Medicine and Health Sciences Commons^™

The Benefits And Risks Of Pudendal Nerve Block And Dorsal Root Ganglion Stimulation In Pudendal Neuralgia, Pooja A. Patel

Rowan-Virtua Research Day

Context: Pudendal neuralgia is a chronic neuropathic pain syndrome worsening throughout daily activities. Although temporarily relieved when standing or lying down, it is often misdiagnosed, improperly treated, and/or refractory to treatment leading to a negative impact on quality of life. The lack of research in proper diagnosis and interventional management (such as dorsal root ganglion stimulation (DRGS) and pudendal nerve block) further contributes to the delay in relief from the chronic pain. Objective: The goal of this scoping review is to assess if research exists on benefits and risks of pudendal nerve block and dorsal root ganglion and …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Inpatient Opioid Use Varies By Construct Length Among Laminoplasty Versus Laminectomy And Fusion Patients, Harry M. Lightsey, Peter J. Georgakas, Matthew H. Lindsey, Caleb M. Yeung, Joseph H. Schwab, Harold A. Fogel, Stuart H. Hershman, Daniel G. Tobert, Kevin M. Hwang

Rothman Institute Faculty Papers

BACKGROUND: Laminoplasty (LP) and laminectomy and fusion (LF) are utilized to achieve decompression in patients with symptomatic degenerative cervical myelopathy (DCM). Comparative analyses aimed at determining outcomes and clarifying indications between these procedures represent an area of active research. Accordingly, we sought to compare inpatient opioid use between LP and LF patients and to determine if opioid use correlated with length of stay.

METHODS: Sociodemographic information, surgical and hospitalization data, and medication administration records were abstracted for patients >18 years of age who underwent LP or LF for DCM in the Mass General Brigham (MGB) health system between 2017 and …

The Effectiveness Of Laser Acupuncture In Pain Management: A Systematic Review, June Park

Theses and Graduate Projects

Background: Pain is a common symptom across many medical conditions that patients experience. Pain management is complex and may need a combination of several management techniques. Laser acupuncture(LA) has been previously used as an adjunct to conventional pain treatments.

Objective: This systematic review aims to evaluate the effectiveness of laser acupuncture in various fields of medical situations such as chronic pain, low back pain, osteoarthritis, osteoporosis, postoperative pain and dental procedures.

Methods: A computer based literature search of databases through GoogleScholar and PubMed was used to identify randomized controlled trials(RCTs) published after 2018 that studied the effect of LA in …

An Interpretative Phenomenological Analysis Of The Lived Experience Of Parental Caregivers For Children With Severe Epidermolysis Bullosa, Michael J. Valentine

Theses and Dissertations

Providing care to child with a chronic, rare diseases has been identified as a major life stressor with a myriad of negative physical and mental health consequences. These stresses have previously been found to create burden that may impair caregiving efforts and increase the risk of mortality for both the caregiver and affected child. Many rare diseases affect children. It is not known how caregiver burden and the source of stress varies by disease. Qualitative methods have been used to understand caregiver experience with the rare disease, epidermolysis bullosa (EB), but no such studies have occurred in the United States. …

The Genetics Of Pain: An Exploration Of Gene-By-Environment Interactions And Their Effects On Pain, Mohamad F. Fakhereddin

Electronic Thesis and Dissertation Repository

The findings presented in this dissertation are part of the bigger SYMBIOME project which aims to use the biopsychosocial model of pain to develop a prognostic clinical phenotype for people that experience musculoskeletal (MSK) trauma. Chapter 2 presents an exploratory analysis to assess the relationships between genetic polymorphisms and pain severity and interference. Early childhood trauma was also explored as a moderator between genetic polymorphisms and pain outcomes. For pain severity, major allele carriers (A/A and G/A) of FKBP5 rs9394314 reported significantly higher scores than minor allele carriers (G/G). Further, major allele carriers who had at least one adverse childhood …

Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla

Journal of Transformative Touch

Does Zero Balancing positively impact occupational performance? This is a question many Occupational Therapists (OTs) ask when discerning if Zero Balancing (ZB) is an evidence-based treatment modality. Case studies from the book Experiencing the Power of Zero Balancing: Case Studies of Journeys to Health and Wholeness (Quarry & King, 2016) were reviewed and compared to the Occupational Therapy domain of practice to show clear evidence that each case study had a positive impact on occupational performance. A comparison chart shows a direct link between the occupational categories and documented evidence of improved occupational performance through practitioner observation and client feedback …

Emotional Component Of Pain Perception In The Medicinal Leech?, Brian D. Burrell

Animal Sentience

Crump et al. have provided a series of criteria to assess animal sentience that is focused on the perception of pain, which is known to have both sensory and emotional components. They also provide a qualitative scoring system to assess data that address the eight criteria and apply this paradigm to decapod crustaceans. The criteria laid out have the potential to be applied to other invertebrates typically thought to have sensory response to tissue damage, but no emotional component to pain perception.

The Aftermath Of Sexual Assault: Creating The "I Am More Than My Experience" Workbook, Isabella Chung

Calvert Undergraduate Research Awards

The following thesis includes a literature review of the immediate and long-term effects of sexual assault on victims in regards to their physical, mental, and emotional health and romantic relationships, followed by a proposed workbook for sexual assault victims/survivors. Being that typical responses immediately after an assault are fear, disbelief, and activation of the sympathetic nervous system, it is to no surprise that long term issues of depression, anxiety, and Posttraumatic Stress Disorder (PTSD) often arise as well. Thus, a workbook was created with the intention of educating readers about sexual assault and helping victims/survivors to heal from the trauma …

Chronic Pain, Malingering, And The Word Memory Test, Dawn Marie Emmett Bishop

Walden Dissertations and Doctoral Studies

AbstractThe importance of using scientifically grounded strategies to detect malingering has been established in the literature and past research. Many reliable tools have been established for the detection of malingered neurocognition; however, research on how pain may affect these tools is sparse. The purpose of this study was to investigate the effect of pain on cognitive symptom validity testing and to establish the validity of the Word Memory Test (WMT), a cognitive symptom validity test with good sensitivity and specificity, when the test taker is feigning pain (simulating) or remembering pain. The biopsychosocial model and the gate theory of pain …

The Impact Of Parental Health Mindset On Postoperative Recovery In Children, Alexandra Kain, Claudia Mueller, Brenda J. Goliamu, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Background

Mindset, or one’s beliefs about the ability to change one’s outcomes, has been studied in the educational domain but not in surgical settings. The purpose of this study was to examine the role of parental health mindset on children’s recovery.

Methods

Participants were part of a larger National Institutes of Health‐funded trial that included 1470 children undergoing outpatient tonsillectomy and adenoidectomy. We used measures of parental coping style (Monitor Blunter Style Scale; MBSS) and medication attitudes (Medication Attitudes Questionnaire; MAQ) to validate the Health Beliefs Scale (HBS; Criterion validity, Cohen’s kappa). HBS categorizes parents as having a growth mindset, …

Feasibility And Validity Of Asking Patients To Define Individual Levels Of Meaningful Change On Patient-Reported Outcomes, Salene M.W. Jones, Yuxian Du, Ari Bell-Brown, Kaylin Bolt, Joseph M. Unger

Journal of Patient-Centered Research and Reviews

Purpose: Patient-reported outcomes (PROs) are frequently used in clinical care to monitor treatment response. However, most guidelines on PRO use treat all patients the same. This study tested the feasibility and validity of a method for determining individually meaningful change in PRO measures.

Methods: Participants (n = 398) completed 12 pain and distress questions to define individually meaningful change. This mixed-methods study used both quantitative and qualitative analyses, including descriptive statistics, inferential statistics, and content analysis.

Results: Two-thirds (67%) of the sample reported at least one medical condition, including depression and back pain. Most participants (70%–90%) were able to answer …

A Comprehensive Examination Of The Immediate Recovery Of Children Following Tonsillectomy And Adenoidectomy, Bryan K. Lao, Zeev N. Kain, Dina Khoury, Brooke N. Jenkins, Jeremy Prager, Robert S. Stevenson, Brenda Golianu, Jeannie Zuk, Jeffrey I. Gold, Qiu Zhong, Michelle A. Fortier

Psychology Faculty Articles and Research

Objectives

Using multiple well-validated measures and a large sample size, the goal of this paper was to describe the immediate clinical and behavioral recovery of children following tonsillectomy with or without an adenoidectomy (T&A) during the first two weeks following surgery.

Study design

Observational, longitudinal study.

Setting

Four major pediatric hospitals in the U.S. consisting of Children's Hospital of Orange County, Children's Hospital of Los Angeles, Lucile Packard Children's Hospital, and Children's Hospital Colorado.

Subjects

and Methods: Participants included 827 patients between 2 and 15 years of age who underwent tonsillectomy with or without adenoidectomy surgery. Baseline and demographic …

How Positive And Negative Affect Relate To Postoperative Pain In Children Undergoing Surgery, Stephanie Munduruca, Ryan Johnson

Student Scholar Symposium Abstracts and Posters

Positive affect has been shown to be associated with lower levels of postoperative pain, while negative affect is associated with higher levels of pain. More recent research asks if subscales of positive affect such as calm, well-being, and vigor could be related to pain experiences. Studies of postoperative pain in children relating to positive and negative affect are limited, with none examining the connection between positive affect subscales and negative affect subscales (anger, anxiety, and depression) and children’s pain. This study addresses that gap by uncovering the relationships between the aforementioned subscales to postoperative pain in children. This study was …

What's All The Buzzy About? Using Cryotherapy And Vibration For Pain During Vaccinations In Children, Marta L. Byma

Evidence-Based Practice Project Reports

Vaccinations are the most common painful needle procedure, with an estimated 12 billion injections given per year (CDC, 2019). The usual method for administration of vaccinations is through needle puncture, which is often painful. Children often report receiving a shot as one of the most feared and painful experiences (McMurtry et al., 2015). The purpose of this evidence-based practice (EBP) project was to improve patient experiences by decreasing the pain that is associated with vaccinations through the use of a nonpharmacological method for comfort via the Buzzy® device. After thorough analysis and synthesis of the literature, the Buzzy® device that …

Systematic Literature Review Of Cognitive Behavioral Treatments For Patients With Classical, Secondary, And Idiopathic Trigeminal Neuralgia, Linnea B. Herzog

Honors Undergraduate Theses

Trigeminal neuralgia is a painful neuralgia with a complicated pathology that is not clearly understood. Due to the ambiguity of the condition, patients often have to search for medical providers that specialize in trigeminal neuralgia, and even with the guidance of a specialist, some patients do not respond well to treatment.¹ Despite the uncertainty surrounding the specifics of the disease, there are treatments available that can provide some level of pain relief for patients suffering from this disorder. When a patient does not respond well to medical therapy, surgery can be the next appropriate step in patient care management. …

Associations Between Sleep And In-Race Gastrointestinal Symptoms: An Observational Study Of Running And Triathlon Race Competitors, Patrick Benjamin Wilson

Human Movement Sciences & Special Education Faculty Publications

OBJECTIVE: It remains unstudied whether poor sleep is involved in the etiology of gastrointestinal (GI) problems in athletes.

METHODS: Eighty-seven running and triathlon/duathlon race (>60 minutes) participants completed questionnaires to quantify the Sleep Problems Index-(SPI)-I and sleep parameters from the night before races. For GI symptoms, participants reported the severity (0-10 scale) of four upper and three lower symptoms during races. Spearman's correlations examined whether sleep measures were associated with in-race GI symptoms. Partial correlations were calculated to control for age, resting GI symptoms, and anxiety.

RESULTS: SPI-I scores correlated with in-race upper GI symptoms (rho=0.26, p=0.013). Controlling for …

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 …

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 …

Children And Their Parents’ Assessment Of Postoperative Surgical Pain: Agree Or Disagree?, Olivia Kaminsky, Michelle Fortier, Brooke N. Jenkins, Robert S. Stevenson, Jeffrey I. Gold, Jeannie Zuk, Brenda Golianu, Sherrie H. Kaplan, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

The purpose of this study is to compare postoperative pain scores between children undergoing tonsillectomy and adenoidectomy (T&A) surgery and their parents, identify potential predictors for this disagreement, and determine possible impact on analgesic administration.

Methods

This is a prospective longitudinal study conducted with children undergoing outpatient T&A in 4 major tertiary hospitals and their parents. Children and their parents were enrolled prior to surgery and completed baseline psychological instruments assessing parental anxiety (STAI), parental coping style (MBSS), child temperament (EAS) and parental medication administration attitude questionnaire (MAQ). Postoperatively, parents and children completed at-home pain severity ratings (Faces Pain …

Increasing Doses Of Intraoperative Hydromorphone Do Not Reduce Postoperative Pain, Craig S. Curry, Michael B. Henry, Wendy Craig, Janelle M. Richard, Denham S. Ward

Maine Medical Center

Introduction:

• Intermediate and long acting opioids are given intraoperatively to reduce pain during emergence from anesthesia.

• Recent evidence suggests that intraoperative opioids have inconsistent effects on nociception and pain in the immediate postoperative period.

• Multiple potent, short-acting opioids such as remifentanil, sufentanil and fentanyl have been shown to produce dose-related increases in pain scores and opioid consumption in the immediate postoperative recovery period.

• Intraoperative doses of longer acting opioids such as morphine and methadone6 have been shown to reduce pain scores and narcotic requirements in the immediate postoperative period.

• Hydromorphone is an intermediate duration narcotic …

Art In The Stages Of Suffering And Death, Joanna Aramini

Visual Arts Department Student Scholarship

There has always been a strong link between art and the study of science and medicine, and one of the most iconic images of suffering and death in history to date is Christ suffering on the cross. In this thesis, I examine if and how art can make it possible to transcend human pain and overcome suffering, especially in our modern society where pain is seen as something we cannot deal with, and where we look to medicine and prescriptions to diminish it. I argue that art in the states of suffering and death, closely examining Michelangelo’s La Pieta and …

Neural Mechanisms Of The Rejection-Aggression Link, David S. Chester, Donald R. Lynam, Richard Milich, C. Nathan Dewall

Psychology Faculty Publications

Social rejection is a painful event that often increases aggression. However, the neural mechanisms of this rejection–aggression link remain unclear. A potential clue may be that rejected people often recruit the ventrolateral prefrontal cortex’s (VLPFC) self-regulatory processes to manage the pain of rejection. Using functional MRI, we replicated previous links between rejection and activity in the brain’s mentalizing network, social pain network and VLPFC. VLPFC recruitment during rejection was associated with greater activity in the brain’s reward network (i.e. the ventral striatum) when individuals were given an opportunity to retaliate. This retaliation-related striatal response was associated with greater levels of …

Early Procedural Pain Is Associated With Regionally-Specific Alterations In Thalamic Development In Preterm Neonates., Emma G Duerden, Ruth E Grunau, Ting Guo, Justin Foong, Alexander Pearson, Stephanie Au-Young, Raphael Lavoie, M Mallar Chakravarty, Vann Chau, Anne Synnes, Steven P Miller

Brain and Mind Institute Researchers' Publications

Very preterm human neonates are exposed to numerous invasive procedures as part of life-saving care. Evidence suggests that repetitive neonatal procedural pain precedes long-term alterations in brain development. However, to date the link between pain and brain development has limited temporal and anatomic specificity. We hypothesized that early exposure to painful stimuli during a period of rapid brain development, before pain modulatory systems reach maturity, will predict pronounced changes in thalamic development, and thereby cognitive and motor function. In a prospective cohort study, 155 very preterm neonates (82 males, 73 females) born 24-32 weeks' gestation underwent two MRIs at median …

Emotion Regulation And Positive Affect In The Context Of Salivary Alpha-Amylase Response To Pain In Children With Cancer, Brooke N. Jenkins, Douglas A. Granger, Ryan J. Roemer, Ariana Martinez, Tara K. Torres, Michelle A. Fortier

Psychology Faculty Articles and Research

Background

Children with cancer routinely undergo painful medical procedures invoking strong physiological stress responses. Resilience to this pain may be conferred through resources such as emotion regulation strategies and positive affect.

Procedure

This study measured dispositional positive affect in children with cancer (N = 73) and randomly assigned participants to one of three emotion regulation strategy conditions (distraction, reappraisal, or reassurance). Children applied their assigned strategy during an experimental pain procedure (the cold pressor task [CPT]) and provided saliva samples before, immediately after, and 15 min after the CPT. Saliva samples were later assayed for salivary alpha amylase (sAA)—a surrogate …

Laughter Frequency, Pain Perception, And Affect In Fibromyalgia Patients, Deidre Gayl Molchan

Walden Dissertations and Doctoral Studies

Fibromyalgia syndrome (FMS), a common chronic pain condition, is often incompletely treated by conventional medical therapies. It can cause disability, psychological distress, work-related absenteeism, increased use of healthcare resources, and result in the inability to carry out the tasks of daily living. The purpose of this quantitative, correlational study was to investigate the potential influence of laughter on affect and pain in individuals with FMS. Laughter produces beneficial effects on acute pain and on chronic pain in general and has been found to improve temporary affective states, but there have been no studies testing the effects of laughter on the …

The Impact Of Neonatal Pain And Reduced Maternal Care On Brain And Behavioral Development, Sean Michael Mooney-Leber

Wayne State University Dissertations

In the neonatal intensive care unit (NICU) preterm infants are exposed to a multitude of stressors, which include both neonatal pain and reduced maternal care. Clinical and preclinical research has demonstrated that exposure to neonatal pain and reduced maternal care has a profound negative impact on brain and behavioral development. Currently, the biological mechanism by which both of these stressors impacts brain and behavioral outcomes remains widely unknown. To uncover a potential biological mechanism, the current dissertation project utilized a preclinical model of repetitive needle pokes and developed a novel model of reduced maternal care through tea-ball encapsulation. Briefly, rat …

Serious Mental Illness Among Young Adult Women Who Use Drugs In The Club Scene: Co-Occurring Biopsychosocial Factors, Maayan Lawental, Hilary L. Surratt, Mance E. Buttram, Steven P. Kurtz

Center for Health Services Research Faculty Publications

Young women who regularly attend nightclubs are at risk for numerous health and social consequences, including mental distress, sexual and physical victimization and substance dependence. This paper uses a biopsychosocial framework to examine co-occurring mental health problems, victimization, substance dependence, sexual risk and physical pain among a sample of young women who use drugs (N = 222) in Miami’s club scene. The majority of women were under 24 years old, Hispanic, and identified as heterosexual. Almost all the women reported past 90-day use of alcohol, ecstasy/MDMA, marijuana, cocaine and prescription opioids and benzodiazepines; 32% of women reported being in a …

Animal Welfare And Individual Characteristics: A Conversation Against Speciesism, Marc Bekoff, Lori Gruen

Marc Bekoff, PhD

It seems impossible for a human being not to have some point of view concerning nonhuman animal (hereafter animal) welfare. Many people make decisions about how humans are permitted to treat animals using speciesist criteria, basing their decisions on an individual's species membership rather than on that animal's individual characteristics. Although speciesism provides a convenient way for making difficult decisions about who should be used in different types of research, we argue that such decisions should rely on an analysis of individual characteristics and should not be based merely on species membership. We do not argue that the concept of …

Recognition Of Distress In Animals – A Philosophical Prolegomenon, Bernard E. Rollin

Bernard Rollin, PhD

For those who continue to doubt the studiability of distress or suffering or misery in all of its forms in animals, consider the following thought experiment: If the government were to come up with a billion dollars in research funding for animal distress, would that money go a-begging? We can study these states just as we studied pain—excellent work on boredom by Franciose Wemelsfelder in a volume on laboratory animal welfare I co-edited made the methodology for such study quite explicit. (Wemelsfelder, 1990) And when the ideological scales fall from our eyes, we realize that the work of scientists like …