Pain
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Pain assessment and treatment is influenced by patient demographic characteristics and nonverbal expressions. Methodological challenges have limited the empirical investigation of these issues. The current analogue study employed an innovative research design and novel virtual human (VH) technology to investigate disparities in pain-related clinical decision-making. ⋯ This study demonstrates the application of VH technology and lens model methodology to the study of disparities in pain-related decision-making. Assessment and treatment of acute post-surgical pain often varies based on VH demographic and facial expression cues. These data contribute to the existing literature on disparities in pain practice and highlight the potential of a novel approach that may serve as a model for future investigation of these critical issues.
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Pain, among the most common symptoms of cancer, impacts on multiple domains of wellbeing. Significant numbers of patients continue to experience pain despite pharmacological interventions. Although there is evidence to suggest that acceptance of pain is related to better wellbeing among patients with chronic nonmalignant pain, little is known about acceptance of cancer pain. ⋯ These relationships were independent of pain severity and physical functioning. These preliminary results suggest that acceptance of cancer pain is related to better psychological wellbeing and that there may be a relational element, with parents at risk of experiencing difficulty in adapting to ongoing cancer pain. These data lay the groundwork for future research and interventions designed to enhance quality of life for patients with advanced cancer and pain.
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The sensation of pain is important and there may be serious consequences if it is missing. Recently, the genetic basis for a channelopathy characterised by a congenital inability to experience pain has been described and channelopathy-associated insensitivity to pain has been proposed as a suitable name for this condition. ⋯ Here we describe a woman with insensitivity to pain with two novel mutations in the SCN9A gene, coding for the Nav1.7 channel. We also discuss the finding of anosmia which apparently is a common feature in these patients.
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Being physically active is often suggested to be important in the prevention and management of low back pain. This simple view does not take into account that the relation between the level of activity and back pain may be a U-shaped curve - i.e. both inactivity and excessive activities (back-unhealthy activity) present an increased risk for back pain. We explored the U-shaped association between physical activity and chronic low back pain (3 months duration) by analyzing cross-sectional data from the Dutch population-based Musculoskeletal Complaints and Consequences Cohort study (DMC(3), 1998) of a sex-age stratified sample of 25 years and older (n=3364). ⋯ A moderate increased risk for CLBP was found for both participants with a sedentary lifestyle (OR 1.31: 95% CI 1.08-1.58) and for those being involved in physical strenuous activities (OR 1.22: 95% CI 1.00-1.49). This was especially true for women (sedentary: OR 1.44: 95% CI 1.10-1.83; physically active: OR 1.36: 95% CI 1.04-1.78). This study provides some evidence that the relation between physical activity and CLBP is U-shaped.