Social and Behavioral Sciences Commons^™

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 …

Assessment Of Posture, Spinal Mobility And Emg Data In Patients With Spinal Stenosis, Ahu Zileli, Tamer Çankaya

Baltic Journal of Health and Physical Activity

Introduction: This study aims to analyze the difference in muscle activation, posture and vertebral mobility values between healthy individuals and patients with lumbar spinal stenosis. Material and Methods: This study involved 48 lumbar spinal stenosis (LSS) patients of the average age of 55.19 ± 10.41 years and 48 healthy individuals with of the average age of 58.15 ± 8.44 years. Posture and spinal mobility of the participants were measured in the standing position, and the maximum flexion posture with spinal mouse. Muscle activation of rectus femoris, biceps femoris, tibialis anterior and medial head of the gastrocnemius muscle was measured during …

A Pilot Survey: Retention In Pain Medicine Among Fellowship Trained Anesthesiologists., Sarang S Koushik, Kelly Leap, Kenneth Seier, Kay See Tan, Naum Shaparin, Alan D Kaye, Omar Viswanath, Grant H Chen

Journal Articles

BACKGROUND: We aim to explore the factors related to job satisfaction among pain physicians and identify the reasons why individuals minimize or stop practicing outpatient pain medicine.

OBJECTIVES/STUDY DESIGN: This is a survey-based study with the primary goal to identify factors determining job satisfaction and dissatisfaction among pain medicine fellowship graduates who continue to practice and those who are no longer practicing interventional pain. A secondary goal is to elucidate reasons for anesthesiologists trained in pain medicine to leave pain medicine, despite an additional year of training, and to work as general anesthesiologists.

METHODS: In this study, all 114 pain …

Meaningful Improvement In General Health Outcomes With Guselkumab Treatment For Psoriatic Arthritis: Patient-Reported Outcomes Measurement Information System-29 Results From A Phase 3 Study, Ana-Maria Orbai, Laura C Coates, Atul Deodhar, Philip S Helliwell, Christopher T Ritchlin, Evan Leibowitz, Alexa P Kollmeier, Elizabeth C Hsia, Xie L Xu, Shihong Sheng, Yusang Jiang, Yan Liu, Chenglong Han

Journal Articles

OBJECTIVE: The Phase 3 DISCOVER-1 study of guselkumab is the first randomized controlled trial to use Patient-Reported Outcomes Measurement Information System (PROMIS) measures to assess the effects of treatment on general health outcomes in patients with psoriatic arthritis (PsA).

METHODS: Patients (N = 381) with active PsA were randomized 1:1:1 to guselkumab 100 mg every 4 weeks (Q4W); guselkumab 100 mg at Week 0, Week 4, then every 8 weeks (Q8W); or placebo with Week 24 crossover to guselkumab Q4W. The PROMIS-29 Profile contains four items for each of seven domains (anxiety, depression, fatigue, pain interference, physical function, sleep disturbance, …

The Role Of Physical Activity In Supporting Treatment Of Coxarthrosis Symptoms In Elderly Patients, Malgorzata Kawa, Malgorzata Kowza-Dzwonkowska, Agnieszka Schenk

Baltic Journal of Health and Physical Activity

Background: Next to degenerative changes of the spine, osteoarthritis of the hip is one of the most common diseases of the musculoskeletal system in people after the age of 65. The purpose of this study is to compare and evaluate the analgesic effectiveness treatments with exercises on a bicycle ergometer in osteoarthritis of the hip in patients. Material/Methods: The study involved 30 persons with degenerative disease of the hip referred to 10-day rehabilitation with a weekend break. In Group A 14 patients were subjected to treatments with local cryotherapy and laser therapy; in Group B 16 this treatment together exercises …

Pain Tolerance In Sport, Ewelina Salwin, Agnieszka Zajac

Baltic Journal of Health and Physical Activity

Pain is an inseparable element of the sports experience, regardless of the chosen discipline. The saying “no pain, no gain” perfectly describes the risk of an injury in sport as well as the expectations of high tolerance of pain. Sociologists note the connection between sport norms and values and the pain and behaviours related to an injury. While competing an athlete is under pressure of the coach, activists and supporters who expect him or her to continue and perform despite pain. However, pain in sport is not always a negative factor as it also plays an informative role indicating physical …

The Use Of Combination Therapy In Rehabilitation Of Patients With Hip Osteoarthritis – Preliminary Report, Magdalena Podczarska-Glowacka, Anna Lysak, Rafal Szulc-Cieplicki

Baltic Journal of Health and Physical Activity

Background: The objective of the study was to assess the effectiveness of a 2-week therapeutic programme consisting of combination therapy and postisometric relaxation and its effect on the mobility of joints and the level of perception of pain in patients with osteoarthritis of hip joints. Material/Methods:The research was carried out on subjects clinically and radiologically diagnosed as patients with osteoarthritis of hip joints. 30 subjects, including 7 men and 23 women (average age of 67.8 yrs), underwent the examinations. The therapy lasted 2 weeks and consisted of 10 treatment sessions. The medical program included a combination therapy and individual exercises, …

Local Cryotherapy In Tennis Elbow (Lateral Epicodylitis), Malgorzata Kawa, Malgorzata Kowza-Dzwonkowska

Baltic Journal of Health and Physical Activity

Background: The study investigated the analgesic effectiveness, the reduction in the intake of painkillers and an improvement in physical activity after local cryotherapy in tennis elbow (TE). Material/Methods: The research group comprised patients of the Physiotherapy Patients diagnosed with so-called tennis elbow were referred to physical therapy treatments by specialist doctors. 34 patients were examined (26 women, 8 men), aged 36-59 years, who were then divided into two groups: Group X (17 persons) – treated with local cryotherapy (10 treatments over 2 weeks), Group Y (17 persons ) – the control group with no therapeutic procedures conducted for a period …

The Role Of Myofascial Massage In Spinal Pains In Professionally Active Women, Malgorzata Kawa, Karol Orlowski, Malgorzata Kowza-Dzwonkowska

Baltic Journal of Health and Physical Activity

Background: Pain ailments of the spine are one of the most common diseases of the system of bones and joints. 75% to 85% of the world’s population suffer or will suffer from it, and lumbar pain is the most common cause of disability of persons over 45 years of age. They are usually the beginning of a chronic, often progressing ailments often leading to disability, incapacity to work and restrictions in daily life. Myofascial massage helps reduce pain sensations. Is a specific method of gradual stretching soft tissues and making muscle fibres more elastic. It reduces increased muscle tone, muscle …

Imagery Use In Rehabilitation After The Knee Joint Arthroscopy, Dominika Wilczynska, Anna Lysak, Magdalena Podczarska-Glowacka

Baltic Journal of Health and Physical Activity

Background: The objective of the study was to assess the efficiency of visualization training based on motivating instructions of a general character in order to increase the knee joint mobility, reduce pain and increase the quadriceps muscle mass of the thigh in patients after the knee joint arthroscopy. Material/Methods: F10 outpatient clinic patients after arthroscopy of the knee joint (average age 35 yrs) were subject to research. Physiotherapeutic treatment comprised an improvement program to increase the range of flexion in the knee joint (full ROM), align limbs circumference and reduce pain. The research group was divided into 2 subgroups. In …

Evaluation Of Analgesic Effectiveness Of Infrared Radiation And Interference Currents In Degenerative Diseases, Malgorzata Kawa, Ewa Muszynska, Malgorzata Kowza-Dzwonkowska

Baltic Journal of Health and Physical Activity

No abstract provided.

The Impact Of Shock Wave Therapy On Reducing Pain In Patients With Plantar Fasciitis, Zaneta Galecka-Szczerba, Malgorzata Kawa, Magdalena Podczarska-Glowacka

Baltic Journal of Health and Physical Activity

Background: The heel spur often accompanied by plantar fascia inflammation is a very troublesome disorder. It causes intense heel and foot pain, disturbs gait, often causing limitation of physical activity. The aim of the work is to evaluate the impact of radial shock therapy patients diagnosed with heel spur on pain and physical activity. Material and methods: The study involved 27 patients - 9 men and 18 women - with a diagnosed spur heel, the average age of the patient is 56 ± SD years. To evaluate the effects of the therapy, two testes were used, the VAS analogue pain …

Deep Tissue Massage And Mobility And Pain In The Thoracic Spine, Anna Srokowska, Malgorzata Bodek, Mikolaj Kurczewski, Grzegorz Srokowski, Marcin Siedlaczek, Andrzej Lewandowski

Baltic Journal of Health and Physical Activity

Background: The aim of the work is to determine the effectiveness of deep tissue massage therapy on mobility and pain of the thoracic spine. Material and methods: The study involved 18 women and men aged 46–63 years doing office work. Functional diagnostics was performed prior to the therapy (study I), after the procedure (study II) and after 30 days (study III). The Otta test for flexion and extension of the spine, pectoralis major muscles length test, chest circumference measurement, and NRS were used. In the statistical analysis mean and standard deviations were determined and the following tests were used: Mann-Whitney …

Can Physical Activity Modulate Pain Perception During Ontogenesis?, Maciej Pawlak, Aleksandra Jazdzewska, Katarzyna Leznicka

Baltic Journal of Health and Physical Activity

The aim of the paper is to emphasise the significance of physical activity as an element directly or indirectly modulating the perception of pain during ontogenesis. Pain is a distinctive sensory sensation and also a subjective criterion of health or disease. In contrast to other modalities (taste, smell, touch), it triggers solely negative emotions and sensations. Pain is a highly individualised sensory phenomenon, involving the physical, cognitive and emotional spheres of human life. Different reactions to pain during ontogeny most often result from the loss of communication skills, a systematic decrease in the functions of all systems and organs, in …

The Effectiveness Of Open Versus Closed Kinetic Chain Exercises On Pain, Function And Range Of Motion In Patients With Knee Osteoarthritis, Babatunde Olusola Adegoke, Arinola Olasumbo Sanya, Samuel Olusegun Ogunlade, Oladapo Michael Olagbegi

Baltic Journal of Health and Physical Activity

Background: The comparative efficacy of open and closed kinetic chain exercises (OKCE and CKCE) on the symptoms of osteoarthritis (OA) has not been exhaustively studied. To evaluate and compare the effectiveness of eight-week open OKCE and CKCE on pain, function and range of motion of patients with knee OA. Material and methods: ‪A quasi-experimental study involved twenty-nine consecutive patients with knee OA allocated to either OKCE or CKCE groups. Participants’ pain intensity (PI), functional score (FS), active range of motion AROM) and knee passive range of motion (PROM) were assessed using the visual analogue scale, the functional index questionnaire and …

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 …

Racial And Ethnic Disparities In Opioid Use For Adolescents At Us Emergency Departments, Michael T. Phan, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Candice D. Donaldson, Michelle A. Fortier, Brooke Jenkins, Erik Linstead, Zeev N. Kain

Pharmacy Faculty Articles and Research

Background

Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED.

Methods

This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11–21 years old were analyzed. …

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, …

Role Of Micro-Rna For Pain After Surgery: Narrative Review Of Animal And Human Studies, Juan P Cata, Aysegul Gorur, Xiaoyi Yuan, Nathaniel K Berg, Anil K Sood, Holger K Eltzschig

Journal Articles

One of the most prevalent symptoms after major surgery is pain. When postoperative pain treatment is unsatisfactory, it can lead to poor surgical recovery, decreased quality of life, and increased health care costs. Current analgesics, single or in combination, have limited efficacy due to low potency, limited duration of action, toxicities, and risk of addiction. The lack of nonaddictive strong analgesics along with the over prescription of opioids has led to an opioid epidemic in the United States. Therefore, there is an urgent need for the development of newer analgesics. Microribonucleic acids (miRNAs) are small noncoding RNA molecules that modulate …

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 …

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 …

Giving Credence To The Experience Of X-Linked Hypophosphatemia In Adulthood: An Interprofessional Mixed-Methods Study, Melissa Hughes, Carolyn Macica, Catherine Meriano, Maya Doyle

Journal of Patient-Centered Research and Reviews

Purpose: X-linked hypophosphatemia (XLH) is a rare X-linked dominant metabolic bone disease, often diagnosed in childhood but causing increasing physical debilitation and pain in adulthood. Physical comorbidities of XLH in adulthood include pervasive and early-onset degenerative arthritis, mineralizing enthesophytes and osteophytes, osteomalacia and pseudofracture, dental abscesses, and hearing loss.

Methods: This mixed-methods analysis included physical findings, diagnostic imaging, occupational and physical therapy assessments, and semi-structured interviews by social work to understand the functional outcomes and lived experience of XLH in adulthood, through connections between qualitative data obtained by social work and occupational therapy with the quantitative findings from other disciplines. …

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

MaineHealth 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 …

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 …

Evaluating The Effectiveness Of Care Choices A Home-Based Palliative Care Program, Katherine Pouliot

Honors Theses

Background: There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid unnecessary hospitalizations and remain with their regular outside care providers. Objective: To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine, a community healthcare system serving New York’s Capital District. Design: A prospective cohort study tracking patient outcomes over the course of one year. Subjects and setting: One hundred twenty-three patients (49 men, 74 women) with serious illnesses who were new enrollees in Care …

Research Brief: An Examination Of The Social And Clinical Influences In Prostate Cancer Treatment In African American And White Men, Keith Elder, Bettina F. Drake, Sara Wagner, James Hebert

Journal of Health Disparities Research and Practice

BACKGROUND: The death rate for prostate cancer (PrCA), the most commonly diagnosed cancer in African-American (AA) men, is twice the rate of European-American (EA) men. AA men in South Carolina have the highest age-adjusted death rate in the nation. Studies have shown that treatment offered to AA men with PrCA is systematically different from that offered to EA men. METHODS: Surveys were mailed to 1,866 men in South Carolina with a diagnosis of PrCA. South Carolina men diagnosed with PrCA between 1996 and 2002 were eligible to participate. We performed a descriptive assessment of the factors that influenced …

Use Of Topical Nsaids In Acute Musculoskeletal Sports Injury: A Brief Review, Amit M. Deokar, Shawn J. Smith, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this chapter is to summarize the current standards of pain management in minor sports-related musculoskeletal injuries. This chapter also addresses the topical form of non-steroidal anti-inflammatory drug as an effective pain management option in an outpatient setting. Design: Quantitive systematic review of randomized controlled trials. Methods: The data was obtained through literature review of articles published in the last 10 years. In addition, FDA information on non-steroidal anti-inflammatory medications was also reviewed. The patient population studied in the articles included children and adults. Conclusion: Current standards of managing pain resulting from sports injuries involve a number of …