Journal articles: 'Posed pain'

1

Croft, P. R. "144 QUESTIONS POSED BY EPIDEMIOLOGICAL STUDIES." European Journal of Pain 10, S1 (September 2006): S40a—S40. http://dx.doi.org/10.1016/s1090-3801(06)60147-x.

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Littlewort, Gwen C., Marian Stewart Bartlett, and Kang Lee. "Automatic coding of facial expressions displayed during posed and genuine pain." Image and Vision Computing 27, no. 12 (November 2009): 1797–803. http://dx.doi.org/10.1016/j.imavis.2008.12.010.

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Orzeł, Paweł. "The Transhumanist Point of View to the Evolutionary Indifference to Pain and Suffering." Scientia et Fides 12, no. 1 (April 9, 2024): 249–67. http://dx.doi.org/10.12775/setf.2024.012.

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The text presents a transhumanist point of view on evolution. It focuses on the lack of clear and obvious evolutionary solutions to the issue of involuntary suffering. It poses difficult questions about the possibility of enhencement of human nature and respecting the laws of evolution. It reflects on the positive role of pain for the development of individual people and the entire human species. It considers the thesis that perhaps evolution “needs” pain for proper human development. It asks whether the transition to a higher than evolutionary stage of human development, as proposed by transhumanists, will not lead to the extinction of our species? After all, it relates all this mosaic of thoughts and theories to God, who can be the answer to many posed questions.

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Corona, Federica. "L’imene imperforato come possibile causa di dolore addominale." Medico e Bambino pagine elettroniche 25, no. 3 (March 31, 2022): 74. http://dx.doi.org/10.53126/mebxxvmr074.

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Broomé, Sofia, Katrina Ask, Maheen Rashid-Engström, Pia Haubro Andersen, and Hedvig Kjellström. "Sharing pain: Using pain domain transfer for video recognition of low grade orthopedic pain in horses." PLOS ONE 17, no. 3 (March 4, 2022): e0263854. http://dx.doi.org/10.1371/journal.pone.0263854.

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Orthopedic disorders are common among horses, often leading to euthanasia, which often could have been avoided with earlier detection. These conditions often create varying degrees of subtle long-term pain. It is challenging to train a visual pain recognition method with video data depicting such pain, since the resulting pain behavior also is subtle, sparsely appearing, and varying, making it challenging for even an expert human labeller to provide accurate ground-truth for the data. We show that a model trained solely on a dataset of horses with acute experimental pain (where labeling is less ambiguous) can aid recognition of the more subtle displays of orthopedic pain. Moreover, we present a human expert baseline for the problem, as well as an extensive empirical study of various domain transfer methods and of what is detected by the pain recognition method trained on clean experimental pain in the orthopedic dataset. Finally, this is accompanied with a discussion around the challenges posed by real-world animal behavior datasets and how best practices can be established for similar fine-grained action recognition tasks. Our code is available at https://github.com/sofiabroome/painface-recognition.

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Muyot, Norma B. "RISK ASSESSMENT OF SALT WORKERS: AN ERGONOMIC APPROACH." Cognizance Journal of Multidisciplinary Studies 2, no. 5 (May 30, 2022): 62–74. http://dx.doi.org/10.47760/cognizance.2022.v02i05.005.

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This study focused on the ergonomic risk assessment of salt workers in Occidental Mindoro. The study intended to determine which work activities posed risks to the farm workers, find if significant relationship between profile variables and the total pain and body parts pain experienced by the salt workers from doing the work activities that posed risks. The Nordic Questionnaire was used to detect symptoms to the neck, back, shoulders and extremities. It is composed of 28 multiple choice questions and structured into two well-differentiated parts, the first part refers to symptoms in nine parts of the body(neck, shoulders, elbows, wrists/hands, upper back, lower back, hip/thighs, knees and ankles during the last 12 months. The second part refers to the symptoms in three parts of the body (neck, shoulders and lower back) throughout the subject’s working life/seven days beforehand. To interpret data, correlation analysis and descriptive statistics were used. Findings of the study revealed that the salt workers are middle adults, have been working in the salt farms for most of their lives, have heights and weights that are well within the average height and weight for Filipino males. Results further suggest that the work activities that posed risks and caused pain to the salt workers are, transporting salt, collecting salt and filling the salterns with brine. Further, age and years of working in the salt farms are also found to be significantly related to the pain in body parts experienced by the saltworkers in doing the activities that pose risks to them. The body parts that are likely to feel pain are neck, lower and upper back and knees. Lastly, in knowing the risky work activities of salt farmers, mitigation measures can be proposed.

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Nam, Janice, Rosie Earle, and Himat Vaghadia. "Anesthetic challenges posed by generalised Medical Adhesive Related Skin Injury (MARSI)." Journal of Clinical Anesthesia 49 (September 2018): 12–13. http://dx.doi.org/10.1016/j.jclinane.2018.05.017.

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Alghamdi, Thoria, and Gita Alaghband. "SAFEPA: An Expandable Multi-Pose Facial Expressions Pain Assessment Method." Applied Sciences 13, no. 12 (June 16, 2023): 7206. http://dx.doi.org/10.3390/app13127206.

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Accurately assessing the intensity of pain from facial expressions captured in videos is crucial for effective pain management and critical for a wide range of healthcare applications. However, in uncontrolled environments, detecting facial expressions from full left and right profiles remains a significant challenge, and even the most advanced models for recognizing pain levels based on facial expressions can suffer from declining performance. In this study, we present a novel model designed to overcome the challenges posed by full left and right profiles—Sparse Autoencoders for Facial Expressions-based Pain Assessment (SAFEPA). Our model utilizes Sparse Autoencoders (SAE) to reconstruct the upper part of the face from the input image, and feeds both the original image and the reconstructed upper face into two pre-trained concurrent and coupled Convolutional Neural Networks (CNNs). This approach gives more weight to the upper part of the face, resulting in superior recognition performance. Moreover, SAFEPA’s design leverages CNNs’ strengths while also accommodating variations in head poses, thus eliminating the need for face detection and upper-face extraction preprocessing steps needed in other models. SAFEPA achieves high accuracy in recognizing four levels of pain on the widely used UNBC-McMaster shoulder pain expression archive dataset. SAFEPA is extended for facial expression recognition, where we show it to outperform state-of-the-art models in recognizing seven facial expressions viewed from five different angles, including the challenging full left and right profiles, on the Karolinska Directed Emotional Faces (KDEF) dataset. Furthermore, the SAFEPA system is capable of processing BioVid Heat Pain datasets with an average processing time of 17.82 s per video (5 s in length), while maintaining a competitive accuracy compared to other state-of-the-art pain detection systems. This experiment demonstrates its applicability in real-life scenarios for monitoring systems. With SAFEPA, we have opened new possibilities for accurate pain assessment, even in challenging situations with varying head poses.

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Spiegl, Paul V., W. Timothy Cullivan, Herbert M. Reiman, and Kenneth A. Johnson. "Neurilemoma of the Lower Extremity." Foot & Ankle 6, no. 4 (February 1986): 194–98. http://dx.doi.org/10.1177/107110078600600404.

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A series of 76 patients with 85 neurilemomas of the lower extremity was reviewed. The tumors were located throughout the lower extremity and had varied clinical presentations, which often posed problems in diagnosis. Pain, however, was a consistent symptom, and 63 (83%) of the patients presented with local or radiating (or both) pain. Electromyography was done in seven cases, but the results were abnormal in only two. When evaluating a painful mass or an atypical pain in the lower extremity, the clinician should have a high index of suspicion for neurilemoma.

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Strang, Susan, and Peter Strang. "Questions Posed to Hospital Chaplains by Palliative Care Patients." Journal of Palliative Medicine 5, no. 6 (December 2002): 857–64. http://dx.doi.org/10.1089/10966210260499041.

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Cheng, Yi-Lo, Klint Allen A. Marinas, Charmine Sheena R. Saflor, and Yung-Tsan Jou. "RULA and REBA risk assessment system on salt workers in Occidental Mindoro, Philippines." RSF Conference Series: Engineering and Technology 2, no. 1 (April 22, 2022): 75–84. http://dx.doi.org/10.31098/cset.v2i1.540.

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This descriptive study focused on the ergonomic risk assessment of salt workers in Occidental Mindoro to determine which work activities posed risks to the farmworkers and assess the relationship between profile variables and the total pain and body parts pain experienced by the salt workers. The Nordic Questionnaire was used to detect symptoms composed of 28 multiple choice questions and structured into two well-differentiated parts; the first part refers to symptoms in nine parts of the body (neck, shoulders, elbows, wrists/hands, upper back, lower back, hip/thighs, knees, and ankles) during the last 12 months. The second part refers to the neck, shoulders, and lower back symptoms throughout the subject’s working life/seven days beforehand. Correlation analysis and descriptive statistics were used to interpret data. The study's findings revealed that the salt workers are middle adults, have been working in the salt farms for most of their lives, have heights and weights within the average height and weight for Filipino males. Results further suggest that the work activities that posed risks and caused pain to the salt workers are, transporting salt, collecting salt, and filling the salterns with brine. Moreover, age and years of working are also significantly related to the pain in body parts experienced by the salt workers in doing the activities that pose risks to them. The body parts that are likely to feel pain are the neck, lower and upper back, and knees. Lastly, in knowing the risky work activities of salt farmers, mitigation measures can be proposed.

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Cotton, Tori Helen. "Defending the Hypothesis of Indifference." Socio-Historical Examination of Religion and Ministry 5, no. 1 (August 1, 2023): 161–67. http://dx.doi.org/10.33929/sherm.2023.vol5.no1.08.

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The problem of evil is the philosophical question regarding how to reconcile the existence of an omnipotent, omnibenevolent, and omniscient God with the pain and suffering in the world. The Hypothesis of Indifference is Paul Draper’s proposal considering that question. His claim is that the pain and pleasure we experience in our lifetimes has nothing to do with God or some other supernatural force acting as an agent of good or evil. In this paper, I argue that Draper’s Hypothesis of Indifference is a better explanation for why we experience pain and pleasure than theism is and that it survives major contemporary criticisms posed by Peter van Inwagen and William Alston.

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Chimakonam, Jonathan, and L. Uchenna Ogbonnaya. "Can Afro-Communitarianism Be Useful in Combating the Challenge of Human Interaction Posed by the COVID-19 Pandemic?" International Journal of Environmental Research and Public Health 19, no. 21 (October 31, 2022): 14255. http://dx.doi.org/10.3390/ijerph192114255.

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Can Afro-communitarianism serve as a viable ideology for addressing the human interaction challenge posed by the COVID-19 pandemic? The ongoing pandemic poses many challenges to the normal functioning of societies around the world. For example, it has caused problems ranging from social, economic, and political disruption to various forms of hardship, including pain, suffering, and millions of deaths. One problem that is not attracting sufficient attention is a disruption to human interaction that leads to isolation, depression, mental health, and emotional crises. This paper will investigate whether Afro-communitarianism can function as an ideological option for addressing this challenge. This ideology, in our opinion, can foster social integration and the type of informal solidarity that engenders emotionally helpful interactions among humans. We will also argue that Afro-communitarian orientation can overturn the individualistic tendencies that hamper efforts aimed at curtailing the spread of the coronavirus.

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Abel, Debra. "Often Posed Questions (and Answers) Regarding Medicare, Contracting, and Non-Hearing Aid Services." Seminars in Hearing 40, no. 03 (August 2019): 253–59. http://dx.doi.org/10.1055/s-0039-1693492.

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AbstractMedicare Part B provider participation is often met with grumbling and disdain by most health care providers, including audiologists. Other pain points for audiologists likely include insurance contracts, third-party administrators, and the unknown of the future. The dynamic landscape that will include technology and delivery systems was, until recently, mere thoughts on paper and in conference rooms. With the moderate amount of misunderstanding about Medicare and contracting rules among the members of the profession, it is this article's intent to dispel these Medicare myths as they pertain to hearing and balance services provided by Medicare Part B–enrolled audiologists, to offer considerations in a practice's decision whether to accept commercial insurance and third-party payer contracts, and to offer the tools to position a practice to provide non-hearing aid–related services based on today's current information.

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Guerrero, Emmanuel, Dalia A. Banks, William R. Auger, and Stuart W. Jamieson. "CASE 1—2011: The Challenges Posed by a Complicated Pulmonary Thromboendarterectomy." Journal of Cardiothoracic and Vascular Anesthesia 25, no. 1 (February 2011): 183–91. http://dx.doi.org/10.1053/j.jvca.2010.11.002.

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16

Tai, Y. M. A., and R. Baker. "Comparison of Controlled-Release Ketoprofen and Diclofenac in the Control of Post-Surgical Dental Pain." Journal of the Royal Society of Medicine 85, no. 1 (January 1992): 16–18. http://dx.doi.org/10.1177/014107689208500106.

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Preoperative treatment with controlled-release ketoprofen or diclofenac was compared in 56 outpatients, for control of postoperative dental pain, following unilateral or bilateral surgical removal of lower third molars. Six patients were excluded due to non-compliance, leaving 50 evaluable patients. Patients were assessed by the dental surgeon, on the day of the operation and one week later, prior to removal of sutures. Additionally, patients completed a daily diary during the postoperative week. Following surgery, scores for graded dental pain, consumption of paracetamol, incidence of dental bleeding, dysphagia, sleep disturbance and trismus were similar for the two treatment groups. However, median pain scores were consistently elevated in the diclofenac group over those seen with the ketoprofen group. The four adverse events reported were all minor and posed no problem to patient management.

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Shapiro, Barbara S., David E. Cohen, Kenneth W. Covelman, Carol J. Howe, and Sam M. Scott. "Experience of an Interdisciplinary Pediatric Pain Service." Pediatrics 88, no. 6 (December 1, 1991): 1226–32. http://dx.doi.org/10.1542/peds.88.6.1226.

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This article is a report of our experience with an interdisciplinary pain service in a large tertiary care pediatric hospital. During the first 2 years of operation, we received 869 consultations and referrals from more than 19 hospital divisions. Postoperative pain was the most frequent reason for consultation (56% of patients). Patients with pain related to cancer and sickle cell disease comprised 25% of the consultations. The remaining patients had a wide variety of primary diagnoses and causes of pain. We calculated the time spent by pain service physicians in direct patient care. The majority (63%) of physician time was spent with a small number of patients (17%). Most of these patients had pain that was unrelated to surgery, cancer, or sickle cell disease, and many posed dilemmas in diagnosis and treatment. Physician time was correlated directly to the use of psychologic and physical therapies for the pain, involving multiple team members. This experience supports the demand for an interdisciplinary pain service in a tertiary care children's hospital. A significant amount of physician time is necessary to provide patient care and to maintain a team approach, however, and pediatricians and other health care professionals who aim to implement such services should be cognizant of the time required.

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Sharma, Abhishek, Nidhi Sharma, and Aksh Chahal. "Navigating the Landscape of Preterm Neonatal Pain: A New Horizon in Sensory Stimulation." Journal of Clinical Neonatology 13, no. 1 (2024): 19–26. http://dx.doi.org/10.4103/jcn.jcn_84_23.

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Preterm infants often undergo painful medical procedures, and mitigating their pain remains a critical challenge in neonatal care. This manuscript explores the innovative approach of sensory stimulation as a promising horizon in alleviating preterm pain. Through a comprehensive review of existing literature, we examine the current understanding of pain perception in preterm infants and the limitations of conventional pain management strategies. The manuscript deals with the neurobiological underpinnings of pain in preterm neonates, shedding light on the unique challenges posed by their immature nervous systems. Drawing on recent advances in sensory science, we propose a paradigm shift toward personalized sensory stimulation interventions tailored to the developmental stage of preterm infants. A critical analysis of studies investigating the efficacy of various sensory modalities, including music therapy, tactile stimulation, and olfactory interventions, is presented. The manuscript also explores the potential integration of technological innovations, such as virtual reality, into neonatal care to enhance the positive impact of sensory stimulation on pain modulation. By fostering a deeper understanding of the neurobiological basis of pain in preterm neonates and exploring innovative interventions, this work aims to contribute to the ongoing efforts to improve the quality of care for this vulnerable population.

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Painca, Diana. "Re-enacting the past: the translation of performativity in oral history interviews." FITISPos International Journal 8, no. 1 (April 26, 2021): 66–78. http://dx.doi.org/10.37536/fitispos-ij.2021.8.1.266.

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This article explores the connection between Translation Studies and Oral History on Romanian communism. Inspired by Portelli’s theoretical framework, it aims to address the problems posed by the translation of performativity from Romanian into English. To this end, transcribed historical interviews are extracted from two main books on the era: Memorial of pain: darkness and light (Hossu Longin, 2013) and The Survivors: testimonies from Romania’s communist prisons (Ştef, 2014).

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Zhang, Hui, Sui-Bin Ma, Yong-Jing Gao, Jun-Ling Xing, Hang Xian, Zhen-Zhen Li, Shu-Ning Shen, Sheng-Xi Wu, Ceng Luo, and Rou-Gang Xie. "Spinal CCL2 Promotes Pain Sensitization by Rapid Enhancement of NMDA-Induced Currents Through the ERK-GluN2B Pathway in Mouse Lamina II Neurons." Neuroscience Bulletin 36, no. 11 (August 18, 2020): 1344–54. http://dx.doi.org/10.1007/s12264-020-00557-9.

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AbstractPrevious studies have shown that CCL2 (C–C motif chemokine ligand 2) induces chronic pain, but the exact mechanisms are still unknown. Here, we established models to explore the potential mechanisms. Behavioral experiments revealed that an antagonist of extracellular signal-regulated kinase (ERK) inhibited not only CCL2-induced inflammatory pain, but also pain responses induced by complete Freund’s adjuvant. We posed the question of the intracellular signaling cascade involved. Subsequent experiments showed that CCL2 up-regulated the expression of phosphorylated ERK (pERK) and N-methyl D-aspartate receptor [NMDAR] subtype 2B (GluN2B); meanwhile, antagonists of CCR2 and ERK effectively reversed these phenomena. Whole-cell patch-clamp recordings revealed that CCL2 enhanced the NMDAR-induced currents via activating the pERK pathway, which was blocked by antagonists of GluN2B and ERK. In summary, we demonstrate that CCL2 directly interacts with CCR2 to enhance NMDAR-induced currents, eventually leading to inflammatory pain mainly through the CCL2–CCR2–pERK–GluN2B pathway.

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Taylor, Douglas K. "Influence of Pain and Analgesia on Cancer Research Studies." Comparative Medicine 69, no. 6 (December 1, 2019): 501–9. http://dx.doi.org/10.30802/aalas-cm-19-000002.

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Mice and rats are valuable and commonly used as models for the study of cancer. The models and methods of experimentation have the potential to cause pain to some degree, and all charged with ensuring animal welfare must determine how to manage it. A commonly posed question, especially from investigators and IACUC, is whether the provision of analgesic agents will render the model invalid. Left untreated, pain is a stressor and has negative consequences, most notably immune system perturbations. In addition, analgesic agents in the opioid and NSAID drug classes exhibit immunomodulatory activity and influence processes such as cell proliferation, apoptosis, and angiogenesis that are important in cancer formation. Therefore, both pain and the agents used to alleviate it have the potential to act as confounding factors in a study. This review article presents data from both human medicine and work with animal models in an attempt to help inform discussions about the withholding of analgesic agents from animals used in cancer studies.

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Begley, J. L., and V. Brazil. "Assessing the risk of nosocomial infection posed by COVID‐19 tracheal intubation: the first intubateCOVID results." Anaesthesia 75, no. 11 (July 22, 2020): 1544. http://dx.doi.org/10.1111/anae.15219.

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Iglesias, Marta Elena Losa, and Ricardo Becerro de Bengoa Vallejo. "Musculoskeletal Pain, Job Satisfaction, Depression, and Anxiety Among Spanish Podiatric Physicians." Journal of the American Podiatric Medical Association 104, no. 2 (March 1, 2014): 191–97. http://dx.doi.org/10.7547/0003-0538-104.2.191.

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Background There is a high prevalence of musculoskeletal complaints related to day-to-day work among podiatric physicians. We sought to determine the relationships among musculoskeletal pain, job satisfaction, depression, and anxiety in Spanish podiatric physicians. Methods A convenience sample of 421 Spanish podiatric physicians was administered a survey that included questions about sociodemographic variables, musculoskeletal pain, job satisfaction, depression, and anxiety. Results On average, respondents were found to have a high level of pain, a moderate level of job satisfaction, and low-to-moderate levels of depression and anxiety. Young single women had the highest levels of pain and anxiety. Analysis with the Student t test indicated significant differences between the sexes for levels of pain (P < .0001) and anxiety (P < .014). Job satisfaction was inversely related to depression and anxiety. Conclusions These findings, particularly the increased levels of pain, job dissatisfaction, anxiety, and depression in young single female podiatrists, indicate a need for strategies to reduce the risks posed by the work environment in podiatric medicine, thus minimizing the negative psychological and physical consequences of participating in the profession.

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Rai, Oman, Sanju Lama, and Sanjay Wazir Pandita. "The importance of a thorough clinical examination in adolescent girls presenting with acute urinary retention." BMJ Case Reports 14, no. 2 (February 2021): e240378. http://dx.doi.org/10.1136/bcr-2020-240378.

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We present an adolescent girl with a 1-day history of acute urinary retention and lower abdominal pain. She was admitted to the paediatric ward for ongoing treatment and investigations. Due to a myriad of factors including pain and anxiety, challenges posed included an incomplete initial abdominal and external genital examination. This case report highlights the importance of a focused history and performing an appropriate sensitive examination at the time of presentation. Furthermore, we explore the common causes of new onset urinary retention and unravel the case as it unfolds. We also highlight differential diagnoses (however, uncommon), which must be considered and not overlooked to avoid unnecessary investigations and to ensure timely management.

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Kerr, Harry D. "Dyspnea Possibly Associated with Controlled-Release Morphine Sulfate Tablets." Drug Intelligence & Clinical Pharmacy 22, no. 5 (May 1988): 397–99. http://dx.doi.org/10.1177/106002808802200506.

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Morphine sulfate in controlled-release tablet form is a relatively new oral preparation being used for the relief of chronic severe pain, such as that related to cancer. A patient with adenocarcinoma of the prostate with bone metastases experienced dyspnea possibly related to the ingestion of these tablets. Discontinuing the drug quickly resulted in disappearance of the dyspnea. The respiratory effects of morphine and the particular risks posed to the elderly patient are discussed.

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Rykov, Mary H. "Facing the Music: Speculations on the Dark Side of Our Moon." Journal of Palliative Care 17, no. 3 (September 2001): 188–92. http://dx.doi.org/10.1177/082585970101700312.

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Work with people who are dying is painful and no palliative caregiver is exempt from this. The emotional pain associated with being a palliative care music therapist is related to professional training, the experience of being a professional minority and newcomer in the workplace, and the intensity and intimacy of the musical workspace. Questions are posed to facilitate music therapist self-reflection. Therapist self-acceptance includes tolerance for imperfection, which, in turn, affects the music's capacity for containment.

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Pozos-Guillén, Amaury, Edith Loredo-Cruz, Vicente Esparza-Villalpando, Ricardo Martínez-Rider, Miguel Noyola-Frías, and Arturo Garrocho-Rangel. "Pain and Anxiety Levels Using Conventional versus Computer-Controlled Local Anesthetic Systems in Pediatric Patients: A Meta-Analysis." Journal of Clinical Pediatric Dentistry 44, no. 6 (December 1, 2020): 371–99. http://dx.doi.org/10.17796/1053-4625-44.6.1.

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The objective of this systematic review and meta-analysis was to compare the pain/anxiety levels associated with the anesthetic process by conventional and computer-controlled delivery systems (CCDS) in children. Four electronic databases (PubMed, EMBASE, Scopus, Google Scholar, and Dentistry & Oral Science Source/EBSCO) were comprehensively explored for eligible studies, in English or Spanish, published from January 1995 to December 2019. A systematic literature review and meta-analysis were conducted according to the PRISMA statement, including only randomized controlled clinical trials. An exhaustive search was performed in different electronic databases under a specific PICO-posed question. Relevant studies were selected based on titles and abstracts, and the full texts were retrieved. From these articles, important information was extracted. Wand demonstrated significantly lower pain than the conventional injection did. In the subgroup by pain scale analysis, the Facial Image Scale and Wong-Baker Faces Pain Scale showed a significant difference in favor of the CCDS. In general, the reviewed evidence shows that less perceived pain and anxiety occur when the local anesthetic technique is performed with a CCDS than with the traditional technique.

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Ahmad, I., R. Owen, D. J. N. Wong, C. Johnstone, and K. El‐Boghdadly. "Associated risks posed to healthcare workers when intubating the trachea of patients with COVID‐19: a reply." Anaesthesia 75, no. 11 (August 2020): 1545–46. http://dx.doi.org/10.1111/anae.15225.

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Albu, Sorin, and Septimiu Voidăzan. "Humanistic Medicine, a Forgotten Concept? The Correct Approach in Palliative Care of Chronic Patients." Journal of Interdisciplinary Medicine 1, no. 3 (December 1, 2016): 300–302. http://dx.doi.org/10.1515/jim-2016-0063.

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Abstract Palliative care in Romania is a relatively new emerging field. Challenges of this specialty, its uniqueness and the several problems posed by a particular category of patients, the chronically ill patients, make this medical specialty a particularly complex one in certain situations, requiring a multidisciplinary team well-prepared in terms of theory and practice. Unlike in the case of most medical specialties, particular emphasis is laid on the “human” side of medical care, this specialty introducing the concept of “total pain”.

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Yadav, Dipak Kumar, Bhesraj Gautam, Amit Bhattarai, Saurav Poudel, and Ashish Bhattarai. "Perforated Subhepatic Appendix Presenting as a Gas under Diaphragm: Clinical Diagnostic Challenges for Surgical Residents: A Case Report." Journal of Nobel Medical College 12, no. 2 (December 31, 2023): 119–22. http://dx.doi.org/10.3126/jonmc.v12i2.61522.

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This study addresses the rarity of the subhepatic location of the appendix, found in only 0.08% of cases, and the infrequent occurrence of perforated appendicitis presenting with gas under the diaphragm. When these two uncommon conditions coincide in the context of one of the common causes of acute abdomen, namely acute appendicitis, it poses a diagnostic challenge for surgical residents in training. The case presented involves a patient with generalized abdominal pain, soft abdomen, and tenderness over all quadrants, particularly the right upper quadrant. Her chest x-ray findings indicated free gas under the right hemi-dome of the diaphragm and an inconclusive ultrasound for acute appendicitis, computed tomography confirmed the subhepatic appendix and pneumoperitoneum. Operative intervention revealed a perforated subhepatic appendix, and the patient recovered well, being discharged on the 4th postoperative day. The clinical discussion emphasizes the ability of surgical residents to safely perform appendectomies but highlights the crucial role of experienced surgeons in managing cases with atypical presentations. The conclusion underscores the diagnostic challenges posed by atypical presentations of acute appendicitis in a clinical setting.

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Mousa, Albeir, Peter Henderson, Rajeev Dayal, Joshua Bernheim, K. Craig Kent, and Peter L. Faries. "Endoluminal Recanalization in a Patient with Phlegmasia Cerulea Dolens Using a Multimodality Approach." Vascular 13, no. 5 (September 1, 2005): 313–17. http://dx.doi.org/10.1258/rsmvasc.13.5.313.

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Phlegmasia cerulea dolens, a rare complication of deep venous thrombosis, has traditionally been difficult to treat. The patient described in this report posed additional therapeutic challenges based on a history of heparin-induced thrombocytopenia. She presented with severe leg pain and swelling, and a venogram showed occlusion of both her inferior vena cava and right iliac vein. The use of a multimodality approach, both chemical and mechanical, was successful in removing the venous occlusion, thereby preventing further complications, such as circulatory shock, postphlebitic syndrome, and venous gangrene.

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Sommers, Elizabeth, Sivarama Prasad Vinjamury, and Jennifer Noborikawa. "Pain and Opioid Use: Evidence for Integrating Acupuncture Into Treatment Planning." Global Advances in Health and Medicine 10 (January 2021): 216495612110425. http://dx.doi.org/10.1177/21649561211042571.

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The epidemics of pain and opioid use pose unique challenges. Comprehensive approaches are required to address minds, bodies and spirits of individuals who live with pain and/or opioid use. The lack of an effective “quick fix” for either condition necessitates developing effective, innovative and multi-disciplinary avenues for treatment. This analytic article reviews epidemiological and demographic factors associated with pain and with opioid use and additional challenges posed by the Covid-19 epidemic. Several large-scale studies and meta-analyses have examined the role of acupuncture as a nonpharmacological approach to pain management as well as a component of comprehensive strategies to address opioid use disorder. We review and describe these in the context of safety, effectiveness, access and cost-related factors. With one in four U.S. hospitals as well as 88% of Veterans Health Administration facilities incorporating acupuncture, the feasibility of mobilizing and scaling up these treatment resources is being developed and demonstrated. We also identify potential facilitators and barriers to implementing acupuncture treatment. As part of a multi-disciplinary approach to pain management and/or opioid use disorder, we suggest that integrating acupuncture into treatment protocols may represent a viable strategy that is based on and consistent with public health principles.

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Manstein, Carl Howard, Samuel Max Manstein, and Ely Manstein. "Is Tourniquet Pain the Result of Increased Compartment Pressure in the Forearm?" Annals of Plastic Surgery 92, no. 4S (April 2024): S255—S257. http://dx.doi.org/10.1097/sap.0000000000003908.

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Abstract The pneumatic tourniquet has been a mainstay in upper extremity surgery by allowing the surgeon to operate in a blood-free field. Many upper extremity surgical procedures are done under local anesthesia or minimal sedation, and the problem of tourniquet pain is a vexing one. The question is posed: Is tourniquet pain the result of increased compartment pressure in the forearm? This study measured compartment pressures of the volar forearm in 10 healthy normotensive volunteers before inflation of a pneumatic tourniquet and compared it with pressure measurements taken while the tourniquet was still inflated after 15 minutes. Compartment pressures were measured using a Stryker needle manometer; all measurements were taken in the volar forearm by the senior author (C.H.M.). There was no increase in the volar/flexor compartment pressure of the forearm after 15 minutes of tourniquet inflation. All subjects complained of pain of the forearm, characteristically what is commonly called “tourniquet pain.” We therefore conclude that in the upper extremity, at least for relatively short operating times, appropriate inflation of a tourniquet does not induce the early onset of increased compartment pressure in the forearm.

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Hogans, Beth, Bernadette Siaton, Laura Frey-Law, Lana Brown, Chris Herndon, Luis Buenaver, Les Katzel, and Patricia Thomas. "PAEAN: Pain in Aging, Educational Assessment of Need - An Interprofessional Collaboration." Innovation in Aging 5, Supplement_1 (December 1, 2021): 835. http://dx.doi.org/10.1093/geroni/igab046.3059.

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Abstract Pain is prevalent in older adults limiting independence directly and through comorbidity-related effects on functional domains such as mobility, well-being, sleep, productivity, and oligo-pharmacy. Improved outcomes for older adults with pain depends on provider knowledge and competence; concomitantly, Veterans, women, and others at socioeconomic disadvantage may face increased pain, comorbidities, and complications of treatments. Previous guidance for educational programs, from pre-licensure to post-graduate training, in geriatrics and pain have focused on expert opinion, whereas an evidence-based approach is preferred. Our working group is conducting a structured needs assessment regarding comorbidities of common pain-associated conditions in older adults. Methods: To capture expertise in medicine, nursing, pharmacy, clinical psychology, and physical therapy, we extended an open invitation to members of the VA Geriatric Research, Education, Clinical Centers Associate Director-Education network and selected, nationally-recognized clinical education experts outside VA. Results: An eight-member working group, interprofessional in composition, through multiple remote meetings has defined goals of the program, evaluated preliminary evidence addressing the clinical needs of older adults with pain, and posed ‘curious questions’ about the available large-scale data. The overarching goal is evidence-based needs assessment of gaps in education about pain in older adults, with purposeful attention to risks of healthcare inequities for older adult women, Veterans, persons of color, those at socioeconomic disadvantage, and caregivers. Conclusions: Interprofessional collaboration is effective in framing a broad needs assessment regarding pain and common comorbidities in older adults with the intent of meeting the educational needs of clinical trainees. More study is needed.

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Wyszyński, Szymon, and Sylwia Stiler. "Assessment of the influence of ischemic compression and clavitherapy on compression pain threshold measured on the lumbar spine rectifier muscle." Medical Science Pulse 12, no. 3 (September 30, 2018): 13–17. http://dx.doi.org/10.5604/01.3001.0012.4665.

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Background. The British physician, Balfour, at the beginning of the nineteenth century was one of the first to describe thickened nodules and bumps in tissue, which could be painful under pressure. This pressure often also caused pain in other distant parts of the body. The above characteristics perfectly reflected what is now referred to as the trigger point. Objective. The aim of this study was to assess the impact of ischemic compression using clavitherapy on the level of compression pain threshold measured with an algometer on the muscle of the lumbar region spine extender. The following research questions were posed: Materials and methods. The research involved 40 patients with pain in the paraspinal muscles who were attending the Physio-Wysz Rehabilitation Center. In each subject, pain threshold was assessed using an algometer, 5 points before and after therapy. Each subject was then subjected to ischemic compression for each of the 5 points. The obtained results were entered into an Excel™ database and then analyzed using the Statistica program. Results. The mean value of the pain threshold for the L1 point before therapy was 114.4 ±17.22 N/cm2 and for P1 was 113.24±18.85 N/cm2. Immediately after therapy, the compression pain threshold decreased to 84.15±10.79 N/cm2 and 84.89 ±10.11 N/cm2 for the L1 and P1 points, respectively. Conclusions. There was a reduction in the mean compression pain threshold immediately after clavicle therapy. There were no significant differences when measuring the pressure pain threshold after therapy.

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Nagy, Örs, Sándor-György Zuh, Attila Kovács, Árpád Sólyom, Réka Sólyom, and István Gergely. "A van Neck–Odelberg-betegség bemutatása két eset kapcsán." Orvosi Hetilap 157, no. 21 (May 2016): 836–39. http://dx.doi.org/10.1556/650.2016.30470.

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Osteochondritis ischiopubica or van Neck–Odelberg disease is characterized by atypical ossification of the ischiopubic synchondrosis. Clinical symptoms are usually pain, limping and limited range of motion of the hip joint. Radiologic images may be confused with the possibility of fracture, tumor or inflammation. In some cases it may be difficult to set up the accurate diagnosis, and during the diagnostic process it is essential that van Neck–Odelberg disease should be considered. In this paper the authors draw attention to this rare disorder and they present the history of two patients who posed diagnostic difficulties. Orv. Hetil., 2016, 157(21), 836–839.

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MOON, Don. "IPEF and the Reconfiguration of the East Asian Economic Order." East Asian Policy 14, no. 04 (October 2022): 42–55. http://dx.doi.org/10.1142/s1793930522000277.

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A successful launch of the Indo-Pacific Economic Framework for Prosperity (IPEF) negotiations has posed new opportunities as well as challenges to all the actors in the East Asian region. The United States—the designer and initiator of the ambitious scheme—has displayed its intention to counter China’s expanding influence using this institutional initiative. This article examines the distinctive features of the IPEF and discusses its strategic implications as the economic instrument of the United States’ Indo-Pacific Strategy. It also explores the impact of the IPEF on the institutional reconfiguration in the region, which is swiftly underway amid the intensifying US–China confrontation.

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Shen, Natalia P., Vladimir V. Logvinenko, Svetlana B. Tsiryatieva, Valentin I. Osin, and Aleksander A. Masserov. "Preliminary outcomes of the COVID-19 pandemic: a new chronic pain profile." Regional Anesthesia and Acute Pain Management 16, no. 3 (January 20, 2023): 171–83. http://dx.doi.org/10.17816/ra109668.

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In summing up the preliminary results of the COVID-19 pandemic that has not yet ended, modern research pays much attention to the so-called post-COVID syndrome, which includes the long-term consequences of the disease. In English, symptoms are reported as long COVID, post-acute COVID, or chronic post-COVID syndrome and are described as symptoms of fatigue, respiratory disorders, memory, and sleep problems. Symptoms such as muscle pain and decreased endurance when performing habitual physical exertion are mentioned much less often. Meanwhile, among the complaints of those who have been ill, this symptom is present quite often, reducing the quality of life and tolerability of normal physical exertion. This review aimed to provide an in-depth study of a new type of the chronic myofascial pain syndrome after COVID-19, i.e., the frequency of occurrence, causes of the development, and pathophysiology of chronic pain syndrome associated with COVID-19 and manifested as fibromyalgia of various localizations. To answer the questions posed, the authors searched for information in four electronic databases. The key search terms used were COVID-19, long COVID, and signs and symptoms of pain syndrome. A review of current literature data has shown that close study and dynamic monitoring of patients who had COVID-19 can contribute to further deciphering the pathophysiological mechanisms of the development of its long-term consequences and provide answers to questions on the prevention and treatment of chronic pain syndrome in this patient cohort.

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Allen, Francis W. "Part 1: “I would Rather have a Root Canal than...” Francis W Allen discusses the challenges of cleaning the canal thoroughly to minimize pain and ensure long-term success." World Journal of Dentistry 1, no. 1 (2010): 21–29. http://dx.doi.org/10.5005/jp-journals-10015-1005.

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ABSTRACT Cleaning and shaping of root canal system forms the most important step in root canal root canal therapy. Unfortunately most of the instruments and techniques advocated are unable to remove residual debris and bacteria, ultimately resulting in pain and failure. To eliminate the causes of pain, and ensure success, we must use instruments and employ a technique that can best accomplish proper cleaning and shaping. Virtually all canals have parallel walls, and are curved and oval in shape. Hence tapered instruments are unable to clean the canal effectively and increase the chances of ledges and transportation and extrusion of debris beyond the apex. With the introduction of Light Speed technology primary goal of endodontics which includes removal of debris safely and effectively can be achieved. This article focuses on the use of Light Speed technology to overcome the difficulties posed by the other instrumentation and techniques to achieve debris and bacteria free canal system.

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McLaren, Steve, Megan Hughes, Catherine Sheehan, and Jagdish Sokhi. "A guide to epidural management." British Journal of Hospital Medicine 81, no. 1 (January 2, 2020): 1–7. http://dx.doi.org/10.12968/hmed.2019.0174.

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Epidural analgesia is a key component in the management of inpatient pain relief, particularly in surgical and trauma patients, and those with comorbidities. When used appropriately epidurals can decrease a patient's opiate consumption, as well as reducing the risk of adverse cardiorespiratory outcomes. To non-anaesthetists, or those not versed in their usage, epidurals can appear complex and intimidating, and the potential complications, although rare, can be catastrophic if not picked up on in a timely fashion. This article demystifies the epidural for hospital clinicians, looking at the anatomy and pharmacology, helping to identify patients who may benefit from epidural analgesia, highlighting some common pitfalls and questions posed by nursing staff, and providing a framework via which junior clinicians can detect, manage and appropriately escalate epidural-related problems and complications. Epidural analgesia is an invasive and high-risk intervention; as such it should always be managed by a multidisciplinary team, including anaesthesia and acute pain services.

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Imamuzzaman, Dr Muhammad, Dr Sulaimanov Baktyar Janyshovich, Dr Kanij Ftaema Mukta, and Dr Sumit Mishra. "Prevalence of Musculoskeletal Pain and Related Factors among Foreign Medical Students of Bishkek, Kyrgyzstan: A Cross-Sectional Study." Journal of Prevention, Diagnosis and Management of Human Diseases, no. 41 (January 31, 2024): 31–36. http://dx.doi.org/10.55529/jpdmhd.41.31.39.

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Musculoskeletal pain impacts our daily lives in numerous ways. So, it is very important to investigate this problem to find out its prevalence and factors related to it. Methods: A descriptive cross-sectional study was carried out among 360 randomly selected medical students from different medical colleges in Bishkek, Kyrgyzstan. With consent, data was collected by the principal investigator by pretested interview schedule through face-to-face interviews. Participants had the freedom to withdraw from the study at any point without the obligation to provide a reason, and measures were taken to maintain data confidentiality. The procedure posed no physical, mental, or social risks. Data were analysed by SPSS version 25.0 and presented through tables and diagrams for clarity. Results: Of the respondents, 213(59.2%) had musculoskeletal pain. But the majority 314(87.2%) had no history of trauma and 221(61.4%) had a family history of musculoskeletal pain. Of them, only 116(32.2%) respondents performed physical exercise while nearly two-thirds 224(62.2%) had normal BMI. Near cent per cent of respondents had prolonged sitting history, which is more than 2 hours. Most 273(75.8%) of them use chairs for study purposes. Near three-fourths, 259(71.9%) had travel time of more than one hour per day and a significant 328(91.1%) number of them use backpacks. Of 213 sufferers, more than two-fifths 128(60.1%) had musculoskeletal pain often. Almost half (47.4%) of medical students were suffering from back pain and 69(32.4%) from neck pain. Conclusion: Medical students were suffering from musculoskeletal pain with no history of trauma and positive family history. Students do not perform physical exercise regularly with normal BMI. During travel, they use backpacks to carry educational materials. Smartphones, computers or laptops are used by them during their leisure time. Students were mainly suffering from back, neck and shoulder pain.

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WERNER, PHILIPP, AYOUB AL-HAMADI, and ROBERT NIESE. "COMPARATIVE LEARNING APPLIED TO INTENSITY RATING OF FACIAL EXPRESSIONS OF PAIN." International Journal of Pattern Recognition and Artificial Intelligence 28, no. 05 (July 31, 2014): 1451008. http://dx.doi.org/10.1142/s0218001414510082.

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Together with classification of facial expressions, the rating of their intensities is of major interest. Classical supervised learning techniques require labeling of the intensities, which is labor intensive and requires expert knowledge, but nevertheless is not guaranteed to be objective. We propose a new approach to learn an intensity rating function which does not require expert knowledge, because it simplifies the labeling task by avoiding the difficulty of selecting an absolute intensity value and to keep the labeling consistent for the whole dataset. It is based on a novel kind of ground truth which we call Comparative Labeling. It specifies sample pairs for which the first element is desired to have a lower intensity than the second. We introduce a learning scheme to find an optimal intensity function in respect of the Comparative Labeling and propose performance measures to assess the quality of the learned function. The technique is applied to rate the intensity of facial expressions of posed pain. The evaluation results show that the learned function is well suited for determining dynamic intensity variation over time. We also assess the suitability of the rating as an inter-individual intensity measure by comparing it to the intensity ratings given by human observers.

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York, Eric J. "Alternate histories and conflicting futures." Communication Design Quarterly 10, no. 2 (July 2022): 57–65. http://dx.doi.org/10.1145/3507857.3507863.

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Despite their central importance to a variety of endeavors and despite widespread use in both industry and academia, version control systems (software for tracking versions of files) have not been extensively studied in fields related to technical communication, rhetoric, and communication design. Git, by far the most dominant version control system today, is largely absent. This study theorizes Git as boundary infrastructure---infrastructure used to facilitate collaboration across disciplines and domains. The unique characteristics of boundary infrastructure explain how something as prominent as Git can be so invisible and help identify dangers posed by boundary infrastructure. Drawing on modes of resistance developed in feminist rhetorics, this article concludes with suggestions to ameliorate the negatives effects such infrastructure might have on collaborative knowledge work.

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Alawadhi, Aydah, and Laszlo Leb. "Massive Retroperitoneal Hemorrhage as an Initial Presentation of a Rare and Aggressive Form of Multiple Myeloma." Case Reports in Hematology 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/8206826.

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Multiple myeloma, a plasma cell neoplasm, presents most commonly with anemia, hypercalcemia, renal failure, and bone pain. Only few cases of clinical aggressive presentation associated with bleeding were reported in the medical literature. The reported cases included gastrointestinal bleeding and cardiac tamponade. Spontaneous retroperitoneal haemorrhage as initial presentation has not been so far reported. We hereby report a case of a 64-year-old female who was found to have catastrophic hemorrhage in the retroperitoneal region that extended into intrathecal space causing cord compression. The case posed a significant diagnostic and management dilemma. This case emphasizes the need to think broadly and include multiple myeloma in the diagnosis of unexplained massive retroperitoneal bleeding.

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Aloua, Y., A. Aouragh, O. Lamzouri, N. Miry, A. Bennani, H. Taheri, H. Saadi, and A. Mimouni. "MANAGEMENT OF AN IMMATURE TERATOMA IN A YOUNG WOMAN DESIRING PREGNANCY : A CASE REPORT." International Journal of Advanced Research 11, no. 05 (May 31, 2023): 1333–37. http://dx.doi.org/10.21474/ijar01/17000.

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Immature teratoma is a rare type of germ cell tumor that primarily affects young women and can present with diverse symptoms. We present a case of a 20-year-old female with a large abdominopelvic mass diagnosed as an immature teratoma. The patients chronic abdominopelvic pain and weight loss posed diagnostic challenges, but comprehensive diagnostic workup facilitated timely diagnosis and management. Radical surgery is the primary treatment option for immature teratomas, but alternative treatments such as chemotherapy may be appropriate in selected cases, particularly in young women with a desire to preserve fertility. A patient-centered approach is crucial for optimal outcomes. Further research is needed to determine the optimal chemotherapy regimen and duration of treatment for immature teratomas.

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Alali, Bader, Maha Al-Gilani, and Boobalan Samynathan. "Dissecting the mystery: A case report of a parapharyngeal ganglioneuroma." International Journal of Case Reports and Images 15, no. 1 (February 28, 2024): 36–39. http://dx.doi.org/10.5348/101441z01ba2024cr.

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Introduction: Ganglioneuromas, slow-growing non-neoplastic tumors from neural crest cells, are typically asymptomatic but may manifest clinically when reaching a significant size. While rare in the parapharynx, imaging assists in preoperative planning and assessing features of more sinister pathologies. Case Report: A 45-year-old woman presented with persistent unilateral neck pain and sore throat, computed tomography (CT) imaging parapharyngeal space, ultimately diagnosed as a parapharyngeal ganglioneuroma on tissue biopsy. Surgical excision was performed with an uneventful postoperative course. Conclusion: Parapharyngeal ganglioneuromas pose diagnostic challenges due to their rarity and diverse presentations. This case underscores the diagnostic challenges posed by rare parapharyngeal lesions and highlights the successful management of ganglioneuromas through appropriate imaging and surgical intervention.

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Suvidha, Saurabh. "A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst." International Journal of Current Research and Review 14, no. 21 (2022): 12–14. http://dx.doi.org/10.31782/ijcrr.2022.142103.

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Introduction: Uterine fibroids are the most common benign pelvic tumors in women of reproductive age. Most of them are asymptomatic but they are also a major source of clinical morbidity. Aim: We present this case due to its uniqueness and the diagnostic difficulties it posed. Case Report: A 40-year-old female presented to the OPD with complaints of pain abdomen on and off and heavy menstrual bleeding. Physical examination revealed a lump of 14-week size.USG and CT scan revealed intramural fibroid with cystic/mucoid degeneration. The patient had an elective total abdominal hysterectomy with bilateral scalping-oophorectomy. Intraoperatively uterus was enlarged with hydrosalpinx on the right side. Histopathological examination showed mucoid degeneration of fibroid with chronic cervicitis. Discussion: Degenerating changes in fibroids are considered to result from excessive growth that outmatches the blood supply or mechanical compression of feeder arteries. Conclusion: This case illustrates that degeneration of uterine leiomyoma should be considered as one of the differential diagnoses for all women presenting with abdominal pain and a large fibroid mass regardless of hormonal status or age.

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Kumar, Ameet, and Sumesh Kaistha. "Abdominal Crunch Syndrome Creates a Diagnostic Challenge in Treating a Pilot with Acute Upper Abdominal Pain." Aerospace Medicine and Human Performance 94, no. 2 (February 1, 2023): 86–89. http://dx.doi.org/10.3357/amhp.6148.2023.

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BACKGROUND: A diagnosis in acute abdomen may remain elusive especially when the cause is rare. We report this interesting case of a fighter pilot presenting with acute abdominal pain. The case posed significant challenges in reaching the correct diagnosis of abdominal crunch syndrome. The syndrome is rare with only seven reports in the literature so far. To the best of our knowledge, this is the first ever report of this condition in an aircrew.CASE REPORT: A 37-yr-old pilot presented with severe upper abdominal pain and sweating. During examination, he developed bradycardia and was admitted with a presumptive diagnosis of acute coronary syndrome. Investigations revealed no myocardial ischemia on ECG, transaminitis, raised CPK, CKMB, and LDH. A CECT scan of chest and abdomen was normal. A GI surgery consult was sought where we connected the transaminitis and raised CPK and considered the possibility of rhabdomyolysis. On specific inquiry, the aviator gave history of unaccustomed exercise with a vigorous session of abdominal crunches a day prior. Thus, a diagnosis of abdominal crunch syndrome was concluded.DISCUSSION: The aviator did not associate his vigorous exercise with the occurrence of pain and, therefore, did not mention it. It would have avoided unnecessary investigations and delay in treatment. From the aeromedical safety aspect, had the aviator flown on the day he developed pain, there was a possibility of developing severe pain exacerbated by the G force and G suit and sudden in-flight incapacitation. From the perspective of the aircrew, it is advisable that they avoid sudden, unaccustomed exercise.Kumar A, Kaistha S. Abdominal crunch syndrome creates a diagnostic challenge in treating a pilot with acute upper abdominal pain. Aerosp Med Hum Perform. 2023; 94(2):86–89.

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Nepal, T., and V. Sharma. "Effects of simulated prolonged restrained sitting on physical and physiological states." Indian Journal of Aerospace Medicine 65 (August 6, 2021): 38–42. http://dx.doi.org/10.25259/ijasm_19_2020.

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Introduction: Advancement in aerospace technology, and resultant change in operational capabilities has posed unique challenges on the aircrew, who is required to operate for prolonged periods seated and restrained. Examination of the effects of prolonged restrained sitting on physical and physiological states was the desired objective of the study. Material and Methods: Longitudinal evaluation of subjective appreciation of physical discomfort and pain, and physiological parameters, namely, heart rate (HR), blood pressure (BP), oxygen saturation (SpO2), skin temperature, and calf girth changes across 6-h of simulated prolonged restrained sitting was undertaken among 15 healthy male non aircrew volunteers with mean age of 31.2 ± 3.63 years. Subjective discomfort was assessed by Category Partitioning Scale (CPS) and pain by Short-Form McGill Pain Questionnaire (SF-MPQ). Results: Prolonged restraint sitting of 6-h resulted in a significant increase in calf girth. Significant changes were also observed in CPS and SF-MPQ scores indicating an increase perception of discomfort and pain. Changes in HR, MAP, SpO2, and lower limb skin temperature were also observed even though these changes were lower in magnitude. Conclusion: The pain and discomfort following 6-h of prolonged restraint sitting were found to be appreciable by the subjects. This, along with a significant change in the calf circumference and other physiological parameters were possibly due to effects of venous pooling as a result of sitting for prolonged periods. The effects so observed could have potential flight safety implications and affect mission effectiveness. However, these findings need to be examined in actual cockpit conditions where the seat is more ergonomically designed; yet the aircrew is subjected to a wide spectrum of additional aeromedical stressors.

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Zartman, I. William. "Mediation: Ripeness and its Challenges in the Middle East." International Negotiation 20, no. 3 (October 26, 2015): 479–93. http://dx.doi.org/10.1163/15718069-12341317.

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A mutually hurting stalemate is a necessary but insufficient condition for the opening of negotiations, direct or mediated. It is subject to perception, buffered by many insulating ploys even if it seems to exist objectively. Thus, the major challenge for a mediator in most cases is to ripen the parties’ perceptions. In addition to the attitudinal challenge, there are structural challenges posed by other types of stalemates and near-stalemates, which call for not only persuasion but also manipulation by the mediator. The ultimate challenge to a mediator is to move successful negotiations producing conflict management onto the consummating phase of negotiations for conflict resolution. But the first removes the incentive for the second, since it ceases the violence that is the most effective source of pain.

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Journal articles on the topic 'Posed pain'

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