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An epidemiological comparison of pain complaints in the general population of Catalonia (Spain)
Epidemiological studies help to establish the health status in a country and allow a better allocation of economic resources. This survey estimated pain prevalence in Catalonia (Spain), analysed its relationship with demographic variables and evaluated pain-associated disabilities. The study was carried out in 1964 adults via phone interviews asking about any pain complaint they experienced in the last 6 months,
Antňnia Bassols; Fčlix Bosch; Mercedes Campillo; Montserrat Cańellas; Josep-Eladi Bańos
Prevalence and Determinants of Cognitive Complaints after Aneurysmal Subarachnoid Hemorrhage
Background: To investigate the prevalence of cognitive complaints after subarachnoid hemorrhage (SAH) and the relationships between cognitive complaints and cognitive impairments, disability and emotional problems. Methods: Cognitive complaints were assessed with the Checklist for Cognitive and Emotional Consequences following stroke (CLCE-24) in 111 persons who visited our outpatient clinic 3 months after SAH. Associations between cognitive complaints and cognitive functioning,
P. E. C. A. Passier; J. M. A. Visser-Meily; M. J. E. van Zandvoort; M. W. M. Post; G. J. E. Rinkel; C. van Heugten
The prevalence of musculoskeletal pain and fibromyalgia in patients hospitalized on internal medicine wards
Objectives: To estimate the prevalence of nonarticular pain complaints (chronic widespread pain, chronic localized pain, transient pain) and fibromyalgia in hospitalized patients and to study utilization patterns of health services associated with pain related problems. Methods: Five hundred twenty-two patients hospitalized on internal medicine wards were enrolled. Data were collected with a questionnaire covering demographic background, information on pain and
Dan Buskila; Lily Neumann; Lisa R. Odes; Elena Schleifer; Roman Depsames; Mahmoud Abu-Shakra
Catastrophic Thinking About Pain is Independently Associated with Pain Severity, Disability, and Somatic Complaints in School Children and Children with Chronic Pain
complaints. Results In both studies, pain catastrophizing significantly accounted for the variance of pain, disability, and somatic complaints, beyond the effects of age, sex, and NA. Furthermore, pain catastrophizing significantly mediated the relationship between NA and somatic complaints in both studies and between NA and functional disability in study 1. Conclusions Results suggest the importance of assessing for pain catastrophizing
Tine Vervoort; Liesbet Goubert; Christopher Eccleston; Patricia Bijttebier; Geert Crombez
Differential Dx Checklist, common complaints for outpatient medicine 1. Abdominal and pelvic pain
. Abnormal uterine bleeding 3. Anxiety, depression 4. Back pain 5. Chest pain 6. Cough 7. Cough, dyspneaDifferential Dx Checklist, common complaints for outpatient medicine 1. Abdominal and pelvic pain 2. Dysphagia 13. Dyspnea, tachypnea 14. Ear pain, otalgia 15. Edema, leg 16. Facial flushing 17. Facial pain 18
Maxwell, Bruce D.
Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations.
Gastrointestinal problems are common, especially in endurance athletes, and often impair performance or subsequent recovery. Generally, studies suggest that 30-50% of athletes experience such complaints. Most gastrointestinal symptoms during exercise are mild and of no risk to health, but hemorrhagic gastritis, hematochezia, and ischemic bowel can present serious medical challenges. Three main causes of gastrointestinal symptoms have been identified, and these are either physiological, mechanical, or nutritional in nature. During intense exercise, and especially when hypohydrated, mesenteric blood flow is reduced; this is believed to be one of the main contributors to the development of gastrointestinal symptoms. Reduced splanchnic perfusion could result in compromised gut permeability in athletes. However, although evidence exists that this might occur, this has not yet been definitively linked to the prevalence of gastrointestinal symptoms. Nutritional training and appropriate nutrition choices can reduce the risk of gastrointestinal discomfort during exercise by ensuring rapid gastric emptying and the absorption of water and nutrients, and by maintaining adequate perfusion of the splanchnic vasculature. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates, and potentially the use of nutrients that stimulate the production of nitric oxide in the intestine and thereby improve splanchnic perfusion. However, at this stage, evidence for beneficial effects of such interventions is lacking, and more research needs to be conducted to obtain a better understanding of the etiology of the problems and to improve the recommendations to athletes. PMID:24791919
de Oliveira, Erick Prado; Burini, Roberto Carlos; Jeukendrup, Asker
Prevalence of cold-related complaints, symptoms and injuries in the general population: the FINRISK 2002 cold substudy
NASA Astrophysics Data System (ADS)
The prevalence of cold-related complaints and symptoms in the general population has remained unknown. As part of the nationwide FINRISK 2002 health survey performed in Finland, 8,723 people aged 25 64 years filled in a questionnaire asking about the number of hours spent weekly in cold air, their sensations during cold exposure, cold-related complaints, symptoms of diseases, and degradation of performance. Cold thermal sensations at +5°C to -5°C were reported by 35% of men and 46% of women. Almost all subjects reported at least some cold-related complaints, most commonly musculoskeletal pain (men 30%, women 27%), followed by respiratory (25% / 29%), white finger (15% / 18%) and episodic peripheral circulation symptoms (12% / 15%). Decreased mental or physical performance in cold was reported by 75% of men and 70% of women, most commonly impairing manual dexterity and tactile sense. With declining temperature, the first symptom to emerge was pain in the elbow or the forearm (at -3°C), followed by increased excretion of mucus from the lungs (-5°C), while most other symptoms appeared only at lower temperatures of -15°C to -20°C. Most symptoms showed little or no association with the weekly duration of exposure, with the exception of cold-induced pain at most sites. Although, in general, Finns are well adapted to the cold climate, the high prevalence of cold-related complaints poses a challenge to the health care system in terms of decreased performance and the possibility that such symptoms predict more serious health effects, such as increased mortality.
Raatikka, Veli-Pekka; Rytkönen, Mika; Näyhä, Simo; Hassi, Juhani
Incidence and prevalence of complaints of the neck and upper extremity in general practice
Objective: To study the incidence and prevalence of neck and upper extremity musculoskeletal complaints in Dutch general practice. Methods: Data were obtained from the second Dutch national survey of general practice. In all, 195 general practitioners (GPs) from 104 practices across the Netherlands recorded all contacts with patients during 12 consecutive months. Incidence densities and consultation rates were calculated. Results: The total number of contacts during the registration period of one year was 1 524 470. The most commonly reported complaint was neck symptoms (incidence 23.1 per 1000 person-years), followed by shoulder symptoms (incidence 19.0 per 1000 person-years). Sixty six GP consultations per 1000 person-years were attributable to a new complaint or new episode of complaint of the neck or upper extremity (incidence density). In all, the GPs were consulted 147 times per 1000 registered persons for complaints of the neck or upper extremity. For most complaints the incidence densities and consultation rates were higher for women than for men. Conclusions: Neck and upper extremity symptoms are common in Dutch general practice. The GP is consulted approximately seven times each week for a complaint relating to the neck or upper extremity; of these, three are new complaints or new episodes. Attention should be paid to training GPs to deal with neck and upper limb complaints, and to research on the prognosis and treatment of these common complaints in primary care. PMID:15608309
Bot, S; van der Waal, J M; Terwee, C; van der Windt, D A W M; Schellevis, F; Bouter, L; Dekker, J
Pain. Author manuscript Prevalence of chronic pain with neuropathic characteristics in the general
Pain. Author manuscript Page /1 10 Prevalence of chronic pain with neuropathic firstname.lastname@example.com> Abstract We conducted a large nationwide postal survey to estimate the prevalence of chronic pain chronic pain (defined as daily pain for at least 3 months), evaluating its intensity, duration and body
Paris-Sud XI, Université de
Abdominal Pain in Dutch Schoolchildren: Relations With Physical and Psychological Comorbid Complaints in Children and Their Parents
Objectives: Children with functional abdominal pain (FAP) frequently report comorbid complaints such as anxiety and activity limitations. Their parents often experience heightened levels of anxiety, depression, and somatization. The aim of the present study was to investigate whether these comorbid complaints in children and their parents are specific for FAP or can also be found in a community sample. Patients
Veek van der S. M; HHF Derkx; Else de Haan; Marc A Benninga; Frits Boer
Abdominal pain in Dutch schoolchildren: relationships with physical and psychological co-morbid complaints in children and their parents
Objectives: Children with functional abdominal pain (FAP) frequently report comorbid complaints such as anxiety and activity limitations. Their parents often experience heightened levels of anxiety, depression, and somatization. The aim of the present study was to investigate whether these comorbid complaints in children and their parents are specific for FAP or can also be found in a community sample. Patients
Veek van der S. M. C; H. H. F. Derkx; Haan de E; M. A. Benninga; Boer de F
Chest Pain as a presenting complaint in patients with acute myocardial infarction (AMI)
Objective: To study various characteristics of chest pain in acute myocardial infarction patients. Methodology: A total of 331 patients of AMI admitted at Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology Multan, irrespective of the age and gender, were included in this study. The study duration was one year starting from June 2011 to June 2012. Non-probability purposive sampling technique was used in this descriptive study. Informed consent to participate in this study was taken. Data were entered and analyzed using SPSS-11. Results: A total number of 331 patients with AMI were included in the study. Mean age was 54.99±11.25 years with minimum age 20 years and maximum age 90 years. It included 264(79.8%) male and 67(20.2%) female patients with male to female ratio of 3.9:1. Out of these 331 patients 308 (93.1%) patients reported chest pain as the presenting complaint. Remaining 23(6.9%) presented with clinical features other than chest pain. There were 127(38.4%) patients with pre-cordial chest pain, 115(34.7%) had retrosternal chest pain, 58(17.5%) were having epigastric pain. Severe chest pain was seen in 281(84.9%) patients while 26(7.9%) had only mild chest discomfort. Radiation of the pain to shoulder, neck and jaw was seen in 75 (22.7%) patients. In 42(12.7%) patients, pain radiated to both sides of chest. Another 55(16.6%) patients had pain radiation to chest, shoulder, upper arm and ulnar side of left forearm. Chest pain radiation to interscapular region along with both sides of chest was present in 10(3.0%) patients. In 11(3.3%) patients' pain radiated only to left side of chest. Pain persisting for >20 minutes was reported by 298 (90%) patients while only 10(3.1%) had pain persisting for <20 minutes. Conclusion: There is considerable overlap in chest pain of cardiac as well as non cardiac causes. However, vigilant evaluation of characteristics of chest pain in history taking may help to overcome this dilemma. Severe and prolonged precordial chest pain in a male patient between the age of 41-70 years, with pain radiation to left shoulder, neck and jaw is highly suggestive of AMI. PMID:24353577
Malik, Muhammad Ajmal; Alam Khan, Shahzad; Safdar, Sohail; Taseer, Ijaz-Ul-Haque
Parent attention versus distraction: Impact on symptom complaints by children with and without chronic functional abdominal pain
The objective of this study was to assess the impact of parent attention and distraction on symptom complaints by children with and without chronic functional abdominal pain. The water load symptom provocation task was used to induce visceral discomfort in pediatric patients with abdominal pain (N=104) and well children (N=119), ages 8–16 years. Parents were randomly assigned and trained to
Lynn S. Walker; Sara E. Williams; Craig A. Smith; Judy Garber; Deborah A. Van Slyke; Tricia A. Lipani
Neck Pain in Military Helicopter Pilots: Prevalence and Associated Factors
Our aim is to estimate the self-reported one-year prevalence of neck pain in military helicopter pilots and to compare work-related, individual, and health-related factors in the pilots with (neck pain group) and without (reference group) regular or continuous neck pain. A questionnaire was completed by 75% (n = 113) of all military helicopter pilots of the Royal Netherlands Air Force
Oord van den M. H. A. H; Loose de V; T. Meeuwsen; J. K. Sluiter; M. H. W. Frings-Dresen
Neck Pain in Military Helicopter Pilots: Prevalence and Associated Factors
Our aim is to estimate the self-reported one-year prevalence of neck pain in military helicopter pilots and to compare work-related, individual, and health-related factors in the pilots with (neck pain group) and without (reference group) regular or continuous neck pain, A questionnaire was completed by 75% (n = 113) of all military helicopter pilots of the Royal Netherlands Air Force
Marieke H. A. H. van den Oord; Veerle De Loose; Judith K. Sluiter; Monique H. W. Frings-Dresen
Depressive symptoms and pain complaints as predictors of later development of depression in portuguese middle-aged women.
Pain complaints and depressive symptoms seem to be risk factors for future depressive episodes. We present a one-year follow-up study on Portuguese women and primary health care (initial sample: n = 503). We used the Center for Epidemiologic Studies Depression Scale (CES-D), a short questionnaire on pain, and clinical interviews. We used forward stepwise logistic regression analysis to define models that enable the prediction of developing a major depressive episode in the one-year follow-up. We concluded that nondepressed women with (a) high scores (?28) at the CES-D, (b) a high severity of pain index, and (c) fatigue complaints at the baseline were particularly at risk. PMID:24279715
Gonçalves, Bruno; Fagulha, Teresa; Ferreira, Ana; Reis, Natália
Prevalence of chronic axial pain, inflammatory back pain and spondyloarthritis in diagnosed psoriasis.
Objective Psoriasis is a chronic inflammatory disorder affecting 3% of the population. The objective of our study was to provide prevalence estimates for inflammatory back pain (IBP) and spondyloarthritis (SpA) in those subjects with psoriasis using 2009-2010 NHANES data. Methods In the NHANES 2009-2010 sample set, 6,684 persons between 20-69 years of age were screened for participation and 5,103 answered questions regarding onset of back pain, location of pain and functional limitations. Dataset assembly and statistical analysis were performed using SASTM and SUDAAN™. Standard errors were estimated by Taylor series linearization. The equality of the prevalence estimates for selected variables were tested (univariately) at the ?=0.05 level using a 2-sided Student's t statistic with appropriate degrees of freedom. Results 148 persons had self-reported medically diagnosed psoriasis. The psoriasis group, versus the non-psoriasis group, had a significantly higher prevalence of axial pain using the 3-month duration criterion (31.1% vs. 18.9%; p=0.04) and alternating buttock pain (7.2% vs. 2.4%; p=0.03) and met IBP criteria - Berlin 7b and 8a - more frequently (p=0.04, 0.02 respectively). The prevalence of SpA was significantly higher in the psoriasis group versus the non-psoriasis group when using Amor or ESSG criteria (14.3% vs. 1.5%; p<0.001). Sudden-onset of axial pain was significantly higher in the psoriasis group (23.3% vs. 13.0%; p=0.01). Conclusion There is a higher prevalence of lower axial pain, IBP, SpA, and alternating buttock pain associated with a prior diagnosis of psoriasis. This data may influence the way psoriasis patients are approached in primary care and specialty clinics. This article is protected by copyright. All rights reserved. PMID:25469666
Thom, Nicole; Ritchlin, Christopher T; Zhang, Xiao; Reveille, John; Weisman, Michael H
Prevalence and Characteristics of Phantom Limb Pain and Residual Limb Pain in the Long Term after Upper Limb Amputation
ERIC Educational Resources Information Center
This study aims to describe the prevalence and characteristics of phantom limb pain and residual limb pain after upper limb amputation. One-hundred and forty-one participants (139 males; mean age 74.8 years; mean time since amputation 50.1 years) completed a self-report questionnaire assessing residual and phantom limb pain experience. Prevalence…
Desmond, Deirdre M.; MacLachlan, Malcolm
Prevalence of swallowing complaints and clinical findings among 50–79-year-old men and women in an urban population
To determine the prevalence of swallowing and esophageal complaints in the general population, 300 men and 300 women were\\u000a asked to answer a mailed questionnaire. The participation rate was 92.5%. Complaints were reported by 35%. The most common\\u000a complaints were symptoms associated with gastroesophageal reflux (GER) and globus sensation, both with a rate of occurrence\\u000a of 20%. Obstruction of the
Sven Lindgren; Lars Janzon
PREVALENCE OF CHRONIC PAIN WITH NEUROPATHIC CHARACTERISTICS IN THE GENERAL POPULATION Didier.pain.2007.08.013 #12; ABSTRACT We conducted a large nationwide postal survey to estimate the prevalence returned and 23,712 (96.8%) could be assessed. 7,522 respondents reported chronic pain (prevalence =31
Paris-Sud XI, Université de
Prevalence and Associated Risk Factors of Low-Back Pain in Textile Fishing Net Manufacturing
Prevalence and Associated Risk Factors of Low-Back Pain in Textile Fishing Net Manufacturing Siritaratiwat1 1 Back, Neck and Other Joint Pain Research Group, Khon Kaen University, Khon Kaen, Thailand 2, North Carolina Abstract This study examined the 7-day prevalence of low-back pain (LBP; i.e., pain
Kaber, David B.
Prevalence of voice complaints, risk factors and impact of voice problems in female student teachers.
A cross-sectional questionnaire survey was done among 457 female student teachers and 144 females in the general population. The conclusions are based on the opinions of student teachers and the general population. The results of this study show that 39.6% of the student teachers and 32.6% of the general population reported voice complaints at the moment and/or over the past year (p=0.198). The association between various risk factors (vocal loading factors, physical factors, environmental factors and psycho-emotional factors) and voice complaints were examined. Vocal load was reported in both the student teachers and the general population (p=0.322). Among the subjects with voice complaints, the student teachers were significantly more of the opinion than the general population that environmental irritants in the classroom (p=0.001) and the composition of the group they communicate with (p=0.033) have a negative influence on their voice. In the groups with voice complaints, the student teachers reported significantly less than the general population that stress (p=0.004) and the deterioration of their general physical condition (p=0.003) have a negative influence on their voice. Remarkably, over a third of the student teachers and one fifth of the general population with voice complaints were of the opinion that decrease of hearing has a negative influence on their voices (p=0.113). There was no significant difference in Voice Handicap Index (VHI) scores (p=0.284) and impact of voice complaints among student teachers and the general population. Over 15% of the student teachers and the general population with voice complaints reported being or having been disabled due to the voice problem, probably reflecting the severity of the voice problem (p=0.838). The groups reporting voice complaints and disability in relation to their voice complaints have significantly higher VHI scores than those without voice complaints and disability, which indicates a higher psychosocial impact of voice complaints. Only around a third of the student teachers and the general population with voice complaints sought paramedical care (p=0.656)/treatment (p=0.361) for their voice complaint. Only a minority of student teachers (18.6%) and the general population (29.5%) with voice complaints were of the opinion that the number of people they communicate with has a negative influence on their voice (p=0.120). Only around a third of the student teachers and less than a tenth of the general population with voice complaints were of the view that they would develop a voice complaint due to their profession (p=0.003). Less than half of the student teachers and less than one fifth of the general population with voice complaints were aware of the potential risks of their profession on their voice (p=0.002). Voice complaints appear to have a multifactorial genesis. The student teachers are not sufficiently aware of the impact of the various risk factors on their voice. Furthermore, they are not aware of the potential risk that future teaching may have on their voice. This apparent lack of awareness in student teachers may be considered a risk factor for voice complaints. PMID:16479130
Thomas, George; de Jong, Felix I C R S; Cremers, Cor W R J; Kooijman, Piet G C
Prevalence of Neuropathic Pain in Radiotherapy Oncology Units
Purpose: Neuropathic pain (NP) in cancer patients severely impacts quality of life. Radiotherapy (RT) may cause NP, and at the same time, cancer patients visit RT units for pain relief. NP prevalence at these sites and current analgesic treatment should be assessed to improve management. Methods and Materials: This epidemiological, prospective, multicenter study was undertaken to assess NP prevalence, according to Douleur Neuropathique 4 questions questtionaire (DN4) test results, and analgesic management in cancer pain patients visiting RT oncologic units. Secondary analyses assessed NP etiology and pain intensity (using the Brief Pain Inventory-Short Form) and impact (using the Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study [MOS] for Sleep, and the Health Survey Short Form-12). Results: A total of 1,098 patients with any kind of pain were registered. NP prevalence was 31.1% (95% confidence interval, 28.4%--33.9%); 291 NP patients (mean age, 62.2 {+-}12.5 years and 57.7% men) were eligible for study; 49% of patients were overweight. The most frequent tumors were those of breast and lung, and stage IIIB was the most common cancer stage. The tumors caused 75% of NP cases. Anxiety, sleepiness, and depression were common. At 8 weeks, pain intensity and interference with daily activities decreased significantly for 50.8% of responders. Depression and anxiety (p < 0.0001) scores on the Physical Component Summary and Mental Component Summary measures (p < 0.0001) and all MOS-Sleep subscales, except for snoring, improved significantly. The percentage of satisfied patients increased from 13.8% to 87.4% (p < 0.0001) with the current analgesic treatment, which meant a 1.2- and 6-fold increase (p < 0.0001) in narcotic analgesics and anticonvulsants, respectively, compared to previous treatment. Conclusions: NP is highly prevalent at RT oncology units, with sleepiness, anxiety, and depression as frequent comorbidities. There is a need to improve management of NP with increased use of more specific NP-targeting drugs.
Manas, Ana [Servicio de Oncologia Radioterapica, Hospital Universitario La Paz, Madrid (Spain); Monroy, Jose Luis [Servicio de Oncologia Radioterapica, Hospital Universitario de la Ribera, Valencia (Spain); Ramos, Avelino Alia [Servicio de Oncologia Radioterapica, Hospital Txagorritxu, Vitoria-Alava (Spain); Cano, Carmen [Servicio de Oncologia Radioterapica, Hospital de Torrecardenas, Almeria (Spain); Lopez-Gomez, Vanessa, E-mail: firstname.lastname@example.com [Medical Unit, Pfizer Espana, Alcobendas (Spain); Masramon, Xavier [Department of Biometrics, European Biometrics Institute, Barcelona (Spain); Perez, Maria [Medical Unit, Pfizer Espana, Alcobendas (Spain)
Prevalence, Practice Patterns and Evidence for Chronic Neck Pain
Objective The primary objectives of this study were to estimate the prevalence of chronic neck pain in North Carolina, to describe health care use (providers, treatments and diagnostic testing) for chronic neck pain and to correlate health care use with current best evidence. Methods A cross-sectional, telephone survey of a representative sample of North Carolina households in 2006. Five thousand three hundred fifty seven households were contacted in 2006 to identify 141 non-institutionalized adults 21 years and older with chronic neck pain and no chronic low back pain. Subjects were interviewed about their health and health care use (i.e., provider, tests, and treatments). Patterns of health care use were compared to current systematic reviews. Results The estimated prevalence of chronic neck pain in 2006 among non-institutionalized individuals for the state of North Carolina was 2.2% (95% CI 1.7 – 2.6). Individuals with chronic neck pain were middle- aged (mean age 48.9 years and a majority were female (56%) and non-Hispanic White (81%). Subjects saw a mean of 5.21 (95% CI 4.8 – 5.6) provider types and had a mean of 21 visits. The types of treatments subjects reported varied with treatments such as electrotherapy stimulation (30.3%), corsets or braces (20.9%), massage (28.1%), ultrasound (27.3%), heat (57.0%) and cold (47.4%) having unclear or little benefit based on current best available reviews. Conclusion Based on current evidence for best practice, our findings indicate over utilization of diagnostic testing, narcotics and modalities, and the under utilization of effective treatments such as therapeutic exercise. PMID:20521306
Goode, Adam P.; Freburger, Janet; Carey, Timothy
The Immediate Effects of Thoracic Spine and Rib Manipulation on Subjects with Primary Complaints of Shoulder Pain
Shoulder pain is a common orthopedic condition seen by physical therapists, with many potential contributing factors and proposed treatments. Although manual physical therapy interventions for the cervicothoracic spine and ribs have been investigated for this patient population, the specific effects of these treatments have not been reported. The purpose of this investigational study is to report the immediate effects of thoracic spine and rib manipulation in patients with primary complaints of shoulder pain. Using a test-retest design, 21 subjects with shoulder pain were treated during a single treatment session with high-velocity thrust manipulation to the thoracic spine or upper ribs. Post-treatment effects demonstrated a 51% (32mm) reduction in shoulder pain, a corresponding increase in shoulder range of motion (30°-38°), and a mean patient-perceived global rating of change of 4.2 (median 5). These immediate post-treatment results suggest that thoracic and rib manipulative therapy is associated with improved shoulder pain and motion in patients with shoulder pain, and further these interventions support the concept of a regional interdependence between the thoracic spine, upper ribs, and shoulder. PMID:20140154
Strunce, Joseph B.; Walker, Michael J.; Boyles, Robert E.; Young, Brian A.
Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents
Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact. PMID:23678258
Son, Kyeong Min; Cho, Nam H.; Lim, Seung Hun
Pain prevalence and its determinants after spinal cord injury: A systematic review.
Pain prevalence studies are important as they illustrate the magnitude of pain problems in a certain patient population, such as patients living with a spinal cord injury (SCI). Strikingly, reported pain prevalence rates in SCI patients are found to vary greatly, while determinants for the differences between pain prevalence reports remain unclear. We here aim to identify determinants for the differences (heterogeneity) in pain prevalence reports through a systematic review of all SCI pain prevalence reporting studies. Literature search was done using Medline, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Knowledge and Embase. Data abstraction was performed while blinded and was followed by meta-(regression)-analyses. We identified 82 studies. Study design-related determinants of SCI pain prevalence reports were pain definition strictness (mild, moderate or high), primary study goal (pain study or not), data source (retrospective or not), and in a limited number of cases response/attrition rates. While correcting for these items, population characteristics correlating with pain prevalence rates were both proportion of patients with a depression and average time after injury (positive correlations). Between-study heterogeneity may remain even after the identification/correction of above-mentioned causes of heterogeneity.Pain after SCI does seem to relate to the duration of the injury and depression, yet major causes of bias in reported pain prevalence are found to be related to the primary study goal (pain study or not), choice of pain definition and the use of retrospective data. PMID:24824334
van Gorp, S; Kessels, A G; Joosten, E A; van Kleef, M; Patijn, J
Children's Pain Threat Appraisal and Catastrophizing Moderate the Impact of Parent Verbal Behavior on Children's Symptom Complaints
Objective ?We tested the hypothesis that pain threat appraisal and catastrophizing by children with functional abdominal pain (FAP) will moderate the relation between parent verbal behavior and children's symptom complaints following experimentally induced visceral discomfort.?Methods ?Thirty-three pediatric patients with FAP and their parents participated. Children completed measures of pain threat appraisal and catastrophizing. Weeks later they completed the Water Load Symptom Provocation Test to induce visceral discomfort. Spontaneous parent–child interactions during child discomfort were audiotaped and coded for content.?Results ?Parent symptom-related talk was associated with more child symptom complaints and parent non-symptom-related talk with fewer child complaints. The relation between symptom talk and complaints was greater for children with high catastrophizing. Non-symptom talk was associated with fewer complaints for children with high threat appraisals.?Conclusions ?Child characteristics should be considered in research on the relation between parent behavior and children's symptom complaints. PMID:20484330
Blount, Ronald L.; Walker, Lynn S.
Prevalence and Characteristics of Breakthrough Pain in Cancer Patients Admitted to a Hospice
A prospective survey was undertaken to determine the prevalence and characteristics of breakthrough pain in cancer patients admitted to a hospice. Of 414 consecutive admissions, 33 patients were confused or too unwell to take part and 136 were pain-free. The remaining 245 reported 404 pains (range 1–5 per patient); of these patients, 218 (89%) had breakthrough pain and identified 361
Giovambattista Zeppetella; Catherine A O'Doherty; Silke Collins
Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain
OBJECTIVES--To determine the prevalence of pain arising from the zygapophysial joint in patients with chronic low back pain and to determine whether any clinical features could distinguish patients with and without such pain. METHODS--Sixty three patients with chronic low back pain were studied prospectively. All patients underwent a detailed history and physical examination as well as a series of intra-articular
A C Schwarzer; S C Wang; N Bogduk; P J McNaught; R Laurent
The prevalence of pain at pressure areas and pressure ulcers in hospitalised patients
Background Patients with pressure ulcers (PUs) report that pain is their most distressing symptom, but there are few PU pain prevalence studies. We sought to estimate the prevalence of unattributed pressure area related pain (UPAR pain) which was defined as pain, soreness or discomfort reported by patients, on an "at risk" or PU skin site, reported at a patient level. Methods We undertook pain prevalence surveys in 2 large UK teaching hospital NHS Trusts (6 hospitals) and a district general hospital NHS Trust (3 hospitals) during their routine annual PU prevalence audits. The hospitals provide secondary and tertiary care beds in acute and elective surgery, trauma and orthopaedics, burns, medicine, elderly medicine, oncology and rehabilitation. Anonymised individual patient data were recorded by the ward nurse and PU prevalence team. The analysis of this prevalence survey included data summaries; no inferential statistical testing was planned or undertaken. Percentages were calculated using the total number of patients from the relevant population as the denominator (i.e. including all patients with missing data for that variable). Results A total of 3,397 patients in 9 acute hospitals were included in routine PU prevalence audits and, of these, 2010 (59.2%) patients participated in the pain prevalence study. UPAR pain prevalence was 16.3% (327/2010). 1769 patients had no PUs and of these 223 patients reported UPAR pain, a prevalence of 12.6%. Of the 241 people with pressure ulcers, 104 patients reported pain, a UPAR pain prevalence of 43.2% (104/241). Conclusion One in six people in acute hospitals experience UPAR pain on 'at risk' or PU skin sites; one in every 8 people without PUs and, more than 2 out of every five people with PUs. The results provide a clear indication that all patients should be asked if they have pain at pressure areas even when they do not have a PU. PMID:23902583
Prevalence of heroin markers in urine for pain management patients.
Surveys of current trends indicate heroin abuse is associated with nonmedical use of pain relievers. Consequently, there is an interest in evaluating the presence of heroin-specific markers in chronic pain patients who are prescribed controlled substances. A total of 926,084 urine specimens from chronic pain patients were tested for heroin/diacetylmorphine (DAM), 6-acetylmorphine (6AM), 6-acetylcodeine (6AC), codeine (COD), and morphine (MOR). Heroin and markers were analyzed using liquid chromatography tandem mass spectrometry (LC-MS-MS). Opiates were analyzed following hydrolysis using LC-MS-MS. The prevalence of heroin use was 0.31%, as 2871 were positive for one or more heroin-specific markers including DAM, 6AM, or 6AC (a known contaminant of illicit heroin). Of these, 1884 were additionally tested for the following markers of illicit drug use: 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), methamphetamine (MAMP), 11-nor-9-carboxy-?(9)-tetracannabinol (THCCOOH), and benzoylecgonine (BZE); 654 (34.7%) had positive findings for one or more of these analytes. The overall prevalence of heroin markers were as follows: DAM 1203 (41.9%), 6AM 2570 (89.5%), 6AC 1082 (37.7%). MOR was present in 2194 (76.4%) and absent (
Knight, Julie; Puet, Brandi L; DePriest, Anne; Heltsley, Rebecca; Hild, Cheryl; Black, David L; Robert, Timothy; Caplan, Yale H; Cone, Edward J
Role of allostatic load in socio-demographic patterns of pain prevalence in the US population
Persistent stressors associated with sociodemographic disadvantage exert a physiologic toll, labeled "allostatis load", that contributes to disparities in some health conditions. We investigated the contribution of allostatic load to pain prevalence in US adults. Interviews with 14,184 adults in the 1999–2004 National Health and Nutrition Examination Survey asked about severe headache, pain that lasted >24 hours, and widespread pain. Ten biomarkers of allostatic load were quantified from blood (glycated hemoglobin), serum (C-reactive protein, homocysteine, cholesterol, triglycerides), urine (creatinine, albumin) and physical measurements (body mass index, systolic and diastolic blood pressure). Log-binomial regression models estimated prevalence ratios (PR) and 95% confidence intervals (95%CIs). Prevalence ranged from 3.4% for widespread pain to 26.9% for pain >24 hours. After adjustment for demographic characteristics, low income was associated with greater prevalence of pain >24 hours (PR=1.65, 95%CI=1.49, 1.83), severe headache (PR=2.05, 95%CI=1.68, 2.50) and widespread pain (PR=3.67, 95%CI=2.56, 5.27). Racial/ethnic minorities had lower prevalence of all three pain conditions than non-Hispanic Whites. While greater allostatic load was associated with elevated prevalence of pain, allostatic load did not meaningfully attenuate prevalence ratios associated with income or race/ethnicity. We conclude that greater pain prevalence among low income groups is not explained by greater allostatic load. PMID:22677453
Slade, Gary D.; Sanders, Anne E.; By, Kunthel
Prevalence of nonmusculoskeletal complaints in chiropractic practice: Report from a practice based research program
Objective: To identify patient and practice characteristics that might contribute to people's seeking chiropractic care for nonmusculoskeletal complaints.Design: This was a cross-sectional study conducted through the methods of practice-based research.Setting: Data were collected in 1998-1999 in chiropractic offices in the United States, Canada, and Australia; data were managed by a practice-based research office operating in a chiropractic research center.Population: The
Cheryl Hawk; Cynthia R. Long; Karen T. Boulanger
Prevalence of Voice Complaints, Risk Factors and Impact of Voice Problems in Female Student Teachers
A cross-sectional questionnaire survey was done among 457 female student teachers and 144 females in the general population. The conclusions are based on the opinions of student teachers and the general population. The results of this study show that 39.6% of the student teachers and 32.6% of the general population reported voice complaints at the moment and\\/or over the past
George Thomas; Felix I. C. R. S. de Jong; Cor W. R. J. Cremers; Piet G. C. Kooijman
Prevalence and Pharmacologic Treatment of Patients with Low Back Pain Treated at Kosovo Energetic Corporation
ABSTRACT Introduction: Low back pain (LBP) is a common complaint among the general population with a subgroup developing chronic and disabling symptoms generating large societal costs. Recurrences and functional limitations can be minimized with appropriate conservative management, including medications, physical therapy modalities, exercise and patient education. Objectives: The purpose of this study was to determine the prevalence of low back complaints in industrial workers, to investigate whether individual risk factors involved in the occurrence of LBP, and to determine the most frequent used drug in LBP treatment. Materials and Methods: Data for this study were provided from Kosovo Energetic Corporation. A cross-sectional study design was utilized. Self-administered questionnaires were distributed among 228 industrial workers. Patient with LBP underwent a comprehensive clinical, radiological and biochemical evaluation. Results: showed that LBP occurred in 63.5% of workers. Individual factors did not show significant associations with LBP. Age (OR=0.99/95% Cl 0.95-1.03), weight (OR=1.13/95% Cl 0.99-1.06), height (OR=0.97/95% Cl 0.91-1.02), and work experience (OR=1.01/95% Cl 0.97-1.05) increase odds for LBP but not significantly. The most frequently used drugs in patients included in this study are NSAIDs. In 33 (55.0%) patients for the treatment of LBP two types of drugs are administered. Conclusion: Increased physical activity, health promotion and reduced body weight can prevent morbidity from LBP. A continuous consultation with the Clinical Pharmacist demonstrates effective way of dosage and drug re-evaluation for the patients with LBP.
Ibraimi, Zana; Murtezani, Ardiana; Haxhiu, Bekim; Mustafa, Aziz; Martinaj, Merita
Prevalence of Helicobacter pylori infection in children with recurrent abdominal pain.
The present study was performed to study the prevalence of Helicobacter pylori (H. pylori) infection in children with recurrent abdominal pain (RAP). Children above 3 years of age of both sexes attending the OPD of a teaching hospital, with complaints of at least three discrete episodes of abdominal pain of sufficient severity to interrupt normal daily activities, occurring over a period of one month or more and with out identifiable cause of pain were enrolled in the study. The subjects were divided into 3 age groups of 3-5 years, 5-8 years and 8-12 years. Thirty normal controls from each age group were also enrolled. Detailed history was taken and thorough physical examination was done. Estimation of haemoglobin and specific IgG antibodies to H. pylori by Immunocomb II was done. Upper gastrointestinal endoscopy was performed with a fibreoptic pediatric sized endoscope in RAP cases after obtaining informed parental consent. Multiple biopsy samples were taken and subjected to Rapid Urease Test (RUT), Gram's Staining, Culture and histology. Data obtained were analyzed, using Fisher's Z Test, Students t-test or Chi Square as applicable. Sixty-eight cases and 90 controls were enrolled, the number in various age groups being comparable (p >0.05). Seropositivity rate was significantly more in cases (60.3%) compared to controls (10%) (p <0.001) even among various age groups (<0.01). Prevalence increased with advancing age from 3.3% to 16.7% in controls, but not among cases. Seropositivity rates among males and females were comparable both among cases and controls. Incidence of malnutrition, stunting and anemia were similar irrespective of serological status. Total duration of illness, frequency, duration of each episode, and location of pain were also comparable. Among 10 seropositive children who underwent upper gastrointestinal endoscopy 80% showed one or more abnormalities, while the single seronegative child had no abnormal finding. Half the seropositive cases had gastritis, hyperemia or erosion on gross examination. Histopathological evidence of gastritis was present in 40%, but culture was negative in all. There is a significant association of H. pylori infection and RAP. But studies involving larger number of children undergoing endoscopy is required for definite evidence of a 'cause and effect'. PMID:16225059
Mukherjee, Punyabrata; Chacko, Betty; Singh, Tejinder; Pawar, Gitanjali; Kaur, Harjit
Differences between Nurses' and Care Workers' Estimations of Pain Prevalence among Older Residents.
A high prevalence of pain and difficulties with pain assessment has been widely reported among residents of long-term-care facilities. We explored nurses' and care workers' estimations of residents' pain (both general and chronic) and the number of residents with unknown pain status. We also examined the relationship between the prevalence of pain and assessment strategies undertaken by nurses and care workers. A cross-sectional design was used. Nurses and care workers across 750 long-term care facilities in four Japanese prefectures were asked to participate. Questionnaires were administered to one nurse and care worker at each facility. The questionnaires assessed the estimated numbers of residents who had pain in general, chronic pain, or unknown pain status on the day of data collection, and pain assessment strategies use by the health care professionals. In all, 263 (17.5%) questionnaires were returned from 147 nurses (55.9%) and 116 care workers (44.1%). The nurses' and care workers' median estimations of pain and chronic pain prevalence among residents were 11.6 and 9.4 and 29.4 and 15.5, respectively (p < .001). Estimations of pain prevalence were significantly higher among nurses who had observed signs of pain among residents in the previous month (p = .04) and who applied a multidisciplinary approach to pain assessment and management (p = .007) than among nurses who did not do either. Nurses and care workers had relatively low estimations of the prevalence of pain among their residents. Staff should undertake appropriate and sufficient pain assessments in order to improve their understanding of residents' pain. PMID:24931874
Takai, Yukari; Yamamoto-Mitani, Noriko; Kawakami, Saori; Abe, Yoshiki; Kamiyama, Manami; Saito, Shigeru
Education and the Prevalence of Pain. NBER Working Paper No. 14964
ERIC Educational Resources Information Center
Many Americans report chronic and disabling pain, even in the absence of identifiable clinical disorders. We first examine the prevalence of pain in the older U.S. population using the Health and Retirement Study (HRS). Among 50-59 year females, for example, pain rates ranged from 26 percent for college graduates to 55 percent for those without a…
Atlas, Steven J.; Skinner, Jonathan S.
A Systematic Review of the Prevalence and Measurement of Chronic Pain in Asian Adults.
There are limited epidemiologic studies on chronic pain in Asian populations. The aim of this review was to gather all epidemiologic studies of chronic pain in Asian countries and systematically describe the measurement and prevalence of chronic pain in Asian adults. A systematic review was performed using PubMed, MEDLINE, EMBASE, Psych INFO, Cochrane Database for Systematic Review, and CINAHL. Additional studies were identified manually by searching bibliographies. We identified 19 relevant articles for this review. Most articles used the definition of chronic pain set by the International Association for the Study of Pain. The majority of the articles used simple single-question methods to measure chronic pain. The prevalence of chronic pain among Asian adults ranges from 7.1% (Malaysia) to 61% (Cambodia and Northern Iraq), whereas among the Asian geriatric population, the prevalence is even higher and ranges from 42% to 90.8%. This review showed that there is great variation in the reported prevalence of chronic pain in Asian adults and the prevalence of chronic pain is high among the Asian geriatric population. To measure the distribution of chronic pain in adults, a uniform measurement strategy should be adopted. PMID:25439125
Mohamed Zaki, Lily R; Hairi, Noran N
The relationship between physical load and musculoskeletal complaints among Brazilian dentists.
The aim of the present study was to assess the relationship between physical load and musculoskeletal complaints in dentistry and to analyze the prevalence and severity of such complaints in nine anatomical regions using a cross-sectional study of 387 dentists from Natal, Brazil. The highest prevalence of complaints was related to the lower back (58.4%) and the lowest prevalence was found in the elbow (10.3%). In general, symptoms were classified as mild because they did not cause absence due to illness. Pain complaints were associated with the following characteristics: awkward posture at work; prolonged standing or sitting; strenuous position of the upper limbs; excessive tightening of the hands during clinical treatment; and the use of vibrating tools. The results of the present study suggest a high prevalence of musculoskeletal complaints in dentists that are significantly associated with variables related to their physical workload. PMID:25479978
Oliveira Dantas, Filipe Fernandes; de Lima, Kenio Costa
Self-Reported Facial Pain in UK Biobank Study: Prevalence and Associated Factors
ABSTRACT Objectives To determine the prevalence of facial pain and to examine the hypothesis that symptoms are associated with socio-demographic, dental, adverse psychological factors and pain elsewhere in the body. Material and Methods Cross-sectional population data were obtained from UK Biobank (www.ukbiobank.ac.uk/) study which was conducted in 2006 - 2010 and recruited over 500,000 people. Results The overall prevalence of facial pain (FP) was 1.9% (women 2.4%, men 1.2%) of which 48% was chronic. The highest prevalence was found in the 51 - 55 age group (2.2%) and the lowest in the 66 - 73 age group (1.4%). There was a difference in prevalence by ethnicity (0.8% and 2.7% in persons reporting themselves as Chinese and Mixed respectively). Prevalence of FP significantly associated with all measures of social class with the most deprived and on lowest income showing the highest prevalence (2.5% and 2.4% respectively). FP was more common in individuals who rated themselves as extremely unhappy, had history of depression and reported sleep problems. Smoking associated with increase in reporting FP while alcohol consumption had inverse association. FP associated with history of painful gums, toothache and all types of regional pain. Conclusions This is the largest ever study to provide estimates of facial pain prevalence. It demonstrates unique features (lower prevalence than previously reported) and common features (more common in women) and confirms multifactorial aetiology of facial pain. Significant association with psychological distress and a strong relationship to pain elsewhere in the body suggests that aetiology is not specific to this regional pain. PMID:25386229
Beasley, Marcus; Macfarlane, Gary J.
Frequency of Entamoeba histolytica and Entamoeba dispar prevalence among patients with gastrointestinal complaints in Chelgerd city, southwest of Iran*
BACKGROUND: Differentiation between Entamoeba histolytica and Entamoeba dispar is very important for both clinical therapy and epidemiological studies. Although these two species are morphologically identical, they have differences in genetic, chemical specifications and pathogenicity. This study was carried out to differentiate E. histolytica from E. dispar and also to find out frequency of the two species. METHODS: Fecal samples were collected three times from 655 patients with gastrointestinal complaints (47.3% male and 52.7% female), who were referred to the primary health care centers of Chelgerd, Chaharmahal and Bakhtiary province. Samples were examined microscopically with direct smear, formalin-ethyl-acetate concentration and trichrom staining methods to distinguish E. histolytica from E. dispar complex and differentiate them from non-pathogenic intestinal amoeba. Genomic DNA was extracted from microscopy positive isolates and polymerase chain reaction (PCR) was carried out to different the two morphologically identical Entamoeba isolates. RESULTS: Among the 655 recruited patients, eleven subjects with E. histolytica / E. dispar isolates (1.7%) were identified by microscopy methods. Ten of the positive isolates (90.9%) were identified as E. histolytica by PCR and one isolate (9.09 %) was positive for E. dispar. CONCLUSIONS: This study revealed that E. histolytica was more prevalent than E. dispar in the studied area. This result was different from the previously reported data in other parts of Iran. PMID:22973344
Pestehchian, Nader; Nazary, Mahnaz; Haghighi, Ali; Salehi, Mansour; Yosefi, Hosinali
[Prevalence and characteristics of chronic pain with neuropathic component at Parakou in northern Benin in 2012].
The burden of chronic and neuropathic pain is high making it an important public health problem. The epidemiology is not well known in the general population in sub-Saharan Africa. We aimed to determine the prevalence of chronic pain with a neuropathic component at Tititou in Parakou in northeastern Benin. A cross-sectional study was conducted from 1st April to 31 May 2012 and included 2314 people in a door-to-door survey. Chronic pain was defined as pain occurring for more than three months. Neuropathic pain was assessed with the DN4 score. A neurological exam was performed by a young physician for all people with chronic pain. During the interview, sociodemographic data, past medical history, weight and height were recorded. Multivariate logistic regression was performed to analyze the main associated factors. Among the 2314 people included in this survey, 49.7% were male. The mean age was 32.3±13.1years. Nine hundred seven reported pain occurring for more than 3months. The prevalence of chronic pain was 39.2% (CI95%: 29.3-34.7). It was more frequent in females, older people, among diabetics, people with a history of any surgery, stroke, brain trauma, and alcoholism. The prevalence of chronic pain with a neuropathic component was 6.3% (CI95%: 5.0-7.9). The main associated factors were age, matrimonial status, professional occupation, body mass index, diabetes, history of zoster, history of any surgery, brain trauma. People with neuropathic pain often reported pain with burning (87.6%), prickling (82.8%), numbness (66.9%), tingling (63.4%), and lightning pain (48.3%). The main locations were the lower limbs and low back pain. This study suggested the high frequency of chronic neuropathic pain in the general population in Parakou compared with rates reported in western countries. PMID:25444451
Adoukonou, T; Gnonlonfoun, D; Kpozehouen, A; Adjien, C; Tchaou, B; Tognon-Tchegnonsi, F; Adechina, H; Covi, R; Houinato, D
Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta: an upright, weightbearing MRI study
The purpose of this study is to determine if patellar maltracking is more prevalent among patellofemoral (PF) pain subjects with patella alta compared to subjects with normal patella height. We imaged 37 PF pain and 15 pain free subjects in an open-configuration magnetic resonance imaging scanner while they stood in a weightbearing posture. We measured patella height using the Caton-Deschamps, Blackburne-Peel, Insall-Salvati, Modified Insall-Salvati, and Patellotrochlear indices, and classified the subjects into patella alta and normal patella height groups. We measured patella tilt and bisect offset from oblique-axial plane images, and classified the subjects into maltracking and normal tracking groups. Patellar maltracking was more prevalent among PF pain subjects with patella alta compared to PF pain subjects with normal patella height (two-tailed Fisher's exact test, p < 0.050). Using the Caton-Deschamps index, 67% (8/12) of PF pain subjects with patella alta were maltrackers, whereas only 16% (4/25) of PF pain subjects with normal patella height were maltrackers. Patellofemoral pain subjects classified as maltrackers displayed a greater patella height compared to the pain free and PF pain subjects classified as normal trackers (two-tailed unpaired t-tests with Bonferroni correction, p < 0.017). This study adds to our understanding of PF pain in two ways - 1) we demonstrate that patellar maltracking is more prevalent in PF pain subjects with patella alta compared to subjects with normal patella height; and 2) we show greater patella height in PF pain subjects compared to pain free subjects using four indices commonly used in clinics. PMID:23165335
Pal, Saikat; Besier, Thor F.; Beaupre, Gary S.; Fredericson, Michael; Delp, Scott L.; Gold, Garry E.
Prevalence of Widespread Pain and Its Influence on Quality of Life: Population Study in Korea
The objective of this study was to examine the prevalence and risk factors for widespread pain and its influence on quality of life in residents of Korean communities. A rural and an urban community were selected, and 5,037 subjects were surveyed. Participants were asked if they had pain, aching, or stiffness in any of their joints on most days. Widespread pain was defined as pain above the waist, below the waist, on both sides of the body and in the axial region. The prevalence of widespread pain was 12% (16.2% and 5.5% in females and males, respectively). It was more frequent among females and increased with age in both genders. Age, female gender, and the presence of hand or knee arthritis were significantly associated with widespread pain after multivariate analysis. Except for mental health, all the items in the SF-12 were adversely affected in the widespread pain group after adjustment for confounding factors. Our findings show that the prevalence of widespread pain among residents of Korean communities is comparable to that reported among Caucasians. The significantly worse quality of life among subjects with widespread pain suggests that it may cause major health issues in the aging population. PMID:22219608
Cho, Nam Han; Kim, Inje; Lim, Seung Hun
High prevalence of ESBL-producing Enterobacteriaceae carriage in Dutch community patients with gastrointestinal complaints.
The aim of this study was to determine the rate of carriage of ESBL-producing Enterobacteriaceae (ESBL-E) in the community in the Netherlands and to gain understanding of the epidemiology of these resistant strains. Faecal samples from 720 consecutive patients presenting to their general practitioner, obtained in May 2010, and between December 2010 and January 2011, were analysed for presence of ESBL-E. Species identification and antibiotic susceptibility testing were performed according to the Dutch national guidelines. PCR, sequencing and microarray were used to characterize the genes encoding for ESBL. Strain typing was performed with amplified fragment length polymorphism (AFLP) and multilocus sequence typing (MLST). Seventy-three of 720 (10.1%) samples yielded ESBL-producing organisms, predominantly E. coli. No carbapenemases were detected. The most frequent ESBL was CTX-M-15 (34/73, 47%). Co-resistance to gentamicin, ciprofloxacin and cotrimoxazole was found in (9/73) 12% of the ESBL-E strains. AFLP did not show any clusters, and MLST revealed that CTX-M-15-producing E. coli belonged to various clonal complexes. Clonal complex ST10 was predominant. This study showed a high prevalence of ESBL-producing Enterobacteriaceae in Dutch primary care patients with presumed gastrointestinal discomfort. Hence, also in the Netherlands, a country with a low rate of consumption of antibiotics in humans, resistance due to the expansion of CTX-M ESBLs, in particular CTX-M-15, is emerging. The majority of ESBL-producing strains do not appear to be related to the international clonal complex ST131. PMID:22757622
Reuland, E A; Overdevest, I T M A; Al Naiemi, N; Kalpoe, J S; Rijnsburger, M C; Raadsen, S A; Ligtenberg-Burgman, I; van der Zwaluw, K W; Heck, M; Savelkoul, P H M; Kluytmans, J A J W; Vandenbroucke-Grauls, C M J E
Chronic diseases in the European Union: the prevalence and health cost implications of chronic pain.
The objective of this study was to assess recent data on the prevalence of chronic pain as part of chronic diseases; the prevalence of chronic pain as a chronic condition in its own right; the costs attributed to chronic pain; and the European Union (EU) policies to addressing chronic pain. Recent literature was reviewed for data on the prevalence and cost implications of chronic pain in the EU. Following on from an earlier systematic review, 8 databases were searched for prevalence and 10 for cost information from 2009 to 2011 and relevant EU organizations were contacted. Ten cost and 29 prevalence studies were included from the 142 full papers screened. The general adult population reported an average chronic pain prevalence of 27%, which was similar to those for common chronic conditions. Fibromyalgia had the highest unemployment rate (6%; Rivera et al., Clin Exp Rheumatol. 2009;27[Suppl 56]:S39-S45) claims for incapacity benefit (up to 29.9%; Sicras-Mainar et al., Arthritis Res Ther. 2009;11:R54), and greatest number of days of absence from work (Rivera et al., Clin Exp Rheumatol. 2009;27[Suppl 56]:S39-S45). Chronic pain is common and the total population cost is high. Despite its high impact, chronic pain as a condition seems to have had little specific policy response. However, there does appear to be sufficient evidence to at least make addressing chronic pain a high priority alongside other chronic diseases as well as to conduct more research, particularly regarding cost. PMID:23216170
Leadley, R M; Armstrong, N; Lee, Y C; Allen, A; Kleijnen, J
Prevalence of widespread pain and associations with work status: a population study
Background This population study based on a representative sample from a Swedish county investigates the prevalence, duration, and determinants of widespread pain (WSP) in the population using two constructs and estimates how WSP affects work status. In addition, this study investigates the prevalence of widespread pain and its relationship to pain intensity, gender, age, income, work status, citizenship, civil status, urban residence, and health care seeking. Methods A cross-sectional survey using a postal questionnaire was sent to a representative sample (n = 9952) of the target population (284,073 people, 18–74 years) in a county (Östergötland) in the southern Sweden. The questionnaire was mailed and followed by two postal reminders when necessary. Results The participation rate was 76.7% (n = 7637); the non-participants were on the average younger, earned less money, and male. Women had higher prevalences of pain in 10 different predetermined anatomical regions. WSP was generally chronic (90–94%) and depending on definition of WSP the prevalence varied between 4.8–7.4% in the population. Women had significantly higher prevalence of WSP than men and the age effect appeared to be stronger in women than in men. WSP was a significant negative factor – together with age 50–64 years, low annual income, and non-Nordic citizen – for work status in the community and in the group with chronic pain. Chronic pain but not the spreading of pain was related to health care seeking in the population. Conclusion This study confirms earlier studies that report high prevalences of widespread pain in the population and especially among females and with increasing age. Widespread pain is associated with prominent effects on work status. PMID:18627605
Gerdle, Björn; Björk, Jonas; Cöster, Lars; Henriksson, KG; Henriksson, Chris; Bengtsson, Ann
Treatment efficacy for pain complaints in women with endometriosis of the lesser pelvis after laparoscopic electroablation vs. CO2 laser ablation.
Endometriosis is a chronic disease affecting mainly women of the reproductive age. Its most common manifestations include impaired fecundity, pelvic pain, and dyschezia. Laparoscopic removal of endometriotic foci remains to be the gold standard for the treatment of endometriosis. More effective techniques of endoscopic approach-among others, laser application-are continually being developed. The aim of the study was to evaluate the efficacy of laparoscopic treatment with the use of CO2 laser ablation vs. electroablation with regard to pain complaints in the affected patients. The study included 48 women (aged 22-42) with varying degrees of endometriosis of the lesser pelvis. The Numeric Rating Scale (NRS) was used to evaluate pain intensity before the surgery in all patients, followed by either laser ablation or electroablation of the endometriotic foci. The results of the laparoscopic treatment were monitored after 3 and 6 months postoperatively. p value of 0.05 was considered to be statistically significant. Patients from both groups reported less intensive pain before/during menstruation (dysmenorrhea) 6 months postoperatively, with more distinct tendency in the electroablation group (p?=?0.004) as compared to the laser ablation group (p?=?0.025). Despite the initial improvement reported at the 3-month checkup (p?=?0.008), 6 months postoperatively, a statistically significant increase in pain intensity was noted in both groups (p?=?0.016 and p?=?0.032 for CO2 laser ablation and electroablation, respectively). Both surgical methods seem to be effective only in the treatment of endometriosis-related dysmenorrhea, whereas the intensity of other pain complaints (dyspareunia, dysuria, dyschezia, pelvic pain syndrome (PPS)) has remained on the same level. PMID:25053520
Posadzka, Ewa; Jach, Robert; Pity?ski, Kazimierz; Jablonski, Marcin Jacek
Head and Neck Cancer Pain: Systematic Review of Prevalence and Associated Factors
ABSTRACT Objectives Pain is a major symptom in patients with cancer; however information on head and neck cancer related pain is limited. The aim of this review was to investigate the prevalence of pain and associated factors among patients with HNC. Material and Methods The systematic review used search of MEDLINE, EMBASE and CINAHL databases to December 2011. Cancers of the oral mucosa, oropharynx, hypopharynx and larynx were included in this review with pain as main outcome. The review was restricted to full research reports of observational studies published in English. A checklist was used to assess the quality of selected studies. Results There were 82 studies included in the review and most of them (84%) were conducted in the past ten years. Studies were relatively small, with a median of 80 patients (IQR 44, 154). The quality of reporting was variable. Most studies (77%) used self-administered quality of life questionnaires, where pain was a component of the overall scale. Only 33 studies reported pain prevalence in HNC patients (combined estimate from meta-analysis before (57%, 95% CI 43% - 70%) and after (42%, 95% CI 33% - 50%) treatment. Only 49 studies (60%) considered associated factors, mostly tumour- or treatment-related. Conclusions The study has shown high levels of pain prevalence and some factors associated with higher levels of pain. There is a need for higher quality studies in a priority area for the care of patients with head and neck cancer. PMID:24422003
Wirth, Tanja; Ranasinghe, Sriyani; Ah-See, Kim W.; Renny, Nick; Hurman, David
Prevalence of back pain among fulltime United States workers.
A source of data on the health and working conditions of a probability sample of United States workers, the Quality of Employment Survey for 1972-3 (QES73), is investigated for the first time to determine which groups of workers are more or are less likely to report back pain. Estimated coefficients from a logistic regression are used to calculate odds ratios and confidence intervals for various groups. Few previous studies on back pain among United States workers control for as many potentially confounding variables as are considered in this study and few use data from a national probability sample of workers. The following independent variables are judged to be important positive correlates based on their estimated odds ratios and confidence intervals: farm, service, blue collar, and clerical work; low levels of schooling and income; jobs needing physical effort; age between and including 50 to 64; and smoking. Marital separation was found to be negatively correlated with back pain. Caution should be exercised in attempting to generalise these findings, since the back pain variable is based on respondents' subjective evaluations. Moreover, the variable does not distinguish between lower or upper back or neck pain, nor is information on the duration or frequency of pain available. PMID:2528986
Leigh, J P; Sheetz, R M
The community prevalence of chronic pelvic pain in women and associated illness behaviour.
BACKGROUND: Chronic pelvic pain has often been described as a major women's health issue, but no information exists on the extent of the problem in the United Kingdom. AIM: To investigate the community prevalence of chronic pelvic pain and its effect on the lives of consulting and non-consulting women. DESIGN OF STUDY: Postal questionnaire survey. SETTING: Women aged 18 to 49 (n = 3916) randomly selected from the Oxfordshire Health Authority Register. METHOD: The questionnaire response rate (adjusted for non-deliveries) was 74% (2304/3106). Chronic pelvic pain was defined as recurrent or constant pelvic pain of at least six months' duration, unrelated to periods, intercourse, or pregnancy. Case subgroups comprised recent consulters, past consulters, and non-consulters. Women who reported dysmenorrhoea alone formed a comparison group. RESULTS: The three-month prevalence of chronic pelvic pain was 24.0% (95% CI = 22.1% to 25.8%). One-third of women reported pain that started more than five years ago. Recent consulters (32% of cases) were most affected by their symptoms in terms of pain severity, use of health care, physical and mental health scores, sleep quality, and pain-related absence from work. Non-consulters (41% of cases) did not differ from women with dysmenorrhoea in terms of symptom-related impairment. Irrespective of consulting behaviour, a high rate of symptom-related anxiety was found in women with chronic pelvic pain (31%) compared with women with dysmenorrhoea (7%). CONCLUSIONS: This study showed a high community prevalence of chronic pelvic pain in women of reproductive age. Cases varied substantially in the degree to which they were affected by their symptoms. The high symptom-related anxiety in these women emphasises the need for more information about chronic pelvic pain and its possible causes. PMID:11462313
Zondervan, K T; Yudkin, P L; Vessey, M P; Jenkinson, C P; Dawes, M G; Barlow, D H; Kennedy, S H
Occupations associated with a high risk of self-reported back pain: representative outcomes of a back pain prevalence study in the Federal Republic of Germany
Given the increasing medical and economic implications of back pain, occupation-specific prevalence data may provide important pointers for preventive programmes targeted at promoting preventive behaviour and improving conditions. The National German Health Survey is the first study to provide the basis for a representative nationwide analysis of back pain prevalence by occupational category. The net sample comprises a total of
Sven Schneider; Slawomira Lipinski; Marcus Schiltenwolf
The prevalence of musculoskeletal pain & its associated factors among female Saudi school teachers
Objectives: To quantify the prevalence and identify the associated factors of musculoskeletal pain among Saudi female school teachers. Methods: An observational quantitative cross-sectional survey of female Saudi school teachers in five different areas of Saudi Arabia was carried out between August and October 2013. A self-administered questionnaire was used in which the items related to participants' demographic information and pain information were included. A numeric pain rating scale was used for patient self-reporting of pain. Data analysis was carried out using SPSS Pc+ version 21.0 statistical software. Results: Four hundred and eighty six female school teachers responded to the survey. Severe Low back pain was reported by 38.1% of teacher, followed by knee pain (26.3%), heel (24.1%), shoulder (20.6%), upper back (17.7%), hip joint (16.5%),ankle (12.3%), neck (11.3%). Sever pain of elbow (5.6%) and wrist (7.4%) was the least reported. Pain affected work at school in 46.1% of school teachers. A combination of variables: body mass index, Vitamin D deficiency, teaching level, presence of chronic illness, were found to be significantly associated with musculoskeletal pain. Conclusion: The results of self-reported prevalence of musculoskeletal pain among female Saudi school teachers is useful to educate the school teachers for adequate care so as to prevent these pains. There is a need for the higher authorities to address this issue and implement intervention programs to alleviate the pain and suffering of these school teachers.
Abdulmonem, Alsiddiky; Hanan, Algethami; Elaf, Ahmed; Haneen, Tokhtah; Jenan, Aldouhan
Social and gender variation in the prevalence, presentation and general practitioner provisional diagnosis of chest pain
OBJECTIVES—To describe the prevalence of Rose angina and non-exertional chest pain in men and women in socioeconomically contrasting areas; to describe the proportions of men and women who present with the symptom of chest pain and who receive a provisional general practitioner diagnosis of coronary heart disease; to assess the effects of gender and deprivation.?DESIGN—Two random general population samples in socially contrasting areas were surveyed using the Rose angina questionnaire: the case notes of people identified with chest pain were reviewed.?SETTING—Glasgow conurbation.?PARTICIPANTS—1107 men and women, aged 45-64, with chest pain.?OUTCOME MEASURES—Prevalence of Rose angina and non-exertional chest pain; the proportions who had presented with chest pain and received a general practitioner's provisional diagnosis of coronary heart disease.?RESULTS—There was no difference between social groups in the prevalence of all chest pain but a greater proportion of those in deprived groups had Rose angina and a greater proportion of these had the more severe grade. The proportion of people who had presented with chest pain was higher among socioeconomically deprived groups but there was no difference in the proportions receiving a general practitioner provisional diagnosis of coronary heart disease. Men were more likely to present with chest pain than women and were more likely to receive a provisional general practitioner diagnosis of coronary heart disease.?CONCLUSIONS—No evidence was found of social differences in patient presentation or general practitioner diagnosis that might explain reported variations in uptake of cardiology services. In contrast, gender variation may originate in part from differences in patient presentation and general practitioner diagnosis. Further investigation of socioeconomic variations in uptake of cardiology services should focus later in the care pathway, on general practitioner referral patterns and clinical decisions taken in secondary care.???Keywords: angina; social class; gender; primary care; chest pain PMID:10942455
Richards, H.; McConnachie, A.; Morrison, C.; Murray, K.; Watt, G.
Gender and Arthroplasty Type Affect Prevalence of Moderate-Severe Pain Post Total Hip Arthroplasty
Objective: To investigate the impact of gender, age and arthroplasty type (primary vs. revision) on prevalence of moderate-severe\\u000a hip pain.\\u000a \\u000a Methods: Using an Institutional Total Joint Registry, we identified a cohort of patients who underwent primary of revision\\u000a THA from 1996–2004 and responded to the follow-up questionnaires. We compared the prevalence of moderate or severe hip pain\\u000a based on arthroplasty
J. A. Singh; S. E. Gabriel; D. Lewallen
Prevalence of acute neuropathic pain after cancer surgery: A prospective study
Background and Aims: Acute neuropathic pain (ANP) is an under-recognised and under-diagnosed condition and often difficult to treat. If left untreated, it may further transform into persistent post-operative chronic pain leading to a disability. Aims: This prospective study was undertaken on 300 patients to identify the prevalence of ANP in the post-operative period by using a neuropathic pain detection questionnaire tool. Methods: This is an open-label study in which patients with six different types of cancer surgeries (Thoracic, gastro-intestinal, gynae/urology, bone/soft-tissue, head and neck and breast subgroups-50 each) were included for painDETECT questionnaire tool on the 2nd and 7th day surgery. Results: This study found a 10% point prevalence of ANP. Analysis showed that 25 patients had 'possible' ANP, the maximum from urological cancer surgery (6) followed by thoracic surgery (5). Five patients were found to have 'positive' ANP including 2 groin node dissection, 2 hemipelvectomy and 1 oesophagectomy. Conclusion: Significant relationship between severity of post-operative pain was found with the occurrence of ANP in the post-operative period requiring a special attention to neuropathic pain assessment. Larger studies are required with longer follow-up to identify accurately the true prevalence and causative factors of ANP after surgery. PMID:24700897
Jain, PN; Padole, Durgesh; Bakshi, Sumitra
Prevalence and determinants of pain in the ipsilateral upper limb of stroke patients (.).
Summary.-This study investigated the prevalence of pain in the ipsilateral upper-limb in stroke patients. 229 stroke patients (133 men, 96 women; M age = 59.0 yr., SD = 12.4) were assessed with the Pain Behaviors Scales and their motor weakness was measured with the Motricity Index. Results indicated that over 27% of patients experienced pain in at least one joint of the ipsilateral upper limb. Shoulder pain was the most common. Further analysis indicated that the occurrence of pain in the ipsilateral upper limb was higher among women, among patients who used a cane, and among patients with a greater weakness of the affected lower limb. PMID:25387036
Kwon, Yong Hyun; Kwon, Jung Won; Lee, Na Kyung; Kang, Kyung Woo; Son, Sung Min
Low Back Pain Prevalence and Associated Factors in Iranian Population: Findings from the National Health Survey
Background. There are very few studies that had a sample size sufficient to explore the association between factors related to low back pain in a representative sample of the Iranian population. Objective. To examine the relationship between sociodemographic factors, smoking, obesity, and low back pain in Iranian people. Methods. We used Iranian adults respondents (n = 25307) from the National Health Survey. Adjusted odds ratios and 95% confidence intervals were estimated by using logistic regression. Results. The prevalence of low back pain was found in 29.3% of the studied sample. High age, female sex, being married, obesity, low-economic index, being smoker, in a rural residence, and low educational attainment, all increased the odds of low back pain. Conclusions. Our findings add to the evidence on the importance of obesity in relation to low back pain. These results can be used as a basis to reinforce health programs to prevent obesity. PMID:23024861
Biglarian, Akbar; Seifi, Behjat; Bakhshi, Enayatollah; Mohammad, Kazem; Rahgozar, Mehdi; Karimlou, Masoud; Serahati, Sara
Back pain in the working population: prevalence rates in Dutch trades and professions
An analysis of three health surveys in the Dutch working population is described, aimed at the identification of Dutch trades and professions with relative high and low prevalence rates of back pain. The sample was representative of the working population in the Netherlands and consisted of 5840 men and 2908 women. The analysis included 33 trades and 34 professions, with
Prevalence of Radiographic Osteoarthritis of the Knee and Its Relationship to Self-Reported Pain
Background and Aim Osteoarthritis (OA) of the knee is one of the most common skeletal disorders, yet little data are available in Asian populations. We sought to assess the prevalence and pattern of radiographic OA of the knee, and its relationship to self-reported pain in a Vietnamese population. Methods The study was based on a sample of 170 men and 488 women aged ?40 years who were randomly sampled from the Ho Chi Minh City (Vietnam). Radiographs of the knee were graded from 0 to 4 according to the Kellgren and Lawrence scale. Osteoarthritis was defined as being present in a knee if radiographic grades of 2 or higher were detected. Knee pain and symptoms were ascertained by direct interview using a structured questionnaire. Results The point prevalence of radiographic OA of the knee was 34.2%, with women having higher rate than men (35.3% vs 31.2%). The prevalence of knee OA increased with advancing age: 8% among those aged 40–49 years, 30% in those aged 50–59 years, and 61.1% in those aged ?60 years. Greater BMI was associated with higher risk of knee OA. Self-reported knee pain was found in 35% of men and 62% of women. There was a statistically significant association between self-reported knee pain and knee OA (prevalence ratio 3.1; 95% CI 2.0 to 4.6). Conclusions These data indicate that approximately a third of Vietnamese men and women have radiographic OA in the knee, and that self-reported knee pain may be used as an indicator of knee osteoarthritis. PMID:24722559
Ho-Pham, Lan T.; Lai, Thai Q.; Mai, Linh D.; Doan, Minh C.; Pham, Hoa N.; Nguyen, Tuan V.
Gender differences in the incidence and prevalence of patellofemoral pain syndrome
The purpose of this investigation was to determine the association between gender and the prevalence and incidence of patellofemoral pain syndrome (PFPS). One thousand five hundred and twenty-five participants from the United States Naval Academy (USNA) were followed for up to 2.5 years for the development of PFPS. Physicians and certified athletic trainers documented the cases of PFPS. PFPS was defined as retropatellar pain during at least two of the following activities: ascending/descending stairs, hopping/jogging, prolonged sitting, kneeling, and squatting, negative findings on examination of knee ligament, menisci, bursa, and synovial plica, and pain on palpation of either the patellar facets or femoral condyles. Poisson and logistic regressions were performed to determine the association between gender and the incidence and prevalence of PFPS, respectively. The incidence rate for PFPS was 22/1000 person-years. Females were 2.23 times (95% CI: 1.19, 4.20) more likely to develop PFPS compared with males. While not statistically significant, the prevalence of PFPS at study enrollment tended to be higher in females (15%) than in males (12%) (P50.09). Females at the USNA are significantly more likely to develop PFPS than males. Additionally, at the time of admission to the academy, the prevalence of PFPS was not significantly different between genders. PMID:19765240
Boling, M.; Padua, D.; Marshall, S.; Guskiewicz, K.; Pyne, S.; Beutler, A.
Pain, Work-related Characteristics, and Psychosocial Factors among Computer Workers at a University Center
[Purpose] Complaint of pain is common in computer workers, encouraging the investigation of pain-related workplace factors. This study investigated the relationship among work-related characteristics, psychosocial factors, and pain among computer workers from a university center. [Subjects and Methods] Fifteen subjects (median age, 32.0?years; interquartile range, 26.8–34.5?years) were subjected to measurement of bioelectrical impedance; photogrammetry; workplace measurements; and pain complaint, quality of life, and motivation questionnaires. [Results] The low back was the most prevalent region of complaint (76.9%). The number of body regions for which subjects complained of pain was greater in the no rest breaks group, which also presented higher prevalences of neck (62.5%) and low back (100%) pain. There were also observed associations between neck complaint and quality of life; neck complaint and head protrusion; wrist complaint and shoulder angle; and use of a chair back and thoracic pain. [Conclusion] Complaint of pain was associated with no short rest breaks, no use of a chair back, poor quality of life, high head protrusion, and shoulder angle while using the mouse of a computer. PMID:24764635
Mainenti, Míriam Raquel Meira; Felicio, Lilian Ramiro; Rodrigues, Érika de Carvalho; Ribeiro da Silva, Dalila Terrinha; Vigário dos Santos, Patrícia
The prevalence of uncontrolled pain in long-term care: a pilot study examining outcomes of pain management processes.
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "The Prevalence of Uncontrolled Pain in Long-Term Care: A Pilot Study Examining Outcomes of Pain Management Processes" found on pages 33-41, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until January 31, 2018. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe barriers to inadequate pain management and opportunities to improve this process for older adults residing in long-term care. 2. Identify outcomes of inadequate pain management in older adults residing in long-term care. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Pain in long-term care (LTC) is common among older residents despite the vast options available for optimal pain management. Inadequate pain management affects individual health care outcomes. Researcher evidence has shown that nurse practitioners (NPs) improve the quality of care in LTC but are challenged by multiple barriers that inhibit optimal pain control. The purpose of the current pilot study was to explore both the pain management processes used by nurses in LTC and the documented patient outcomes that come from these processes. In addition, factors were identified that may impact the NP role in providing adequate pain control in LTC. This descriptive study used a retrospective, case-controlled research design that incorporated reviewing 55 LTC resident medical records. Results show how the process of pain management in LTC can be improved by expanding the professional role of the NP. [Journal of Gerontological Nursing, 41(2), 33-41.]. PMID:25369582
Good, Heidi; Riley-Doucet, Cheryl K; Dunn, Karen S
Knee Pain and Its Severity in Elderly Koreans: Prevalence, Risk Factors and Impact on Quality of Life
This study investigated the epidemiology (prevalence, risk factors, and impact on quality of life) of knee pain and its severity in elderly Koreans. The subjects (n=3,054) were participants aged ?50 yr from the fifth Korea National Health and Nutrition Examination Survey, conducted in 2010. Knee pain was defined as pain in the knee lasting ?30 days during the most recent 3 months; severity was categorized as mild, moderate, or severe. EQ-5D was used to measure quality of life. The prevalence of knee pain was 23.1% (11.7% in men, 31.9% in women). The prevalences of mild, moderate, and severe knee pain were 4.3%, 9.1%, and 9.7%, respectively (2.8%, 5.4%, and 3.5% in men and 5.4%, 12.0%, and 14.4% in women). Old age, female gender, a low level of education, a manual occupation, obesity, and radiographic osteoarthritis were risk factors for knee pain, and were associated with increased severity of knee pain. Excluding men with mild knee pain, people with knee pain had significantly lower quality of life than those without knee pain. Early interventional approaches are needed to reduce the medical, social, and economic burden of knee pain in elderly Koreans. PMID:24339713
Jhun, Hyung-Joon; Sung, Nak-Jeong
Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: a 2-year prospective multicentre study
Background: Persistent postoperative pain continues to be an underrecognized complication. We examined the prevalence of and risk factors for this type of pain after cardiac surgery. Methods: We enrolled patients scheduled for coronary artery bypass grafting or valve replacement, or both, from Feb. 8, 2005, to Sept. 1, 2009. Validated measures were used to assess (a) preoperative anxiety and depression, tendency to catastrophize in the face of pain, health-related quality of life and presence of persistent pain; (b) pain intensity and interference in the first postoperative week; and (c) presence and intensity of persistent postoperative pain at 3, 6, 12 and 24 months after surgery. The primary outcome was the presence of persistent postoperative pain during 24 months of follow-up. Results: A total of 1247 patients completed the preoperative assessment. Follow-up retention rates at 3 and 24 months were 84% and 78%, respectively. The prevalence of persistent postoperative pain decreased significantly over time, from 40.1% at 3 months to 22.1% at 6 months, 16.5% at 12 months and 9.5% at 24 months; the pain was rated as moderate to severe in 3.6% at 24 months. Acute postoperative pain predicted both the presence and severity of persistent postoperative pain. The more intense the pain during the first week after surgery and the more it interfered with functioning, the more likely the patients were to report persistent postoperative pain. Pre-existing persistent pain and increased preoperative anxiety also predicted the presence of persistent postoperative pain. Interpretation: Persistent postoperative pain of nonanginal origin after cardiac surgery affected a substantial proportion of the study population. Future research is needed to determine whether interventions to modify certain risk factors, such as preoperative anxiety and the severity of pain before and immediately after surgery, may help to minimize or prevent persistent postoperative pain. PMID:24566643
Choiničre, Manon; Watt-Watson, Judy; Victor, J. Charles; Baskett, Roger J.F.; Bussičres, Jean S.; Carrier, Michel; Cogan, Jennifer; Costello, Judy; Feindel, Christopher; Guertin, Marie-Claude; Racine, Mélanie; Taillefer, Marie-Christine
Work-related musculoskeletal complaints in sonologists.
The prevalence of musculoskeletal complaints of the hand and wrist, and the neck and back, in physicians who operate sonography equipment was evaluated, and associations between these complaints and various work-related and personal variables were studied. A questionnaire survey was distributed among physician sonographers (sonologists) in Italy. The relationship between work habits and musculoskeletal complaints was analyzed by logistic regression models adjusted for gender, age, and duration of work with ultrasound. A total of 2041 physician sonographers completed the questionnaire. It was found that a large proportion of the subjects regularly had work-related complaints, such as neck and back pain (NBP) (18.5%) or hand and wrist cumulative trauma disorder (HWD) (5.3%). Roughly 80% of the sonographers were currently affected, or had been affected in the past, by one or more work-related symptoms. Various work-related factors appeared to be related to musculoskeletal syndromes. The average time spent for each examination was related both to NBP and HWD. Discomfort for transducer design was the best predictor of HWD, whereas a comfortable chair and correct position of the body protected from the onset of NBP. These results support the role of ergonomic factors in the pathogenesis of both NBP and HWD in sonographers. PMID:10570504
Magnavita, N; Bevilacqua, L; Mirk, P; Fileni, A; Castellino, N
Purpose/Background: Anterior knee pain (AKP), also known as patellofemoral pain syndrome (PFPS), is believed to be common in young, active females. A prevalence rate of 25% has been commonly cited in the literature. However, this rate may be more anecdotal than empirical. The purpose of this study was to estimate the prevalence of AKP in females 18 to 35 years of age. Methods: Three cohorts of females, totaling 724 participants between 18 and 35 years of age participated in this study. The mean age of participants was 24.17 years (SD: 2.34), mean height was 165.10 cm (SD: 7.26), mean weight was 65.46 kg (SD: 14.10), and mean BMI was 23.95 kg/m2 (SD: 4.86). Participants completed the Anterior Knee Pain Questionnaire (AKPQ), a functional outcome tool developed to document symptoms of AKP and progress in patients during rehabilitation. Results: The mean score on the AKPQ for the left lower extremity was 93.38 (SD: 10.00) and 93.16 (SD: 11.37) for the right lower extremity. Using a cutoff score of 83 on the AKPQ, 85 of 724 subjects were classified as having AKP in the left lower extremity for a prevalence of 12% (95% CI = 9%-14%) while 94 subjects were classified with AKP in the right lower extremity for a prevalence of 13% (95% CI = 11%-15%). Conclusion: The estimated prevalence of AKP in this sample of 18–35 year old females of 12–13% is much less than the commonly cited value of 25%. The results may provide a better representation of subjects with AKP. Level of Evidence: 3 PMID:22893859
Curtis Bay, R.
Prevalence of low back pain in children and adolescents: a meta-analysis
Background Low back pain (LBP) is common in children and adolescents, and it is becoming a public health concern. In recent years there has been a considerable increase in research studies that examine the prevalence of LBP in this population, but studies exhibit great variability in the prevalence rates reported. The purpose of this research was to examine, by means of a meta-analytic investigation, the prevalence rates of LBP in children and adolescents. Methods Studies were located from computerized databases (ISI Web of Knowledge, MedLine, PEDro, IME, LILACS, and CINAHL) and other sources. The search period extended to April 2011. To be included in the meta-analysis, studies had to report a prevalence rate (whether point, period or lifetime prevalence) of LBP in children and/or adolescents (? 18 years old). Two independent researchers coded the moderator variables of the studies, and extracted the prevalence rates. Separate meta-analyses were carried out for the different types of prevalence in order to avoid dependence problems. In each meta-analysis, a random-effects model was assumed to carry out the statistical analyses. Results A total of 59 articles fulfilled the selection criteria. The mean point prevalence obtained from 10 studies was 0.120 (95% CI: 0.09 and 0.159). The mean period prevalence at 12 months obtained from 13 studies was 0.336 (95% CI: 0.269 and 0.410), whereas the mean period prevalence at one week obtained from six studies was 0.177 (95% CI: 0.124 and 0.247). The mean lifetime prevalence obtained from 30 studies was 0.399 (95% CI: 0.342 and 0.459). Lifetime prevalence exhibited a positive, statistically significant relationship with the mean age of the participants in the samples and with the publication year of the studies. Conclusions The most recent studies showed higher prevalence rates than the oldest ones, and studies with a better methodology exhibited higher lifetime prevalence rates than studies that were methodologically poor. Future studies should report more information regarding the definition of LBP and there is a need to improve the methodological quality of studies. PMID:23351394
A study of lifetime prevalence of anxiety and depressive disorders in patients presenting with chest pain to emergency medicine
We studied the prevalence of anxiety and depressive disorders in patients with chest pain presenting to an emergency department. Majority of the patients had coronary artery disease (CAD). Twenty-three percent of patients with chest pain had a diagnosable psychiatric disorder according to ICD-10 research criteria. Anxiety and depressive disorders were equally distributed among patients with concomitant psychiatric syndrome. The level
Krishnamachari Srinivasan; Willie Joseph
[Disability related to chronic low back pain: prevalence and associated factors].
Disability related to chronic low back pain (CLBP) is a complex and multidimensional phenomenon. The aim of the study was to identify the prevalence of disability and factors associated with disability outcome in 177 CLBP adults. Respondents were recruited from three health care service centers and answered questions from: Demographic Identification Form, Oswestry Disability Index, Chronic Pain Self-efficacy Scale, Tampa Scale Kinesiophobia, Beck Depression Inventory, and the Revised Piper Fatigue Scale. The prevalence of disability among the respondents was 65% (95% CI: 57.5 - 72.0), and disability was moderate to severe in 80.7% of them. The multiple regression model identified three factors as independently associated with disability: work situation, low self-efficacy and depression. The factors identified to be associated with disability are modifiable. Interventions such as work relocation, depression treatment and re-conceptualization of self-efficacy may have an important impact in preventing and reducing disability in chronic low back pain patients. PMID:23250253
Salvetti, Marina de Góes; Pimenta, Cibele Andrucioli de Mattos; Braga, Patrícia Emília; Corręa, Claudio Fernandes
Severely disabling chronic pain in young adults: prevalence from a population-based postal survey in North Staffordshire
Background Severely disabling chronic pain in the adult population is strongly associated with a range of negative health consequences for individuals and high health care costs, yet its prevalence in young adults is less clear. Methods All adults aged 18–25 years old registered with three general practices in North Staffordshire were invited to complete a postal questionnaire containing questions on pain within the last 6 months, pain location and duration. Severity of chronic pain was assessed by the Chronic Pain Grade. Severely disabling chronic pain was defined as pain within the last six months that had lasted for three months or more and was highly disabling-severely limiting (Grade IV). Results 858 responses from 2,389 were received (adjusted response = 37.0%). The prevalence of any pain within the previous six months was 66.9% (95%CI: 63.7%, 70.1%). Chronic pain was reported by 14.3% (95%CI: 12.0%, 16.8%) of respondents with severely disabling chronic pain affecting 3.0% (95%CI: 2.0%, 4.4%) of this population. Late responders were very similar to early responders in their prevalence of pain. Cross-checking the practice register against the electoral roll suggested register inaccuracies contributed to non-response. Conclusion Pain is a common phenomenon encountered by young adults, affecting 66.9% of this study population. Previously observed age-related trends in severely disabling chronic pain in older adults extend to younger adults. Although a small minority of younger adults are affected, they are likely to represent a group with particularly high health care needs. High levels of non-response in the present study means that these estimates should be interpreted cautiously although there was no evidence of non-response bias. PMID:16042761
Mallen, Christian; Peat, George; Thomas, Elaine; Croft, Peter
Neuropathic Pain and Psychological Morbidity in Patients with Treated Leprosy: A Cross-Sectional Prevalence Study in Mumbai
Background Neuropathic pain has been little studied in leprosy. We assessed the prevalence and clinical characteristics of neuropathic pain and the validity of the Douleur Neuropathique 4 questionnaire as a screening tool for neuropathic pain in patients with treated leprosy. The association of neuropathic pain with psychological morbidity was also evaluated. Methodology/Principal Findings Adult patients who had completed multi-drug therapy for leprosy were recruited from several Bombay Leprosy Project clinics. Clinical neurological examination, assessment of leprosy affected skin and nerves and pain evaluation were performed for all patients. Patients completed the Douleur Neuropathique 4 and the 12-item General Health Questionnaire to identify neuropathic pain and psychological morbidity. Conclusions/Significance One hundred and one patients were recruited, and 22 (21.8%) had neuropathic pain. The main sensory symptoms were numbness (86.4%), tingling (68.2%), hypoesthesia to touch (81.2%) and pinprick (72.7%). Neuropathic pain was associated with nerve enlargement and tenderness, painful skin lesions and with psychological morbidity. The Douleur Neuropathique 4 had a sensitivity of 100% and specificity of 92% in diagnosing neuropathic pain. The Douleur Neuropathique 4 is a simple tool for the screening of neuropathic pain in leprosy patients. Psychological morbidity was detected in 15% of the patients and 41% of the patients with neuropathic pain had psychological morbidity. PMID:21408111
Lasry-Levy, Estrella; Hietaharju, Aki; Pai, Vivek; Ganapati, Ramaswamy; Rice, Andrew S. C.; Haanpää, Maija; Lockwood, Diana N. J.
Evaluating anterior knee pain.
Musculoskeletal complaints account for about 20% to 30% of all primary care office visits; of these visits, discomfort in the knee, shoulder, and back are the most prevalent musculoskeletal symptoms. Having pain or dysfunction in the front part of the knee is a common presentation and reason for a patient to see a health care provider. There are a number of pathophysiological etiologies to anterior knee pain. This article describes some of the common and less common causes, and includes sections on diagnosis and treatment for each condition as well as key points. PMID:24994047
Hong, Engene; Kraft, Michael C
Expected Prevalence From the Differential Diagnosis of Anterior Knee Pain in Adolescent Female Athletes During Preparticipation Screening
Context Anterior knee pain is a common disorder in female athletes with an undefined cause. The relative prevalence of specific patellofemoral disorders associated with anterior knee pain in adolescent females remains undetermined. Objective To determine the prevalence of specific patellofemoral disorders obtained using the differential diagnosis of anterior knee pain in adolescent female athletes during preparticipation screening. Design Descriptive epidemiology study. Setting Preparticipation screening evaluations at a county public school district in Kentucky. Patients or Other Participants A total of 419 unique middle and high school–aged female athletes. Main Outcome Measure(s) Participants were evaluated by physicians for anterior knee pain over 3 consecutive basketball seasons. Given the longitudinal nature of this study, some participants were tested longitudinally over multiple years. Results Over the course of 3 basketball seasons, 688 patient evaluations were performed. Of these, 183 (26.6%) were positive for anterior knee pain. A statistically significant difference was noted in the prevalence of anterior knee pain by school level, with 34.4% (n = 67) in high school–aged athletes versus 23.5% (n = 116) in middle school–aged athletes (P < .05). In the 1376 knees evaluated, patellofemoral dysfunction was the most common diagnosis, with an overall prevalence of 7.3% (n = 100). The only diagnosis shown to be statistically different between age levels was Sinding-Larsen-Johansson disease or patellar tendinopathy, with 38 cases (9.7%) in high school–aged and 31 (3.1%) in middle school–aged athletes (P < .05). Conclusions Anterior knee pain was present in 26.6% of the adolescent female athletes screened over 3 years. Symptoms of anterior knee pain likely persist after middle school–aged onset and reach peak prevalence during the high school years. PMID:23068589
Barber Foss, Kim D.; Myer, Gregory D.; Chen, Stephen S.; Hewett, Timothy E.
Breakthrough pain in malignant and non-malignant diseases: a review of prevalence, characteristics and mechanisms
Breakthrough pain or transient worsening of pain in patients with an ongoing steady pain is a well known feature in cancer pain patients, but it is also seen in non-malignant pain conditions with involvement of nerves, muscles, bones or viscera. Continuous and intermittent pain seems to be a general feature of these different pain conditions, and this raises the possibility
Kristina B. Svendsen; Steen Andersen; Sigurdur Arnason; Staffan Arnér; Harald Breivik; Tarja Heiskanen; Eija Kalso; Ulf E. Kongsgaard; Per Sjogren; Peter Strang; Flemming W. Bach; Troels S. Jensen
Prevalence of dysmenorrhea in university students in Turkey: effect on daily activities and evaluation of different pain management methods.
This study was conducted to determine the following among a group of female university students: the prevalence of dysmenorrhea; pain severity ratings; methods used to manage dysmenorrhea; and the effect of dysmenorrhea on daily activities, school attendance, and ability to communicate with friends. This cross-sectional study was conducted between December 2009 and February 2010 at a public university located in Istanbul, in the northwest area of Turkey. The study group included 1515 female students. Data were collected from the female students in the study group using a self-report questionnaire; the severity of dysmenorrhea was determined with the visual analog scale. The data were examined with mean, percentages, chi-square analysis, and logistic regression. The prevalence of dysmenorrhea in the study group was 85.7%. Of this group of subjects with dysmenorrhea, 30.4% described their menstrual pain as severe, 49.8% as moderate, and 19.8% as mild. The mean severity of pain among the students was 6.33 ± 2.32 on the VAS. The majority of participants who experienced moderate or severe pain regularly used analgesics for pain management, and participants who experienced severe pain used analgesics before the beginning of menstruation. Participants who experienced moderate pain used herbal tea, massage, heat application, rest, and distraction for pain management. Participants who experienced severe pain consulted a physician and that a significant difference existed between the dysmenorrhea rating groups in this regard (p < .001). Severe pain was significantly associated with school absenteeism and limitations in social activities/functioning (p < .001). Dysmenorrhea is highly prevalent among university students and is related to school absenteeism, ability to participate in and enjoy daily activities, and limitations in social activities/functioning. PMID:24230963
Potur, Dilek Coskuner; Bilgin, Nevin Citak; Komurcu, Nuran
Prevalence of persistent neck and upper limb pain in a historical cohort of sewing machine operators.
Four hundred and twenty-four sewing machine operators from a historical cohort of garment industry workers answered questionnaires concerning musculoskeletal symptoms and job exposure. They were compared with 781 women from the general population of the region and an internal control group of 89 women from the garment industry. The risk for persistent neck and shoulder complaints increased with years of being a sewing machine operator: (up to seven years, eight to fifteen years, and more than fifteen years: prevalence proportion ratio 1.8, 3.5 and 4.4 [neck] and 1.5, 4 and 6.8 [shoulder] compared with the controls [n = 781]). The exposure-response relationships remained when adjusted for potential confounders, of which age, current shoulder-neck exposure, and child bearing were the most contributing. The study revealed that work for more than eight years as a sewing machine operator probably has a cumulative deleterious effect on the neck and shoulders. PMID:8311098
Andersen, J H; Gaardboe, O
Untying chronic pain: prevalence and societal burden of chronic pain stages in the general population - a cross-sectional survey
Background Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods A cross-sectional survey with 4360 people aged???14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12 months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load, were tested by Poisson and logistic regression analyses. Results 2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and 6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]). Conclusion Chronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load. PMID:24725286
Prevalence of radiological signs of femoroacetabular impingement in patients presenting with long-standing adductor-related groin pain
ObjectiveA decreased range of motion (ROM) of the hip joint is known to predispose to athletic groin injury. Femoroacetabular impingement (FAI) of the hip leads to a reduced ROM. This study examined the prevalence of radiological signs of FAI in patients presenting with long-standing adductor-related groin pain (LSARGP).DesignProspective case series.SettingOutpatient Sports Medicine Department.Patients34 athletes with LSARGP defined as pain on
A. Weir; R. J. de Vos; M. Moen; P. Holmich; J L Tol
Prevalence of Pain and Analgesic Use in Men With Metastatic Prostate Cancer Using a Patient-Reported Outcome Measure
Purpose: Contemporary tumor-directed therapies for metastatic castration-resistant prostate cancer (mCRPC) are approved to prolong life, but their effects on symptoms such as pain are less well understood as a result of the lack of analytically valid assessments of pain prevalence and severity, clinically meaningful definitions of therapeutic benefit, and methodologic standards of trial conduct. This study establishes pain characteristics in the mCRPC population using a PRO measure. Materials and Methods: Patients with prostate cancer participated in an anonymous survey at five US comprehensive cancer centers in the Prostate Cancer Clinical Trials Consortium that incorporated the Brief Pain Inventory (BPI), analgesic use, and interference with daily activities. Prevalence and severity of cancer-related pain and analgesic use were tabulated according to castration-resistant status and exposure to docetaxel chemotherapy. Results: Four hundred sixty-one patients with prostate cancer participated, of whom 147 had mCRPC involving bone (61% [89 of 147] docetaxel exposed, 39% [58 of 147] docetaxel naive). Pain of any level was more common among docetaxel-exposed versus docetaxel-naive patients with mCRPC (70% [62 of 89] v 38% [22 of 58], respectively; P < .001). BPI score ? 4 was reported by 38% (34 of 89) of docetaxel-pretreated and 24% (14 of 58) of docetaxel-naive patients with mCRPC; 40% of these patients with pain intensity ? 4 reported no current narcotic analgesic. Conclusion: Pain prevalence and severity were higher in patients with prior docetaxel exposure. Analgesics were underutilized. These results provide a method for estimating accruals along the disease continuum, and for enabling design of trials appropriately powered to assess pain. PMID:23943897
Autio, Karen A.; Bennett, Antonia V.; Jia, Xiaoyu; Fruscione, Michael; Beer, Tomasz M.; George, Daniel J.; Carducci, Michael A.; Logothetis, Christopher J.; Kane, Robert C.; Sit, Laura; Rogak, Lauren; Morris, Michael J.; Scher, Howard I.; Basch, Ethan M.
Prevalence and severity of pain in cancer patients in an outpatient palliative care setting in Saudi Arabia
Background: The prevalence and severity of cancer pain in the outpatient palliative care (PC) setting have not been explored previously in Saudi Arabia (SA). Exploration of this basic information may help in evaluating pain severity in patients new to PC as compared to those with previous PC exposure. Objective: This paper aims to determine the prevalence and severity of cancer pain among new and follow-up patients attending a PC outpatient clinic. Methods: In a PC outpatient setting in a major tertiary hospital in SA, we interviewed adult patients with cancer during their attendance to the clinic. Patients were requested to score the severity of their pain on a 0 to 10 numerical scale. Results: A total of 124 patients were interviewed, of whom 73 (59%) were females. The majority of patients (82.3%) had metastatic disease. The most common cancers were breast (27.4%) and head and neck (15.3%). The majority of patients (85.5%) reported pain, with a median intensity score of 5 and a mean of 4.6. Of those who reported pain, 54 (51%) scored above 4. The mean pain score did not differ between groups of patients according to various characteristics such as age, sex, performance status, type of cancer or encounter type. Conclusion: Pain is a prevalent symptom in new and follow-up cancer patients seen in a PC outpatient setting in SA. Further research on a larger scale is needed to evaluate the magnitude of the problem more comprehensively with emphasis on detailed pain assessment and exploration of the adopted management approaches. PMID:25320691
Al-Zahrani, Omar; Eldali, Abdelmoneim; Al-Shahri, Mohammad Zafir
Ergonomic intervention, workplace exercises and musculoskeletal complaints: a comparative study
Background: Musculoskeletal disorders are among the most prevalent occupational disorders in different jobs such as office work. Some interventions such as ergonomic modifications and workplace exercises are introduced as the methods for alleviating these disorders. In this study we compared the effect of ergonomic modifications and workplace exercises on musculoskeletal pain and discomfort in a group of office workers. Methods: In an interventional study on office workers, the effect of two interventions was compared. Ergonomic modification consisted of correcting the arrangement of workstation and changing some equipment; workplace exercises included stretching exercises focusing on neck, shoulders, low back, and hand and wrist. Musculoskeletal complaints were assessed and compared before and after 1 month interventions. Results: The frequency of musculoskeletal complaints was high before the study. Both interventions significantly reduced complaints in a similar manner except for low back pain which was reduced in exercise group more than the other group. Conclusion: In this study we found a beneficial short-term effect for both ergonomic modifications and stretching work-place exercises on reducing musculoskeletal pain in office workers. PMID:25405134
Mehrparvar, Amir Houshang; Heydari, Mohammad; Mirmohammadi, Seyyed Jalil; Mostaghaci, Mehrdad; Davari, Mohammad Hossein; Taheri, Mahmoud
A School-Based Survey of Recurrent Non-Specific Low-Back Pain Prevalence and Consequences in Children
ERIC Educational Resources Information Center
The aim of this investigation was to provide evidence of the prevalence and consequences of recurrent low-back pain in children from Northwest England. A cross-sectional survey was conducted involving a standardized questionnaire with established reliability and validity. A cross-sectional sample of 500 boys (n = 249) and girls (n = 251) aged…
Jones, M. A.; Stratton, G.; Reilly, T.; Unnithan, V. B.
Factors associated with temporomandibular disorders pain in adolescents.
To gain a better understanding of temporomandibular disorders (TMD) pain in adolescents, it is important to study the factors associated with its presence. Therefore, the aim of this study was to investigate potential predictors for TMD pain in adolescents, thereby including a diversity of factors from the biopsychosocial model to determine the strongest predictors. The sample of this cross-sectional study consisted of 1094 adolescents. The presence of TMD pain was assessed using the RDC/TMD, Axis I. Apart from demographical characteristics, the roles of parafunctional habits, psychosocial aspects, menarche and other bodily pain complaints were evaluated. Single and multiple logistic regression models were used to identify associations between the predictor variables and TMD pain. Painful TMD had a prevalence of 25·5%. Logistic regression analyses showed that TMD pain was associated with sleep bruxism (OR = 1·8 95% CI = 1·34-2·34), awake bruxism (OR = 2·1 95% CI = 1·56-2·83), other parafunctional habits (OR = 2·2 95% CI = 1·17-4·08) and bodily pain complaints (OR = 5·0 95% CI = 3·48-7·28). Parafunctional habits and other bodily pain complaints may play an important role in the presence of TMD pain in adolescents. Of course, it remains unclear whether the observed associations between the investigated factors and the adolescent's TMD pain have a true causal linkage. PMID:25244610
Fernandes, G; van Selms, M K A; Gonçalves, D A G; Lobbezoo, F; Camparis, C M
Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology
Most patients with advanced cancer develop diverse symptoms that can limit the efficacy of pain treatment and undermine their quality of life. The present study surveys symptom prevalence, etiology and severity in 593 cancer patients treated by a pain service. Non-opioid analgesics, opioids and adjuvants were administered following the WHO-guidelines for cancer pain relief. Other symptoms were systematically treated by
Thomas Meuser; Christian Pietruck; Lukas Radbruch; Petra Stute; Klaus A Lehmann; Stefan Grond
Prevalence and impact of chronic widespread pain in the Bangladeshi and White populations of Tower Hamlets, East London.
The prevalence and impact of chronic pain differ between ethnic groups. We report a study of the comparative prevalence and impact of chronic pain in Bangladeshi, British Bangladeshi and White British/Irish people. We posted a short questionnaire to a random sample of 4,480 patients registered with 16 general practices in the London Borough of Tower Hamlets and conducted a longer questionnaire with patients in the waiting areas at those practices. We distinguished between Bangladeshi participants who were born in the UK or had arrived in the UK at the age of 14 or under (British Bangladeshi) and those who arrived in UK at the age of over 14 (Bangladeshi). We obtained 1,223/4,480 (27 %) responses to the short survey and 600/637 (94 %) to the long survey. From the former, the prevalence of chronic pain in the White, British Bangladeshi and Bangladeshi groups was 55, 54 and 72 %, respectively. The corresponding figures from the long survey were 49, 45 and 70 %. Chronic widespread pain was commoner in the Bangladeshi (16 %) than in the White (10 %) or British Bangladeshi (9 %) groups. People with chronic pain experienced poorer quality of life (odds ratio for scoring best possible health vs. good health (or good vs. poor health) 5.6 (95 % confidence interval 3.4 to 9.8)), but we found no evidence of differences between ethnic groups in the impact of chronic pain on the quality of life. Chronic pain is commoner and, of greater severity, in Bangladeshis than in Whites. On most measures in this study, British Bangladeshis resembled the Whites more than the Bangladeshis. PMID:23719834
Choudhury, Yasmin; Bremner, Stephen A; Ali, Anwara; Eldridge, Sandra; Griffiths, Chris J; Hussain, Iqbal; Parsons, Suzanne; Rahman, Anisur; Underwood, Martin
Prevalence and Characteristics of Flare-ups of Chronic Non-specific Back Pain in Primary Care: A Telephone Survey
Objectives To describe the prevalence and characteristics of flare-ups of chronic non-specific back pain (CNSBP) among primary care patients, and to examine associations with measures of pain severity and psychosocial factors. Methods Six hundred and thirty-four subjects with nonspecific back pain were interviewed by telephone 2 years after an initial primary care visit for back pain. Subjects experiencing flare-ups in the last 6 months reported on frequency, duration, and other characteristics of flare-ups. Using bivariate and multivariate analyses, we compared individuals with and without CNSBP flare-ups with respect to demographic characteristics, measures of pain severity, and psychosocial factors. Results 51% of subjects reported flare-ups. Physical activities, including lifting and bending, were the most common perceived triggers of flare-ups. Subjects with flare-ups experienced greater levels of pain intensity, disability, opioid medication use, and psychosocial comorbidities. After adjustment for demographic factors, pain intensity, and pain frequency, subjects with flare-ups were more disabled than those without (mean [95% confidence interval] disability score 4.2 [3.9– 4.4] vs. 3.3 [2.9– 3.6]; p <0.0001) and demonstrated higher levels of passive coping (mean passive coping score 4.1[3.8–4.3] vs. 3.4 [3.1–3.7]; p=0.0008). Discussion Flare-ups of CNSBP are common among primary care patients, and are independently associated with higher levels of pain intensity, disability, and passive coping. The presence of flare-ups and the perception of activity as a trigger may predispose patients with flare-ups to experience disability not explained by pain intensity alone. Further longitudinal studies are required to better characterize CNSBP flare-ups and determine their clinical implications. PMID:22699128
Suri, Pradeep; Saunders, Kathleen W.; Von Korff, Michael
The Prevalence of Musculoskeletal Pain and Forward Head Posture among Heroin Users during their Withdrawal with Methadone
Background Heroin is an extremely addictive narcotic drug derived from morphine. Its continued use requires increased amounts of the drug to achieve the same effect, resulting in tolerance and addiction. This study was done in order to determine the prevalence of musculoskeletal pain and forward head posture among heroin users during their withdrawal. Methods This research was a cross-sectional study that was done on 90 heroin users (83 males, 7 females) aged between 20 to 40 years (32.5 ± 3.81) during their withdrawal in Shiraz, Iran. They were selected by simple randomized sampling. Data were collected by a form regarding age, sex, the duration of heroin use, and musculoskeletal pain. Pain was measured by VAS (visual analog scale) and forward head posture was evaluated by plumb line. Pearson correlation technique and chi-square were used for analyzing the data. Findings The results revealed that the majority of heroin users suffered from musculoskeletal pain during their withdrawal. At the end of withdrawal 53.4% had severe pain, 38.8% had moderate pain, and 7.8% of them had mild pain. Pain in the lower extremities and low back was more common than the upper extremities. The intensity of pain before withdrawal was mild, during withdrawal was moderate, and at the end was sever, but there was no significant correlation between them. The results also showed 43.3% of subjects had normal posture and 56.7% had forward posture. Conclusion According to the results, the intensity of pain increased during the withdrawal period; therefore, more attention must be paid to this complication in heroin users for better evaluation and a successful withdrawal. PMID:25140215
Kamali-Sarvestani, Fahimeh; Motiallah, Tahereh; Ghaffarinejad, Farahnaz
Prevalence of undertreatment in cancer pain. A review of published literature
Background: Pain is a major health care problem for patients with cancer: despite the existence of guidelines for cancer pain management, undertreatment is a widespread problem. Pain Management Indexes (PMIs) evaluate the congruence between the patient's reported level of pain and the intensity\\/strength of the analgesic therapy. Negative scores indicate inadequate prescriptions. Materials and methods: We conducted a Medline search
S. Deandrea; M. Montanari; L. Moja; G. Apolone
Prevalence and diagnostic distribution of medically unexplained painful somatic symptoms across 571 major depressed outpatients
Objective: To assess the prevalence and distribution of medically unexplained painful somatic symptoms (PSSs) versus nonpainful somatic symptoms (NPSSs) in patients diagnosed with major depressive episode (MDE). Method: A total of 571 outpatients diagnosed with MDE according to DSM-IV-TR criteria were consecutively enrolled into a cross-sectional, multicentric, observational study over a period of 7 months. Subjects were evaluated by means of the ad hoc validated 30-item Somatic Symptoms Checklist (SSCL-30) and Zung's questionnaires for depression and anxiety. The 32-item Hypomania Checklist (HCL-32) was also administered in order to explore any eventual association of PSSs or NPSSs with sub-threshold (DSM-IV-TR [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision] not recognized) bipolar disorder (BD). Results: In our sample, just 183 patients (32%) did not report painful somatic symptoms (NPSSs). Of these, 90 patients (15.76%) had no somatic symptoms at all. The remaining 388 (68%) had at least one PSS being subdivided as follows: 248 (43%) had one or two PSSs, while 140 (25%) experienced two or more. Patients with at least one PSS also reported a greater number of nonpainful somatic symptoms than NPSS. Bipolar patients (associated with higher HCL-32 scores) were less represented across PSS cases than NPSS subjects. Conversely, females were more prone to having a higher number of total somatic symptoms (and bipolar features). Conclusion: PSSs are common in patients with MDE, especially among those patients reporting fewer somatic symptoms in general as opposed to those patients who exhibit more somatic symptoms (both PSSs and NPSSs) with lower relative number of PSSs. A major therapeutic implication is that antidepressant monotherapy could be used with more confidence in unexplained PSS patients than in NPSS patients because of the latter group's lower frequency of (sub)-threshold bipolar features. PMID:21573083
Fornaro, Michele; Maremmani, Icro; Canonico, Pier Luigi; Carbonatto, Paolo; Mencacci, Claudio; Muscettola, Giovanni; Pani, Luca; Torta, Riccardo; Vampini, Claudio; Parazzini, Fabio; Dumitriu, Arina; Perugi, Giulio
Musculoskeletal pain in Arctic indigenous and non-indigenous adolescents, prevalence and associations with psychosocial factors: a population-based study
Background Pain is common in otherwise healthy adolescents. In recent years widespread musculoskeletal pain, in contrast to single site pain, and associating factors has been emphasized. Musculoskeletal pain has not been examined in Arctic indigenous adolescents. The aim of this study was to explore the prevalence of widespread musculoskeletal pain and its association with psychosocial factors, with emphasis on gender- and ethnic differences (Sami vs. non-Sami), and the influence of pain related functional impairment. Methods This is a cross-sectional study based on The Norwegian Arctic Adolescent Health Study; a school-based survey responded by 4,881 10th grade students (RR: 83%) in North Norway, in 2003–2005. 10% were indigenous Sami. Musculoskeletal pain was based on reported pain in the head, shoulder/neck, back and/or arm/knee/leg, measured by the number of pain sites. Linear multiple regression was used for the multivariable analyses. Results The prevalence of musculoskeletal pain was high, and significantly higher in females. In total, 22.4% reported 3–4 pain sites. We found a strong association between musculoskeletal pain sites and psychosocial problems, with a higher explained variance in those reporting pain related functional impairment and in females. There were no major differences in the prevalence of musculoskeletal pain in Sami and non-Sami, however the associating factors differed somewhat between the indigenous and non-indigenous group. The final multivariable model, for the total sample, explained 21.2% of the variance of musculoskeletal pain. Anxiety/depression symptoms was the dominant factor associated with musculoskeletal pain followed by negative life events and school-related stress. Conclusions Anxiety/depression, negative life events, and school-related stress were the most important factors associated with musculoskeletal pain, especially in those reporting pain related functional impairment. The most important sociocultural aspect is the finding that the indigenous Sami are not worse off. PMID:24939210
High prevalence of chronic pelvic pain in women in Ribeirăo Preto, Brazil and direct association with abdominal surgery
INTRODUCTION: Chronic pelvic pain is a disease that directly affects the social and professional lives of women. OBJECTIVE: To estimate the prevalence of this clinical condition and to identify independent factors associated with it in women living in Ribeirăo Preto, Brazil. METHODS: A one-year cross-sectional study was conducted in a population sample of 1,278 women over the age of 14 years. The target population was predominantly composed of women who are treated by the public health system. The questionnaire was administered by interviewers who were not linked to the city health care programs. The prevalence of the morbidity was estimated. First, we identified the significant variables associated with pelvic pain (p<0.10) and then we attributed values of 0 or 1 to the absence or presence of these variables. Logistic regression analysis was used to identify and estimate the simultaneous impact of the independent variables. The results were expressed by odds ratio and their 95% confidence interval with p<0.05. RESULTS: The disease was found in 11.5% (147/1,278) of the sample. The independent predictors were dyspareunia, previous abdominal surgery, depression, dysmenorrhea, anxiety, current sexual activity, low back pain, constipation, urinary symptoms, and low educational level. CONCLUSION: The prevalence of chronic pelvic pain in Ribeirăo Preto is high and is associated with conditions that can usually be prevented, controlled, or resolved by improvement of public health policies and public education. PMID:21915476
de Oliveira Gonçalves da Silva, Gabriela Pagano; do Nascimento, Anderson Luís; Michelazzo, Daniela; Junior, Fernando Filardi Alves; Rocha, Marcelo Gondim; Rosa-e-Silva, Júlio César; Candido-dos-Reis, Francisco José; Nogueira, Antonio Alberto; Poli-Neto, Omero Benedicto
Prevalence and individual risk factors associated with clinical lumbar instability in rice farmers with low back pain
Introduction Clinical lumbar instability (CLI) is one of the subgroups of chronic non-specific low back pain. Thai rice farmers often have poor sustained postures during a rice planting process and start their farming at an early age. However, individual associated factors of CLI are not known and have rarely been diagnosed in low back pain. This study aimed to determine the prevalence and individual associated factors of CLI in Thai rice farmers. Methods A cross-sectional survey was conducted among 323 Thai rice farmers in a rural area of Khon Kaen province, Thailand. Face-to-face interviews were conducted using the 13-item Delphi criteria questionnaire, after which an objective examination was performed using aberrant movement sign, painful catch sign, and prone instability test to obtain information. Individual factors such as sex, body mass index, waist-hip ratio, smoking, and number of years of farming experience, were recorded during the face-to-face interview. Results The prevalence of CLI in Thai rice farmers calculated by the method described in this study was 13% (age 44±10 years). Number of years of farming experience was found to be significantly correlated with the prevalence of CLI (adjusted odds ratio =2.02, 95% confidence interval =1.03–3.98, P<0.05). Conclusion This study provides prevalence of CLI in Thai rice farmers. Those with long-term farming experience of at least 30 years have a greater risk of CLI.
Puntumetakul, Rungthip; Yodchaisarn, Wantanee; Emasithi, Alongkot; Keawduangdee, Petcharat; Chatchawan, Uraiwan; Yamauchi, Junichiro
Gender differences in pain levels before and after treatment: a prospective outcomes study on 3,900 Swiss patients with musculoskeletal complaints
Background Current studies comparing musculoskeletal pain levels between the genders focus on a single point in time rather than measuring change over time. The purpose of this study is to compare pain levels between males and females before and after treatment. Methods Eleven different patient cohorts (3,900 patients) included in two prospective outcome databases collected pain data at baseline and 1?month after treatment. Treatments were either imaging-guided therapeutic injections or chiropractic therapy. The Mann–Whitney U test was used to calculate differences in numerical rating scale (NRS) median scores between the genders for both time points in all 11 cohorts. Results Females reported significantly higher baseline pain scores at 4 of the 11 sites evaluated (glenohumeral (p = 0.015), subacromial (p = 0.002), knee (p = 0.023) injections sites and chiropractic low back pain (LBP) patients (p = 0.041)). However, at 1?month after treatment there were no significant gender differences in pain scores at any of the extremity sites. Only the chiropractic LBP patients continued to show higher pain levels in females at 1?month. Conclusions In these 11 musculoskeletal sites evaluated before and after treatment, only 3 extremity sites and the chiropractic LBP patients showed significantly higher baseline pain levels in females. At 1?month after treatment only the LBP patients had significant gender differences in pain levels. Gender evaluation of change in pain over time is likely to be more clinically important than an isolated pain measurement for certain anatomical sites. PMID:23217116
Construction Workers Struggle with a High Prevalence of Mental Distress and this is Associated with Their Pain and Injuries
Objectives We aimed to investigate how mental distress was associated with pain and injuries in a convenience sample of construction workers. Methods A cross-sectional, mental health assessment was conducted in a convenience sample of construction workers (N=172). A subsample participated in a clinical interview (N=10). We used a cut-off (?1.50) on HSCL-25 to determine substantial mental distress and determined associations with pain and injury outcomes. Results The prevalence of substantial mental distress was 16 % in the workers. This was supported by follow-up clinical interviews where nine out of ten workers fulfilled the criteria for a mental disorder. Substantial mental distress was associated with both injury rate and self-reported pain. Conclusion This pilot study strongly suggests the need for rigorous studies on construction worker mental health, and how it affects their work and wellbeing. PMID:24064778
Jacobsen, Henrik Borsting; Caban-Martinez, Alberto; Onyebeke, Lynn C.; Sorensen, Glorian; Dennerlein, Jack T.; Reme, Silje Endresen
Prevalence of lower urinary tract symptoms and level of quality of life in men and women with chronic pelvic pain.
Abstract Objectives. The aim of this study was to evaluate the prevalence of lower urinary tract symptoms and quality of life in patients with chronic pelvic pain syndrome (CPPS). Materials and methods. The McGill Pain Questionnaire, Dutch Leiden/Leuven Version (MPQ-DLV), Pain Disability Index (PDI), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), Interstitial Cystitis Symptom Index (ICSI) and Pelvic Pain and Urinary/Frequency Symptom Scale (PUF) were used, based on their specific properties, to assess the symptoms and impact on the quality of life. Total scores and domains were compared for gender. Results. The studied group (N = 35; 18 male, 17 female) showed a good distribution in gender for age [Mann-Whitney U test (MW-U) p = 0.4] and body mass index (MW-U p = 0.2). The MPQ-DLV showed significantly higher scores for pain in women for Pain Rating Index - Affective (MW-U p = 0.030) and Total (MW-U p = 0.031), and Visual Analogue Scale for Pain - Most (MW-U p = 0.005). Women were less sexually active (PUF-SA) (chi-squared test p = 0.021) and had a significantly higher disability (PDI-T) (MW-U p = 0.005) and MPQ - Quality of Life (MW-U p = 0.003). The urinary symptoms showed similar results for gender (chi-squared test p > 0.05). Conclusions. A wide variety of symptoms and a negative impact on quality of life were shown. No differences in lower urinary tract symptoms were found between genders. Women were less sexually active than men. Chronic pelvic pain had a significantly higher negative impact on the level of quality of life in women than in men. PMID:25438989
Quaghebeur, Jörgen; Wyndaele, Jean-Jacques
Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study1
OBJECTIVE: to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status. METHOD: cross-sectional study with a populational sample (n=934), conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more) was measured using a numerical scale (0-10) and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor). For the statistical analysis, the absolute frequency and percentage, CI (95%), Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%. RESULTS: The prevalence of chronic pain was 52.8% [CI (95%):49.4-56.1]; most frequently located in the lower limbs (34.5%) and lumbar region (29.5%); with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001) a worse self-perception of health (OR=4.2:2.5-7.0), a greater number of chronic diseases (OR=1.8:1.2-2.7), joint disease (OR=3.5:2.4-5.1) and the female gender (OR=2.3:1.7-3.0). A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001). CONCLUSION: the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population. PMID:25296151
Pereira, Lilian Varanda; de Vasconcelos, Patrícia Pereira; Souza, Layz Alves Ferreira; Pereira, Gilberto de Araújo; Nakatani, Adélia Yaeko Kyosen; Bachion, Maria Márcia
Lower Urinary Tract Pain and Anterior Urethral Stricture Disease: Prevalence and Effects of Urethral Reconstruction
Purpose Anterior urethral stricture disease most commonly presents as urinary obstruction. Lower urinary tract pain is not commonly reported as a presenting symptom. We prospectively characterized lower urinary tract pain in association with urethral stricture disease and assessed the effects of urethroplasty on this pain. Materials and Methods Men (18 years old or older) with anterior urethral stricture disease were prospectively enrolled in a longitudinal, multi-institutional, urethral reconstruction outcomes study from June 2010 to January 2013 as part of TURNS (Trauma and Urologic Reconstruction Network of Surgeons). Preoperative and postoperative lower urinary tract pain was assessed by the validated CLSS. Voiding and sexual function was assessed using validated patient-reported measures, including I-PSS. Results Preoperatively 118 of 167 men (71%) reported urethral pain and 68 (41%) reported bladder pain. Age was the only predictor of urethral pain with men 40 years or younger reporting more pain than those 60 years old or older (81% vs 58%, p = 0.0104). Lower urinary tract pain was associated with worse quality of life and overall voiding symptoms on CLSS and I-PSS (each p <0.01). Postoperatively lower urinary tract pain completely resolved in 64% of men with urethral pain and in 73.5% with bladder pain. There were no predictive factors for changes in lower urinary tract pain after urethral reconstruction. Conclusions Lower urinary tract pain is common in urethral stricture disease, especially in younger men. It is associated with worse quality of life and voiding function. In most men lower urinary tract pain resolves after urethral reconstruction. PMID:25046621
Bertrand, Laura A.; Warren, Gareth J.; Voelzke, Bryan B.; Elliott, Sean P.; Myers, Jeremy B.; McClung, Christopher D.; Oleson, Jacob J.; Erickson, Bradley A.
High prevalence of daily and multi-site pain – a cross-sectional population-based study among 3000 Danish adolescents
Background Daily pain and multi-site pain are both associated with reduction in work ability and health-related quality of life (HRQoL) among adults. However, no population-based studies have yet investigated the prevalence of daily and multi-site pain among adolescents and how these are associated with respondent characteristics. The purpose of this study was to investigate the prevalence of self-reported daily and multi-site pain among adolescents aged 12–19 years and associations of almost daily pain and multi-site pain with respondent characteristics (sex, age, body mass index, HRQoL and sports participation). Methods A population-based cross-sectional study was conducted among 4,007 adolescents aged 12–19 years in Denmark. Adolescents answered an online questionnaire during physical education lessons. The questionnaire contained a mannequin divided into 12 regions on which the respondents indicated their current pain sites and pain frequency (rarely, monthly, weekly, more than once per week, almost daily pain), characteristics, sports participation and HRQoL measured by the EuroQoL 5D. Multivariate regression was used to calculate the odds ratio for the association between almost daily pain, multi-site pain and respondent characteristics. Results The response rate was 73.7%. A total of 2,953 adolescents (62% females) answered the questionnaire. 33.3% reported multi-site pain (pain in >1 region) while 19.8% reported almost daily pain. 61% reported current pain in at least one region with knee and back pain being the most common sites. Female sex (OR: 1.35-1.44) and a high level of sports participation (OR: 1.51-2.09) were associated with increased odds of having almost daily pain and multi-site pain. Better EQ-5D score was associated with decreased odds of having almost daily pain or multi-site pain (OR: 0.92-0.94). Conclusion In this population-based cohort of school-attending Danish adolescents, nearly two out of three reported current pain and, on average, one out of three reported pain in more than one body region. Female sex, and high level of sports participation were associated with increased odds of having almost daily pain and multi-site pain. The study highlights an important health issue that calls for investigations to improve our understanding of adolescent pain and our capacity to prevent and treat this condition. PMID:24252440
Prevalence and impact of pain among older adults in the United States: findings from the 2011 National Health and Aging Trends Study.
This study sought to determine the prevalence and impact of pain in a nationally representative sample of older adults in the United States. Data from the 2011 National Health and Aging Trends Study were analyzed. In-person interviews were conducted in 7601 adults ages ?65 years. The response rate was 71.0% and all analyses were weighted to account for the sampling design. The overall prevalence of bothersome pain in the last month was 52.9%, afflicting 18.7 million older adults in the United States. Pain did not vary across age groups (P = 0.21), and this pattern remained unchanged when accounting for cognitive performance, dementia, proxy responses, and residential care living status. Pain prevalence was higher in women and in older adults with obesity, musculoskeletal conditions, and depressive symptoms (P < 0.001). The majority (74.9%) of older adults with pain endorsed multiple sites of pain. Several measures of physical capacity, including grip strength and lower-extremity physical performance, were associated with pain and multisite pain. For example, self-reported inability to walk 3 blocks was 72% higher in participants with than without pain (adjusted prevalence ratio 1.72 [95% confidence interval 1.56-1.90]). Participants with 1, 2, 3, and ?4 sites of pain had gait speeds that were 0.01, 0.03, 0.05, and 0.08 meters per second slower, respectively, than older adults without pain, adjusting for disease burden and other potential confounders (P < 0.001). In summary, bothersome pain in the last month was reported by half of the older adult population of the United States in 2011 and was strongly associated with decreased physical function. PMID:24287107
Patel, Kushang V; Guralnik, Jack M; Dansie, Elizabeth J; Turk, Dennis C
Urine drug testing of chronic pain patients. V. Prevalence of propoxyphene following its withdrawal from the United States market.
Propoxyphene is an opioid analgesic that was surrounded by controversy concerning its safety and efficacy during its lifespan in the US market. Propoxyphene was withdrawn in November of 2010 from the US market and is still being detected one year post-withdrawal in urine specimens from the pain management population. In this study, the prevalence of propoxyphene was determined in a total of 417,914 urine specimens collected from 630 clinics involved in pain management located in 24 states during the period of January 1, 2010, through December 31, 2011. Propoxyphene and norpropoxyphene were measured in urine by a validated liquid chromatography-tandem mass spectrometry procedure with a lower limit of quantitation of 50 ng/mL. The positivity rate for propoxyphene prevalence declined sharply between November and December of 2010 and further declined at a gradual rate, ending in a prevalence of 0.27% (one out of every 370 specimens, n = 25,658) for the month of December 2011. The presented data provide evidence of the dramatic decline in the use of propoxyphene products since their removal from the medical market, and may be beneficial to US urine drug testing programs determining the need for continual monitoring of propoxyphene levels. PMID:23129731
Puet, Brandi; DePriest, Anne; Knight, Julie; Heltsley, Rebecca; Black, David L; Caplan, Yale H; Cone, Edward J
Prevalence of occupation-related pain among baristas and an examination of low back and shoulder demand during the preparation of espresso-based beverages.
Many baristas complain of low back pain (LBP) and upper extremity discomfort while at work. This study documented the prevalence of LBP and shoulder pain, via questionnaire, among a population of baristas to determine whether cumulative low back loads and shoulder moments are associated with pain reporting. Fifty-nine baristas completed the questionnaire; ten were also video-recorded for biomechanical analysis while making espresso beverages and cumulative and peak low back loads and shoulder moments were calculated. Seventy-three percent of those who completed the questionnaire reported having experienced LBP, and half attributed this pain to their job as a barista. Furthermore, 68% reported having experienced shoulder pain and half also attributed this pain to their job. Those who suffered from LBP had higher peak low back compression and those with shoulder pain had, in general, higher moments about their dominant shoulder. PMID:24837283
Dainty, R Scott; Alcorn, Eric; Ferguson, Chantelle A; Gregory, Diane E
The prevalence of post-traumatic stress disorder in chronic pain patients
Several of the more common causes of chronic pain include traumatic events such as motor vehicle accidents and workrelated\\u000a incidents. Therefore, it is not unusual for patients presenting with chronic pain to also describe significant levels of distress\\u000a including post-traumatic symptomatology and, in the more severe cases, post-traumatic stress disorder (PTSD). Throughout the\\u000a past few decades, the literature relating to
Timothy J. Sharp
A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome
Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain. PMID:16800878
Kirchhoff, Gertrud; Kirchhoff, Chlodwig; Buhmann, Sonja; Kanz, Karl-Georg; Lenz, Miriam; Vogel, Tobias; Kichhoff, Rainer Maria
Invasive stimulation of the motor (precentral) cortex using surgically implanted epidural electrodes is indicated for the treatment of neuropathic pain that is refractory to medical treatment. Controlled trials have demonstrated the efficacy of epidural motor cortex stimulation (MCS), but MCS outcome remains variable and validated criteria for selecting good candidates for implantation are lacking. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive approach that could be used as a preoperative tool to predict MCS outcome and also could serve as a therapeutic procedure in itself to treat pain disorders. This requires repeated rTMS sessions and a maintenance protocol. Other studies have also demonstrated the efficacy of transcranial direct current stimulation (tDCS) in relieving chronic pain syndromes. The most studied target is the precentral cortex, but other targets, such as the prefrontal and parietal cortices, could be of interest. The analgesic effects of cortical stimulation relate to the activation of various circuits modulating neural activities in remote structures, such as the thalamus, limbic cortex, insula, or descending inhibitory controls. In addition to the treatment of refractory neuropathic pain by epidural MCS, new developments of this type of strategy are ongoing, for other types of pain syndrome and stimulation techniques. PMID:24112914
Lefaucheur, Jean-Pascal
Prevalence of post-mastectomy pain syndrome and associated risk factors: a cross-sectional cohort study.
This study was designed to determine the prevalence of post-mastectomy pain and its associated risk factors in women submitted to surgical treatment for breast cancer. A cross-sectional cohort study was conducted involving 250 women treated surgically for breast cancer. The variables evaluated were (a) post-mastectomy pain syndrome (PMPS) (as a dependent variable or outcome) and (b) the patients' social characteristics (schooling, marital status), biological characteristics (body mass index, skin color, age), prior history of headache and dysmenorrhea, occurrence of acute postoperative pain, and type of surgery (mastectomy or quadrantectomy) (as independent or predictive variables). The prevalence ratios (PR) and their respective 95% confidence intervals (95% CI) were calculated as a measure of the risk of PMPS. Multivariate analysis was performed using a hierarchical model of stepwise logistic regression that included possible explanatory variables, calculating the adjusted risk of PMPS from the odds ratio (OR) and the 95% CI at a significance level of 5%. PMPS was found in 44.4% of patients. The variables that remained strongly associated with PMPS following multiple logistic regression analysis were quadrantectomy with axillary lymphadenectomy (OR = 2.83; 95% CI: 1.60-5.02), prior history of headache (OR = 1.92; 95% CI: 1.10-3.34), and age <50 years (OR = 4.37; 95% CI: 2.43-7.86). PMPS is a common condition, particularly in women submitted to quadrantectomy with axillary lymphadenectomy, those under 50 years of age, and those with a prior history of headache. Attention should be paid to these factors at preoperative evaluation and counseling, and they should be taken into consideration in postoperative management. PMID:24144570
de Menezes Couceiro, Tania Cursino; Valença, Marcelo Moraes; Raposo, Maria Cristina Falcăo; de Orange, Flávia Augusta; Amorim, Melania M R
Prevalence and Correlates of Sexual Dysfunction among Women with Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC)
Objectives Sexual dysfunction can contribute to reduced quality of life among women with bladder pain syndrome/interstitial cystitis (BPS/IC). We examined prevalence and correlates of general and BPS/IC-specific sexual dysfunction among women in the RAND Interstitial Cystitis Epidemiology Study (RICE) based on a probability sample survey of U.S. households. Methods We telephoned 146,231 households to identify women who reported bladder symptoms or a BPS/IC diagnosis. Those who reported either were subject to a second-stage screening using RICE high-specificity symptom criteria (pain, pressure, or discomfort in pelvic area; daytime urinary frequency 10+ times or urgency due to pain, pressure, or discomfort (not fear of wetting); pain worsens as the bladder fills; bladder symptoms did not resolve after antibiotic treatment; and never treated with hormone injections for endometriosis). Women who met RICE criteria (n = 1,469) completed measures of BPS/IC-specific and general sexual dysfunction symptoms, bladder symptom severity, general physical health, depression, medical care-seeking, and socio-demographic characteristics. Results Of those with a current sexual partner (75%), 88% reported ?1 general sexual dysfunction symptom and 90% reported ?1 BPS/IC-specific sexual dysfunction symptom in the past 4 weeks. In multivariate models, BPS/IC-specific sexual dysfunction was significantly associated with more severe BPS/IC symptoms, younger age, worse depression symptoms, and worse perceived general health. Multivariate correlates of general sexual dysfunction included non-Latino race/ethnicity, being married, and having depression symptoms. Conclusions Women with BPS/IC symptoms experience very high levels of sexual dysfunction. Sexual dysfunction covaries with symptoms. PMID:21215432
Bogart, Laura M.; Suttorp, Marika J.; Elliott, Marc N.; Clemens, J. Quentin; Berry, Sandra H.
Magnetic resonance imaging changes of sacroiliac joints in patients with recent-onset inflammatory back pain: inter-reader reliability and prevalence of abnormalities
To study the inter-reader reliability of detecting abnormalities of sacroiliac (SI) joints in patients with recent-onset inflammatory back pain by magnetic resonance imaging (MRI), and to study the prevalence of inflammation and structural changes at various sites of the SI joints. Sixty-eight patients with inflammatory back pain (at least four of the five following criteria: symptom onset before age 40,
Liesbeth Heuft-Dorenbosch; René Weijers; Robert Landewé; Sjef van der Linden; Désirée van der Heijde
Prevalence of pain and association with psychiatric symptom severity in perinatally HIV-infected children as compared to controls living in HIV-affected households
This cross-sectional study evaluated the prevalence of pain and psychiatric symptoms in perinatally HIV-infected children at entry into P1055, a multicenter investigation of the prevalence and severity of psychiatric symptoms in HIV-infected children. Subjects 6–17 years of age and their primary caregivers were recruited from 29 International Maternal Pediatric Adolescent AIDS Clinical Trials sites in the USA and Puerto Rico.
Leslie K. Serchuck; Paige L. Williams; Sharon Nachman; Kenneth D. Gadow; Miriam Chernoff; Lynnae Schwartz
Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender – a cross-sectional school study in Northern Sweden
Background Negative trends in adolescent mental and subjective health are a challenge to public health work in Sweden and worldwide. Self-reported mental and subjective health complaints such as pain, sleeping problems, anxiety, and various stress-related problems seem to have increased over time among older adolescents, especially girls. The aim of this study has therefore been to investigate perceived stress, mental and subjective health complaints among older adolescents in Northern Sweden. Methods Data were derived from a cross-sectional school-based survey with a sample consisting of 16–18?year olds (n?=?1027), boys and girls, in the first two years of upper secondary school, from different vocational and academic programmes in three public upper secondary schools in a university town in northern Sweden. Prevalence of perceived stress, subjective health complaints, general self-rated health, anxiety, and depression were measured using a questionnaire, including the Hospital Anxiety and Depression Scale (HADS). Results A large proportion of both girls and boys reported health complaints and perceived stress. There was a clear gender difference: two to three times as many girls as boys reported subjective health complaints, such as headache, tiredness and sleeping difficulties and musculoskeletal pain, as well as sadness and anxiety. High pressure and demands from school were experienced by 63.6% of girls and 38.5% of boys. Perceived stress in the form of pressure and demands correlated strongly with reported health complaints (r?=?0.71) and anxiety (r?=?0.71). Conclusions The results indicate that mental and subjective health complaints are prevalent during adolescence, especially in girls, and furthermore, that perceived stress and demands may be important explanatory factors. Future studies should pay attention to the balance between gender-related demands, perceived control and social support, particularly in the school environment, in order to prevent negative strain and stress-related ill-health. The gender gap in subjective adolescent health needs to be further explored. PMID:23158724
Chronic Abdominal Pain in Children Is Associated with High Prevalence of Abnormal Microbial Fermentation
Background Chronic abdominal pain (CAP) in children, a condition that accounts for approximately 25% of pediatric gastroenterology office\\u000a visits, may be a precursor to irritable bowel syndrome in adults. Recently, small intestinal bacterial overgrowth (SIBO) has\\u000a been reported in 78–84% of IBS patients regardless of their abdominal symptoms, compared to 20% in healthy controls.\\u000a \\u000a \\u000a \\u000a Aims The aim of this study was, therefore,
Brynie Slome Collins; Henry C. Lin
nterior knee pain (AKP) is a common complaint in primary care and orthopedic clinics. In fact, in the sports medicine clinic, up to 25% of patients with knee complaints have symptoms of anterior knee pain (1). Adolescent females and other young individuals are at particular risk for AKP. In these individuals, symptoms are usually related to increased use, fre- quently
Stephen R. Christian; M. Bret Anderson; Ronald Workman; William F. Conway; Thomas L. Pope
Physical demands of work and health complaints among women working late in pregnancy
Health complaints before, during and after pregnancy were collected from 2251 women in Montreal who had been in paid employment beyond the twenty-seventh week of their first or second pregnancy. Complaints of breathlessness, fatigue, back pain, varicose veins and haemorrhoids increased during pregnancy, the proportion of women reporting these symptoms being greatest in the third trimester. Complaints at this stage
Determining zolpidem compliance: urinary metabolite detection and prevalence in chronic pain patients.
Zolpidem (Ambien(®)) is the most prescribed insomnia treatment in the USA; however, little is known about zolpidem metabolite excretion in chronic pain patients. As zolpidem is extensively metabolized in vivo to zolpidem 4-phenyl carboxylic acid (ZCA), metabolite detection may provide improved accuracy for compliance determinations, thereby improving clinical decisions. Zolpidem and ZCA were extracted from 1 mL human urine by mixed-mode solid-phase extraction. Samples were analyzed by LC-MS-MS using positive electrospray ionization with multiple reaction monitoring mode employed for detection and quantification. Gradient chromatographic separation was achieved with a reversed-phase column in a rapid 1.8 min analysis. The assay was linear from 4 to 1,000 µg/L for zolpidem and 4 to 10,000 µg/L for ZCA. Interday recovery (bias) and imprecision (n = 20) were 100-107% of target and 2.4-3.7% relative standard deviation, respectively. Extraction efficiencies were 78-90%. Pain compliance samples (n = 3,142) were de-identified and analyzed for zolpidem and ZCA. Zolpidem was detected greater than limit of quantification in 720 specimens (22.9%), while ZCA was detected in 1,579 specimens (50.3%). Only five specimens contained zolpidem alone. ZCA was observed without parent zolpidem in 864 specimens, thereby increasing population detection rates by 27.5%. Addition of a zolpidem metabolite to compliance determinations substantially improved detection for zolpidem intake and also should prove useful in clinical and forensic settings. PMID:25217539
Schwope, David M; DePriest, Anne; Black, David L; Caplan, Yale H; Cone, Edward J; Heltsley, Rebecca
Back pain and sciatica are common health complaints. Almost everyone has back pain at some time in their life. Most of ... DANGER SIGNS AND BACK PAIN Both you and your doctor may be worried that something serious is causing your low back pain. Could your ...
Prevalence of low back pain experienced after delivery with and without epidural analgesia: A non-randomised prospective direct and telephonic survey
Background and Aims: The most frequent concern of patients receiving epidural analgesia for labour pain relief is post-partum back pain. This survey was designed to assess the prevalence of post-partum backache with and without epidural analgesia among post-partum women. Methods: The study was conducted at a university teaching hospital and women presenting to labour room for labour and delivery formed the target population. A total of 482 women were recruited during the study period. Response rate was 95.4% and these cases were included in our statistical analysis. Two forms were designed for data collection before and after delivery; form I was filled by one of the investigators while form II was filled by a research assistant to prevent bias which included follow-up of back pain. The primary outcome variable was backache quantified with visual analogue scale score. Out of 460 women, 230 women received epidural analgesia for labour and 230 women had not. Results: The prevalence of post-partum back pain in epidural analgesia versus non epidural analgesia groups was 40.9% versus 40% on day one and 32.2% versus 35.2% after 1 week. However, after one and 3rd months follow-up, backache prevalence was less in epidural analgesia group (unadjusted odds ratio [OR]: 0.63; 95% confidence interval [CI]: 0.39-0.99) and (unadjustedd OR: 0.32; 95% CI: 0.15-0.69) respectively. The adjusted odd ratio was 0.59 at 1st month and 0.25 at 3rd month. There was no significant difference between the two groups in pain scores. Conclusion: There was no association between the epidural analgesia and post-partum back pain PMID:24963177
Abbasi, Shemila; Hamid, M; Ahmed, Z; Nawaz, Fauzia Haq
The effect of education on decreasing the prevalence and severity of neck and shoulder pain: a longitudinal study in Korean male adolescents
Background Neck and shoulder pain is fairly common among adolescents in Korea and results in significant health problem. The aims of this prospective study was to identify the effects of education, in terms of recognition of this issue and posture correction, on prevalence and severity of neck and shoulder pain in Korean adolescents. Methods A prospective, observational cohort design was used. The 912 students from two academic high schools in the city of Seoul were eligible for the current study and 887 completed this study. After a baseline cross-sectional survey, students listened to a lecture about cervical health, focusing on good posture, habits, and stretching exercises to protect the spine, and were encouraged by their teachers to keep the appropriate position. And follow-ups were conducted 3 months later, to evaluate the effect of education. Results The prevalence of neck and shoulder pain was decreased 19.5% (from 82.5 to 66.4%). The baseline mean usual and worst numeric rating scale were 19.9/100 (95% CI, 18.1-21.7) and 31.2/100 (95% CI, 28.7-33.2), respectively. On the follow-up survey, the mean usual and worst numeric rating scale were decreased significantly by 24.1 and 21.7%, respectively, compared with baseline (P < 0.01). Of the 570 students reporting neck and shoulder pain, 16.4% responded that they had experienced improvement during the 3 months. Conclusions Education; recognition of this issue and posture correction, for cervical health appeared to be effective in decreasing the prevalence and severity of neck and shoulder pain at a 3 month follow-up. PMID:25301193
Koh, Min Jung; Park, Eun Jung; Park, Sang Hoon; Jeon, Hea Rim; Kim, Mun-Gyu; Lee, Se-Jin; Kim, Sang Ho; Ok, Si Young; Kim, Soon Im
Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain.
Diastasis recti abdominis (DRA) is an impairment characterized by a midline separation of the rectus abdominis muscles along the linea alba. It has its onset during pregnancy and the first weeks following childbirth. There is scant knowledge on both prevalence and risk factors for development of the condition. The aim of this study was to investigate the prevalence of DRA at gestational week 35 and three timepoints postpartum, possible risk factors, and the relationship between DRA and lumbo-pelvic pain. Ultrasound images of inter rectus distance (IRD) were recorded in 84 healthy primiparous women, at three locations on the linea alba. The IRD was measured at: gestational week 35 and 6-8, 12-14, and 24-26 weeks postpartum. Diagnosis of DRA was defined as 16 mm at 2 cm below the umbilicus. Independent sample t-test and binary logistic regression was used to assess differences and risk factors in women with and without DRA and women with and without lumbo-pelvic pain. P < 0.05 was considered statistically significant. The prevalence of DRA decreased from 100% at gestational week 35-39% at 6 months postpartum. No statistically significant differences were found in prepregnancy body mass index (BMI), weight gain, baby's birth weight or abdominal circumference between women with and without DRA at 6 months postpartum. Women with DRA at 6 months postpartum were not more likely to report lumbo-pelvic pain than women without DRA. DRA is prevalent at 6 months postpartum, but is not linked with lumbo-pelvic pain. PMID:25282439
Mota, Patrícia Gonçalves Fernandes da; Pascoal, Augusto Gil Brites Andrade; Carita, Ana Isabel Andrade Dinis; Bř, Kari
Prevalence and factors associated with neck, shoulder and low back pains among medical students in a Malaysian Medical College
Background The main purpose of the study was to assess the prevalence, body distributions and factors associated with musculoskeletal pain (MSP) among medical students in a private Malaysian medical college. Method This cross-sectional study was conducted among 232 medical students in a private medical college using an online questionnaire. The questionnaire was a modified Standardized Nordic Questionnaire focused on neck, shoulder and low back pain in the past week and the past year. Results Two hundred and thirty two medical students responded to the questionnaire out of 642. Mean age was 20.7?±?2.1 years. The majority were female (62.9%), Malay (80.6%) and in the preclinical years (72%). One hundred and six (45.7%) of all students had at least one site of MSP in the past week and 151 (65.1%) had at least one site of MSP in the past year. MSP in the past week was associated significantly with the academic year, (OR 2.0, 95% CI 1.15-3.67, P?=?0.015), history of trauma (OR 2.6, 95% CI 1.2-5.3, P?=?0.011), family history of MSP (OR 2.1, 95% CI 1.1-3.9, P?=?0.023) and Body Mass Index (BMI) (P?=?0.028). MSP in the past year was significantly associated with computer use (P?=?0.027), daily hours of computer use (median?±?IQR (5.0 ±3.0), history of trauma (OR 7.5, 95% CI 2.24-2.56, P?0.01) and family history of MSP (OR 2.5, 95% CI 1.31-4.90, P?=?0.006). On multivariate analysis, factors associated with MSP during the past week were a family history of MSP (p?=?0.029) and BMI (p?=?0.03). Factors associated with MSP during the past year were being in clinical years (p?=?0.002, computer use (p?=?0.038), and a history of trauma (p?=?0.030). Conclusion MSP among medical students was relatively high, thus, further clinical assessment is needed in depth study of ergonomics. The study results indicate that medical school authorities should take measures to prevent MSP due to factors related to medical school. Students should make aware of importance of weight reduction to reduce MSP. PMID:23815853
Persistent of Neck/Shoulder Pain among Computer Office Workers with Specific Attention to Pain Expectation, Somatization Tendency, and Beliefs
Background: Neck and shoulder pains are the prevalent complaints among computer office workers. The purpose of this study was to assess the relationship of somatization tendency, expectation of pain, mental health and beliefs about causation of pain with persistence of neck/shoulder pains among computer office workers. Methods: This research is a kind of prospective cohort study with 1-year follow-up. It has done among all eligible computer office workers of Shahroud universities (n = 182) in 2008-2009 and 1-year later. Data were collected using the Cultural and Psychosocial Influences on Disability questionnaire. Multiple logistic regression analysis was used to analyze the data through SPSS (P < 0.05). Results: At the baseline 100 (54.9%) of participants reported neck/shoulder pains and at follow-up 34.3% of them reported persistence pains. Significant relationships were found between persistence of neck/shoulder pains and negative expectation about pain in next 1-year P = 0.002, (odds ratio [OR] =8.3, 95% confidence interval [CI]: 2.1-32.9) and somatization tendency P = 0.01, (OR = 6.5, 95% CI: 1.6-27.4). Conclusions: Pain expectation and somatization tendency recognized as associated risk factors of persistent neck/shoulder pain among computer operators. This confirmed some other similar studies on work-related musculoskeletal disorders in Europe countries in recent years. PMID:25317301
Sadeghian, Farideh; Raei, Mehdi; Amiri, Mohammad
Internet Fraud Complaint Center
NSDL National Science Digital Library
The Internet Fraud Complaint Center was created by Federal Bureau of Investigation (FBI) and the National White Collar Crime Center (NW3C) to "combat the growing problem of fraud occurring over the Internet by providing a vehicle for victims around the country to report incidents of fraud online." The IFCC allows cooperation between private citizens and law enforcement agencies in order to track and prosecute fraudulent Internet practices. Users provide details on specific cases of Internet fraud, and each complaint is carefully reviewed and referred to a law enforcement or regulatory agency for further investigation. Along with the complaint form, the site also contains basic information about the IFCC. Two valuable resources, Internet Fraud Statistics and the Flow Chart of the Complaint Data Path, will be added soon.
Prevalence of "Red Flags" Among the Internet User with Low Back Pain Seeking Information on Spinal Health-A Web Survey.
Abstract Background: In early management of low back pain (LBP) the identification of "red flags" (RFs) plays an important role, as this condition is highly prevalent, and advanced treatment would not be feasible in every case. These alarm signs are designed to detect serious causes requiring prompt interventions, such as malignancy, fracture, inflammation, or cauda equina syndrome. Although their predictive value has been questioned, they are commonly used in clinical practice. The use of RFs in Web applications has never been evaluated before. In theory, they should reduce risks related to online counseling on LBP, screening for possible potentially serious underlying conditions based on relatively simple questionnaires. This study was designed to assess the prevalence of RFs among Internet users with LBP seeking information about spinal disorders. Materials and Methods: Of 2,471 respondents who completed the RF questionnaire, 2,349 entries were used for analysis. Of another 1,959 respondents who completed the additional questionnaire containing the Oswestry Disability Scale, data from 1,850 were included in the study. Results: The majority of subjects (68.16%) reported at least one RF. The most prevalent RF was a foot weakness; the least prevalent was unexplained weight loss. Pain intensity was a significant risk factor for presence of at least one RF. Conclusions: The results show that RFs are highly prevalent and that most likely the negative predictive value of RFs will be low. Unfortunately, considering the nature of this study it was impossible to evaluate their sensitivity and specificity. In conclusion, although RFs are highly prevalent in the population studied, simple screening should be mandatory in all Web sites providing information on spinal health. Further research should be undertaken to optimize RFs. PMID:25453719
Miekisiak, Grzegorz; Latka, Dariusz; Sobolewski, Tomasz; Sulewski, Adam; Kubaszewski, Lukasz; Kaczmarczyk, Jacek
Scrotal pain: Evaluation and management
Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete history and physical examination. This article discusses the evaluation and management of several entities of scrotal pain, including testicular torsion, epididymitis, postvasectomy pain, varicocele, and chronic orchialgia.
Gordhan, Chirag G
NSDL National Science Digital Library
You may have heard about a "chorus of complaints" as a phrase in a magazine article, casual conversation, or as a bit of acerbic social commentary. Well, it is now a very real cultural phenomenon which is documented on this website. The idea behind the Complaints Choirs movement is that a group of people can get together to voice their complaints, and put them to song. They are creating a real choir of complaints, and the movement has become a worldwide success. On the homepage, visitors can use the "do-it" section to learn about how the process works, and they will find that it is relatively easy. The site also contains a "News" area, a bit of "History", and a number of video clips of these complaint choirs in action. The "Choir" area is perhaps the best place to look for authoritative information on past performances, and the "Files" area contains high-resolution photographs of the choirs doing what they do best. As a piece of irreverent social and collective gathering, these choirs may catch the interest of sociologists, musicologists, and scholars of public culture.
Prevalence and influencing factors of chronic back pain among staff at special schools with multiple and severely handicapped children in Germany: results of a cross-sectional study
Background In Germany, about 70,000 teachers and educational staff were teaching at more than 3,000 special schools during the school year 2010/2011. Nursing services like lifting pupils form a substantial part of the work content of the staff at special schools. Since nursing care often involves carrying and lifting pupils, there is a reason to assume an adverse effect on the musculoskeletal health of teachers and other professionals. With the present study we aimed to describe the prevalence and risk factors of chronic back pain among employees at this type of school. Methods The cross-sectional survey was carried out between August 2010 and August 2012 at 13 special schools focusing on motoric and/or holistic development of handicapped children in Rhineland-Palatinate (Germany). Teachers and educational staff were interviewed using a questionnaire. We applied multivariable logistic regression analyses to identify influencing factors of chronic back pain. Results Altogether 395 persons (response rate: 59.7%) participated in our study. Respondents were mostly female (86.8%) with a mean age of 45 years. The prevalence of chronic back pain was 38.7%. More than 40% reported frequently carrying and lifting heavy loads (>20 kg). Age [adjusted OR?=?1.03 (95%-CI 1.00-1.05) for 1-year increase in age], current smoking [adjusted OR?=?2.31 (95%-CI 1.27-4.23)], depression/depressive mood [adjusted OR?=?1.85 (95%-CI 1.12-3.06)], frequently carrying and lifting heavy loads [adjusted OR?=?2.69 (95%-CI 1.53-4.75)], and frequent exposure to environmental impacts [adjusted OR?=?2.18 (95%-CI 1.26-3.76)] were influencing factors of chronic back pain in the final multivariable regression model. Conclusions A large proportion of teachers and educational staff suffered from chronic back pain in our study, indicating a high need for treatment in this professional group. Increasing age, current smoking, a diagnosed depression/depressive mood, carrying and lifting heavy loads, and exposure to environmental impacts were associated with chronic back pain. Due to the sparse literature on the topic, further studies using a longitudinal design are necessary for a better understanding of the risk factors of chronic back pain. PMID:24568286
The dosing frequency of sustained-release opioids and the prevalence of end-of-dose failure in cancer pain control: a Korean multicenter study
Background End-of-dose failure is commonly observed as therapeutic levels of sustained-release opioids fall. However, little is known\\u000a about using these medications for cancer pain control. To determine the dosing frequency of sustained-release opioids (morphine,\\u000a oxycodone, and transdermal fentanyl) and the prevalence of end-of-dose failure in clinical practice, a patient-reported survey\\u000a was performed.\\u000a \\u000a \\u000a \\u000a \\u000a Methods A multicenter survey was conducted in 56 hospitals in
Do-Yeun Kim; Hong-Suk Song; Jin-Seok Ahn; Baek-Yeol Ryoo; Dong-Bok Shin; Chang-Yeol Yim; Si-Young Kim
The association between exposure to a rear-end collision and future health complaints
Different symptoms, together with neck pain, have been attributed to persons with persistent complaints after a previous motor vehicle crash (MVC) and are sometimes referred to as the "late whiplash syndrome." A cohort study was conducted to determine whether exposure to a rear-end collision, with or without whiplash injury, is associated with future health complaints. The results regarding future neck
Anita Berglund; Lars Alfredsson; Irene Jensen; J. David Cassidy; Ĺke Nygren
Clinical use of opioids for cancer pain
Successful management of pain in the cancer patient requires careful assessment of the components of the pain complaint and\\u000a accurate diagnosis of the cause of pain. Symptomatic management of pain involves pharmacotherapeutic strategies that focus\\u000a on opioid use. Factors influencing the choice of opioid in patients with cancer pain include the severity of pain, the presence\\u000a of coexisting disease, response
Dermot R. Fitzgibbon
The sacroiliac joint is a source of pain in the lower back and buttocks in approximately 15% of the population. Diagnosing sacroiliac joint-mediated pain is difficult because the presenting complaints are similar to those of other causes of back pain. Patients with sacroiliac joint-mediated pain rarely report pain above L5; most localize their pain to the area around the posterior superior iliac spine. Radiographic and laboratory tests primarily help exclude other sources of low back pain. Magnetic resonance imaging, computed tomography, and bone scans of the sacroiliac joint cannot reliably determine whether the joint is the source of the pain. Controlled analgesic injections of the sacroiliac joint are the most important tool in the diagnosis. Treatment modalities include medications, physical therapy, bracing, manual therapy, injections, radiofrequency denervation, and arthrodesis; however, no published prospective data compare the efficacy of these modalities. PMID:15473677
Dreyfuss, Paul; Dreyer, Susan J; Cole, Andrew; Mayo, Keith
Effects of bariatric surgery for knee complaints in (morbidly) obese adult patients: a systematic review.
Obesity is a major risk factor for the development of knee osteoarthritis, and over the past 30 years the prevalence of obesity has more than doubled. In an advanced-stage knee osteoarthritis is treated with total knee arthroplasty, and the demand for primary total knee arthroplasties is expected to grow exponentially. However, total knee arthroplasty in obese patients is associated with more complications, longer hospital stay and higher costs. We aimed to determine the effects of bariatric surgery on knee complaints in (morbidly) obese (body mass index >30?kg?m(-2) ) adult patients. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, TRIP, BIOSIS-Previews and reference lists of retrieved publications were systematically searched from earliest available up to 20 April?2014 for any English, German, French and Dutch studies. There was no restriction on study design. We included studies on the effect of surgically induced weight reduction on knee complaints in (morbidly) obese adult patients, with a minimal follow-up of 3 months. Studies on the effects of lipectomy or liposuction and studies in which patients had already received a total knee arthroplasty were excluded. Thirteen studies were included in this systematic review with a total of 3,837 patients. Although different assessment tools were used, an overall significant improvement in knee pain was seen in 73% out of the used assessments. All studies measuring intensity of knee pain, knee physical function and knee stiffness showed a significant improvement after bariatric surgery. The quality of evidence was very low or too low for most of the included studies and moderate for one study. Bariatric surgery with subsequent marked weight loss is likely to improve knee pain, physical function and stiffness in (morbidly) obese adult patients. However, with the current available evidence, there is need for high-quality studies. PMID:25487972
Groen, V A; van de Graaf, V A; Scholtes, V A B; Sprague, S; van Wagensveld, B A; Poolman, R W
Effectiveness of behavioural graded activity compared with physiotherapy treatment in chronic neck pain: design of a randomised clinical trial [ISRCTN88733332
Background Chronic neck pain is a common complaint in the Netherlands with a point prevalence of 14.3%. Patients with chronic neck pain are often referred to a physiotherapist and, although many treatments are available, it remains unclear which type of treatment is to be preferred. The objective of this article is to present the design of a randomised clinical trial, Ephysion, which examines the clinical and cost effectiveness of behavioural graded activity compared with a physiotherapy treatment for patients with chronic non-specific neck pain. Methods Eligible patients with non-specific neck pain persisting longer than 3 months will be randomly allocated to either the behavioural graded activity programme or to the physiotherapy treatment. The graded activity programme is based on an operant approach, which uses a time-contingent method to increase the patient's activity level. This treatment is compared with physiotherapy treatment using a pain-contingent method. Primary treatment outcome is the patient's global perceived effect concerning recovery from the complaint. Global perceived effect on daily functioning is also explored as primary outcome to establish the impact of treatment on daily activity. Direct and indirect costs will also be assessed. Secondary outcomes include the patient's main complaints, pain intensity, medical consumption, functional status, quality of life, and psychological variables. Recruitment of patients will take place up to the end of the year 2004 and follow-up measurement will continue until end 2005. PMID:15469609
Vonk, Frieke; Verhagen, Arianne P; Geilen, Mario; Vos, Cees J; Koes, Bart W
Determinants of the clinical course of musculoskeletal complaints in general practice: design of a cohort study
Background Musculoskeletal complaints are frequent and have large consequences for public health. Information about the prognosis after presentation in general practice is far from complete. Knowledge about determinants of the clinical course of musculoskeletal complaints is essential for management decisions and to inform patients about their prognosis. The purpose of this study is to provide information about the prognosis of musculoskeletal complaints other than low back pain by studying the course of these complaints in general practice and to identify determinants of this course. Methods Patients of 18 years and older, who present in general practice with a new episode of a musculoskeletal complaint of the neck, shoulder, elbow, wrist, hand, arm, hip, knee, ankle or foot, are recruited by their general practitioner (GP). Participants will receive complaint-specific questionnaires by mail at baseline and after 3, 6, 12 and 18 months. The following putative determinants of the course of the complaints will be investigated: sociodemographic characteristics, characteristics of the complaint, psychosocial job characteristics, physical workload, physical activity during leisure time, pain coping, mood, kinesiophobia, social support, optimism. The primary outcomes are perceived recovery, pain, functional status, sick leave and overall quality of life. PMID:12600275
van der Waal, Johanna M; Bot, Sandra DM; Terwee, Caroline B; van der Windt, Daniëlle AWM; Bouter, Lex M; Dekker, Joost
Time to Talk: 4 Things to Know about Spinal Manipulation for Low-Back Pain
... Things To Know About Spinal Manipulation for Low-Back Pain Back pain is one of the most common health complaints, ... medical doctors with a goal of relieving low-back pain and improving physical functioning. These health professionals perform ...
Magnetic resonance imaging changes of sacroiliac joints in patients with recent-onset inflammatory back pain: inter-reader reliability and prevalence of abnormalities.
To study the inter-reader reliability of detecting abnormalities of sacroiliac (SI) joints in patients with recent-onset inflammatory back pain by magnetic resonance imaging (MRI), and to study the prevalence of inflammation and structural changes at various sites of the SI joints. Sixty-eight patients with inflammatory back pain (at least four of the five following criteria: symptom onset before age 40, insidious onset, morning stiffness, duration >3 months, improvement with exercise--or three out of five of these plus night pain) were included (38% male; mean age, 34.9 years [standard deviation 10.3]; 46% HLA-B27-positive; mean symptom duration, 18 months), with symptom duration <2 years. A MRI scan of the SI joints was made in the coronal plane with the following sequences: T1-weighted spin echo, short-tau inversion recovery, T2-weighted fast-spin echo with fat saturation, and T1-spin echo with fat saturation after the administration of gadolinium. Both SI joints were scored for inflammation (separately for subchondral bone and bone marrow, joint space, joint capsule, ligaments) as well as for structural changes (erosions, sclerosis, ankylosis), by two observers independently. Agreement between the two readers was analysed by concordance and discordance rates and by kappa statistics. Inflammation was present in 32 SI joints of 22 patients, most frequently located in bone marrow and/or subchondral bone (29 joints in 21 patients). Readers agreed on the presence of inflammation in 85% of the cases in the right SI joint and in 78% of the cases in the left SI joint. Structural changes on MRI were present in 11 patients. Ten of these 11 patients also showed signs of inflammation. Agreement on the presence or absence of inflammation and structural changes of SI joints by MRI was acceptable, and was sufficiently high to be useful in ascertaining inflammatory and structural changes due to sacroiliitis. About one-third of patients with recent-onset inflammatory back pain show inflammation, and about one-sixth show structural changes in at least one SI joint. PMID:16356197
Heuft-Dorenbosch, Liesbeth; Weijers, René; Landewé, Robert; van der Linden, Sjef; van der Heijde, Désirée
Magnetic resonance imaging changes of sacroiliac joints in patients with recent-onset inflammatory back pain: inter-reader reliability and prevalence of abnormalities
To study the inter-reader reliability of detecting abnormalities of sacroiliac (SI) joints in patients with recent-onset inflammatory back pain by magnetic resonance imaging (MRI), and to study the prevalence of inflammation and structural changes at various sites of the SI joints. Sixty-eight patients with inflammatory back pain (at least four of the five following criteria: symptom onset before age 40, insidious onset, morning stiffness, duration >3 months, improvement with exercise — or three out of five of these plus night pain) were included (38% male; mean age, 34.9 years [standard deviation 10.3]; 46% HLA-B27-positive; mean symptom duration, 18 months), with symptom duration <2 years. A MRI scan of the SI joints was made in the coronal plane with the following sequences: T1-weighted spin echo, short-tau inversion recovery, T2-weighted fast-spin echo with fat saturation, and T1-spin echo with fat saturation after the administration of gadolinium. Both SI joints were scored for inflammation (separately for subchondral bone and bone marrow, joint space, joint capsule, ligaments) as well as for structural changes (erosions, sclerosis, ankylosis), by two observers independently. Agreement between the two readers was analysed by concordance and discordance rates and by kappa statistics. Inflammation was present in 32 SI joints of 22 patients, most frequently located in bone marrow and/or subchondral bone (29 joints in 21 patients). Readers agreed on the presence of inflammation in 85% of the cases in the right SI joint and in 78% of the cases in the left SI joint. Structural changes on MRI were present in 11 patients. Ten of these 11 patients also showed signs of inflammation. Agreement on the presence or absence of inflammation and structural changes of SI joints by MRI was acceptable, and was sufficiently high to be useful in ascertaining inflammatory and structural changes due to sacroiliitis. About one-third of patients with recent-onset inflammatory back pain show inflammation, and about one-sixth show structural changes in at least one SI joint. PMID:16356197
Heuft-Dorenbosch, Liesbeth; Weijers, René; Landewé, Robert; van der Linden, Sjef; van der Heijde, Désirée
29 CFR 30.11 - Complaint procedure.
Code of Federal Regulations, 2010 CFR
...true Complaint procedure. 30.11 ...§ 30.11 Complaint procedure. (a) Filing...equal opportunity standards with respect...followed in the operation of an apprenticeship...representative, file a complaint with the...
47 CFR 8.12 - Formal complaints.
Code of Federal Regulations, 2012 CFR
...complaints. 8.12 Section 8.12 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.12 Formal complaints. Any person may file a formal complaint alleging a violation of the rules in this...
47 CFR 8.12 - Formal complaints.
Code of Federal Regulations, 2013 CFR
...complaints. 8.12 Section 8.12 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.12 Formal complaints. Any person may file a formal complaint alleging a violation of the rules in this...
47 CFR 8.12 - Formal Complaints.
Code of Federal Regulations, 2011 CFR
...Complaints. 8.12 Section 8.12 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.12 Formal Complaints. Any person may file a formal complaint alleging a violation of the rules in this...
How Does the General Population Treat Their Pain? A Survey in Catalonia, Spain
Several epidemiological studies have shown that pain is a very common complaint in patients who seek medical care. However, the characteristics of how pain is treated in the general population have been studied less. The present survey was conducted to describe and analyze how the general population of Catalonia (Spain) approaches the treatment of their pain complaints. The study was
Antňnia Bassols; Fčlix Bosch; Josep-Eladi Bańos
The application of a classification-tree model for predicting low back pain prevalence among hospital staff.
Low back pain (LBP) is a widespread musculoskeletal condition that frequently occurs in the working-age population (including hospital staff). This study proposes a classification-tree model to predict LBP risk levels in Sacré-Cśur Hospital, Lebanon (as a case study-236 chosen staffs) using various predictor individual and occupational factors. The developed tree model explained 80% of variance in LBP risk levels using standing hours/day (90% in relative importance), job status/sitting hours per day (80% each), body mass index (71%), working days/week (63%), domestic activity hours/week (36%), weight (35%), job dissatisfaction/sitting on ergonomic chairs (30% each), height (28%), gender (27%), sufficient break time (26%), using handling techniques/age (25% each), job stress (24%), marital status/wearing orthopedic insoles/extra professional activity (22% each), practicing prevention measures (20%), children care hours/week (16%), and type of sport activity/sports hours per week, car sitting, and fear of changing work due to LBP (15% each). The overall accuracy of this predictive tree once compared with actual subjects was estimated to be 77%. The proposed tree model can be used by expert physicians in their decision-making for LBP diagnosis among hospital staff. PMID:23566320
Mendelek, Fady; Caby, Isabelle; Pelayo, Patrick; Kheir, Rania Bou
[Osteoarticular pains as early manifestation of malignancies in children].
Based on the rewiew of the literature and own clinical observations, we presented examples of the most common pediatric onco-hematologic malignancies, that are manifested early by osteoarticular complaints. When these complaints predominate in the clinical presentation, they lead the diagnosis towards nonmalignant conditions, that are most common cause of such symptoms in children, like injuries, nonspecific reactive arthritis or inflammatory connective tissue diseases. However, in acute lymphoblastic leukaemia, the most prevalent childhood malignancy, bone and joint pains are present early in 40-60% of cases and they frequently anticipate any abnormalities in complete blood counts. Findings reported in the literature and own observations indicate that these complaints correlate with: lower white cell counts, lower percentage of blast cells in the peripheral blood and lower incidence of organomegaly - that may delay the decision of bone marrow aspiration. In our study we have also presented 4 cases of other malignancies in children, who were complaining of the osteoarticular pains, that limited they activity, long time before the beginning of treatment in Department of Oncology and Pediatric Hematology of University's Pediatric Hospital in Cracow. Long-lasting and intensive osteoarticular complains, that restraint normal activity and do not resolve during rest, spinal compression symptoms, coexisting adenopathy, hepatosplenomegaly, weight loss, change of behaviour, unexplicained fever must be recognized as specific "red flags". Oncologic vigilance must be inspired by discreet hematological abnormalites (like increased anemia, lower white cell counts with lymphocytosis, mild thrombocytopenia) -that indicate bone marrow infiltration, as well as high erythrocyte sedimentation rate, accompanied by moderately elevated C-reactive protein - characteristic for malignancy. Basic and commonly accessible radiological imaging may provide valuable information, because it can reveal tumors, osteolytic lesions or destruction of bone architecture. Laboratory tests of lactate dehydrogenase (LDH) and uric acid level, often raised in malignancies are also helpful. The aim of this study was to focus the attention of pediatricians to the necessity of including malignancy in the differential diagnosis of intensive or unexplained osteoarticular complaints. PMID:19485254
Cwikli?ska, Magdalena; Balwierz, Walentyna
Prevalence of narcotic bowel syndrome in opioid abusers in iran.
BACKGROUND In spite of the increasing trend in opioid abusers worldwide, the prevalence of narcotic bowel syndrome (NBS) is undetermined. We aimed to estimate the prevalence of NBS and other opioid bowel dysfunction (OBD) in opioid abusers in Kerman, southeast Iran. According to the best of our knowledge, this is the first study to assess the prevalence of NBS in opioid abusers. METHODS By referring to addiction treatment centers in Kerman city and in a cross-sectional study, 577 subjects with opium or opioid subtracts abuse were included in our study. A validated questionnaire was used for OBD assessment and diagnosis of NBS was made according to both the presence of chronic abdominal pain despite increasing the opioid dose and ruling out other causes of abdominal pain. SPSS software version 16 was used for data analysis. p value<0.05 was considered as statistically significant. RESULTS Constipation, regurgitation, and heartburn were the most gastrointestinal complaints that were found in 132(22.9%), 123(21.3%) and 91(15.8%) subjects, respectively. Only 16(2.8%) participants fulfilled all the NBS criteria. Simultaneous use of non-narcotic sedative drugs increased the risk of NBS significantly (the odds ratio 3:1 and p=0.049). CONCLUSION NBS is not rare among opioid abusers and should be considered as a cause of chronic abdominal pain in this group. PMID:25349684
Ahmadi, Bizhan; Arab, Peyman; Zahedi, Mohammad Javad; Shafieipour, Sara; Drossman, Douglas A; Banivaheb, Ghodseyeh
Prevalence of Narcotic Bowel Syndrome in Opioid Abusers in Iran
BACKGROUND In spite of the increasing trend in opioid abusers worldwide, the prevalence of narcotic bowel syndrome (NBS) is undetermined. We aimed to estimate the prevalence of NBS and other opioid bowel dysfunction (OBD) in opioid abusers in Kerman, southeast Iran. According to the best of our knowledge, this is the first study to assess the prevalence of NBS in opioid abusers. METHODS By referring to addiction treatment centers in Kerman city and in a cross-sectional study, 577 subjects with opium or opioid subtracts abuse were included in our study. A validated questionnaire was used for OBD assessment and diagnosis of NBS was made according to both the presence of chronic abdominal pain despite increasing the opioid dose and ruling out other causes of abdominal pain. SPSS software version 16 was used for data analysis. p value<0.05 was considered as statistically significant. RESULTS Constipation, regurgitation, and heartburn were the most gastrointestinal complaints that were found in 132(22.9%), 123(21.3%) and 91(15.8%) subjects, respectively. Only 16(2.8%) participants fulfilled all the NBS criteria. Simultaneous use of non-narcotic sedative drugs increased the risk of NBS significantly (the odds ratio 3:1 and p=0.049). CONCLUSION NBS is not rare among opioid abusers and should be considered as a cause of chronic abdominal pain in this group. PMID:25349684
Ahmadi, Bizhan; Arab, Peyman; Zahedi, Mohammad Javad; Shafieipour, Sara; Drossman, Douglas A.; Banivaheb, Ghodseyeh
Pain following traumatic brain injury: Assessment and management
Traumatic brain injury is frequently associated with painful complaints immediately after injury and subsequently. Early assessment of possible painful conditions can be made at the time of physical examination in those who are unable to give a history. Non-verbal signs of pain, including withdrawal of a painful limb or body part, irritability or tears should draw the attention of the
Stephen Tyrer; Amy Lievesley
Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey
Breakthrough pain (BKP) is a transitory flare of pain that occurs on a background of relatively well controlled baseline pain. Previous surveys have found that BKP is highly prevalent among patients with cancer pain and predicts more severe pain, pain-related distress and functional impairment, and relatively poor quality of life. An international group of investigators assembled by a task force
Augusto Caraceni; Cinzia Martini; Ernesto Zecca; Russell K Portenoy; M. A. Ashby; G. Hawson; K. A. Jackson; N. Lickiss; N. Muirden; M. Pisasale; D. Moulin; V. N. Schulz; M. A. Rico Pazo; J. A. Serrano; H. S. Andersen; H. T. Henriksen; I. Mejholm; P. M. Sjogren; T. Heiskanen; E. Kalso; P. Pere; R. Poyhia; E. Vuorinen; I. Tigerstedt; P. Ruismaki; M. Bertolino; F. Larue; J. Y. Ranchere; G. Hege-Scheuing; I. Bowdler; F. Helbing; E. Kostner; L. Radbruch; K. Kastrinaki; S. Shah; S. Vijayaram; K. S. Sharma; P. S. Devi; P. N. Jain; P. V. Ramamani; A. Beny; C. Brunelli; M. Maltoni; S. Mercadante; R. Plancarte; S. Schug; P. Engstrand; A. F. Ovalle; X. Wang; M. F. Alves; M. R. Abrunhosa; W. Z. Sun; L. Zhang; A. Gazizov; M. Vaisman; S. Rudoy; M. G. Sancho; P. Vila; J. Trelis; P. Chaudakshetrin; M. L. Koh; R. T. M. van Dongen; A. Vielvoye-Kerkmeer; M. V. Boswell; T. Elliott; E. Hargus; L. Lutz
Mental Health Levels and Incidence of Musculoskeletal Complaints among Speed Boat Crew Members
Background The occupational health is an important issue. In some jobs, the working conditions contribute to musculoskeletal complaints and the overall health of the individual is compromised. Musculoskeletal complaints have gained credence in the public as one of the most important problems in the field of occupational diseases. Physical and mental health of crew members with critical jobs and stressful environments must be considered as well. Objectives This study performed an assessment on levels of mental health and the correlation with the frequency of accompanying musculoskeletal complaints (such as neck, back and knee pain) of crew members of speed boats. Material and Methods 149 onboard crew members of speed boats were recruited in a descriptive-correlation study by nonrandom sampling using conducted GHQ12, NMQ and demographic questionnaires. Results Although 63.8% (95 people) had what is conventionally defined as normal mental health, 36.2% (54 cases) had an inherent mental health condition. Overall, 61.1% (91 cases) suffered from back pain, 60.4% (90 cases) complained of knee pain, and 40.3% (60 patients) complained of neck pain. The combination of knee and back pain (48.3%) were the most common complaints whereas the combination of neck and knee pain (31.5%) were the least frequent; 28.2% complained of pain in all three areas. Interestingly, there was correlation between the presence of musculoskeletal complaints and less than optimum mental health. Conclusions Due to the high number of musculoskeletal complaints and the compromised mental health conditions among one-third of the onboard crew members of speed boats, attention for maintaining and improving the health of these members must be considered. PMID:24350130
Zigheimat, Farzaneh; Ebadi, Abbas; Rahmati Najarkolaei, Fatemeh; Malakoti, Mohammad; Kheiri Tootkaleh, Farhad
Practical approach to hip pain.
Hip pain is a common complaint among patients presenting to outpatient clinics. Stratifying patients based on age, acuity, and location of pain (extra-articular vs intra-articular) can help to aid in appropriate imaging and timely referral to an orthopedic surgeon. A thorough history and an organized physical examination combined with radiographs are usually sufficient to diagnose most hip complaints. If the diagnosis remains uncertain, magnetic resonance imaging, usually with intra-articular gadolinium, is the imaging modality of choice in diagnosing both intra-articular and extra-articular pathologies. PMID:24994049
Karrasch, Christopher; Lynch, Scott
Overtreating Chronic Back Pain: Time to Back Off?
Chronic back pain is among the most common patient complaints. Its prevalence and impact have spawned a rapidly expanding range of tests and treatments. Some of these have become widely used for indications that are not well-validated, leading to uncertainty about efficacy and safety, increasing complication rates, and marketing abuses. Recent studies document – over approximately a decade - a 629% increase in Medicare expenditures for epidural steroid injections; a 423% increase in expenditures for opioids for back pain; a 307% increase in the number of lumbar MRIs among Medicare beneficiaries; and a 220% increase in spinal fusion surgery rates. The limited studies available suggest that these increases have not been accompanied by population-level improvements in patient outcomes or disability rates. We suggest a need for a better understanding of the basic science of pain mechanisms; more rigorous and independent trials of many treatments; a stronger regulatory stance toward approval and post-marketing surveillance of new drugs and devices for chronic pain; and a chronic disease model for managing chronic back pain. PMID:19124635
Deyo, Richard A.; Mirza, Sohail K.; Turner, Judith A.; Martin, Brook I.
Cross-cultural conceptions of pain and pain control
Pain is a ubiquitous feature of the human experience. This paper presents an anthropology of pain. Anthropology is defined as the cross-cultural and comparative study of human behavior. Pain can be acute and episodic, and pain can be constant and uninterrupted. Acute pain, lasting for minutes or hours, is reported at some time by virtually all adults and by most juveniles and is indicated by the cries and facial expressions of toddlers and infants. This universality of pain as a part of the human condition has been established by the research of many biological, physical, and social scientists. Ethnographers, physicians, and public health experts describe pain complaints for a variety of modern, industrial societies and traditional, undeveloped societies. Pain is the most frequent complaint brought to the offices of physicians in North America, and it is a focus of attention in the literate medical traditions of China, India, and Islamic cultures. Hence, the study of pain and the cultural perceptions of pain are prominent foci of anthropologists. Given that the goal of medicine is to offer medical care to all people who seek it, the practice of modern medicine may be assisted by an exploration of the possibility of cultural differences in medical beliefs and practices in the multiethnic and racially diverse patient populations today. PMID:16333427
Course and prognosis of elbow complaints: a cohort study in general practice
Objective: To describe the course of new episodes of elbow complaints in general practice, and to identify predictors of short term and long term outcome in terms of pain intensity and functional disability. Methods: 181 patients with elbow complaints filled in questionnaires at baseline and at 3, 6, and 12 months of follow up. Baseline scores of pain and disability, characteristics of the complaint, sociodemographic and psychosocial factors, physical activity, general health, and comorbidity were investigated as possible predictors of outcome. Outcome measures were analysed separately using multiple regression analyses. Results: 13% of the patients reported recovery at the 3 month follow up and 34% at 12 months. Irrespective of outcome and length of follow up, a longer duration of the complaint before consulting the general practitioner, having musculoskeletal comorbidity, and using "retreating" as coping style increased the likelihood of an unfavourable outcome. Less social support was associated with an unfavourable outcome at 3 months, and having a history of elbow complaints and using "worrying" as coping style were associated with an unfavourable outcome at 12 months. The explained variance of the models ranged from 46% to 49%. Conclusions: Recovery of patients with elbow complaints in general practice was poor. Besides characteristic of the complaint, passive coping and less social support were related to a worse prognosis. The results of this study may help general practitioners to provide patients with more accurate information about their prognosis. PMID:15708885
Bot, S; van der Waal, J M; Terwee, C; van der Windt, D A W M; Bouter, L; Dekker, J
Introduction On 6 April 2009, at 03:32 local time, an Mw 6.3 earthquake hit the Abruzzi region of central Italy causing widespread damage in the City of L Aquila and its nearby villages. The earthquake caused 308 casualties and over 1,500 injuries, displaced more than 25,000 people and induced significant damage to more than 10,000 buildings in the L'Aquila region. Objectives This observational retrospective study evaluated the prevalence and drug treatment of pain in the five weeks following the L'Aquila earthquake (April 6, 2009). Methods 958 triage documents were analysed for patients pain severity, pain type, and treatment efficacy. Results A third of pain patients reported pain with a prevalence of 34.6%. More than half of pain patients reported severe pain (58.8%). Analgesic agents were limited to available drugs: anti-inflammatory agents, paracetamol, and weak opioids. Reduction in verbal numerical pain scores within the first 24 hours after treatment was achieved with the medications at hand. Pain prevalence and characterization exhibited a biphasic pattern with acute pain syndromes owing to trauma occurring in the first 15 days after the earthquake; traumatic pain then decreased and re-surged at around week five, owing to rebuilding efforts. In the second through fourth week, reports of pain occurred mainly owing to relapses of chronic conditions. Conclusions This study indicates that pain is prevalent during natural disasters, may exhibit a discernible pattern over the weeks following the event, and current drug treatments in this region may be adequate for emergency situations. PMID:22747796
Chronic Low Back Pain in Young Korean Urban Males: The Life-Time Prevalence and Its Impact on Health Related Quality of Life
Objective We assessed the life-time prevalence (LTP) of chronic low back pain (LBP) in young Korean males. We also evaluated the relationship between lumbar spinal lesions and their health related quality-of-life (HRQOL). Methods A cross-sectional, self-reported survey was conducted in Korean males (aged 19-year-old) who underwent physical examinations for the conscript. We examined 3331 examinees in November 2014. We included 2411 subjects, who accepted to participate this study without any comorbidities. We interviewed using simple binary questions for their LBP experience and chronicity. HRQOL was assessed by Short-Form Health-Survey-36 (SF-36) in chronic LBP and healthy control groups. Radiological assessment was performed in chronic LBP group to determine whether there were any pathological causes of their symptoms. Results The LTP of chronic LBP was 13.4%. Most (71.7%) of them didn't have any lumbar spinal lesions (i.e., non-specific chronic LBP). The SF-36 subscale and summary scores were significantly lower in subjects with chronic LBP. Between specific and non-specific chronic LBP group, all physical and mental subscale scores were significantly lower in specific chronic LBP group, except mental health (MH) subscale score. In MH subscale and mental component summary score, statistical significant differences didn't appear between two groups (p=0.154, 0.126). Conclusion In Korean males 19 years of age, the LTP of chronic LBP was 13.4%, and more than two-thirds were non-specific chronic LBP. Chronic LBP had a significant impact on HRQOL. The presence of lumbar spinal pathoanatomical lesions affected mainly on the physical aspect of HRQOL. It influenced little on the mental health.
Shim, Jae-Hyun; Yoon, Sang-Young; Lee, Chang-Hoon; Doh, Jae-Won; Bae, Hack-Gun
\\u000a Functional abdominal pain (FAP) is a frequent complaint seen in the pediatric primary care setting. Current diagnostic criteria\\u000a for functional gastrointestinal disorders (FGIDs) are defi ned in the Rome III criteria, which outline a positive symptom\\u000a profi le for diagnosis. In addition, clinicians should be aware of specifi c "red fl ag " rule-out symptoms that may suggest\\u000a organic disease
Lisa Scharff; Laura E. Simons
Atypical temporomandibular joint pain: a case report.
Atypical temporomandibular joint (TMJ) pain can consist of an unusual intensity, location or set of pain descriptors that do not match what is traditionally observed for TMJ capsular pain, disc displacements or arthritic conditions. Presented in this case report is an atypical pain report regarding a unilateral TMJ pain as the chief complaint. An overview of typical vs atypical TMJ pain is also reviewed to highlight unusual signs and symptoms so that the clinician can identify these atypical presentations and pursue further diagnostic approaches. PMID:25457893
Widmer, Charles G; Wold, Courtney C; Stoll, Ethan M; Dolwick, M Franklin
Loin pain hematuria syndrome is a rare disease with a prevalence of ?0.012%. The most prominent clinical features include periods of severe intermittent or persistent unilateral or bilateral loin pain accompanied by either microscopic or gross hematuria. Patients with loin pain hematuria syndrome initially present with hematuria, flank pain, or most often both hematuria and flank pain. Kidney biopsies from patients with loin pain hematuria typically reveal only minor pathologic abnormalities. Further, loin pain hematuria syndrome is not associated with loss of kidney function or urinary tract infections. Loin pain hematuria syndrome-associated hematuria and pain are postulated to be linked to vascular disease of the kidney, coagulopathy, renal vasospasm with microinfarction, hypersensitivity, complement activation on arterioles, venocalyceal fistula, abnormal ureteral peristalsis, and intratubular deposition of calcium or uric acid microcrystals. Many patients with loin pain hematuria syndrome also meet criteria for a somatoform disorder, and analgesic medications, including narcotics, commonly are used to treat loin pain hematuria syndrome-associated pain. Interventional treatments include renal denervation, kidney autotransplantation, and nephrectomy; however, these methods should be used only as a last resort when less invasive measures have been tried unsuccessfully. In this review article, we discuss and critique current clinical practices related to loin pain hematuria syndrome pathophysiology, diagnosis, treatment, and prognosis. PMID:24725981
Taba Taba Vakili, Sahar; Alam, Tausif; Sollinger, Hans
Chronic pain management in the active-duty military
NASA Astrophysics Data System (ADS)
As in the general population, chronic pain is a prevalent and burdensome affliction in active-duty military personnel. Painful conditions in military members can be categorized broadly in terms of whether they arise directly from combat injuries (gunshot, fragmentation wound, blast impact) or whether they result from non-combat injuries (sprains, herniated discs, motor vehicle accidents). Both combat-related and non-combat-related causes of pain can further be classified as either acute or chronic. Here we discuss the state of pain management as it relates to the military population in both deployed and non-deployed settings. The term non-battle injury (NBI) is commonly used to refer to those conditions not directly associated with the combat actions of war. In the history of warfare, NBI have far outstripped battle-related injuries in terms not only of morbidity, but also mortality. It was not until improvements in health care and field medicine were applied in World War I that battle-related deaths finally outnumbered those attributed to disease and pestilence. However, NBI have been the leading cause of morbidity and hospital admission in every major conflict since the Korean War. Pain remains a leading cause of presentation to military medical facilities, both in and out of theater. The absence of pain services is associated with a low return-to-duty rate among the deployed population. The most common pain complaints involve the low-back and neck, and studies have suggested that earlier treatment is associated with more significant improvement and a higher return to duty rate. It is recognized that military medicine is often at the forefront of medical innovation, and that many fields of medicine have reaped benefit from the conduct of war.
Jamison, David; Cohen, Steven P.
21 CFR 211.198 - Complaint files.
Code of Federal Regulations, 2010 CFR
...complaint involving the possible failure of a drug product to meet any of its specifications and, for such drug products, a determination as to the...complaint represents a serious and unexpected adverse drug experience which is required to be...
40 CFR 7.120 - Complaint investigations.
Code of Federal Regulations, 2010 CFR
...120 Complaint investigations. The OCR shall promptly investigate all complaints...alleged discriminatory acts, unless the OCR waives the time limit for good cause...discriminatory acts. (c) Notification. The OCR will notify the complainant and the...
48 CFR 422.1308 - Complaint procedures.
Code of Federal Regulations, 2010 CFR
...ACQUISITIONS Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans 422.1308 Complaint...forward complaints received about the administration of the Vietnam Era Veterans Readjustment Assistance Act directly to the...
48 CFR 408.711 - Quality complaints.
Code of Federal Regulations, 2010 CFR
...REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Nonprofit...Severely Disabled 408.711 Quality complaints. Prior to attempting...resolve a complaint regarding the quality of goods or services provided by participating...
48 CFR 408.711 - Quality complaints.
Code of Federal Regulations, 2011 CFR
...REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Nonprofit...Severely Disabled 408.711 Quality complaints. Prior to attempting...resolve a complaint regarding the quality of goods or services provided by participating...
Code of Federal Regulations, 2010 CFR
... Any complainant or recipient may request from the Department information regarding the complaint process. (e) Mediation. (1) When a complaint is referred for mediation, the complainant and the recipient shall participate in...
Code of Federal Regulations, 2010 CFR
...limit. Complaints may be submitted to the Director, Office of Equal Opportunity (06B), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420. (b) VA will attempt to facilitate the filing of complaints wherever...
32 CFR 776.79 - The complaint.
Code of Federal Regulations, 2010 CFR
...complaint. (b) A complaint may be initiated by any person, including the Administrative Law Division of the Office of JAG (JAG (13)), or the Judge Advocate Research and Civil Law Branch, JA Division, HQMC...
32 CFR 776.79 - The complaint.
Code of Federal Regulations, 2011 CFR
...complaint. (b) A complaint may be initiated by any person, including the Administrative Law Division of the Office of JAG (JAG (13)), or the Judge Advocate Research and Civil Law Branch, JA Division, HQMC...
21 CFR 1271.320 - Complaint file.
Code of Federal Regulations, 2010 CFR
...ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS...BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED...of complaints as appropriate. (b) Complaint file . You...
POLICY ON HABITUAL OR VEXATIOUS REQUESTS, COMPLAINTS & APPEALS Approved by (Committee) Date Review of Strathclyde Policy on Habitual or Vexatious Requests, Complaints & Appeals Approved: Staff Committee September 2011 2 POLICY ON HABITUAL OR VEXATIOUS REQUESTS, COMPLAINTS & APPEALS 1 Introduction 1.1 The University
Mottram, Nigel
1 ADMISSIONS APPEALS AND COMPLAINTS PROCEDURE 1. ADMISSION APPEALS AND COMPLAINTS PROCEDURE Where an applicant wishes to appeal against the decision on an application for a place to study or in any way penalised for raising a complaint or making an appeal. The Admission Appeals and Complaints
Subramanian, Sriram
Public Complaints and Complaint Responses in Calls to a Jordanian Radio Phone-In Program
ERIC Educational Resources Information Center
This study investigates complaints and complaint responses in interactions between local citizens and the hosts of a live two-hour radio phone-in in Jordan devoted to receiving and handling complaints of a public nature. Using Brown and Levinson's (1987) politeness model, the study examines the functions and patterns of complaints and the types of…
Migdadi, Fathi; Badarneh, Muhammad A.; Momani, Kawakib
Pain - groin; Lower abdominal pain; Genital pain; Perineal pain ... Common causes of groin pain include: Pulled muscle, tendon, or ligaments in the leg. This problem often occurs in people who play sports such as ...
The neurosurgical treatment of neuropathic facial pain.
This article reviews the definition, etiology and evaluation, and medical and neurosurgical treatment of neuropathic facial pain. A neuropathic origin for facial pain should be considered when evaluating a patient for rhinologic surgery because of complaints of facial pain. Neuropathic facial pain is caused by vascular compression of the trigeminal nerve in the prepontine cistern and is characterized by an intermittent prickling or stabbing component or a constant burning, searing pain. Medical treatment consists of anticonvulsant medication. Neurosurgical treatment may require microvascular decompression of the trigeminal nerve. PMID:24680498
Brown, Jeffrey A
Prevalence of chronic musculoskeletal disorders in elderly Brazilians: a systematic review of the literature
Background Population ageing is a worldwide phenomenon that has recently challenged public healthcare systems. The knowledge of the burden of chronic musculoskeletal disorders in elders is still limited, particularly in the developing world. This systematic review aimed to investigate the prevalence of chronic musculoskeletal disorders in elderly Brazilians. Methods A comprehensive literature search was performed in five electronic databases (from inception to January 2012) and completed by additional searches in reference lists. Two review authors independently selected the eligible studies and extracted data on participants' characteristics and rates of chronic musculoskeletal disorders. One review author extracted methodological quality data. We performed a critical synthesis of the results, which were grouped into the diagnoses "chronic musculoskeletal pain" or "specific musculoskeletal diagnoses". Results Twenty five studies reporting on a total of 116,091 elderly Brazilians were included. Eight studies (32%) were of high methodological quality. There was a large variation in the measure of prevalence used by individual studies and in their definition of chronic pain. Prevalence estimates reached 86% for chronic musculoskeletal pain in any location. Studies investigating multiple pain sites found the lower limb and the spine to be the most prevalent complaints (50% each). Arthritis and rheumatism (including osteoarthritis) were the most prevalent specific musculoskeletal diagnoses (9% to 40%), followed by herniated disc (6% to 27%). Conclusions Despite the growth of the elderly population worldwide, high-quality research on the burden of chronic musculoskeletal disorders in the elderly is still scarce. Future healthcare research focusing on this age group should be a priority in developing countries since their public healthcare systems are not yet fully prepared to accommodate the needs of an aging population. PMID:22642899
47 CFR 1.718 - Unsatisfied informal complaints; formal complaints relating back to the filing dates of informal...
Code of Federal Regulations, 2010 CFR
...complaints; formal complaints relating back to the filing dates of informal complaints...complaints; formal complaints relating back to the filing dates of informal complaints...721. Such filing will be deemed to relate back to the filing date of the informal...
Is acupuncture effective for the treatment of chronic pain? A systematic review
Pain is the major complaint of the estimated one million U.S. consumers who use acupuncture each year. Although acupuncture is widely available in chronic pain clinics, the effectiveness of acupuncture for chronic pain remains in question. Our aim was to assess the effectiveness of acupuncture as a treatment for chronic pain within the context of the methodological quality of the
Jeanette Ezzo; Brian Berman; Victoria A Hadhazy; Alejandro R Jadad; Lixing Lao; Betsy B Singh
Posterior Hip Pain in an Athletic Population
Context: Posterior hip pain is a relatively uncommon but increasingly recognized complaint in the orthopaedic community. Patient complaints and presentations are often vague or nonspecific, making diagnosis and subsequent treatment decisions difficult. The purposes of this article are to review the anatomy and pathophysiology related to posterior hip pain in the athletic patient population. Evidence Acquisition: Data were collected through a thorough review of the literature via a MEDLINE search of all relevant articles between 1980 and 2010. Results: Many patients who complain of posterior hip pain actually have pain referred from another part of the body—notably, the lumbar spine or sacroiliac joint. Treatment options for posterior hip pain are typically nonoperative; however, surgery is warranted in some cases. Conclusions: Recent advancements in the understanding of hip anatomy, pathophysiology, and treatment options have enabled physicians to better diagnosis athletic hip injuries and select patients for appropriate treatment. PMID:23015944
Frank, Rachel M.; Slabaugh, Mark A.; Grumet, Robert C.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.
A population study on differences in the determinants of a specific shoulder disorder versus nonspecific shoulder pain without clinical findings.
Musculoskeletal pain frequently occurs without particular clinical findings. Pain per se may be determined by factors other than those indicating a clinical disorder. The authors examined the prevalence and determinants of clinically diagnosed chronic rotator cuff tendinitis and self-reported nonspecific shoulder pain. The Health 2000 survey, carried out in 2000-2001 in Finland, included a nationally representative sample of 8,028 persons aged 30 years or more. In the present study, analyses were restricted to subjects aged 30-64 years who had held a job during the preceding 12 months. The prevalences of chronic rotator cuff tendinitis and nonspecific shoulder pain were 2.0% (78 of 3,909 subjects) and 12% (410 of 3,525 subjects), respectively. Nonspecific pain was related to burnout (adjusted odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.4, 2.2), depression (among women, the adjusted OR was 1.8 (95% CI: 1.1, 2.9) for mild depression and 3.0 (95% CI: 1.6, 5.6) for severe depression), and inability to express one's feelings (alexithymia) (adjusted OR = 1.6, 95% CI: 1.1, 2.5). However, these factors were not associated with chronic rotator cuff tendinitis, determinants of which were work-related cumulative loading on the shoulder, age, and insulin-dependent diabetes mellitus (adjusted OR = 8.8, 95% CI: 1.9, 40.3). The determinants of specific musculoskeletal disorders differ from those of subjective complaints without clinical findings. Such complaints may be indicators of adverse psychological and psychosocial factors rather than the presence of an underlying pathologic condition. PMID:15840617
Miranda, Helena; Viikari-Juntura, Eira; Heistaro, Sami; Heliövaara, Markku; Riihimäki, Hilkka
Current Issues in the Management of Pediatric Functional Abdominal Pain.
Chronic abdominal pain (CAP) is a prevalent disorder related to functional gastrointestinal disorders (FGIDs). In pediatric setting, CAP is a common presenting problem among children and adolescents ages 2 to 18 years with a median prevalence rate of 12%. It was proposed that CAP is the result of the altered pain sensation due to a dysfunction ofthe brain-gut axis after a complex interaction among biological, psychological and social factors. Children with CAP experience decrease in quality of life compared to children with identifiable organic disease such as inflammatory bowel disease. Despite treatment, 30% of children with CAP have long-lasting complaints with evidence that CAP is a risk factor for the occurrence of irritable bowel syndrome in adults. Efforts have subsequently been made to standardize the diagnostic criteria and adequate follow-up. CAP is associated with significative impairment with considerable impact on selfreported quality of life. The direct and indirect costs are not known in pediatric population and the access to investigations it's frequent. A more appropriate use of Rome III criteria would allow for a clinical diagnosis. The focus of this article will be to report the updated criteria for the diagnosis, follow-up and treatment of this condition. PMID:24758536
Romano, Claudio; Porcaro, Federica
Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia
Objectives (1) To determine the distribution of formal patient complaints across Australia's medical workforce and (2) to identify characteristics of doctors at high risk of incurring recurrent complaints. Methods We assembled a national sample of all 18?907 formal patient complaints filed against doctors with health service ombudsmen ('Commissions') in Australia over an 11-year period. We analysed the distribution of complaints among practicing doctors. We then used recurrent-event survival analysis to identify characteristics of doctors at high risk of recurrent complaints, and to estimate each individual doctor's risk of incurring future complaints. Results The distribution of complaints among doctors was highly skewed: 3% of Australia's medical workforce accounted for 49% of complaints and 1% accounted for a quarter of complaints. Short-term risks of recurrence varied significantly among doctors: there was a strong dose-response relationship with number of previous complaints and significant differences by doctor specialty and sex. At the practitioner level, risks varied widely, from doctors with <10% risk of further complaints within 2?years to doctors with >80% risk. Conclusions A small group of doctors accounts for half of all patient complaints lodged with Australian Commissions. It is feasible to predict which doctors are at high risk of incurring more complaints in the near future. Widespread use of this approach to identify high-risk doctors and target quality improvement efforts coupled with effective interventions, could help reduce adverse events and patient dissatisfaction in health systems. PMID:23576774
Bismark, Marie M; Spittal, Matthew J; Gurrin, Lyle C; Ward, Michael; Studdert, David M
[Repetitive work and psychosomatic complaints].
200 workers of the Swiss watch industry were examined in an interdisciplinary study on the effect of repetitive work on the wellbeing of the worker. Women doing repetitive work with little autonomy complained more often about psychosomatic problems than the male workers doing non-repetitive work. This difference is interpreted as a difference of sexe rather than one of the work situation. However, there is a significant difference in the complaint about nervosity between women being paid monthly and women who were paid by piece or by hour with a premium. PMID:706840
Liebrich, J; Geiger, L; Rupp, M
Ontology-Based Customer Complaint Management
This paper presents an ontology-based approach for managing and maintaining multilingual online customer complaints. To achieve trust and transparency in e-commerce communications and transactions, effective and cross-border complaint platforms need to be established and may be integrated in e-business activities. The effectiveness and width of such complaint service platforms depend on rising to several challenges, such as the sensitivity of
Mustafa Jarrar; Ruben Verlinden; Robert Meersman
The Prevalence of Sacroiliitis and Spondyloarthritis in Patients with Sarcoidosis
Introduction. Sarcoidosis is a chronic granulomatous disease, which can involve different organs and systems. Coexistence of sarcoidosis and spondyloarthritis has been reported in numerous case reports. Purpose. To determine the prevalence of sacroiliitis and spondyloarthritis in patients previously diagnosed with sarcoidosis and to investigate any possible relation with clinical findings. Materials and Methods. Forty-two patients with sarcoidosis were enrolled in the study. Any signs and symptoms in regard to spondyloarthritis (i.e., existence of inflammatory back pain, gluteal pain, uveitis, enthesitis, dactylitis, inflammatory bowel disease, and psoriasis) were questioned in detail and biochemical tests were evaluated. Sacroiliac joint imaging and lateral heel imaging were performed in all patients. Results. Sacroiliitis was found in 6 of the 42 (14.3%) sarcoidosis patients and all of these patients were female. Common features of the disease in these six patients were inflammatory back pain as the major clinical complaint, stage 2 sacroiliitis as revealed by radiological staging, and the negativity of HLA B-27 test. These six patients with sacroiliitis were diagnosed with spondyloarthritis according to the criteria of ASAS and of ESSG. Conclusion. We found spondyloarthritis in patients with sarcoidosis at a higher percentage rate than in the general population (1–1.9%). Controlled trials involving large series of patients are required for the confirmation of the data. PMID:24899899
Kobak, Senol; Sever, Fidan; Ince, Ozlem; Orman, Mehmet
Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...
Pain - side; Side pain ... Flank pain can be a sign of a kidney problem. However, since many organs are in this area, other causes are possible. If you have flank pain and fever , chills, blood in the urine, or ...
Cognitive complaints in patients after whiplash injury: the impact of malingering
OBJECTIVESThe validity of memory and concentration complaints that are often reported after a whiplash trauma is controversial. The prevalence of malingering or underperformance in post-whiplash patients, and its impact on their cognitive test results were studied.METHODSThe Amsterdam short term memory (ASTM) test, a recently developed malingering test, was used as well as a series of conventional memory and concentration tests.
B. A. Schmand; J. Lindeboom; S. Schagen; R. Heijt; T. Koene; H. L. Hamburger
Code of Federal Regulations, 2010 CFR
...INTERNATIONAL DEVELOPMENT NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 218.32 Complaints. (a) Any person,...
Code of Federal Regulations, 2013 CFR
...SPACE ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 1252.401 Complaints. (a) Any...
Code of Federal Regulations, 2013 CFR
...INTERNATIONAL DEVELOPMENT NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 218.32 Complaints. (a) Any person,...
Code of Federal Regulations, 2010 CFR
...SPACE ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 1252.401 Complaints. (a) Any...
Code of Federal Regulations, 2011 CFR
...ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM HHS Investigation, Conciliation, and Enforcement Procedures § 91.42 Complaints. (a) Any...
Code of Federal Regulations, 2012 CFR
...SPACE ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 1252.401 Complaints. (a) Any...
Code of Federal Regulations, 2013 CFR
...ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM HHS Investigation, Conciliation, and Enforcement Procedures § 91.42 Complaints. (a) Any...
Code of Federal Regulations, 2012 CFR
...ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM HHS Investigation, Conciliation, and Enforcement Procedures § 91.42 Complaints. (a) Any...
Code of Federal Regulations, 2011 CFR
...SPACE ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 1252.401 Complaints. (a) Any...
Code of Federal Regulations, 2012 CFR
...INTERNATIONAL DEVELOPMENT NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 218.32 Complaints. (a) Any person,...
Code of Federal Regulations, 2010 CFR
...ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM HHS Investigation, Conciliation, and Enforcement Procedures § 91.42 Complaints. (a) Any...
Code of Federal Regulations, 2011 CFR
...INTERNATIONAL DEVELOPMENT NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 218.32 Complaints. (a) Any person,...
Although the prevalence of post vasectomy pain syndrome is unknown, it is certain that the incidence of this uncommon complication\\u000a will increase because of the continued popularity of vasectomy as a highly effective and economic means of contraception.\\u000a This chapter covers the evaluation of and treatment options available for the sequelae of symptoms associated with post vasectomy\\u000a pain syndrome and
Jeannette M. Potts
Failure of physician documentation of sleep complaints in hospitalized patients.
Sleep disorders are acknowledged to be common but remain underrecognized by the medical community, often attributed to the failure to question patients about their sleep quality. We examined the prevalence of sleep complaints (insomnia or excessive daytime sleepiness) in a group of general medical patients by administering a questionnaire to hospitalized patients in a Veterans Affairs tertiary care medical center. A total of 222 consecutive adults (215 men, 60 +/- 14 years; body mass index, 24.8 +/- 5.6) completed the questionnaire. Of these, 105 patients (47%) had either insomnia, excessive daytime somnolence, or both; 63 (28%) had excessive daytime somnolence, which was severe in 27 (12%). Of 75 patients (34%) who had insomnia, a third were taking hypnotic medication. Forty patients (18%) had snoring, which was associated with excessive daytime somnolence in 36, whereas 46 patients (21%) had either restless legs or a combination of leg jerks and leg kicking or twitching during sleep, associated with a sleep complaint (insomnia in 32). The medical records were subsequently reviewed to assess the admitting physicians' recognition of these symptoms. No record included mention of any patient symptom related to sleep. We conclude that symptoms related to sleep, some of which may be clinically important, are common, and that none of these complaints appear to be recognized by the physicians of record. PMID:9771152
Meissner, H H; Riemer, A; Santiago, S M; Stein, M; Goldman, M D; Williams, A J
Medicine is a human enterprise dedicated to the goals of restoration of health and the alleviation of suffering. The rising prevalence of pain in chronic illness and the illness of chronic pain (i.e., maldynia) make evident the deficiencies in our current disease-based therapeutic approach. Distinctions in types of pain and suffering are sine qua non to effective and sound pain
Yuri Maricich; James Giordano
Plantar heel pain is a common complaint encountered by orthopedic surgeons, internists, and family practitioners. Although it is most often caused by plantar fasciitis, this is a diagnosis of exclusion. Other mechanical, rheumatologic, and neurologic causes must be considered first. The history and physical examination are typically all that is needed to make the proper diagnosis, but diagnostic adjuncts are available to assist the clinician. When plantar fasciitis is diagnosed, conservative modalities must be tried first. Corticosteroid injections and extracorporeal shock-wave therapy may also be used. After 6 months of failed conservative treatments, surgical intervention should be considered. PMID:24559879
Rosenbaum, Andrew J; DiPreta, John A; Misener, David
Risk factors and musculoskeletal complaints in non-specialized nurses, IC nurses, operation room nurses, and X-ray technologists
Objectives: To gain more insight into the prevalence rates of musculoskeletal complaints of neck-shoulder and low back and to determine\\u000a the relation between physical and psychosocial work-related risk factors and the complaints mentioned in non-specialized nurses,\\u000a operation room nurses, Intensive Care (IC) nurses and X-ray technologists. Methods: The study population consists of 3,169 employees affiliated to eight university hospitals in
Ellen Bos; Boudien Krol; Lex van der Star; Johan Groothoff
Theories on Common Adolescent Pain Syndromes
\\u000a Pain is a prevalent condition among adolescents. In fact, 30–40% of children and adolescents report experiencing pain at least\\u000a once a week (Palermo 2000), and 5–25% of adolescents report some form of recurrent or chronic pain (Perquin et al. 2000; Goodman\\u000a and McGrath 1991). Of those reporting recurrent pain, 30–40% of children report pain episodes at least once a week
Jill MacLaren Chorney; Kathryn Crofton; Brenda C. McClain
Duloxetine in the management of chronic musculoskeletal pain
Chronic musculoskeletal pain is among the most frequent painful complaints that healthcare providers address. The bulk of these complaints are chronic low back pain and chronic osteoarthritis. Osteoarthritis is the most common form of arthritis in the United States. It is a chronic degenerative disorder characterized by a loss of cartilage, and occurs most often in older persons. The management of osteoarthritis and chronic low back pain may involve both nonpharmacologic (eg, weight loss, resistive and aerobic exercise, patient education, cognitive behavioral therapy) and pharmacologic approaches. Older adults with severe osteoarthritis pain are more likely to take analgesics than those with less severe pain. The pharmacologic approaches to painful osteoarthritis remain controversial, but may include topical as well as oral nonsteroidal antiinflammatory drugs, acetaminophen, duloxetine, and opioids. The role of duloxetine for musculoskeletal conditions is still evolving. PMID:22767991
Smith, Howard S; Smith, Eric J; Smith, Benjamin R
Biomechanical and organizational risk and prevalence of low back pain in the old adults caregivers of a nursing home in Joao Pessoa/PB.
The objective present study was to investigate the presence of low back pain in caregivers of a nursing home, related with the labored activities executed by these workers. 16 subjects were investigated, 15 female and one male, with 40,8 age average all being caregivers as their profession. It consisted of three phases, where the first concerns the analysis of the collective work, assessed in a perspective of caregivers, Second, a postural assessment to verify the retractions in such workers and the third stage was used Diagram of Corllet to identify the presence of signs and symptoms in caregivers. The study demonstrated that organizational and biomechanical factors are responsible for the high level of physical fatigue and presence of pain in 93,75% of the caregivers in some region of the body. 50% referred pain in the lumbar region. The results of the postural evaluation confirmed that the caregivers had alterations in the postural alignment, presenting retractions of the anterior and posterior chain. The suggestions are to minimize the risk factors of this productive process and the symptoms and signals presented from these workers by adoption ergonomic measures and the realization of a physical program with stretching and muscular strengthening of the muscles of the anterior and posterior body chain based on the method of Reorganization Postural Sensoperceptive. PMID:22316998
Ribeiro, Sânzia Bezerra; Cárdia, Maria Claudia Gatto; Almeida, Lais Cristina
Code of Federal Regulations, 2010 CFR
...2010-04-01 2010-04-01 false Complaint. 355.7 Section 355.7 Employees' Benefits RAILROAD RETIREMENT BOARD...UNDER THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 355.7 Complaint. (a) On or after the date...
Code of Federal Regulations, 2010 CFR
...Complaints with respect to the CCDF shall be submitted in writing to the Assistant Secretary for Children and Families, 370 L'Enfant Promenade, SW., Washington, DC 20447. The complaint shall identify the provision of the Plan, the Act, or this...
12 CFR 227.2 - Consumer complaint procedure.
Code of Federal Regulations, 2010 CFR
...complainant. (2) Consumer complaints should be made to—Federal Reserve Consumer Help Center, P...complaints. Within 15 business days of receipt of...Federal Reserve Consumer Help Center, P...complaints. Within 15 business days of receipt...
29 CFR 1981.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2010 CFR
...2010-07-01 false Filing of discrimination complaint. 1981.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 6 OF THE...Orders § 1981.103 Filing of discrimination complaint. (a) Who may...
29 CFR 1980.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2010 CFR
...2010-07-01 false Filing of discrimination complaint. 1980.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 806 OF...Orders § 1980.103 Filing of discrimination complaint. (a) Who may...
29 CFR 1979.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2010 CFR
...2010-07-01 false Filing of discrimination complaint. 1979.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 519 OF...Orders § 1979.103 Filing of discrimination complaint. (a) Who may...
49 CFR 1111.6 - Satisfaction of complaint.
Code of Federal Regulations, 2010 CFR
...Transportation 8 2010-10-01 2010-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation...PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction of complaint. If a defendant satisfies a formal...
49 CFR 1111.6 - Satisfaction of complaint.
Code of Federal Regulations, 2011 CFR
...Transportation 8 2011-10-01 2011-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation...PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction of complaint. If a defendant satisfies a formal...
R& A -Appeals and Complaints Procedure Manchester Metropolitan University
R& A - Appeals and Complaints Procedure Manchester Metropolitan University Recruitment and Admissions Student Appeals and Complaints Procedure for Applicants This document should be read in conjunction with the separate Student Appeals and Complaints Policy for Applicants. This procedure undergoes
Title IX & Discrimination Complaint Form (including sexual harassment)
Title IX & Discrimination Complaint Form (including sexual harassment) Office of Diversity. Although the university cannot commit to keeping a complaint of discrimination confidential the process for filing or investigating complaints of discrimination (including sexual harassment). Note
Hemmers, Oliver
29 CFR 1979.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2011 CFR
...2011-07-01 false Filing of discrimination complaint. 1979.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 519 OF...Orders § 1979.103 Filing of discrimination complaint. (a) Who may...
29 CFR 1979.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2012 CFR
...2012-07-01 false Filing of discrimination complaint. 1979.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 519 OF...Orders § 1979.103 Filing of discrimination complaint. (a) Who may...
29 CFR 1981.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2011 CFR
...2011-07-01 false Filing of discrimination complaint. 1981.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 6 OF THE...Orders § 1981.103 Filing of discrimination complaint. (a) Who may...
29 CFR 1980.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2011 CFR
...2011-07-01 false Filing of discrimination complaint. 1980.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 806 OF...Orders § 1980.103 Filing of discrimination complaint. (a) Who may...
29 CFR 1981.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2013 CFR
...2013-07-01 false Filing of discrimination complaint. 1981.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 6 OF THE...Orders § 1981.103 Filing of discrimination complaint. (a) Who may...
29 CFR 1981.103 - Filing of discrimination complaint.
Code of Federal Regulations, 2012 CFR
...2012-07-01 false Filing of discrimination complaint. 1981.103 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 6 OF THE...Orders § 1981.103 Filing of discrimination complaint. (a) Who may...
Orofacial pain syndromes: evaluation and management.
Patients will often visit their primary medical practitioner with orofacial pain complaints. Hence, it is important to recognize and have an understanding of these conditions to properly evaluate and potentially manage these disorders. If the practitioner is uncertain or uncomfortable with these conditions, then patient referral to a knowledgeable health care practitioner should be considered for further evaluation and management. In this article, the evaluation and management of various neuropathic, neurovascular, and vascular pains are discussed. PMID:25443681
Balasubramaniam, Ramesh; Klasser, Gary D
Does warming local anesthetic reduce the pain of subcutaneous injection?
The most frequent complaint noted with the use of lidocaine (or other amide local anesthetic) is stinging or burning pain associated with subcutaneous infiltration. The purpose of this study was to evaluate the efficacy of warming buffered lidocaine for reducing the pain of infiltration. Forty adult volunteers were entered into a randomized, crossover study conducted at a community teaching hospital.
Stacy Martin; Jeffrey S Jones; Barbara N Wynn
Management of chronic pelvic pain.
Chronic pelvic pain (CPP) is a common complaint of women presenting for gynecologic and primary care. Evaluation of CPP requires obtaining a careful history including not only obstetrical and gynecologic information but also screening for gastrointestinal, urologic, musculoskeletal, and neurological disorders. A detailed physical examination is also necessary. Management of CPP depends largely on the cause. Gynecologic causes include endometriosis, pelvic inflammatory disease, adhesive disease, pelvic congestion syndrome, ovarian retention syndrome, ovarian remnant syndrome, adenomyosis, and leiomyomas. Some non-gynecologic causes are interstitial cystitis/painful bladder syndrome, irritable bowel syndrome, pelvic floor tension myalgia, and abdominal myofascial pain syndrome. Treatments may be directed toward specific causes or may be targeted to general pain management. The most effective therapy may involve using both approaches. The diagnosis and treatment of each of the above disorders, and the management of CPP itself, is discussed. PMID:20938429
Benjamin-Pratt, A R; Howard, F M
31 CFR 10.63 - Service of complaint; service of other papers; service of evidence in support of complaint...
Code of Federal Regulations, 2010 CFR
...Service of complaint; service of other papers; service of evidence in support of complaint; filing of papers. 10.63 Section 10.63 Money...Service of complaint; service of other papers; service of evidence in support of...
Inguinoscrotal pain resistant to conventional treatment
Inguinoscrotal pain (ISP) is a common complaint that affects almost all age groups. The etiology may be vascular, neurogenic, visceral, muscular or psychological. Most causes of ISP are benign, but Pott's spine as a cause of ISP, when missed, may lead to serious outcomes. PMID:25624580
Jain, Anuj; Agarwal, Anil
Changes in prevalence of subjective fatigue during 14-day 6° head-down bed rest
NASA Astrophysics Data System (ADS)
The present study examines the prevalence of subjective fatigue in young healthy males during 14 days of 6° head-down bed rest (HDBR) by using a multidimensional questionnaire. Forty-one subjects completed the Subjective Fatigue Scale questionnaire to assess the fatigue-related complaints and symptoms. The questionnaire is composed of three sections, with 10 items each. The sections measured drowsiness and dullness (Section 1), difficulty in concentration (Section 2), and the projection of physical disintegration (Section 3). The subjects answered simple questions between 1400 and 1700 on 6 measurement days before and during the HDBR period. The prevalence rate of low back pain was markedly high (80.5%) on the second day and more than 50% in the first half of the HDBR period, and any complaints related to either a lack of sleep or a deterioration in the quality of sleep continued until the end of the HDBR period. Our findings may be useful in developing preventive strategies against physical and mental fatigue associated with prolonged HDBR, horizontal bed rest, and microgravity environments.
Hirayanagi, Kaname; Natsuno, Toyoki; Shiozawa, Tomoki; Yamaguchi, Nobuhisa; Watanabe, Yoriko; Suzuki, Satomi; Iwase, Satoshi; Mano, Tadaaki; Yajima, Kazuyoshi
Pain - heel ... Heel pain is most often the result of overuse. Rarely, it may be caused by an injury. Your heel ... on the heel Conditions that may cause heel pain include: When the tendon that connects the back ...
Pain - wrist ... Carpal tunnel syndrome: A common cause of wrist pain is carpal tunnel syndrome . You may feel aching, ... become weak, making it difficult to grasp things. Pain may extend up to your elbow. Carpal tunnel ...
Pain - ankle ... Ankle pain is often due to an ankle sprain. An ankle sprain is an injury to the ligaments, which ... the joint. In addition to ankle sprains, ankle pain can be caused by: Damage or swelling of ...
Pain - elbow ... Elbow pain can be caused by a variety of problems. A common cause in adults is tendinitis , an inflammation ... a partial dislocation ). Other common causes of elbow pain are: Bursitis -- inflammation of a fluid-filled cushion ...
Pain - foot ... Foot pain may be due to: Aging Being on your feet for long periods of time Being overweight A ... other sports activity The following can cause foot pain: Arthritis and gout : Common in the big toe, ...
... Pregnancy and Rheumatic Disease Sex and Arthritis Neck Pain PRINT Download PDF Description Saying, "It's a pain ... requires expensive or uncomfortable tests. What is neck pain? Acute strain may occur after sleeping in an ...
Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There ... also have a slightly different response to a pain reliever. Over-the-counter (OTC) medicines are good for ...
Depression, Pain, and Pain Behavior.
ERIC Educational Resources Information Center
Examined the degree to which depression predicted pain and pain behavior. The Beck Depression Inventory was administered to 207 low back pain patients. Depression and physical findings were the most important predictors of pain and pain behavior. Depression proved significant even after controlling for important demographic and medical status…
Keefe, Francis J.; And Others
Effectiveness of Massage Therapy for Chronic, NonMalignant Pain: A Review
Previous reviews of massage therapy for chronic, non-malignant pain have focused on discrete pain conditions. This article aims to provide a broad overview of the literature on the effectiveness of massage for a variety of chronic, non-malignant pain complaints to identify gaps in the research and to inform future clinical trials. Computerized databases were searched for relevant studies including prior
Jennie C. I. Tsao
19 CFR 210.12 - The complaint.
Code of Federal Regulations, 2010 CFR
...accompany the submission of the original of each complaint based upon the alleged unauthorized importation or sale of a semiconductor chip in a manner that constitutes infringement of a Federally registered mask work, one certified copy of the Federal...
19 CFR 210.12 - The complaint.
Code of Federal Regulations, 2012 CFR
...accompany the submission of the original of each complaint based upon the alleged unauthorized importation or sale of a semiconductor chip in a manner that constitutes infringement of a Federally registered mask work, one certified copy of the Federal...
19 CFR 210.12 - The complaint.
Code of Federal Regulations, 2011 CFR
...accompany the submission of the original of each complaint based upon the alleged unauthorized importation or sale of a semiconductor chip in a manner that constitutes infringement of a Federally registered mask work, one certified copy of the Federal...
19 CFR 210.12 - The complaint.
Code of Federal Regulations, 2013 CFR
...accompany the submission of the original of each complaint based upon the alleged unauthorized importation or sale of a semiconductor chip in a manner that constitutes infringement of a Federally registered mask work, one certified copy of the Federal...
Code of Federal Regulations, 2011 CFR
...STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 143.32 Complaints. (a) Any person,...
Code of Federal Regulations, 2011 CFR
...DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 110.31 Complaints. (a) Any person,...
Code of Federal Regulations, 2012 CFR
...Secretary of Commerce NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 20.11 Complaints. (a) Any person,...
Code of Federal Regulations, 2013 CFR
...Secretary of Commerce NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 20.11 Complaints. (a) Any person,...
Code of Federal Regulations, 2011 CFR
...BUSINESS OPPORTUNITY NONDISCRIMINATION ON THE BASIS OF AGE IN HUD PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Settlement, and Enforcement Procedures § 146.33 Complaints. (a) Any person,...
Code of Federal Regulations, 2011 CFR
...Secretary of Commerce NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 20.11 Complaints. (a) Any person,...
Code of Federal Regulations, 2012 CFR
...DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 110.31 Complaints. (a) Any person,...
Code of Federal Regulations, 2012 CFR
...BUSINESS OPPORTUNITY NONDISCRIMINATION ON THE BASIS OF AGE IN HUD PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Settlement, and Enforcement Procedures § 146.33 Complaints. (a) Any person,...
Code of Federal Regulations, 2010 CFR
...DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 110.31 Complaints. (a) Any person,...
Code of Federal Regulations, 2013 CFR
...DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 110.31 Complaints. (a) Any person,...
Code of Federal Regulations, 2010 CFR
...STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 143.32 Complaints. (a) Any person,...
Code of Federal Regulations, 2013 CFR
...STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 143.32 Complaints. (a) Any person,...
Code of Federal Regulations, 2012 CFR
...STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 143.32 Complaints. (a) Any person,...
Code of Federal Regulations, 2010 CFR
...Secretary of Commerce NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 20.11 Complaints. (a) Any person,...
Code of Federal Regulations, 2013 CFR
...BUSINESS OPPORTUNITY NONDISCRIMINATION ON THE BASIS OF AGE IN HUD PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Settlement, and Enforcement Procedures § 146.33 Complaints. (a) Any person,...
Code of Federal Regulations, 2010 CFR
...BUSINESS OPPORTUNITY NONDISCRIMINATION ON THE BASIS OF AGE IN HUD PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Settlement, and Enforcement Procedures § 146.33 Complaints. (a) Any person,...
29 CFR 1614.204 - Class complaints.
Code of Federal Regulations, 2010 CFR
...age, disability, or genetic information. (2...class complaint must seek counseling and be counseled in...after completing the counseling process contained in § 1614.105, no additional counseling is required. The...
Code of Federal Regulations, 2013 CFR
... false Complaints. 4.332 Section 4.332 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED...ASSISTANCE FROM THE COMMISSION Regulations Implementing the Age Discrimination Act of 1975, as Amended Investigation,...
Code of Federal Regulations, 2010 CFR
... false Complaints. 4.332 Section 4.332 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED...ASSISTANCE FROM THE COMMISSION Regulations Implementing the Age Discrimination Act of 1975, as Amended Investigation,...
Code of Federal Regulations, 2012 CFR
... false Complaints. 4.332 Section 4.332 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED...ASSISTANCE FROM THE COMMISSION Regulations Implementing the Age Discrimination Act of 1975, as Amended Investigation,...
Code of Federal Regulations, 2011 CFR
... false Complaints. 4.332 Section 4.332 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED...ASSISTANCE FROM THE COMMISSION Regulations Implementing the Age Discrimination Act of 1975, as Amended Investigation,...
41 CFR 105-70.007 - Complaint.
Code of Federal Regulations, 2010 CFR
...2010-07-01 2010-07-01 false Complaint. 105-70.007 Section 105-70.007 Public Contracts and Property Management ...Regional Offices-General Services Administration 70-IMPLEMENTATION OF THE PROGRAM FRAUD CIVIL...
Code of Federal Regulations, 2013 CFR
...NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS (FEMA REG. 5) Nondiscrimination on the...Receiving Federal Financial Assistance From FEMA Investigation, Conciliation, and Enforcement...behalf of others, may file a complaint with FEMA, alleging discrimination...
Code of Federal Regulations, 2011 CFR
...NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS (FEMA REG. 5) Nondiscrimination on the...Receiving Federal Financial Assistance From FEMA Investigation, Conciliation, and Enforcement...behalf of others, may file a complaint with FEMA, alleging discrimination...
Code of Federal Regulations, 2012 CFR
...NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS (FEMA REG. 5) Nondiscrimination on the...Receiving Federal Financial Assistance From FEMA Investigation, Conciliation, and Enforcement...behalf of others, may file a complaint with FEMA, alleging discrimination...
Code of Federal Regulations, 2010 CFR
...NONDISCRIMINATION IN FEDERALLY-ASSISTED PROGRAMS (FEMA REG. 5) Nondiscrimination on the...Receiving Federal Financial Assistance From FEMA Investigation, Conciliation, and Enforcement...behalf of others, may file a complaint with FEMA, alleging discrimination...
Code of Federal Regulations, 2011 CFR
...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS NONDISCRIMINATION ON THE...others, may file a complaint with the Endowment, alleging discrimination prohibited...discrimination. However, for good cause, the Endowment may extend this time limit. The...
Code of Federal Regulations, 2013 CFR
...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS NONDISCRIMINATION ON THE...others, may file a complaint with the Endowment, alleging discrimination prohibited...discrimination. However, for good cause, the Endowment may extend this time limit. The...
Code of Federal Regulations, 2010 CFR
...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS NONDISCRIMINATION ON THE...others, may file a complaint with the Endowment, alleging discrimination prohibited...discrimination. However, for good cause, the Endowment may extend this time limit. The...
Code of Federal Regulations, 2012 CFR
...THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS NONDISCRIMINATION ON THE...others, may file a complaint with the Endowment, alleging discrimination prohibited...discrimination. However, for good cause, the Endowment may extend this time limit. The...
21 CFR 820.198 - Complaint files.
Code of Federal Regulations, 2013 CFR
21 Food and Drugs 8 2013-04-01 ...Section 820.198 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...complaint represents an event which is required to be...the reported incident or adverse event. (e)...
21 CFR 820.198 - Complaint files.
Code of Federal Regulations, 2010 CFR
21 Food and Drugs 8 2010-04-01 ...Section 820.198 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...complaint represents an event which is required to be...the reported incident or adverse event. (e)...
21 CFR 1271.320 - Complaint file.
Code of Federal Regulations, 2012 CFR
...1271.320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN...complaint is an isolated event or represents a trend...P deviation or to an adverse reaction, and to...
21 CFR 820.198 - Complaint files.
Code of Federal Regulations, 2011 CFR
21 Food and Drugs 8 2011-04-01 ...Section 820.198 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...complaint represents an event which is required to be...the reported incident or adverse event. (e)...
21 CFR 820.198 - Complaint files.
Code of Federal Regulations, 2012 CFR
21 Food and Drugs 8 2012-04-01 ...Section 820.198 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...complaint represents an event which is required to be...the reported incident or adverse event. (e)...
21 CFR 1271.320 - Complaint file.
Code of Federal Regulations, 2013 CFR
...1271.320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN...complaint is an isolated event or represents a trend...P deviation or to an adverse reaction, and to...
21 CFR 1271.320 - Complaint file.
Code of Federal Regulations, 2011 CFR
...1271.320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT...ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN...complaint is an isolated event or represents a trend...P deviation or to an adverse reaction, and to...
48 CFR 22.1406 - Complaint procedures.
Code of Federal Regulations, 2010 CFR
...of the Act to the Deputy Assistant Secretary for Federal Contract Compliance, 200 Constitution Avenue, NW., Washington, DC 20210, or to any OFCCP regional or area office. The OFCCP shall institute investigation of each complaint and shall be...
48 CFR 222.1308 - Complaint procedures.
Code of Federal Regulations, 2010 CFR
...SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans 222.1308 Complaint procedures. The contracting officer shall— (1)...
48 CFR 8.711 - Quality complaints.
Code of Federal Regulations, 2011 CFR
...PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Nonprofit Agencies...Blind or Severely Disabled 8.711 Quality complaints. (a) When the quality of supplies or services received is unsatisfactory, the...
48 CFR 8.711 - Quality complaints.
Code of Federal Regulations, 2010 CFR
...PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Acquisition From Nonprofit Agencies...Blind or Severely Disabled 8.711 Quality complaints. (a) When the quality of supplies or services received is unsatisfactory, the...
45 CFR 606.70 - Complaint procedures.
Code of Federal Regulations, 2011 CFR
...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...
45 CFR 606.70 - Complaint procedures.
Code of Federal Regulations, 2010 CFR
...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...
45 CFR 606.70 - Complaint procedures.
Code of Federal Regulations, 2013 CFR
...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...
45 CFR 606.70 - Complaint procedures.
Code of Federal Regulations, 2012 CFR
...Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION...OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.70 Complaint procedures...Equal Opportunity Programs, National Science Foundation, 4201 Wilson...
77 FR 73621 - Baby Matters, LLC; Complaint
Federal Register 2010, 2011, 2012, 2013
...counsel, as follows: Baby Matters LLC, 531 Winston Way, Berwyn, PA 19312. Raymond G. Mullady, Jr., BLANK ROME LLP, Watergate, 600 New Hampshire Avenue NW., Washington, DC 20037, Counsel for Baby Matters LLC. Mary B. Murphy, Complaint...
20 CFR 405.30 - Discrimination complaints.
Code of Federal Regulations, 2010 CFR
...DISABILITY CLAIMS Introduction, General Description, and Definitions § 405.30 Discrimination complaints. At all levels...consideration to your race, color, national origin, age, sex, religion, or nature of your impairment(s). If you believe that...
Chest Pain in the Athlete: Differential Diagnosis, Evaluation, and Treatment
\\u000a Chest pain remains one of the most concerning complaints among athletes and active individuals. Fortunately, the vast majority\\u000a of chest pain in this group is benign, noncardiac, and rarely associated with catastrophic manifestations such as sudden death\\u000a [1]. [2] A thorough assessment requires a full understanding of the differential of chest pain, a detailed history designed\\u000a to elicit the nuances
John M. MacKnight; Dilaawar J. Mistry
Beyond pain in fibromyalgia: insights into the symptom of fatigue
Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue. PMID:24289848
Predictors of Genital Pain in Young Women
Despite the high prevalence of genital pain in healthy young adult women, limited research has addressed genital pain during intercourse using contemporary models of multidimensional sexual function. The objectives of this study were threefold: (1) to identify differences in sexual functioning in women who experience genital pain compared to pain free women; (2) to identify predictors of sexual functioning in women with and without genital pain; and (3) to identify predictors of sexual satisfaction in women with and without genital pain. Sexually active female undergraduates (n = 651) were administered the Female Sexual Function Index and the Derogatis Sexual Functioning Inventory. We evaluated the sexual factors that impact the sexual function of women with any pain (including high and low pain groups) versus women with no history of pain. Women with genital pain reported greater rates of sexual dysfunction as compared to pain-free women; however, sexual functioning in the high versus low pain groups was distinguished primarily by vaginal lubrication. Women in the high pain group showed negative correlations between domains of sexual satisfaction and genital pain frequency and intensity that were not found in the low pain group. For pain-free women, intercourse played a strong role in sexual satisfaction, whereas non-intercourse sexual behavior was central to sexual satisfaction in women who reported pain. The evaluation of levels of genital pain may provide insight into the mechanisms underlying the impairment of sexual function, sexual behavior, and sexual satisfaction. PMID:17674182
Farmer, Melissa A.; Meston, Cindy M.
22 CFR 18.10 - Service of complaint and other papers.
Code of Federal Regulations, 2010 CFR
...false Service of complaint and other papers. 18.10 Section 18.10 Foreign...10 Service of complaint and other papers. (a) Complaint. The complaint...person resident abroad. (b) Service of papers other than complaint. Any paper...
Fibromyalgia and neuropathic pain - differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia
Background Patients with diabetic neuropathy (DPN) and fibromyalgia differ substantially in pathogenetic factors and the spatial distribution\\u000a of the perceived pain. We questioned whether, despite these obvious differences, similar abnormal sensory complaints and pain\\u000a qualities exist in both entities. We hypothesized that similar sensory symptoms might be associated with similar mechanisms\\u000a of pain generation. The aims were (1) to compare epidemiological
Jana Koroschetz; Stefanie E Rehm; Ulrich Gockel; Mathias Brosz; Rainer Freynhagen; Thomas R Tölle; Ralf Baron
The management of risk. Part 4: Resolving complaints.
Patient complaints invariably cause concern and distress. Whilst prevention should be the primary objective, this is not always possible. This final article in the series describes strategies for the management and resolution of complaints, as well as the advantages of good complaint handling. Clinical Relevance: Early and efficient resolution of complaints will reduce stress to all members of the dental team. PMID:25073223
Collier, Andrew
The ethical leadership challenge for effective resolution of patient and family complaints and grievances: proven methods and models.
Health care leaders and managers face the ethical leadership challenge in ensuring effective resolution of patient and family complaints and grievances. In today's society of increasing discontent about safety, quality, cost, and satisfaction, patient complaints and grievances are becoming more prevalent. Under the mandates of the Patient Protection and Affordable Care Act for transparency of quality and patient satisfaction scores and to be compliant with the standards from the Centers for Medicare & Medicaid Services and The Joint Commission, it is imperative that leadership ensure an ethical culture for effective resolution of patient and family complaints and grievances. This article addresses this ethical leadership challenge by providing a systematic approach with proven methods and models for effective resolution of complaints and grievances and thereby improving satisfaction, quality, safety, and cost. PMID:25627856
Piper, Llewellyn E; Tallman, Erin
Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...
NINDS Back Pain Information Page Condensed from Low Back Pain Fact Sheet Table of Contents (click to jump to sections) ... Trials Organizations Additional resources from MedlinePlus What is Back Pain? Acute or short-term low back pain generally ...
Chronic pain has both high prevalence and a significant economic impact in Germany. The most common chronic pain types are low back pain and headache. On the one hand, the management of chronic pain patients is incomplete, yet it is often overtreated in orthopaedic surgical settings with interventional procedures. The reason for this is the structure of outpatient management and the way it is paid for in Germany. Pain management of patients with private insurance cover is no better because of "doctor shopping". Medical guidelines could be of some help in improving the situation, but they are widely unknown, and have still to demonstrate whether they have any impact on GP treatment pathways. The "gold standard" multimodal pain therapy shows significant improvement in many studies compared to monomodal therapy regimes and interventional regimes, but is too rarely recommended by the patients' physicians, whether GPs or specialists. Because of the huge number of institutions nowadays that, for the sake of form, offer such multimodal therapies, these need to be differentiated in terms of their structural and process quality. A first step is the "k edoq" project. It is essential to improve knowledge of the principles of modern pain management. This includes better networking and communication between doctors, physiotherapists and psychologists, and at the grassroots level, providing the public with more detailed and better information. PMID:25000627
Böger, A
Among older persons, sleep complaints in the form of insomnia and daytime drowsiness are highly prevalent and associated with adverse outcomes. The underlying mechanisms are linked to age-related declines in physiology, i.e., normal aging, and age-related increases in disease prevalence, i.e., usual aging. In this monograph, we describe how normal aging leads to less restorative sleep, characterized by reductions in homeostatic and circadian sleep, and to phase advancement of the sleep-wake cycle, characterized by older persons being more alert in the early morning but drowsier in the early evening. We also describe how usual aging leads to sleep complaints through reductions in health status, loss of physical function, and primary sleep disorders. Psychosocial influences are likewise described and their relevance to sleep complaints is discussed. We subsequently incorporate these aging-related changes into a conceptual model that describes sleep complaints as a consequence of multiple and interdependent predisposing, precipitating, and perpetuating factors, akin to a geriatric syndrome. We conclude our discussion by applying our conceptual model to the sleep-related care of an older person with insomnia and daytime drowsiness, and suggest that the diagnostic assessment consider, in addition to primary sleep disorders, multiple domains including medical, physical, cognitive, psychological, and social issues with the intent of developing an overall therapeutic plan and establishing long-term follow-up. PMID:17916123
Vaz Fragoso, Carlos A.; Gill, Thomas M.
Complaints of Sleep Disturbances Are Associated with Cardiovascular Disease: Results from the Gutenberg Health Study
Background Despite their high prevalence, sleep disorders often remain unrecognized and untreated because of barriers to assessment and management. The aims of the present study were to examine associations of complaints of sleep disturbances with cardiovascular disease, related risk factors, and inflammation in the community and to determine the contribution of sleep disturbances to self-perceived physical health. Method The sample consists of n?=?10.000 participants, aged 35 to 74 years of a population based community sample in Germany. Cross-sectional associations of complaints of sleep disturbances with cardiovascular risk factors and disease, biomarkers of inflammation, depression, anxiety, and physical health status were analyzed. Results 19% of our sample endorsed clinically significant sleep disturbances. In the unadjusted analyses severity of sleep disturbances increased with female sex, low socioeconomic status, living without a partnership, cardiovascular disease, depression, anxiety, poor physical health, increased levels of C-reactive protein and fibrinogen. After multivariate adjustment robust associations with coronary heart disease, myocardial infarction and dyslipidemia remained. Complaints of sleep disturbances were strong and independent contributors to self-perceived poor physical health beyond depression, anxiety and medical disease burden. Conclusions Given the high prevalence of complaints of sleep disturbances and their strong impact on health status, increased efforts should be undertaken for their identification and treatment. PMID:25093413
Michal, Matthias; Wiltink, Jörg; Kirschner, Yvonne; Schneider, Astrid; Wild, Philipp S.; Münzel, Thomas; Blettner, Maria; Schulz, Andreas; Lackner, Karl; Pfeiffer, Norbert; Blankenberg, Stefan; Tschan, Regine; Tuin, Inka; Beutel, Manfred E.
Greater Trochanteric Pain Syndrome: Epidemiology and Associated Factors
Objectives To describe the prevalence of greater trochanteric pain syndrome (GTPS); to determine whether GTPS is associated with iliotibial band (ITB) tenderness, knee osteoarthritis (OA), body mass index (BMI), or low back pain (LBP); and to assess whether GTPS is associated with reduced hip internal rotation, physical activity, and mobility. Design Cross-sectional, population-based study. Setting Multicenter observational study. Participants Community-dwelling adults (N=3026) ages 50 to 79 years. Interventions Not applicable. Main Outcome Measures Greater trochanteric tenderness to palpation in subjects with complaints of hip pain and no signs of hip OA or generalized myofascial tenderness. Results The prevalence of unilateral and bilateral GTPS was 15.0% and 8.5% in women and 6.6% and 1.9% men. Odds ratio (OR) for women was 3.37 (95% confidence interval [CI], 2.67–4.25), but age and race were not significantly associated with GTPS. In a multivariate model, adjusting for age, sex, ITB tenderness, ipsilateral and contralateral knee OA, BMI, and LBP, ITB tenderness (OR=1.72; 95% CI, 1.34–2.19), knee OA ipsilaterally (OR=3.47; 95% CI, 2.72–4.42) and con-tralaterally (OR=1.74; 95% CI, 1.32–2.28), and LBP (OR=2.79; 95% CI, 2.22–3.50) were positively related to GTPS. In this complete model, BMI was not associated with GTPS (OR=1.10; 95% CI, 0.80–1.52 when comparing ? 30 with <25kg/m2). Hip internal rotation range of motion did not differ based on GTPS status. After multivariate adjustment, GTPS did not alter physical activity score, but bilateal GTPS was significantly associated with a higher 20-meter walk time and chair stand time. Conclusions The higher prevalence of GTPS in women and in adults with ITB pain or knee OA indicates that altered lower-limb biomechanics may be related to GTPS. Slower functional performance in those with GTPS suggests that the study of targeted rehabilitation may be useful. A longitudinal study will be necessary to identify causal factors and outcomes of interventions. PMID:17678660
Segal, Neil A.; Felson, David T.; Torner, James C.; Zhu, Yanyan; Curtis, Jeffrey R.; Niu, Jingbo; Nevitt, Michael C.
Cancer pain remains undertreated. Pain occurs in over three-quarters of cancer patients and remains one of the most feared\\u000a aspects of this illness despite the excellent therapies that are available. Cancer pain commonly results from tumor compressing\\u000a or invading soft tissue, bone, or nerves or from diagnostic or therapeutic endeavors. Optimal pain management involves determining\\u000a pain intensity, evaluating the etiology
Suzanne A. Nesbit
Imaging the painful osteoarthritic knee joint: what have we learned?
Pain in the peripheral joints is an increasingly common problem, resulting in significant patient disability and health-care expenditure. Osteoarthritis (OA), a syndrome of joint pain with associated structural changes, is the most prevalent joint disease, yet the etiology of pain in OA is not entirely clear. Traditional assessment of the structure–pain relationship in knee OA has relied on conventional radiography,
Claire YJ Wenham; Philip G Conaghan
Children's catastrophic thinking about their pain predicts pain and disability 6 months later.
Catastrophic thinking about pain has been identified as an important determinant of adjustment to pain, in both adults and children. No study has investigated the prospective and unique role of catastrophizing in explaining later pain and disability in children. The aim of the present study was to investigate the prospective roles of catastrophic thinking about pain, pain intensity, and trait anxiety and their putative relationship with pain and disability tested 6 months later. Participants were 323 schoolchildren. Analyses revealed that the child's pain catastrophizing at baseline had a small but unique contribution to the prediction of pain and disability 6 months later, even when controlling for the initial pain and disability levels. In line with expectations, moderation analyses revealed that the effects of catastrophizing upon pain and disability at follow-up were only true for those children reporting low levels intensity of pain at baseline. The variability in disability and pain complaint could not be explained by trait anxiety. Instead anxious disposition might be best conceived of as a precursor of catastrophizing in children; i.e. children with higher levels of trait anxiety at baseline were more inclined to report higher levels of catastrophizing at follow-up. The findings are discussed in terms of potential mechanisms through which catastrophizing might exert its negative impact upon pain and disability outcomes in children. PMID:19359203
Vervoort, T; Eccleston, C; Goubert, L; Buysse, A; Crombez, G
The Biopsychosocial Approach to Chronic Pain: Scientific Advances and Future Directions
The prevalence and cost of chronic pain is a major physical and mental health care problem in the United States, the prevalence and cost of chronic pain is a major physical and mental health care problem in the United States a 19% prevalence for chronic spinal pain (neck and back) in the United States in the previous year
Meagher, Mary
INTRODUCTION Dynamics of Pain perception: Distinctive Features of Ongoing Chronic Pain Ratings Revealed By Nonlinear Analysis
highly prevalent conditions, post herpetic neuropathy (PHN) and chronic low back pain (CLBP), and normal subjects imagining back pain. We use a non-linear technique to demonstrate that the time-series examined spectrum gives the scaling exponent a. Lower Back Pain Example An analog to the power spectrum
Apkarian, A. Vania
NIH Pain Consortium PCORI Proposals Five pain-related proposals were submitted to PCORI for funding consideration
January NIH Pain Consortium PCORI Proposals · Five pain-related proposals were submitted to PCORI for funding consideration Call with Senate Staff · The Office of Pain Policy discussed the types, prevalence agenda, videocast, and presentations can be found on the IPRCC website National Pain Strategy Update
Chronic pain, defined as continuous or recurrent pain of three months duration, is a widespread problem in pediatric patients with an overall prevalence of up to 25% in a study of 5424 Dutch children 0 -18 years old1. The prevalence of chronic pain however varies considerably depending on patient age and sex. A peak incidence of chronic pain of nearly
John B. Rose
Pathogenesis of Painful Diabetic Neuropathy
The prevalence of diabetes is rising globally and, as a result, its associated complications are also rising. Painful diabetic neuropathy (PDN) is a well-known complication of diabetes and the most common cause of all neuropathic pain. About one-third of all diabetes patients suffer from PDN. It has a huge effect on a person's daily life, both physically and mentally. Despite huge advances in diabetes and neurology, the exact mechanism of pain causation in PDN is still not clear. The origin of pain could be in the peripheral nerves of the central nervous system. In this review, we discuss various possible mechanisms of the pathogenesis of pain in PDN. We discuss the role of hyperglycaemia in altering the physiology of peripheral nerves. We also describe central mechanisms of pain. PMID:24891949
Rajbhandari, Satyan
Adults with ADHD and Sleep Complaints: A Pilot Study Identifying Sleep-Disordered Breathing Using Polysomnography and Sleep Quality Assessment
ERIC Educational Resources Information Center
Objective: ADHD and sleep-disordered breathing are both prevalent in adulthood. Because both conditions may be responsible for similar symptoms of cognitive impairment, the authors investigate whether their presentation may overlap in adults diagnosed with ADHD. Method: Data are collected from six adults with sleep complaints who were diagnosed…
Surman, Craig B. H.; Thomas, Robert J.; Aleardi, Megan; Pagano, Christine; Biederman, Joseph
Pain management today—what have we learned?
Pain is a leading cause of morbidity worldwide, with published data showing its prevalence as high as 50% for chronic pain\\u000a in the European population. This prevalence is likely to continue to rise, particularly in elderly people with comorbid conditions\\u000a and complex aetiologies of pain. There is thus a rapidly growing demand for safe and effective pain management. Management\\u000a of
Richard M. Langford
Acupuncture for Cancer Pain and Related Symptoms
Cancer pain is one of most prevalent symptoms in patients with cancer. Acupuncture and related techniques have been suggested for the management of cancer pain. The National Comprehensive Cancer Network (NCCN®) guidelines for adult cancer pain recommends acupuncture, as one of integrative interventions, in conjunction with pharmacologic intervention as needed. This review presents the latest available evidence regarding the use of acupuncture for cancer pain. It also provides "actionable" acupuncture protocols for specific cancer pain conditions and related symptoms in order to provide more clinically relevant solutions for clinicians and cancer patients with pain. These conditions include postoperative cancer pain, postoperative nausea and vomiting, postsurgical gastroparesis syndrome, opioid-induced constipation, opioid-induced pruritus, chemotherapy-induced neuropathy, aromatase inhibitor-associated joint pain, and neck dissection-related pain and dysfunction. PMID:23338773
Lu, Weidong; Rosenthal, David S
Abdominal Pain following Gastric Bypass: Suspects & Solutions
Introduction Gastric bypass remains the mainstay of surgical therapy for obesity. Abdominal pain after gastric bypass is common, and accounts for up to half of all postoperative complaints and emergency room visits. This manuscript reviews the most important causes of abdominal pain specific to gastric bypass and discusses management considerations. Data Sources The current surgical literature was reviewed using PubMed, with a focus on abdominal pain after gastric bypass and the known pathologies that underlie its pathogenesis. Conclusions The differential diagnosis for abdominal pain after gastric bypass is large and includes benign and life-threatening entities. Its diverse causes require a broad evaluation that should be directed by history and clinical presentation. In the absence of a clear diagnosis, the threshold for surgical exploration in patients with abdominal pain after gastric bypass should be low. PMID:21333269
Greenstein, Alexander J.; O'Rourke, Robert W.
Backache; Low back pain; Lumbar pain; Pain - back; Acute back pain; Back pain - new; Back pain - short-term; Back strain - new ... back supports most of your body's weight. Low back pain is the number two reason that Americans see ...
Upper Extremity Thrombosis Presenting as Medial Elbow Pain after Shoulder Arthroscopy
Deep vein thrombosis of the upper extremity is believed to be an uncommon complication of arthroscopic shoulder surgery. It most commonly presents with significant swelling and pain throughout the upper extremity. However the diagnosis can be easily missed when findings are more subtle and unrelated or the patient asymptomatic. In this study we report on 5 cases of postoperative upper extremity deep vein thrombosis (UEDVT). Each case was performed in the lateral decubitus position with an interscalene block and postoperative sling immobilization. All patients presented with a primary complaint of medial elbow pain and went on to require anticoagulation. Only one patient was found to have a heritable coagulopathy. The true incidence of thromboembolic phenomena after shoulder arthroscopy may be higher than that reported in the current literature. Therefore a high index of suspicion must be maintained when evaluating patients postoperatively to avoid misdiagnosis. Symptoms of medial elbow pain after immobilization in a sling should be considered an indication for duplex ultrasound evaluation. Ultimately, further prospective study is needed to better understand the prevalence, prevention, and management of this entity. PMID:24772360
Manaqibwala, Moiz I.; Ghobrial, Irene E.; Curtis, Alan S.
Orofacial pain management: current perspectives
Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). Orofacial pain (OFP) can arise from different regions and etiologies. Temporomandibular disorders (TMD) are the most prevalent orofacial pain conditions for which patients seek treatment. Temporomandibular disorders include a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ) or both. Trigeminal neuropathic pain conditions can arise from injury secondary to dental procedures, infection, neoplasias, or disease or dysfunction of the peripheral and/or central nervous system. Neurovascular disorders, such as primary headaches, can present as chronic orofacial pain, such as in the case of facial migraine, where the pain is localized in the second and third division of the trigeminal nerve. Together, these disorders of the trigeminal system impact the quality of life of the sufferer dramatically. A multidisciplinary pain management approach should be considered for the optimal treatment of orofacial pain disorders including both non-pharmacological and pharmacological modalities. PMID:24591846
Romero-Reyes, Marcela; Uyanik, James M
... not cause the pain in those who have pleurisy (swelling of the lining of the lungs) or ... Inflammation of cartilage near the breastbone ( costochondritis ) Osteoporosis Pleurisy (the pain is worse when breathing deeply)
... Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, ... 10 people at some point during their lives. Back pain can range from a dull, constant ache to ...
Back Pain The Centers for Disease Control and Prevention's 2008 Health Report states that over 27% of the ... States population age 18 and older have active back pain. As many as 80-90% of Americans will ...
Low Back Pain in Port Machinery Operators
NASA Astrophysics Data System (ADS)
The occurrence of several types of low back pain (LBP) was investigated by a standardized questionnaire in a group of 219 port machinery operators exposed to whole-body vibration (WBV) and postural load and in a control group of 85 maintenance workers employed at the same transport company. The group of port machinery operators included 85 straddle carrier drivers, 88 fork-lift truck drivers, and 46 crane operators. The vector sum of the frequency-weighted r.m.s. acceleration of vibration measured on the seatpan of port vehicles and machines averaged 0·90 m/s2 for fork-lift trucks, 0·48 m/s2 for straddle carriers, 0·53 m/s2 for mobile cranes, and 0·22 m/s2 for overhead cranes. The 12-month prevalence of low back symptoms (LBP, sciatic pain, treated LBP, sick leave due to LBP) was significantly greater in the fork-lift truck drivers than in the controls and the other two groups of port machinery operators. After adjusting for potential confounders, the prevalence of low back symptoms was found to increase with the increase of WBV exposure expressed as duration of exposure (driving years), equivalent vibration magnitude (m/s2), or cumulative vibration exposure (yr m2/s4). An excess risk for lumbar disc herniation was observed in the port machinery operators with prolonged driving experience. In both the controls and the port machinery operators, low back complaints were strongly associated with perceived postural load assessed in terms of frequency and/or duration of awkward postures at work. Multivariate analysis showed that vibration exposure and postural load were independent predictors of LBP. Even though the cross-sectional design of the present study does not permit firm conclusions on the relationship between WBV exposure and low back disorders, the findings of this investigation provide additional epidemiological evidence that seated WBV exposure combined with non-neutral trunk postures, as while driving, is associated with an increased risk of long-term adverse health effects on the lower back.
Frequency of Migraine as a Chief Complaint in Otolaryngology Outpatient Practice
Objective. To identify the frequency of typical (headache and dizziness) and common atypical (ear fullness, pressure, pain, tinnitus, facial fullness, and nasal congestion) migraine symptoms as chief complaints among patients presenting to otolaryngology clinic. Methods. This is a descriptive study of prospectively collected data from a general otolaryngology practice. Typical migraine presentations were diagnosed by applying international headache society (IHS) criteria for migraine headache and Neuhauser's criteria for migrainous vertigo. Atypical otologic and rhinologic migraine symptoms were diagnosed using individualized criteria. Charts were reviewed at 6-month interval from the first presentation. Results. Out of 1002 consecutive patients, 10.8% presented with "migrainous chief complaint." All migrainous chief complaint patients had a history of headache but not all of them presented with headache. Corrected female to male ratio in the migraine group was 3 to 1; age distributions were significantly different between the migraine and nonmigraine groups by applying t-test. Out of the atypical complaints, 86% of the patients had a history of concomitant typical presentation. Conclusion. Actual diagnostic criteria for migraine do not satisfy the diversity of its presentation. Investigating the history of migraine is enough to diagnose most atypical presentations. Sound knowledge about migraine seems essential for any ENT practitioner.
Muhammad Ali, Maria; Al Zayer, Maha
Pain and Inflammatory Bowel Disease
Abdominal pain is a common symptom of inflammatory bowel disease (IBD: Crohn's disease, ulcerative colitis). Pain may arise from different mechanisms, which can include partial blockage and gut distention as well as severe intestinal inflammation. A majority of patients suffering from acute flares of IBD will experience pain, which will typically improve as disease activity decreases. However, a significant percentage of IBD patients continue experiencing symptoms of pain despite resolving inflammation and achieving what appears to be clinical remission. Current evidence suggests that sensory pathways sensitize during inflammation, leading to persistent changes in afferent neurons and central nervous system pain processing. Such persistent pain is not only a simple result of sensory input. Pain processing and even the activation of sensory pathways is modulated by arousal, emotion, and cognitive factors. Considering the high prevalence of iatrogenic as well as essential neuropsychiatric comorbidities including anxiety and depression in IBD patients, these central modulating factors may significantly contribute to the clinical manifestation of chronic pain. The improved understanding of peripheral and central pain mechanisms is leading to new treatment strategies that view pain as a biopsychosocial problem. Thus, improving the underlying inflammation, decreasing the excitability of sensitized afferent pathways, and altering emotional and/or cognitive functions may be required to more effectively address the difficult and disabling disease manifestations. PMID:19130619
Bielefeldt, Klaus; Davis, Brian; Binion, David G.
Self-reported Risk Factors Related to the Most Frequent Musculoskeletal Complaints among Czech Dentists.
The purpose of the study was to describe the occurrence of the most common complaints related to MSDs in Czech dentists and to assess the risk factors affecting them. A questionnaire survey of 581 Czech dentists (the response rate 72.6%) was conducted in 2011. The questionnaire ascertained general information about the respondents, their work habits and environment along with the occurrence of musculoskeletal disorders. The respondents filled out the questionnaires during the educational events organized by the Czech Dental Chamber. At least mild difficulties associated with the motoric system were reported by 96.9% of the respondents, with 66.3% of respondents reporting moderate or major difficulties. Back and neck pain followed by shoulder pain and headache were the most common complaints in our sample. According to our data: age, gender, length of practice, a history of serious MSDs, the occurrence of MSDs in blood relatives, the perception of work as psychologically demanding, and especially a perceived moderate/bad general health were significantly associated with the four most common musculoskeletal complaints. Some of the factors were found as protective. This study suggests that MSDs represent a significant burden for Czech dentists and further research is needed to elucidate this issue. PMID:25327296
Hodacova, Lenka; Sustova, Zdenka; Cermakova, Eva; Kapitan, Martin; Smejkalova, Jindra
Self-reported risk factors related to the most frequent musculoskeletal complaints among Czech dentists
The purpose of the study was to describe the occurrence of the most common complaints related to MSDs in Czech dentists and to assess the risk factors affecting them. A questionnaire survey of 581 Czech dentists (the response rate 72.6%) was conducted in 2011. The questionnaire ascertained general information about the respondents, their work habits and environment along with the occurrence of musculoskeletal disorders. The respondents filled out the questionnaires during the educational events organized by the Czech Dental Chamber. At least mild difficulties associated with the motoric system were reported by 96.9% of the respondents, with 66.3% of respondents reporting moderate or major difficulties. Back and neck pain followed by shoulder pain and headache were the most common complaints in our sample. According to our data: age, gender, length of practice, a history of serious MSDs, the occurrence of MSDs in blood relatives, the perception of work as psychologically demanding, and especially a perceived moderate/bad general health were significantly associated with the four most common musculoskeletal complaints. Some of the factors were found as protective. This study suggests that MSDs represent a significant burden for Czech dentists and further research is needed to elucidate this issue.
HODACOVA, Lenka; SUSTOVA, Zdenka; CERMAKOVA, Eva; KAPITAN, Martin; SMEJKALOVA, Jindra
[Complaints associated with locomotor system and other health problems of female health professionals.].
In a group of 393 nurses, laboratory assistants and rehabilitation workers, mean age 37.5 years, employed in the health services for an average period of 17.7 years the authors assessed, using an anonymous questionnaire, complaints regarding the locomotor apparatus and other health problems. Although the majority of respondents liked their jobs, 74% of the subjects suffered from vertebrogenic pain, painful feet (45 %), and headache (46 %). One third of the examined subjects reported insomnia and vertigo. Overweight was minimal in the investigated group. Physical activity was very restricted (only 14% of the women were regularly engaged in sports); an important factor was inadequate rest in 34 % of the women. As to weaknesses, the high rate of smokers was striking (33 %) and the popularity of sweets (30%) which apparently is associated with the stress of the medical profession. Social problems in interpersonal relations at the work place were mentioned by 28 % of the respondents. The percentage of subjects with impaired eyesight (22 %) was highly significant. From the investigation ensues that more attention should be paid to the control of risks in health professions, to regeneration of strength and prophylaxis of locomotor disorders by exercise. A major task is also to improve interpersonal relations and social problems of women in the health services. Key words: vertebrogenic complaints, articular complaints, stress among health professionals, prevention. PMID:20444388
Müller, I; Chlubnová, B
28 CFR 42.606 - General rules concerning EEOC action on complaints.
Code of Federal Regulations, 2011 CFR
...JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients...complaints. (a) A complaint of employment discrimination filed with...
28 CFR 42.606 - General rules concerning EEOC action on complaints.
Code of Federal Regulations, 2010 CFR
...JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients...complaints. (a) A complaint of employment discrimination filed with...
Pain - neck; Neck stiffness ... this as having a stiff neck. If neck pain involves nerves, you may feel numbness, tingling, or ... A common cause of neck pain is muscle strain or tension. Usually, ... Such activities include: Bending over a desk for hours Poor ...
Geriatric pain will be a significant health care problem in the next millennium. Pain can be acute due to trauma or surgery,\\u000a and chronic due to medical illnesses and their sequels. In this article, management of geriatric chronic pain is discussed.
Daniel Lynch
The primary purposes of acute pain and the reason it is noxious are to interrupt ongoing activity in order to warn the sufferer of tissue damage, to discourage movement that might exacerbate injury or prevent healing, and to teach the organism to avoid the pain-producing circumstances. Therefore, it is no wonder that when pain persists to become chronic, many sufferers
Malcolm H. Johnson
Self-reported musculoskeletal complaints among garment workers.
One hundred forty-four sewing machine operators answered questionnaires concerning occupational history and musculoskeletal symptoms adapted from the National Health and Nutrition Examination Survey. They were matched for age within 5 years, race, and sex with persons completing the HANES I Augmentation Survey, and the prevalence of self-reported musculoskeletal morbidity was compared. Operators complained significantly more often of knee pain (prevalence odds ratio [POR] = 1.84, p = .0001) and knee swelling (POR = 9.98, p less than .00001), although they were no more likely to have had knee surgery. Similar increases were reported for upper-back pain (POR = 2.13, p = .002) joint ache, and joint swelling (both were significant for fingers, wrists, elbows, and shoulders at p less than .05 levels). No differences in low-back pain or in hospitalization for joint conditions were noted. Ergonomic redesign of sewing machines needs to address knee and upper-back movements as well as the arm, wrist, and finger movements. PMID:2786337
Sokas, R K; Spiegelman, D; Wegman, D H
Chronic and Recurrent Pelvic Pain
\\u000a Chronic and recurrent pelvic pain (CPP) in children and adolescents has been recognized for decades. However, data on the\\u000a etiology, natural history, treatment, and long-term consequences of painful pelvic conditions in these patients are lacking.\\u000a The problem's prevalence remains uncertain, and the majority of therapies are extrapolated from research on adults. The normal\\u000a developmental changes and coping strategies of children
Lynda Wells
Page 1 of 5 Sexual Harassment Complaint,
Sexual Harassment and is intended as the means for implementing this policy. 2.0 GENERAL INFORMATION 2 be filed against employees, students, or third parties not affiliated with the School who are present the School's Unlawful Discrimination Policy and Complaint Procedure or the State of Colorado Personnel Board
Szymczak, Andrzej
7 CFR 47.6 - Formal complaints.
Code of Federal Regulations, 2010 CFR
...complaint with the Fruit and Vegetable...nonresident of the United States, complainant...either with a surety company approved by the Treasury Department of the United States as surety...a resident of the United States against...Upon receipt by the Fruit and Vegetable...
Student Complaints and Appeals: The Practitioner's View
ERIC Educational Resources Information Center
This article explores the issues facing practitioners working in the field of student complaints and appeals (including academic appeals). It is a reflective study which examines some general and historical issues, using anonymised case studies where appropriate and highlighting the diversity of practice across the sector. The author observes that…
Buckton, Liz
How to File a Complaint of Discrimination
How to File a Complaint of Discrimination Office for Equity and Diversity 179A Bascom Hall 500-Madison. http://adac.wisc.edu UW-Madison prohibits discrimination in employment and in all University programs and activities on a wide variety of bases, including prohibitions against sex discrimination and sexual
Sheridan, Jennifer
Prevalence of respiratory symptoms and cases suspicious for tuberculosis among public health clinic patients in Afghanistan,
Prevalence of respiratory symptoms and cases suspicious for tuberculosis among public health clinic of suspected pulmonary tuberculosis (TB) among patients with respiratory complaints attending Comprehensive Health Centers (CHCs) in Afghanistan. methods Consecutive consenting patients presenting with respiratory
Scharfstein, Daniel
Prevalence of radiographic primary hip and knee osteoarthritis in a representative Central European population.
The aim of our study was to determine the radiographic prevalence of hip and knee osteoarthritis and compare our results with prevalence data reported by other studies, as no similar study had been performed in Hungary previously. Our aim was also to investigate the usefulness of the different radiological scoring methods for the definition of osteoarthritis. Patients who earlier reported complaints and gave written consent were asked to participate in a clinical follow-up. In the 682 participants Harris hip score, visual analogue pain scale values for both joints, Knee Society score and knee functional score were calculated. Weight-bearing radiographs were taken of both joints. Kellgren-Lawrence radiological evaluation was performed and osteoarthritis prevalence was defined. Hip osteoarthritis was found in 109 cases (16.49%), and knee osteoarthritis was found in 111 cases (16.54%). Harris hip score, Knee Society score, functional score and visual analogue scale values were significantly worse in people with radiographically proven osteoarthritis compared to the control group (p?0.05). Significantly higher osteoarthritis prevalence of both joints was found in those with increased body mass index values. Age also plays a significant role in the development of both hip and knee osteoarthritis. No significant difference was observed between male and female participants regarding osteoarthritis prevalence. The Kellgren-Lawrence score with a cut-off value of 2 or more is a useful evaluation method for the detection of osteoarthritis prevalence in epidemiological studies; according to our observations, in clinical practice a cut-off value of three or more is more relevant. PMID:20556380
Horváth, Gábor; Koroknai, Gabriella; Ács, Barnabás; Than, Péter; Bellyei, Árpád; Illés, Tamás
32 CFR 1901.04 - Suggestions and complaints.
Code of Federal Regulations, 2010 CFR
...suggestions or complaints with regard to its administration of the Privacy Act. Many requesters will receive pre-paid, customer satisfaction survey cards. Letters of suggestion or complaint should identify the specific purpose and the issues for...
32 CFR 1901.04 - Suggestions and complaints.
Code of Federal Regulations, 2011 CFR
...suggestions or complaints with regard to its administration of the Privacy Act. Many requesters will receive pre-paid, customer satisfaction survey cards. Letters of suggestion or complaint should identify the specific purpose and the issues for...
32 CFR 1900.04 - Suggestions and complaints.
Code of Federal Regulations, 2010 CFR
...complaints with regard to its administration of the Freedom of Information Act. Many requesters will receive pre-paid, customer satisfaction survey cards. Letters of suggestion or complaint should identify the specific purpose and the issues for...
32 CFR 1900.04 - Suggestions and complaints.
Code of Federal Regulations, 2013 CFR
...complaints with regard to its administration of the Freedom of Information Act. Many requesters will receive pre-paid, customer satisfaction survey cards. Letters of suggestion or complaint should identify the specific purpose and the issues for...
32 CFR 1901.04 - Suggestions and complaints.
Code of Federal Regulations, 2012 CFR
...suggestions or complaints with regard to its administration of the Privacy Act. Many requesters will receive pre-paid, customer satisfaction survey cards. Letters of suggestion or complaint should identify the specific purpose and the issues for...
32 CFR 1901.04 - Suggestions and complaints.
Code of Federal Regulations, 2013 CFR
...suggestions or complaints with regard to its administration of the Privacy Act. Many requesters will receive pre-paid, customer satisfaction survey cards. Letters of suggestion or complaint should identify the specific purpose and the issues for...
32 CFR 1900.04 - Suggestions and complaints.
Code of Federal Regulations, 2012 CFR
...complaints with regard to its administration of the Freedom of Information Act. Many requesters will receive pre-paid, customer satisfaction survey cards. Letters of suggestion or complaint should identify the specific purpose and the issues for...
32 CFR 1900.04 - Suggestions and complaints.
Code of Federal Regulations, 2011 CFR
...complaints with regard to its administration of the Freedom of Information Act. Many requesters will receive pre-paid, customer satisfaction survey cards. Letters of suggestion or complaint should identify the specific purpose and the issues for...
32 CFR 513.2 - Administrative procedures for processing complaints.
Code of Federal Regulations, 2010 CFR
...Administrative procedures for processing complaints. 513.2 Section...Administrative procedures for processing complaints. (a) Commander's...believed the creditor's debt processing privileges should be revoked...affects the Army's public image. Also, explain that...
32 CFR 513.2 - Administrative procedures for processing complaints.
Code of Federal Regulations, 2013 CFR
...Administrative procedures for processing complaints. 513.2 Section...Administrative procedures for processing complaints. (a) Commander's...believed the creditor's debt processing privileges should be revoked...affects the Army's public image. Also, explain that...
32 CFR 513.2 - Administrative procedures for processing complaints.
Code of Federal Regulations, 2011 CFR
...Administrative procedures for processing complaints. 513.2 Section...Administrative procedures for processing complaints. (a) Commander's...believed the creditor's debt processing privileges should be revoked...affects the Army's public image. Also, explain that...
32 CFR 513.2 - Administrative procedures for processing complaints.
Code of Federal Regulations, 2012 CFR
...Administrative procedures for processing complaints. 513.2 Section...Administrative procedures for processing complaints. (a) Commander's...believed the creditor's debt processing privileges should be revoked...affects the Army's public image. Also, explain that...
29 CFR 1977.15 - Filing of complaint for discrimination.
Code of Federal Regulations, 2010 CFR
... false Filing of complaint for discrimination. 1977.15 Section 1977.15...DEPARTMENT OF LABOR (CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS...1977.15 Filing of complaint for discrimination. (a) Who may file. A...
20 CFR 355.6 - Prerequisites for issuing a complaint.
Code of Federal Regulations, 2010 CFR
...2010-04-01 false Prerequisites for issuing a complaint. 355.6 Section 355.6 Employees' Benefits RAILROAD RETIREMENT BOARD...UNDER THE PROGRAM FRAUD CIVIL REMEDIES ACT OF 1986 § 355.6 Prerequisites for issuing a complaint....
On the relationship between blast noise complaints and community annoyance.
Military installations typically rely on noise complaints to indicate adverse noise environments and often restrict the firing of certain weapons to reduce the number of noise complaints. Using complaints in this manner may also imply that the absence of complaints is an indicator of low community annoyance. The relationship between individual complaints and general community annoyance, however, is currently not established, and it is unknown whether implementing restrictions in reaction to individual complaints is an appropriate or necessary way to reduce community annoyance. This paper looks at whether there are significant differences in reported annoyance to complaint-referenced blast events and general military noise annoyance between those who complain and their non-complaining neighbors. Those who complained were significantly more annoyed to both complaint-referenced blast events and general military noise in comparison to their non-complaining neighbors. The implications of these findings are discussed in terms of range management. PMID:23654377
Nykaza, Edward T; Hodgdon, Kathleen K; Gaugler, Trent; Krecker, Peg; Luz, George A
45 CFR 672.7 - Issuance of complaint.
Code of Federal Regulations, 2011 CFR
...Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.7...complaint. The complainant may amend the complaint once as a matter of right at any time before the answer is filed....
29 CFR 1954.20 - Complaints about State program administration.
Code of Federal Regulations, 2010 CFR
...false Complaints about State program administration. 1954.20 Section 1954.20... OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED...PLANS Complaints About State Program Administration (CASPA) § 1954.20...
47 CFR 68.417 - Informal complaints; form and content.
Code of Federal Regulations, 2010 CFR
...CONTINUED) CONNECTION OF TERMINAL EQUIPMENT TO THE TELEPHONE NETWORK Complaint Procedures § 68.417 Informal complaints...alleging a violation of hearing aid compatibility and/or volume control rules in this subpart may be transmitted to the...
32 CFR 112.5 - Processing of debt complaints.
Code of Federal Regulations, 2011 CFR
...112.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN INDEBTEDNESS OF MILITARY PERSONNEL § 112.5 Processing of debt complaints. (a) Debt complaints meeting the...
32 CFR 112.5 - Processing of debt complaints.
Code of Federal Regulations, 2010 CFR
...112.5 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN INDEBTEDNESS OF MILITARY PERSONNEL § 112.5 Processing of debt complaints. (a) Debt complaints meeting the...
47 CFR 8.14 - General formal complaint procedures.
Code of Federal Regulations, 2013 CFR
...procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general pleading...
47 CFR 8.14 - General formal complaint procedures.
Code of Federal Regulations, 2011 CFR
...procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general pleading...
47 CFR 8.14 - General formal complaint procedures.
Code of Federal Regulations, 2012 CFR
...procedures. 8.14 Section 8.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRESERVING THE OPEN INTERNET § 8.14 General formal complaint procedures. (a) Complaints. In addition to the general pleading...
40 CFR 7.180 - Mediation of age discrimination complaints.
Code of Federal Regulations, 2011 CFR
...2011-07-01 false Mediation of age discrimination complaints. 7.180 Section...ENVIRONMENTAL PROTECTION AGENCY Discrimination Prohibited on the Basis of Age § 7.180 Mediation of age discrimination complaints. (a) The...
29 CFR 1977.15 - Filing of complaint for discrimination.
Code of Federal Regulations, 2011 CFR
... false Filing of complaint for discrimination. 1977.15 Section 1977.15...DEPARTMENT OF LABOR (CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS...1977.15 Filing of complaint for discrimination. (a) Who may file. A...
40 CFR 7.180 - Mediation of age discrimination complaints.
Code of Federal Regulations, 2012 CFR
...2012-07-01 false Mediation of age discrimination complaints. 7.180 Section...ENVIRONMENTAL PROTECTION AGENCY Discrimination Prohibited on the Basis of Age § 7.180 Mediation of age discrimination complaints. (a) The...
29 CFR 1977.15 - Filing of complaint for discrimination.
Code of Federal Regulations, 2013 CFR
... false Filing of complaint for discrimination. 1977.15 Section 1977.15...DEPARTMENT OF LABOR (CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS...1977.15 Filing of complaint for discrimination. (a) Who may file. A...
40 CFR 7.180 - Mediation of age discrimination complaints.
Code of Federal Regulations, 2013 CFR
...2013-07-01 false Mediation of age discrimination complaints. 7.180 Section...ENVIRONMENTAL PROTECTION AGENCY Discrimination Prohibited on the Basis of Age § 7.180 Mediation of age discrimination complaints. (a) The...
29 CFR 1977.15 - Filing of complaint for discrimination.
Code of Federal Regulations, 2012 CFR
... false Filing of complaint for discrimination. 1977.15 Section 1977.15...DEPARTMENT OF LABOR (CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS...1977.15 Filing of complaint for discrimination. (a) Who may file. A...
Pain in Parkinson's Disease Associated with COMT Gene Polymorphisms
Background. PD patients present high incidence of pain with unknown pathogenesis. Objective. We investigated the relation of COMT polymorphisms rs4633 and rs6267 with PD pain. Subjects and Methods. One hundred PD patients and 105 controls were evaluated with simplified Mc GILL pain scale and VAS scale. PD patients were assessed with H&Y grade, UPDRS score, and HAMD scale. Polymorphisms rs4633 and rs6267 were detected by PCR and direct sequencing. Results. Fifty-seven percent of PD patients experienced pain, consisting of PD-related pain (64.91%) (the majority was dystonia pain) and non-PD-related pain (35.09%) (psychogenic pain was most frequent). The frequency of rs6267 genotype "GT/TT" and allele "T" was higher in PD pain. No difference was observed in frequencies of rs4633 between PD pain and without pain. UPDRS and depression score were higher in PD pain. The onset age was earlier in PD-related pain (57.43 ± 19.71) than non-PD-related pain (63.36 ± 6.88). Conclusion. PD patients possess a high prevalence of pain. Dystonia pain was the most frequent type of PD-related pain. COMT gene rs6267 allele "T" associated with PD pain. PD pain was influenced by disease severity and depression. PD onsets earlier in patients with PD-related pain than non-PD-related pain. PMID:24825955
Li, Wanjun; Chen, Yongqian; Yin, Bowen; Zhang, Limei
Cross-sectional assessment of pain and physical function in skeletal dysplasia patients.
Short stature skeletal dysplasia (SD) patients have orthopedic and neurologic complications causing significant pain and physical disability. We conducted a large cross-sectional online survey in 361 people with short stature SD (>10?years) to describe pain prevalence, characteristics, and the relationship between pain and function. Chronic pain prevalence per Brief Pain Inventory (BPI) was 70.3%. Women reported more pain than men (73% vs 63% p?=?0.04). Pain Severity Score (average of current, worst, least and average pain) averaged 3.3?±?2, while the Pain Interference Score (with daily activities) averaged 3.4?±?2.7 on a 10-point scale. Per Bleck scale, 20.5% had little or no functional capacity. Increasing age and decreased ambulation independently predicted chronic pain. Chronic pain is prevalent in short stature SD patients and associated with poor physical function. Further study is required to clarify the temporal relationship among pain, function and treatments. PMID:23106480
Alade, Y; Tunkel, D; Schulze, K; McGready, J; Jallo, G; Ain, M; Yost, T; Hoover-Fong, J
Non-invasive brain stimulation techniques for chronic pain in adults
Description of the condition: Chronic pain is a common problem. When defined as pain of greater than three months duration, prevalence studies indicate that up to half the adult population suffer from chronic pain, and 10 to 20% experience clinically significant chronic pain (Smith 2008). In Europe 19% of adults experience chronic pain of moderate to severe intensity with serious
Neil E OConnell; Benedict M Wand; Louise Marston; Sally Spencer; Lorraine H De Souza
Psychosocial Working Conditions and Cognitive Complaints among Swedish Employees
Background Cognitive complaints involving problems with concentration, memory, decision-making and thinking are relatively common in the work force. The sensitivity of both subjective and objective cognitive functioning to common psychiatric conditions, stress levels and to cognitive load makes it plausible that psychosocial working conditions play a role in cognitive complaints. Thus, this study aimed to test the associations between psychosocial work factors and cognitive complaints in nationally representative samples of the Swedish work force. Cross-sectional (n?=?9751) and prospective (n?=?3644; two time points two years apart) sequential multiple regression analyses were run, adjusting for general confounders, depressive- and sleeping problems. Additional prospective analyses were run adjusting for baseline cognitive complaints. Cross-sectional results High quantitative demands, information and communication technology (ICT) demands, underqualification and conflicts were positively associated with cognitive complaints, while social support, good resources at work and overqualification were negatively associated with cognitive complaints in all models. Skill discretion and decision authority were weakly associated with cognitive complaints. Conflicts were more strongly associated with cognitive complaints in women than in men, after adjustment for general confounders. Prospective results Quantitative job demands, ICT demands and underqualification were positively associated with future cognitive complaints in all models, including when adjusted for baseline cognitive complaints. Decision authority was weakly positively associated with future cognitive complaints, only after adjustment for depressive- and sleeping problems respectively. Social support was negatively associated with future cognitive complaints after adjustment for general confounders and baseline cognitive complaints. Skill discretion and resources were negatively associated with future cognitive complaints after adjustment for general confounders. The associations between quantitative demands and future cognitive complaints were stronger in women. Discussion/Conclusions The findings indicate that psychosocial working conditions should be taken into account when considering cognitive complaints among employees. PMID:23560101
Stenfors, Cecilia U. D.; Magnusson Hanson, Linda; Oxenstierna, Gabriel; Theorell, Töres; Nilsson, Lars-Göran
Complaints Handling Procedure Annual Report 2013/14
Complaints Handling Procedure Annual Report 2013/14 Background 1. The Public Services Reform including higher education. The main aims of the model CHP are early resolution of a complaint as close August 2013. The University's Complaints Handling Procedure is available here: http://www.strath.ac.uk
Mottram, Nigel
Perceived stress and everyday memory complaints among older adult women
Memory complaints among older adults are often influenced by depression and anxiety, but the association of stress to memory complaints has received little attention. We examined the associations of perceived stress, life events, and activity level to everyday memory complaints among healthy older women, while controlling for the influence of depression and anxiety. Participants (N=54) completed self-report questionnaires on memory
Guy G. Potter; Marilyn Hartman; Taeh Ward
Report a Complaint (about a Health Care Organization)
... Complaint Do you have a complaint about a health care organization? What can you do about complaints that The Joint Commission cannot help with? You may want to talk to the organization about your concern. Your state's department of health may be able to help. What information do ...
Experiences of employees with arm, neck or shoulder complaints: a focus group study
Background Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. Methods A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. Results Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). Conclusions Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an existing self-management program to the characteristics of employees suffering from CANS. PMID:24779360
Pregnancy-related low back pain
Pregnancy related low back pain is a common complaint among pregnant women. It can potentially have a negative impact on their quality of life. The aim of this article is to present a current review of the literature concerning this issue. By using PubMed database and low back pain, pelvic girdle pain, pregnancy as keywords, abstracts and original articles in English investigating the diagnosis treatment of back pain during pregnancy were searched and analyzed Low back pain could present as either a pelvic girdle pain between the posterior iliac crest and the gluteal fold or as a lumbar pain over and around the lumbar spine. The source of the pain should be diagnosed and differentiated early.The appropriate treatment aims to reduce the discomfort and the impact on the pregnant womans quality of life. This article reveals the most common risk factors, as well as treatment methods, which may help to alleviate the pain. Some suggestions for additional research are also discussed. PMID:22435016
Katonis, P; Kampouroglou, A; Aggelopoulos, A; Kakavelakis, K; Lykoudis, S; Makrigiannakis, A; Alpantaki, K
20 CFR 901.36 - Service of complaint and other papers.
Code of Federal Regulations, 2010 CFR
...false Service of complaint and other papers. 901.36 Section 901.36 Employees...36 Service of complaint and other papers. (a) Complaint. ...proof of such service. (b) Service of papers other than complaint. Any paper...
31 CFR 15.737-13 - Service of complaint and other papers.
Code of Federal Regulations, 2010 CFR
...false Service of complaint and other papers. 15.737-13 Section 15.737-13...737-13 Service of complaint and other papers. (a) Complaint. ...proof of such service. (b) Service of papers other than complaint. Any paper...
Knee complaints seen in general practice: active sport participants versus non-sport participants
Background Since knee complaints are common among athletes and are frequently presented in general practice, it is of interest to investigate the type of knee complaints represented in general practice of athletes in comparison with those of non-athletes. Therefore, the aim of this study is to investigate the differences in type of knee complaints between sport participants, in this study defined as athletes, and non-sport participants, defined as non-athletes, presenting in general practice. Further, differences in the initial policy of the GP, medical consumption, and outcome at one-year follow-up were also investigated. Methods Patients consulting their GP for a new episode of knee complaints were invited to participate in this prospective cohort study. From the total HONEUR knee cohort population (n = 1068) we extracted patients who were athletes (n = 421) or non-athletes (n = 388). Results The results showed that acute distortions of the knee were significantly more diagnosed in athletes than in non-athletes (p = 0.04). Further, more athletes were advised by their GP to 'go easy on the knee' than the non-athletes (p < 0.01), but no differences were found in number of referrals and medication prescribed by the GP. The medical consumption was significantly higher among athletes; however, no significant differences were found between the two groups for recovery at one-year follow-up. Conclusion There are no major differences in the diagnosis and prognosis of knee complaints between athletes and non-athletes presented to the GP. This implies that there are no indications for different treatment strategies applied in both groups. However, athletes are more often advised to 'go easy on the knee' and to rest than non-athletes. Further, there is a trend towards increased medical consumption among athletes while functional disability and pain are lower than among the non-athletes. PMID:18366679
van Middelkoop, Marienke; van Linschoten, Robbart; Berger, Marjolein Y; Koes, Bart W; Bierma-Zeinstra, Sita MA
Chronic lower back pain due to sarcoma.
We describe a 74-year-old woman with extensive pelvic leiomyosarcoma presenting with uncharacteristic musculoskeletal pain of the lumbosacral region and left lower extremity. Hemipelvectomy was considered the treatment of choice, and a model for a pelvic prosthesis was constructed based on imaging analysis. However, the tumour (and the complaints) responded surprisingly well to a combined treatment regimen including superselective arterial catheter embolization, which led to tumour regression to such a degree that aggressive surgical treatment became unnecessary. PMID:9631756
Hueber, W; Dominkus, M; Vesely, M; Mendel, M; Kotz, R; Czembirek, H; Smolen, J S
Nonspecific back pain; Backache - chronic; Lumbar pain - chronic; Pain - back - chronic; Chronic back pain - low ... waist, leads to pain. Many people with chronic back pain have arthritis. Or they may have extra wear ...
Neuropathic pain is triggered by lesions to the somatosensory nervous system that alter its structure and function so that pain occurs spontaneously and responses to noxious and innocuous stimuli are pathologically amplified. The pain is an expression of maladaptive plasticity within the nociceptive system, a series of changes that constitute a neural disease state. Multiple alterations distributed widely across the nervous system contribute to complex pain phenotypes. These alterations include ectopic generation of action potentials, facilitation and disinhibition of synaptic transmission, loss of synaptic connectivity and formation of new synaptic circuits, and neuroimmune interactions. Although neural lesions are necessary, they are not sufficient to generate neuropathic pain; genetic polymorphisms, gender, and age all influence the risk of developing persistent pain. Treatment needs to move from merely suppressing symptoms to a disease-modifying strategy aimed at both preventing maladaptive plasticity and reducing intrinsic risk. PMID:19400724
Costigan, Michael; Scholz, Joachim; Woolf, Clifford J.
Latent Variable Analysis of Coping, Anxiety/Depression, and Somatic Symptoms in Adolescents with Chronic Pain
ERIC Educational Resources Information Center
Reports of adolescents' coping with recurrent pain, symptoms of anxiety/depression, and somatic complaints were obtained from a sample of 164 adolescents with recurrent abdominal pain and their parents. Confirmatory factor analysis revealed that coping consisted of 3 nonorthogonal factors: Primary Control Engagement Coping (problem solving,…
Compas, Bruce E.; Boyer, Margaret C.; Stanger, Catherine; Colletti, Richard B.; Thomsen, Alexandra H.; Dufton, Lynette M.; Cole, David A.
Adult Outcomes of Pediatric Recurrent Abdominal Pain: Do They Just Grow Out of It?
Objective. To determine whether medi- cally unexplained recurrent abdominal pain (RAP) in childhood predicts abdominal pain, irritable bowel syn- drome (IBS), other somatic complaints, and psychiatric symptoms and disorders in young adulthood. Methods. A sample of 28 young adults evaluated for RAP between the ages of 6 and 17 years were compared with 28 individually matched former childhood partici- pants
John V. Campo; Carlo Di Lorenzo; Laurel Chiappetta; D. Kathleen Colborn; J. Carlton Gartner; Paul Gaffney; Samuel Kocoshis; David Brent
Parents' Experiences of Pain and Discomfort in People with Learning Disabilities
ERIC Educational Resources Information Center
There are few measures of pain for people with limited ability to communicate. Eight parents of adults with a known learning disability and associated physical health complaint were interviewed to explore their experience of identifying and managing the pain felt by their children. The parents did not often perceive their son or daughter to be in…
Clarke, Zara Jane; Thompson, Andrew R.; Buchan, Linda; Combes, Helen
Transdermal Opioids for Cancer Pain Management
•The prevalence of pain in cancer is up to 90%, more than 45% of this can be adequately managed using the World Health Organisation three step analgesic ladder.•Transdermal opioids are safe, effective, and produce significantly fewer side effects than oral morphine when used for moderate to severe cancer pain.•Transdermal buprenorphine has a lower incidence of systemic side effects than transdermal
Rohan Hasmukh Vithlani; Ganesan Baranidharan
Pain in cognitively impaired nursing home patients
Pain is an understudied problem in frail elderly patients, especially those with cognitive impairment, delirium, or dementia. The focus of this study was to describe the pain experienced by patients in skilled nursing homes, which have a high prevalence of cognitive impairment. A random sample of 325 subjects was selected from ten community skilled nursing homes. Subjects underwent a cross-sectional
Bruce A. Ferrell; Betty R. Ferrell; Lynne Rivera
Upper Body Quadrant Pain in Bus Drivers
The aims of this study were to evaluate the prevalence of upper body quadrant pain among Israeli professional urban bus drivers and to evaluate the association between individual, ergonomic, and psychosocial risk factors and occurrence of neck pain. Three hundred and eighty-four male urban bus drivers were consecutively enrolled in the study. Data pertaining to work-related ergonomic and psychosocial stress
Deborah Alperovitch-Najenson; Michal Katz-Leurer; Yoav Santo; Diana Golman; Leonid Kalichman
The effectiveness of cancer pain therapy is influenced by the attitudes and knowledge of the treating physicians. As part of a quality improvement project in the management of cancer pain, a survey of 236 medical practitioners was conducted. One hundred seventy-six respondents (74.5%) completed the survey. Fifty-two percent treated patients with cancer pain several times a week or more. Whereas
Rama Sapir; Raphael Catane; Nurith Strauss-Liviatan; Nathan I. Cherny
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is central pain, a neuropathic pain syndrome caused by a lesion in the brain or spinal cord that sensitizes one's perception of pain. It is a debilitating condition caused by various diseases such as multiple sclerosis, strokes, spinal cord injuries, or brain tumors. Varied symptoms and the use of pharmacological medicines and nonpharmacological therapies will be addressed. PMID:25295639
Singh, Supreet
Determining the pain-affecting factors of university students with nonspecific low back pain.
[Purpose] This study was conducted on university students with nonspecific low back pain in order to determine the independent variables that affect their pain. [Methods] A total of 514 students were included in this study. Pain was evaluated using a Visual Analogue Scale (VAS). A special form was prepared in order to evaluate the following independent variables: gender, weight, height, Body Mass Index (BMI), working periods sitting straight (television, computer, seminar, etc.), working periods bending at a table (reading, writing, etc.), using lumbar support while sitting, the mean duration of pain within the last one year, type of pain, time of the pain, faculty, class, physical activity habits and smoking. The collected data were evaluated using the CHAID (Chi-squared Automatic Interaction Detection) analysis method. [Results] The working hours bending at a table, physical activity, height, weight, BMI and educational departments were found not to affect the severity of the pain. The pain severity was affected by the duration of pain complaints within the last one year, the duration of working staying upright, smoking, classes, usage of lumbar support and age variables. [Conclusions] The results of this study show that nonspecific low back pain of university students is affected by many factors such as smoking, class, age, using a computer and lumbar support. PMID:24409020
Taspinar, Ferruh; Taspinar, Betul; Cavlak, Ugur; Celik, Erdal
Determining the Pain-Affecting Factors of University Students with Nonspecific Low Back Pain
[Purpose] This study was conducted on university students with nonspecific low back pain in order to determine the independent variables that affect their pain. [Methods] A total of 514 students were included in this study. Pain was evaluated using a Visual Analogue Scale (VAS). A special form was prepared in order to evaluate the following independent variables: gender, weight, height, Body Mass Index (BMI), working periods sitting straight (television, computer, seminar, etc.), working periods bending at a table (reading, writing, etc.), using lumbar support while sitting, the mean duration of pain within the last one year, type of pain, time of the pain, faculty, class, physical activity habits and smoking. The collected data were evaluated using the CHAID (Chi-squared Automatic Interaction Detection) analysis method. [Results] The working hours bending at a table, physical activity, height, weight, BMI and educational departments were found not to affect the severity of the pain. The pain severity was affected by the duration of pain complaints within the last one year, the duration of working staying upright, smoking, classes, usage of lumbar support and age variables. [Conclusions] The results of this study show that nonspecific low back pain of university students is affected by many factors such as smoking, class, age, using a computer and lumbar support. PMID:24409020
Taspinar, Ferruh; Taspinar, Betul; Cavlak, Ugur; Celik, Erdal
PAIN SCALES (ATTACHMENT A) 0-10 NUMERIC PAIN INTENSITY SCALE 0 1 2 3 4 5 6 7 8 9 10 NO PAIN MODERATE WORST PAIN PAIN #12;PAIN SCALES (ATTACHMENT A) FLACC PAIN SCALE The FLACC is a behavioral pain assessment scale for use in non-verbal patients unable to provide numeric reports of pain. SCORING Categories
Oliver, Douglas L.
Complaint Behaviors of the Millennial Generation
Major Subject: Recreation, Park, and Tourism Sciences iii ABSTRACT Complaint Behaviors of the Millennial Generation. (December 2009) Brittany Diane Philmon, B.A., Texas A&M University Chair of Advisory Committee: Dr. Ulrike Gretzel... ACKNOWLEDGEMENTS I would like to thank my committee chair, Dr. Gretzel, and my committee members, Dr. Outley, and Dr. Rutherford, for their guidance and support throughout the course of this research. Your motivation and faith in my abilities truly made all...
Philmon, Brittany Diane
Postoperative sleep disruptions: a potential catalyst of acute pain?
Despite the substantial advances in the understanding of pain mechanisms and management, postoperative pain relief remains an important health care issue. Surgical patients also frequently report postoperative sleep complaints. Major sleep alterations in the postoperative period include sleep fragmentation, reduced total sleep time, and loss of time spent in slow wave and rapid eye movement sleep. Clinical and experimental studies show that sleep disturbances may exacerbate pain, whereas pain and opioid treatments disturb sleep. Surgical stress appears to be a major contributor to both sleep disruptions and altered pain perception. However, pain and the use of opioid analgesics could worsen sleep alterations, whereas sleep disruptions may contribute to intensify pain. Nevertheless, little is known about the relationship between postoperative sleep and pain. Although the sleep-pain interaction has been addressed from both ends, this review focuses on the impact of sleep disruptions on pain perception. A better understanding of the effect of postoperative sleep disruptions on pain perception would help in selecting patients at risk for more severe pain and may facilitate the development of more effective and safer pain management programs. PMID:24074687
Chouchou, Florian; Khoury, Samar; Chauny, Jean-Marc; Denis, Ronald; Lavigne, Gilles J
Treatment Considerations for Cancer Pain: A Global Perspective.
Cancer pain is prevalent, undertreated, and feared by patients with cancer. In April 2013, a panel of pain experts convened in Singapore to address the treatment of cancer pain. They discussed the various types of cancer pain, including breakthrough pain, which is sometimes clinically confused with analgesic gaps. Reasons for undertreating cancer pain include attitudes of patients, clinicians, and factors associated with healthcare systems. The consequences of not treating cancer pain may include reduced quality of life for patients with cancer (who now live longer than ever), functional decline, and increased psychological stress. Early analgesic intervention for cancer pain may reduce the risk of central sensitization and chronification of pain. To manage pain in oncology patients, clinicians should assess pain during regular follow-up visits using validated pain measurement tools and follow prescribing guidelines, if necessary referring patients with cancer to pain specialists. Many patients with cancer require opioids for pain relief. Pain associated with cancer may also relate to cancer treatments, such as chemotherapy-induced peripheral neuropathy. Many patients with cancer are what might be considered "special populations," in that they may be elderly, frail, comorbid, or have end-stage organ failure. Specific pain therapy guidelines for those populations are reviewed. Patients with cancer with a history of or active substance abuse disorder deserve pain control but may require close medical supervision. While much "treatment inertia" exists in cancer pain control, cancer pain can be safely and effectively managed and should be carried out to alleviate suffering and improve outcomes. PMID:25469726
Pergolizzi, Joseph V; Gharibo, Christopher; Ho, Kok-Yuen
Psychosocial Correlates of Recurrent Childhood Pain: A Comparison of Pediatric Patients With Recurrent Abdominal Pain, Organic Illness, and Psychiatric Disorders
Pediatric patients with recurrent abdominal pain (RAP) were compared with patients with peptic disease, patients with emotional disorders, and well children with regard to (a) emotional and somatic symptoms and (b) theoretically derived variables, including negative life events, competence, family functioning, and the modeling and encouragement of illness behavior. RAP patients had levels of emotional distress and somatic complaints higher
Lynn S. Walker; Judy Garber; John W. Greene
The purpose of the present article is to provide unification to a number of somewhat disparate themes in the chronic pain and phobia literature. First, we present a summary review of the early writings and current theoretical perspectives regarding the role of avoidance in the maintenance of chronic pain. Second, we present an integrative review of recent empirical investigations of
Gordon J. G Asmundson; Peter J Norton; G. Ron Norton
Pain frequency moderates the relationship between pain catastrophizing and pain
Background: Pain frequency has been shown to influence sensitization, psychological distress, and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method: A non-clinical (247 students) and a clinical (223 pain patients) sample completed the Danish versions of the Pain Catastrophizing Scale (PCS), Beck Depression Inventory, and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency. Results: In both samples, high pain frequency was found to moderate the association between pain catastrophizing and pain intensity, whereas low pain frequency did not. The psychometric properties and the factor structure of the Danish version of the PCS were confirmed. Conclusions: This is the first study to validate the Danish version of the PCS and to show that pain frequency moderates the relationship between pain catastrophizing and reported pain in both non-clinical and clinical populations. PMID:25646089
Kjřgx, Heidi; Zachariae, Robert; Pfeiffer-Jensen, Mogens; Kasch, Helge; Svensson, Peter; Jensen, Troels S.; Vase, Lene
Pain in patients with multiple sclerosis: a complex assessment including quantitative and qualitative measurements provides for a disease-related biopsychosocial pain model
Background: Pain of various causes is a common phenomenon in patients with Multiple Sclerosis (MS). A biopsychosocial perspective has proven a useful theoretical construct in other chronic pain conditions and was also started in MS. To support such an approach, we aimed to investigate pain in MS with special emphasis on separating quantitative and qualitative aspects, and its interrelation to behavioral and physical aspects. Materials and methods: Pain intensity (NRS) and quality (SES) were measured in 38 consecutive outpatients with MS (mean age, 42.0 ± 11.5 years, 82% women). Pain-related behavior (FSR), health care utilization, bodily complaints (GBB-24) and fatigue (WEIMuS) were assessed by questionnaires, and MS-related neurological impairment by a standardized neurological examination (EDSS). Results: Mean pain intensity was 4.0 (range, 0–10) and mean EDSS 3.7 (range, 0–8) in the overall sample. Currently present pain was reported by 81.6% of all patients. Disease duration and EDSS did not differ between patients with and without pain and were not correlated to quality or intensity of pain. Patients with pain had significantly higher scores of musculoskeletal complaints, but equal scores of exhaustion, gastrointestinal and cardiovascular complaints. Pain intensity correlated only with physical aspects, whereas quality of pain was additionally associated with increased avoidance, resignation and cognitive fatigue. Conclusion: As in other conditions, pain in MS must be assessed in a multidimensional way. Further research should be devoted to adapt existing models to a MS-specific model of pain. PMID:21887119
Michalski, Dominik; Liebig, Stefanie; Thomae, Eva; Hinz, Andreas; Bergh, Florian Then
The relationship between symptoms of post-traumatic stress disorder and pain, affective disturbance and disability among patients with accident and non-accident related pain
Recent studies have reported a high prevalence of symptoms of post-traumatic stress disorder (PTSD) among individuals with chronic pain. Studies suggest that persons with pain and PTSD also display higher levels of affective disturbance. In the present study we examined self-reports of pain, affective disturbance, and disability among pain patients with and without symptoms of PTSD. Patients without PTSD symptoms
Michael E. Geisser; Randy S. Roth; Jan E. Bachman; Thomas A. Eckert
Does Fatigue Complaint Reflect Memory Impairment in Multiple Sclerosis?
Background and Purpose. Fatigue and memory impairment are common symptoms in multiple sclerosis (MS) and both may interact with cognition. This can contribute to making a complaint misrepresentative of the objective disorder. We sought to determine whether fatigue complaint in MS reflects memory impairment and investigated whether patients' subjective fatigue is associated with memory complaint. Methods. Fifty MS patients complaining of fatigue underwent subjective assessment of fatigue and memory complaint measured using self-assessment scales. Cognitive functions were assessed using a battery of neuropsychological tests, including a test of verbal episodic memory, the selective reminding test (SRT). Correlations were studied between subjective fatigue, memory complaint, and performance in verbal episodic memory. Results. Depression score, psychotropic and/or antiepileptic drug use, Expanded Disability Status Scale (EDSS) score, and MS form were confounding factors. After adjusting for these confounding factors, neither fatigue complaint nor memory complaint was correlated with SRT performance. Subjective fatigue was significantly associated with memory complaint. Conclusion. Although complaint of fatigue in MS was correlated with memory complaint, subjective fatigue was not the expression of memory impairment. PMID:24724029
Jougleux-Vie, Caroline; Duhin, Emeline; Deken, Valerie; Outteryck, Olivier; Vermersch, Patrick; Zéphir, Hélčne
Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly. These include the use of skin biopsies to measure small unmyelinated fibers, as well as even newer techniques that can measure both small unmyelinated fibers and large myelinated fibers in the same biopsy. The main treatments for painful diabetic neuropathy remain management of the underlying diabetes and drugs for the relief of pain. However, emerging evidence points to major differences between type 1 and type 2 diabetes, including the ability of glycemic control to prevent neuropathy. Enhanced glucose control is much more effective at preventing neuropathy in patients with type 1 diabetes than in those with type 2 disease [corrected]. This dichotomy emphasizes the need to study the pathophysiologic differences between the two types of diabetes, because different treatments may be needed for each condition. The impact of the metabolic syndrome on neuropathy in patients with type 2 diabetes may account for the difference between the two types of diabetes and requires further study. Finally, neuropathic pain is under-recognized and undertreated despite an ever evolving list of effective drugs. Evidence exists to support several drugs, but the optimal sequence and combination of these drugs are still to be determined. PMID:24803311
Peltier, Amanda; Goutman, Stephen A; Callaghan, Brian C
General practitioners' experiences of patients' complaints: qualitative study
Objective To examine how general practitioners experience patients' complaints. Setting General practices in Lambeth, Southwark, and Lewisham health authority. Participants Representative sample of 30 general practitioners who had had complaints made against them under either the old or new complaints system. Design Qualitative study with detailed interviews. Results Participants described their experiences of patients' complaints in three stages: initial impact, conflict, and resolution. The first stage described being out of control, feelings of shock and panic, and a sense of indignation towards patients generally. The second stage described the many conflicts generated by the complaint: emotional conflicts such as feelings of anger, depression, and even suicide, conflicts around aspects of professional identity including doubts about clinical competence, conflicts with family and colleagues, and conflicts arising from the management of the complaint. The third stage described a sense of resolution. For many this meant practising defensively, for others it meant planning to leave general practice, and for a minority no resolution was achieved. Not all participants, however, reported such a negative experience. Some described how they had become immune to complaints, and a small minority described the complaint as a learning experience. Conclusion The initial impact stage and conflict stage may be necessary aspects of the experience that general practitioners endure when they have a complaint made against them. Support structures should, however, be in place to help general practitioners through these stages. Key messagesPatients' complaints against general practitioners are increasingNegative experiences of a complaint were shock, being out of control, depression, suicide, doubts about clinical competence, conflicts with family and colleagues, defensive practice, and a decision to leave general practiceA minority of participants expressed immunity towards complaints and a small minority saw complaints as a learning experience PMID:10364121
Jain, Ashok; Ogden, Jane
Using Chief Complaints for Syndromic Surveillance: A Review of Chief Complaint Based Classifiers in North America
A major goal of Natural Language Processing in the public health informatics domain is the automatic extraction and encoding of data stored in free text patient records. This extracted data can then be utilized by computerized systems to perform syndromic surveillance. In particular, the chief complaint — a short string that describes a patient's symptoms — has come to be a vital resource for syndromic surveillance in the North American context due to its near ubiquity. This paper reviews fifteen systems in North America — at the city, county, state and federal level — that use chief complaints for syndromic surveillance. PMID:23602781
Conway, Mike; Dowling, John N.; Chapman, Wendy W.
[Complex regional pain syndrome versus chronic regional pain syndrome (Hand-Finger Syndrome)].
Dystrophy is a main factor of CRPS. A large number of patients do not develop dystrophy but, instead, they suffer from pain with limitation in movement, possible paraesthesia and/or swelling. This is then a chronic regional pain syndrome or (shoulder-arm-) hand-finger syndrome. These patients should never be confronted with the diagnosis Morbus Sudeck or algodystrophy, which are today also well known among non-professionals, to avoid pushing them into a status of constant severe invalidity. Histories, clinical examination, as well as a good personal understanding of the patient are indispensable. Knowing that pain, or the extent of pain, remains subjective until today, the clinical diagnosis depends on the absence of side differences in: a) the circumference of soft tissues of both upper extremities; b) the callosity of the palm; c) the bone-density. These three parameters allow verification of the consequences of the pain complaints (indirect pain verification). It is essential to find the cause for their suffering and to treat it as far as possible: 1) Too long and inappropriate immobilisation (patient's suffering not considered sufficiently). These patients can recover quickly when the right diagnosis is made in good time. 2) Limitation of movement due to scar, neuroma, or elongation pain: a) bizarre functional disabilities can develop; b) due to the patient's complaints, one or several operations would finally be performed, which will not lead to an improvement but rather to an aggravation of the pain; c) socially-induced purposeful pain increase, the typical statement of the patient will be: "I can't stand it any longer". Patients who are socially over-burdened, or have psycho-social problems, may experience a decline of performance or a post-traumatic stress disorder. Several patients will be introduced as illustrations for each of the relevant groups. PMID:20205065
Wulle, C
Effects of Ambulant Myofeedback Training and Ergonomic Counselling in Female Computer Workers with Work-Related Neck-Shoulder Complaints: A Randomized Controlled Trial
Objective: To investigate the effects of ambulant myofeedback training including ergonomic counselling (Mfb) and ergonomic counselling alone (EC), on work-related neck-shoulder pain and disability. Methods: Seventy-nine female computer workers reporting neck-shoulder complaints were randomly assigned to Mfb or EC and received four weeks of intervention. Pain intensity in neck, shoulders, and upper back, and pain disability, were measured at baseline, immediately after intervention, and at three and six months follow-up. Results: Pain intensity and disability had significantly decreased immediately after four weeks Mfb or EC, and the effects remained at follow up. No differences were observed between the Mfb and EC group for outcome and subjects in both intervention groups showed comparable chances for improvement in pain intensity and disability. Conclusions: Pain intensity and disability significantly reduced after both interventions and this effect remained at follow-up. No differences were observed between the two intervention groups. PMID:17260162
Sandsjö, Leif; Vollenbroek-Hutten, Miriam M. R.; Larsman, Pernilla; Kadefors, Roland; Hermens, Hermie J.
What a Pain! Kids and Growing Pains
... Main Page The Pink Locker Society What a Pain! Kids and Growing Pains KidsHealth > Kids > Illnesses & Injuries > Aches, Pains & Injuries > What ... something doctors call growing pains . What Are Growing Pains? Growing pains aren't a disease. You probably ...
Reproducibility of pain measurement and pain perception
The reproducibility of both the conscious experience of pain and the reproducibility of psychophysical assessments of pain remain critical, yet poorly characterized factors in pain research and treatment. To assess the reproducibility of both the pain experience and two methods of pain assessment, 15 subjects evaluated experimental heat pain during four weekly sessions. In each session, both brief (5s) and
Elisa M. Rosier; Michael J. Iadarola; Robert C. Coghill
... breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some amount ... unless a woman is taking hormone replacement therapy) Menstruation and premenstrual syndrome (PMS) Pregnancy -- breast tenderness tends ...
Pain - penis; Priapism ... Bladder stone Bites, either human or insect Cancer of the penis Erection that does not go away (priapism) Genital herpes Infected hair follicles Infected prosthesis of the penis Infection under the ...
Chest pain in primary care: is the localization of pain diagnostically helpful in the critical evaluation of patients? - A cross sectional study
Background Chest pain is a common complaint and reason for consultation in primary care. Traditional textbooks still assign pain localization a certain discriminative role in the differential diagnosis of chest pain. The aim of our study was to synthesize pain drawings from a large sample of chest pain patients and to examine whether pain localizations differ for different underlying etiologies. Methods We conducted a cross-sectional study including 1212 consecutive patients with chest pain recruited in 74 primary care offices in Germany. Primary care providers (PCPs) marked pain localization and radiation of each patient on a pictogram. After 6 months, an independent interdisciplinary reference panel reviewed clinical data of every patient, deciding on the etiology of chest pain at the time of patient recruitment. PCP drawings were entered in a specially designed computer program to produce merged pain charts for different etiologies. Dissimilarities between individual pain localizations and differences on the level of diagnostic groups were analyzed using the Hausdorff distance and the C-index. Results Pain location in patients with coronary heart disease (CHD) did not differ from the combined group of all other patients, including patients with chest wall syndrome (CWS), gastro-esophageal reflux disease (GERD) or psychogenic chest pain. There was also no difference in chest pain location between male and female CHD patients. Conclusions Pain localization is not helpful in discriminating CHD from other common chest pain etiologies. PMID:24138299
Education On Prehospital Pain Management: A Follow-Up Study
Introduction: The most common reason patients seek medical attention is pain. However, there may be significant delays in initiating prehospital pain therapy. In a 2001 quality improvement (QI) study, we demonstrated improvement in paramedic knowledge, perceptions, and management of pain. This follow-up study examines the impact of this QI program, repeated educational intervention (EI), and effectiveness of a new pain management standard operating procedure. Methods: 176 paramedics from 10 urban and suburban fire departments and two private ambulance services participated in a 3-hour EI. A survey was performed prior to the EI and repeated one month after the EI. We reviewed emergency medical services (EMS) runs with pain complaints prior to the EI and one month after the EI. Follow-up results were compared to our prior study. We performed data analysis using descriptive statistics and chi-square tests. Results: The authors reviewed 352 surveys and 438 EMS runs with pain complaints. Using the same survey questions, even before the EI, 2007 paramedics demonstrated significant improvement in the knowledge (18.2%; 95% CI 8.9%, 27.9%), perceptions (9.2%; 95% CI 6.5%, 11.9%), and management of pain (13.8%; 95% CI 11.3%, 16.2%) compared to 2001. Following EI in 2007, there were no significant improvements in the baseline knowledge (0%; 95% CI 5.3%, 5.3%) but significant improvements in the perceptions of pain principles (6.4%; 95% CI 3.9%, 9.0%) and the management of pain (14.7%; 95% CI 11.4%, 18.0%). Conclusion: In this follow up study, paramedics' baseline knowledge, perceptions, and management of pain have all improved from 6 years ago. Following a repeat educational intervention, paramedics further improved their field management of pain suggesting paramedics will still benefit from both initial and also ongoing continuing education on the topic of pain management. PMID:23599840
French, Scott C.; Chan, Shu B.; Ramaker, Jill
An Unusual Case of Abdominal Pain in a Female Child
Non-traumatic abdominal pain is a common presenting complaint in emergency department (ED) patients, quoted in some contemporary literature as being the third most frequent reason for ED visits. We present the ED and hospital course of an unusual case of an 11 year old female with right lower quadrant abdominal pain. The admission assessment of this patient was "possible appendicitis versus gastroenteritis"; however, laparatomy revealed a right adnexal torsion. The need for emergency medicine physicians to always include gynecologic and other less common causes in the differential diagnosis and workup of abdominal pain in children is emphasized. PMID:20847863
Heer, Jag; Bowker, Debra; Ferguson, Glen
Risk indicators in low back pain.
Injuries leading to low back pain can occur by direct trauma, overexertion or repetitive trauma. Overexertion is claimed by 60% of low back pain patients as the cause of injury. Of these patients with overexertion injuries, 66% implicated lifting and 20% pushing or pulling. It is, however, difficult to relate the workplace to the complaint of low back pain in a specific worker, and low back pain is found quite often in those with sedentary occupations. The incidence, severity and potential disability are all related to the demands on the individual in the workplace. Among the factors implicated are the requirements for lifting (particularly when compared to the worker's lifting capacity), pushing and pulling, posture, and cyclic loading. Drivers of heavy vehicles have two to four times the average incidence of serious low back pain. This is probably due to the cyclic loading environment. The general psychosocial environment (including that at work) is an important risk factor. The first attack of low back pain occurs in the teens or twenties. Low back pain is as frequent in females as males, although women in manual materials handling jobs are at greater risk. Posture, anthropometry and mobility measures have limited prognostic value. Muscle strength and physical fitness probably have some value. Radiographic findings have little pragmatic value. PMID:2532529
Pope, M H
Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints
Objectives To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. Results In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07–1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR = 0.17, 95%-CI 0.04–0.72). Other work-related risk factors were not significantly related to sick leave. Conclusions Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results. PMID:17410376
Terwee, Caroline B.; van der Windt, Daniëlle A. W. M.; van der Beek, Allard J.; Bouter, Lex M.; Dekker, Joost
A review of accident and emergency attendances for non-traumatic musculo-skeletal complaints.
As there have been no previous studies, we undertook a systematic review to determine the number and nature of musculo-skeletal complaints presenting to casualty departments, review the appropriateness of treatment and referrals to other departments and also to identify potential problem areas so as to address these. Over the review period of 40 non-consecutive days, the total attendance was 2863 patients of which 85 (2.97%) presented with musculo-skeletal complaints. The majority (691) were in the age group of 20-59 years. Most complaints were in the back (26), neck (11), chest (10), shoulder (8), knee (8). Main complaints were pain (78), tenderness (10), swelling (9), stiffness (9), reduced movements (8) or a combination thereof; the rest were miscellaneous, e.g. pyrexia, headache and paraesthesia. The majority had a duration of symptoms from 1 to 7 days. Investigations at the casualty department were radiographs (29), full blood count (6), biochemistry (6), erythrocyte sedimentation rate (ESR) (1), blood culture (1), electrocardiogram (ECG) (7), and joint aspiration (2). Advice was sought from orthopaedic (2), rheumatology or general medicine (0), or other departments (2). Casualty diagnoses were mainly non-inflammatory conditions. Treatment given included analgesics/non-steroidal inflammatory drugs (NSAIDs) (44), splints and slings (5), Tubigrip (6), and collars (5). Only two patients (2.4%) were admitted. We were pleasantly surprised to note very small numbers of patients with inflammatory conditions, possibly indicating previous optimal management in our locality. A surprising finding was the lack of any attendance with gout. More direct referrals to orthopaedic or rheumatology departments would be appropriate in some instances. As a result of this review, we decided to offer short courses on musculo-skeletal medicine for new casualty officers and we have also produced guidelines/algorithm for management which would be equally useful for general practitioners. PMID:10984134
Pal, B; Quennell, P; Hawes, S
28 CFR 42.610 - Agency enforcement of unresolved complaints.
Code of Federal Regulations, 2011 CFR
... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients of Federal Financial Assistance...
28 CFR 42.607 - EEOC dismissals of complaints.
Code of Federal Regulations, 2011 CFR
... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients of Federal Financial Assistance...
28 CFR 42.610 - Agency enforcement of unresolved complaints.
Code of Federal Regulations, 2010 CFR
... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients of Federal Financial Assistance...
28 CFR 42.607 - EEOC dismissals of complaints.
Code of Federal Regulations, 2010 CFR
... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients of Federal Financial Assistance...
78 FR 21218 - Disclosure of Consumer Complaint Data
Federal Register 2010, 2011, 2012, 2013
...customer experience efforts, Business Wire Jan. 31, 2013, available...Reliability and Validity of the Consumer Financial Protection Bureau (CFPB) Complaint Database, Business Over Broadway (Sept....
Review of the role of opioids in cancer pain.
Cancer pain is unfortunately very prevalent, with opioids the mainstay of treatment. Knowledge of the types of pain caused by cancer and the effects of various opioids would be expected to improve pain therapy. This article addresses the use, side effects, formulations, and metabolism of the most commonly used opioids in cancer pain management, including morphine, codeine, hydrocodone, hydromorphone, fentanyl, and methadone. The role of opioid conversion and equipotent dosing when changing from one opioid to another is also described. PMID:20876545
Trescot, Andrea M
Symptoms and Health Complaints and Their Association with Perceived Stressors among Students at Nine Libyan Universities
University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall), socio-demographic characteristics (five variables), health behaviours/lifestyle factors (six variables), as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints). A sample of 2100 undergraduate students from nine institutions (six universities, three colleges) located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%–60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15–2.02), depressive mood (OR 2.20; 95% CI 1.64–2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19–2.03). Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population. PMID:25429678
El Ansari, Walid; Khalil, Khalid; Stock, Christiane
Chronic Pain in People with an Intellectual Disability: Under-Recognised and Under-Treated?
ERIC Educational Resources Information Center
Aim: To examine the nature, prevalence and impact of chronic pain in adults with an intellectual disability (ID) based on carer report. Methods: Postal questionnaires were sent to 250 care-givers and 157 responses were received (63%). Results: Chronic pain was reported in 13% of the sample (n = 21), 6.3% had pain in two sites and 2% had pain in…
McGuire, B. E.; Daly, P.; Smyth, F.
Correlational analysis and predictive validity of psychological constructs related with pain in fibromyalgia
BACKGROUND: Fibromyalgia (FM) is a prevalent and disabling disorder characterized by a history of widespread pain for at least three months. Pain is considered a complex experience in which affective and cognitive aspects are crucial for prognosis. The aim of this study is to assess the importance of pain-related psychological constructs on function and pain in patients with FM. METHODS:
Sara Maurel; Baltasar Rodero; Yolanda Lopez-del-Hoyo; Juan V Luciano; Eva Andrés; Miquel Roca; Raquel del Moral Bergos; Yolanda Ruiz-Lancina; Javier García-Campayo
Breakthrough pain in patients with controlled or uncontrolled pain: An observational study
BACKGROUND: Breakthrough pain (BTP) is traditionally defined as a pain exacerbation in patients with chronic controlled pain. However, this definition has recently been challenged. OBJECTIVES: To evaluate the prevalence of unsatisfactory control in patients with chronic cancer pain, and investigate the frequency and intensity of BTP episodes. METHODS: A total of 665 patients with chronic cancer pain attending 21 pain therapy units in Italy were evaluated for baseline pain intensity and number of BTP episodes over a 30-day period. All patients started, continued or modified treatment for BTP at enrollment, according to medical judgment. RESULTS: The number of BTP events was higher in patients with uncontrolled baseline pain, although the intensity and duration of episodes were similar. In patients with uncontrolled baseline pain, the number of events decreased with time and reached values comparable with those reported in patients with controlled pain. Both the intensity of the pain and the duration of the BTP events exhibited similar values in the two groups at all time points, following increased monitoring and the prescription of analgesic medication. CONCLUSION: Patients with uncontrolled baseline pain experienced BTP flares with higher frequency, but similar intensity and duration with respect to patients with controlled pain at baseline. Notably, a close follow-up and adequate management of the BTP episodes led to an improvement of BTP in the observed patients. PMID:24945289
Gatti, Antonio; Gentili, Marta; Baciarello, Marco; Lazzari, Marzia; Marzi, Rossella; Palombo, Elisa; Sabato, Alessandro F; Fanelli, Guido
Prevalence and risk factors of gastroesophageal reflux disease in Qashqai migrating nomads, southern Iran
AIM: To investigate the prevalence and risk factors of gastroesophageal reflux disease (GERD) symptoms in Qashqai migrating nomads with a different life style in Fars province, southern Iran. METHODS: In summer 2006, 748 Qashqai migrating nomads aged 25 years or more were enrolled using a multiple-stage stratified cluster random sampling method. A questionnaire consisting of demographic characteristics, lifestyle and GERD symptoms (heartburn, regurgitation, chest pain, dysphagia, hoarseness and cough) as completed for each subject. RESULTS: The questionnaire was completed in 717 subjects. The prevalence rate of GERD, defined as reflux occurring at least one time per week in the preceding year, was 33% (237 subjects). The prevalence was higher in older individuals (36.0% vs 28.9%, P < 0.05) and in those with other gastrointestinal complaints (51.0% vs 27.8%, P < 0.001), but not different in obese and non-obese subjects. It was also higher in those consuming fruits and vegetables more than once a week (36.2% vs 17.3%, P < 0.001). GERD had a positive correlation with smoking (42.1% vs 27.8%, P < 0.001), but a negative relation with non-alcoholic beverages. The association between GERD and non-steroidal anti-inflammatory drugs (NSAIDs) consumption was also significant (40.2% vs 25.4%, P < 0.001). CONCLUSION: The prevalence of GERD (33%) is very high in Qashqai migrating nomads which may be due to a lower socioeconomic and educational level of these people and difference in the life style. Older age, frequent consumption of fruits and vegetables, smoking and NSAIDs are risk factors for GERD in this population. PMID:19248195
Mostaghni, Ahmad; Mehrabani, Davood; Khademolhosseini, Farnaz; Masoumi, Seyed Jalil; Moradi, Fariba; Zare, Najaf; Saberi-Firoozi, Mehdi
Idiopathic Hand and Arm Pain: Delivering Cognitive Behavioral Therapy as Part of a Multidisciplinary Team in a Surgical Practice
ERIC Educational Resources Information Center
Cognitive behavioral therapists may have a unique and growing role in orthopedics departments. In helping patients cope with pain, particularly where there is no specific biomedical treatment or cure, cognitive behavioral practitioners can help prevent, early on, the transition from an acute pain complaint to a costly, disabling, and interfering…
Vranceanu, Ana-Maria.; Ring, David; Kulich, Ronald; Zhao, Meijuan; Cowan, James; Safren, Steven
Examination of Clinical Efficacy of Keishibukuryogan on Non-Specific Complaints Associated with Varicose Veins of the Lower Extremity
The subjective symptoms of varicose veins of the lower extremity often include malaise, numbness, coldness, pain, and pruritus of the lower extremity, and relieving these complaints is important in managing the quality of life of patients. We have examined the clinical efficacy of keishibukuryogan, a Kampo prescription for improving oketsu (impaired microcirculation, congestion), on non-specific complaints associated with varicose veins of the lower extremity. Keishibukuryogan was administered to 30 patients with non-specific complaints associated with varicose veins of the lower extremity for 12 weeks, resulting in improvements in the scores of subjective symptoms, severity of varicose veins, and oketsu as well as an increase in skin perfusion pressure. And especially the effect was remarkable in female. In addition, oketsu was shown to be involved in the subjective symptoms associated with varicose veins of the lower extremity, demonstrating efficacy of keishibukuryogan. No adverse drug reaction or abnormal laboratory result was observed in patients receiving keishibukuryogan, and the rate of general improvement and usefulness was 73.3%. It was suggested that keishibukuryogan was useful to improve the symptoms of patients with non-specific complaints associated with varicose veins of the lower extremity especially in female patients. (*English translation of Jpn J Phlebol 2013; 24: 303-310) PMID:25298828
Shibutani, Shintaro; Okubo, Hirotoki; Shimogawara, Tatsuya; Ichinose, Tsuyoshi; Ito, Yasuhiro; Mihara, Kouki; Egawa, Tomohisa; Nagashima, Atsushi; Obara, Hideaki; Kitagawa, Yuko
Pain management among medical in-patients in Blantyre, Malawi
Background Pain is a leading symptom which influences patients to seek medical attention. The management of pain among patients attending in-patient care in southern African countries has been little described. Information regarding the prevalence of pain and the quality of its management may be useful in guiding clinical decisions, training of health workers and health care quality improvements. Methods A hospital-based audit was conducted to estimate the prevalence of pain and examine the quality of its management among patients admitted to adult medical wards at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi in 2004. Data were abstracted from ward charts of consecutive patients' who had been either been discharged or had died within a specified period. Characteristics of interest included; socio-demographic data, presence or absence of pain at admission, characterization or description of pain when present, and drug treatment given. Data were analyzed to obtain frequencies and proportions of the characteristics and assess the prevalence of pain and quality of care. Results A total of 121 patients' case notes were reviewed and the prevalence of pain was recorded for 91 (75.2%) of the patients. Clinicians had recorded pertinent information regarding pain management with the following frequency: pain severity or intensity 5/91 (5.5%), alleviating factors 5 (5.5%), pain radiation 7 (7.7%), exacerbating factors in 9 (9.9%) and periodicity in 43 (47.3%) of the cases. Males with pain were more than 3 times more likely to receive analgesic as compared to females, p < 0.01. Paracetamol was the commonest analgesic prescribed. Conclusion Inadequate management of pain among patients attending medical wards at QECH was found. There is need for prospective studies to further characterize pain management and identify pain management gaps in Malawi. Interviews of clinicians and documentation of observations within clinical practice are likely to be of value. PMID:19323817
Muula, Adamson S; Misiri, Humphreys E
Chronic abdominal pain in children.
Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians, medical subspecialists, and surgical specialists. Chronic abdominal pain in children is usually functional, that is, without objective evidence of an underlying organic disorder. The Subcommittee on Chronic Abdominal Pain of the American Academy of Pediatrics and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition has prepared this report based on a comprehensive, systematic review and rating of the medical literature. This report accompanies a clinical report based on the literature review and expert opinion. The subcommittee examined the diagnostic and therapeutic value of a medical and psychological history, diagnostic tests, and pharmacologic and behavioral therapy. The presence of alarm symptoms or signs (such as weight loss, gastrointestinal bleeding, persistent fever, chronic severe diarrhea, and significant vomiting) is associated with a higher prevalence of organic disease. There was insufficient evidence to state that the nature of the abdominal pain or the presence of associated symptoms (such as anorexia, nausea, headache, and joint pain) can discriminate between functional and organic disorders. Although children with chronic abdominal pain and their parents are more often anxious or depressed, the presence of anxiety, depression, behavior problems, or recent negative life events does not distinguish between functional and organic abdominal pain. Most children who are brought to the primary care physician's office for chronic abdominal pain are unlikely to require diagnostic testing. Pediatric studies of therapeutic interventions were examined and found to be limited or inconclusive. PMID:15741363
Technology Transfer Automated Retrieval System (TEKTRAN)
It has long been believed that adult somatic complaints are associated with early family dysfunction. Yet few studies have examined this hypothesis in community samples, where medically unexplained symptom complaints are estimated to be very common. Given the potential population-wide impact of subt...
Guidelines for Investigating Complaints of Discrimination and Harassment
of discrimination and harassment. In some instances appropriately trained units may be delegated authority that a Discrimination/Harassment Complaint Form or other appropriate documentation is filed within five working daysGuidelines for Investigating Complaints of Discrimination and Harassment Used in conjunction
Howat, Ian M.
41 CFR 60-741.61 - Complaint procedures.
Code of Federal Regulations, 2010 CFR
...class-wide violation(s). Complaints may be submitted to the OFCCP, 200 Constitution Avenue, N.W., Washington, D.C. 20210, or to any OFCCP regional, district, or area office. Such complaint must be filed within 300 days of the date of the...
17 CFR 12.17 - Satisfaction of complaint.
Code of Federal Regulations, 2010 CFR
...2010-04-01 2010-04-01 false Satisfaction of complaint. 12.17 Section...Consideration of Pleadings § 12.17 Satisfaction of complaint. A respondent...amount as the complainant will accept in satisfaction of his claim; and (b) by...
17 CFR 12.17 - Satisfaction of complaint.
Code of Federal Regulations, 2011 CFR
...2011-04-01 2011-04-01 false Satisfaction of complaint. 12.17 Section...Consideration of Pleadings § 12.17 Satisfaction of complaint. A respondent...amount as the complainant will accept in satisfaction of his claim; and (b) by...
What will the Federal agency do with my complaint?
What will the Federal agency do with my complaint? Once a complaint is filed, it will be reviewed be instituted. What is the Department ofJustice's role? The Department of Justice, under Executive Order 12250 assisted programs. If you cannot determine what Federal agency may have Title VI jurisdiction, or if you do
California at Davis, University of
Customer complaints: a managed care firm's best weapon in CQI.
Encouraging customer feedback and developing an automated customer complaint system are two essential steps a health plan must take if it wishes to develop a balanced relationship with the customer. The author explores how the right attitude and appropriate action can ensure that both customers and the company reap the benefits of a comprehensive customer complaint system. PMID:10139955
Polonski, G J
32.01.02 Complaint and Appeal Process for Nonfaculty Employees Page 1 of 4 32.01.02 Complaint and Appeal Process
32.01.02 Complaint and Appeal Process for Nonfaculty Employees Page 1 of 4 32.01.02 Complaint and Appeal Process for Nonfaculty Employees Approved June 25, 1998 Revised January 14, 2002 Revised November complaint procedures and is required by System Policy 32.01, Employee Complaint and Appeal Procedures
[Textual analysis of patients' complaints in the hospital milieu].
The text of patient's complaints in a parisian hospital have been examined in order to describe the recurrent types, but also the argumentation's modalities of both sides. We describe the process of answering by showing the different stages in building the answer. A process of enquiry appears, where the answer has to reconstitute the facts and to relate them with the expressed complaint. This process is especially important in the case of medical and informational complaints, domains where the asymmetry between patient and clinician is especially wide. This drives us to show the deficiencies of a purely written complaint-process. To avoid these insufficiencies, the relevant answers and questions have to be involved in a real dialogue, where both sides can equally contribute in reconstructing the information. This confirms the necessity of introducing conciliation commissions in medical structures, where patients could directly express their complaints. PMID:11765570
Quinche, F
Evaluation of Low Back Pain in Athletes
Context: Low back pain is a common complaint in athletes. Athletes differ from the general population physiologically, making it unclear if the evaluation of low back pain should differ between these 2 groups. Evidence Acquisition: A literature search (PubMed, Ovid) was performed for the years 1995 through 2010. Keywords used were lumbar back pain, athletes, and adolescence. Results: Athletes with low back pain represent a very diverse group. The evaluation depends on the athlete's age and the presence of "red flags." The most common causes of low back pain in the preadolescent population are infection, tumor, and trauma. In the adolescent population, trauma spondylolysis/spondylolisthesis and hyperlordosis are commonly seen. Leading causes in the adult population are mechanics and osteoarthritis. The elderly frequently present with osteoarthritis, spinal stenosis, and internal medical etiologies. Conclusion: Athletes with back pain should have a diagnostic workup guided by their age, history, and physical examination. Although this work up is similar in nonathletes, the demands of the athlete must be taken into account in a treatment plan. PMID:23016026
Daniels, James M.; Pontius, Gina; El-Amin, Saadiq; Gabriel, Keith
Assessment and treatment of pain in children and adolescents.
Pain is one of the most common and distressing symptoms experienced by children and adolescents with juvenile idiopathic arthritis. Pain is known to negatively affect all aspects of health-related quality of life, including physical, emotional, social, and role functioning. The valid and reliable assessment of pain is the first critical step to developing an effective plan for pain management. This chapter will address the following key questions: (1) What is the prevalence and impact of pain in children and adolescents with arthritis? (2) Why is it important for clinicians to assess the multidimensional nature of pain and what are the practical issues that should be considered? (3) What tools are available to help clinicians to assess pain? (4) How can Internet and mobile technologies be used to improve the assessment of pain? (5) What are the recommended strategies for clinically managing pain, including pharmacological, physical, and psychological approaches? PMID:24974065
Lalloo, Chitra; Stinson, Jennifer N
Noncardiac Chest Pain: Epidemiology, Natural Course and Pathogenesis
Noncardiac chest pain is defined as recurrent chest pain that is indistinguishable from ischemic heart pain after a reasonable workup has excluded a cardiac cause. Noncardiac chest pain is a prevalent disorder resulting in high healthcare utilization and significant work absenteeism. However, despite its chronic nature, noncardiac chest pain has no impact on patients' mortality. The main underlying mechanisms include gastroesophageal reflux, esophageal dysmotility and esophageal hypersensitivity. Gastroesophageal reflux disease is likely the most common cause of noncardiac chest pain. Esophageal dysmotility affects only the minority of noncardiac chest pain patients. Esophageal hypersensitivity may be present in non-GERD-related noncardiac chest pain patients regardless if esophageal dysmotility is present or absent. Psychological co-morbidities such as panic disorder, anxiety, and depression are also common in noncardiac chest pain patients and often modulate patients' perception of disease severity. PMID:21602987
Achem, Sami R
Anatomical and Physiological Factors Contributing to Chronic Muscle Pain
Chronic muscle pain remains a significant source of suffering and disability despite the adoption of pharmacologic and physical therapies. Muscle pain is mediated by free nerve endings distributed through the muscle along arteries. These nerves project to the superficial dorsal horn and are transmitted primarily through the spinothalamic tract to several cortical and subcortical structures, some of which are more active during the processing of muscle pain than other painful conditions. Mechanical forces, ischemia, and inflammation are the primary stimuli for muscle pain, which is reflected in the array of peripheral receptors contributing to muscle pain-ASIC, P2X, and TRP channels. Sensitization of peripheral receptors and of central pain processing structures are both critical for the development and maintenance of chronic muscle pain. Further, variations in peripheral receptors and central structures contribute to the significantly greater prevalence of chronic muscle pain in females. PMID:24633937
Gregory, Nicholas S.; Sluka, Kathleen A.
76 FR 56506 - Agency Information Collection (Complaint of Employment Discrimination) Activity Under OMB Review
Federal Register 2010, 2011, 2012, 2013
...Collection (Complaint of Employment Discrimination) Activity Under OMB Review AGENCY...Title: Complaint of Employment Discrimination, VA Form 4939. OMB Control Number...VA Form 4939 to file complaint of discrimination. An agency may not conduct or...
76 FR 35949 - Agency Information Collection (Civil Rights Discrimination Complaint) Activity Under OMB Review
Federal Register 2010, 2011, 2012, 2013
...Information Collection (Civil Rights Discrimination Complaint) Activity Under OMB Review...INFORMATION: Title: Civil Rights Discrimination Complaint, VA Form 10-0381. OMB...a formal complaint of the alleged discrimination. An agency may not conduct or...
29 CFR 1980.114 - District Court jurisdiction of discrimination complaints.
Code of Federal Regulations, 2010 CFR
...false District Court jurisdiction of discrimination complaints. 1980.114 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 806 OF...114 District Court jurisdiction of discrimination complaints. (a) If the...
76 FR 38743 - Proposed Information Collection (Complaint of Employment Discrimination) Activity: Comment Request
Federal Register 2010, 2011, 2012, 2013
...Collection (Complaint of Employment Discrimination) Activity: Comment Request AGENCY...process a complaint of employment discrimination. DATES: Written comments and recommendations...Title: Complaint of Employment Discrimination, VA Form 4939. OMB Control...
20 CFR 670.990 - What procedures are available to resolve complaints and disputes?
Code of Federal Regulations, 2010 CFR
...470 or complaints alleging fraud or other criminal activity, complaints may be filed within one year of the occurrence that led to the complaint. (b) The procedure established under paragraph (a) of this section must include procedures to...
78 FR 21149 - Certain Linear Actuators; Notice of Receipt of Complaint; Solicitation of Comments Relating to...
Federal Register 2010, 2011, 2012, 2013
...COMMISSION [Docket No. 2949] Certain Linear Actuators; Notice of Receipt of Complaint; Solicitation...received a complaint entitled Certain Linear Actuators, DN 2949; the Commission is soliciting...States after importation of certain linear actuators. The complaint names as...
47 CFR 73.810 - Third adjacent channel complaint and license modification procedure.
Code of Federal Regulations, 2012 CFR
...2012-10-01 false Third adjacent channel complaint and license modification procedure...LPFM) § 73.810 Third adjacent channel complaint and license modification procedure...Is a complaint alleging third adjacent channel interference caused by an LPFM...
31 CFR 8.56 - Service of complaint and other papers.
Code of Federal Regulations, 2010 CFR
...false Service of complaint and other papers. 8.56 Section 8.56 Money and...56 Service of complaint and other papers. (a) Complaint. ...of service. (b) Service of other papers. Any paper other than the...
29 CFR 1980.114 - District Court jurisdiction of discrimination complaints.
Code of Federal Regulations, 2011 CFR
...false District Court jurisdiction of discrimination complaints. 1980.114 Section... PROCEDURES FOR THE HANDLING OF DISCRIMINATION COMPLAINTS UNDER SECTION 806 OF...114 District Court jurisdiction of discrimination complaints. (a) If the...
COMPLAINT AND INVESTIGATION PROCEDURE An individual filing a complaint of alleged discrimination or sexual harassment shall have the opportunity
or sexual harassment shall have the opportunity to select an independent advisor for assistance, support institution or unit. An individual against whom a complaint of alleged discrimination or sexual harassment a complaint of alleged discrimination or sexual harassment, or observes or becomes aware of conduct that may
Hemmers, Oliver
32.01 Employee Complaint and Appeal Procedures Page 1 of 2 32.01 Employee Complaint and Appeal Procedures
32.01 Employee Complaint and Appeal Procedures Page 1 of 2 32.01 Employee Complaint and Appeal, including appeals of employment actions. 2. The chancellor may establish procedures to determine's or former foster child's employment preference under Texas Government Code, Chapters 657 and 672, may appeal
Inflammatory Back Pain vs. Mechanical Back Pain
MedlinePLUS Videos and Cool Tools
... cause. Specifically, is the back pain inflammatory in nature or mechanical? INFLAMMATORY VS MECHANICAL BACK PAIN VIDEO: ... determing if the back pain is inflammatory in nature and related to a disease such as ankylosing ...
Challenges in Using Opioids to Treat Pain in Persons With Substance Use Disorders
Pain and substance abuse co-occur frequently, and each can make the other more difficult to treat. A knowledge of pain and its interrelationships with addiction enhances the addiction specialist's efficacy with many patients, both in the substance abuse setting and in collaboration with pain specialists. This article discusses the neurobiology and clinical presentation of pain and its synergies with substance use disorders, presents methodical approaches to the evaluation and treatment of pain that co-occurs with substance use disorders, and provides practical guidelines for the use of opioids to treat pain in individuals with histories of addiction. The authors consider that every pain complaint deserves careful investigation and every patient in pain has a right to effective treatment. PMID:18497713
Savage, Seddon R.; Kirsh, Kenneth L.; Passik, Steven D.
ERIC Educational Resources Information Center
Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…
Connors, G. Patrick

subset: commoncrawl