (ED) visits or unanticipated hospital admissions (UHA), within a second-year fellow Hematology/Oncology clinic.

Primary aims included: (a) aggregating demographic data to determine the profile of a high-risk patient seen within this clinic, (b) determining those referred to and who followed up with symptom specialists or the ED, and (c) identifying barriers for the next iteration of the project. …

Gabapentin As An Adjunct To Decrease Opioid Consumption, Bethany L. Myhre

Nursing Capstones

No abstract provided.