DOCSLIB.ORG

Psychological Interventions for Needle-Related Procedural Pain and Distress in Children and Adolescents (Review)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Psychological Interventions for Needle-Related Procedural Pain and Distress in Children and Adolescents (Review) Psychological interventions for needle-related procedural pain and distress in children and adolescents (Review) Uman LS, Birnie KA, Noel M, Parker JA, Chambers CT, McGrath PJ, Kisely SR This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2013, Issue 10 http://www.thecochranelibrary.com Psychological interventions for needle-related procedural pain and distress in children and adolescents (Review) Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 BACKGROUND .................................... 2 OBJECTIVES ..................................... 4 METHODS ...................................... 4 RESULTS....................................... 10 Figure1. ..................................... 13 Figure2. ..................................... 14 DISCUSSION ..................................... 17 AUTHORS’CONCLUSIONS . 20 ACKNOWLEDGEMENTS . 21 REFERENCES ..................................... 22 CHARACTERISTICSOFSTUDIES . 33 DATAANDANALYSES. 103 Analysis 1.1. Comparison 1 Distraction, Outcome 1 Self-reportedpain.. 105 Analysis 1.2. Comparison 1 Distraction, Outcome 2 Observer-reported pain. 106 Analysis 1.3. Comparison 1 Distraction, Outcome 3 Self-reported distress. 107 Analysis 1.4. Comparison 1 Distraction, Outcome 4 Observer-reported distress. 107 Analysis 1.5. Comparison 1 Distraction, Outcome 5 Behavioral measures- Pain. 108 Analysis 1.6. Comparison 1 Distraction, Outcome 6 Behavioral measures- Distress. 109 Analysis 1.7. Comparison 1 Distraction, Outcome 7 Physiological measure - Heart Rate. 110 Analysis 1.8. Comparison 1 Distraction, Outcome 8 Physiological measure - Oxygen Saturation. 110 Analysis 2.1. Comparison 2 Hypnosis, Outcome 1 Self-reported pain. ................ 111 Analysis 2.2. Comparison 2 Hypnosis, Outcome 2 Self-reported distress. 112 Analysis 2.3. Comparison 2 Hypnosis, Outcome 3 Behavioral measures- Distress. 113 Analysis 3.1. Comparison 3 Preparation and information, Outcome 1 Self-reported pain. 114 Analysis 4.1. Comparison 4 Virtual reality, Outcome 1 Self-reported pain. 114 Analysis 5.1. Comparison 5 CBT-combined, Outcome 1 Self-reportedpain. 115 Analysis 5.2. Comparison 5 CBT-combined, Outcome 2 Self-reported distress. 116 Analysis 5.3. Comparison 5 CBT-combined, Outcome 3 Observer-reported distress. 116 Analysis 5.4. Comparison 5 CBT-combined, Outcome 4 Behavioral measures- Distress. 117 Analysis 6.1. Comparison 6 Parent coaching + child distraction, Outcome 1 Self-reported pain. 118 Analysis 6.2. Comparison 6 Parent coaching + child distraction, Outcome 2 Observer-reported distress. 118 Analysis 6.3. Comparison 6 Parent coaching + child distraction, Outcome 3 Behavioral measures- Distress. 119 Analysis 7.1. Comparison 7 Suggestion, Outcome 1 Self-reportedpain. ... ... ... ... ... 120 ADDITIONALTABLES. 120 APPENDICES ..................................... 124 WHAT’SNEW..................................... 133 HISTORY....................................... 133 CONTRIBUTIONSOFAUTHORS . 134 DECLARATIONSOFINTEREST . 134 SOURCESOFSUPPORT . 134 DIFFERENCES BETWEEN PROTOCOL AND REVIEW . .... 135 NOTES........................................ 135 INDEXTERMS .................................... 135 Psychological interventions for needle-related procedural pain and distress in children and adolescents (Review) i Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. [Intervention Review] Psychological interventions for needle-related procedural pain and distress in children and adolescents Lindsay S Uman1, Kathryn A Birnie2, Melanie Noel2, Jennifer A Parker2, Christine T Chambers3, Patrick J McGrath3, Steve R Kisely 4 1IWK Health Centre & Dalhousie University, Halifax, Canada. 2Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada. 3Department of Psychology, Dalhousie University, Department of Pediatrics (GI Division), IWK Health Centre, Halifax, Canada. 4School of Population Health, The University of Queensland, Brisbane, Australia Contact address: Christine T Chambers, Department of Psychology, Dalhousie University, Department of Pediatrics (GI Division), IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Noval Scotia, B3K 6R8, Canada. christine.chambers@dal.ca. Editorial group: Cochrane Pain, Palliative and Supportive Care Group. Publication status and date: New search for studies and content updated (conclusions changed), published in Issue 10, 2013. Review content assessed as up-to-date: 2 September 2013. Citation: Uman LS, Birnie KA, Noel M, Parker JA, Chambers CT, McGrath PJ, Kisely SR. Psychological interventions for needle- related procedural pain and distress in children and adolescents. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD005179. DOI: 10.1002/14651858.CD005179.pub3. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. ABSTRACT Background This review is an updated version of the original Cochrane review published in Issue 4, 2006. Needle-related procedures are a common source of pain and distress for children. Our previous review on this topic indicated that a number of psychological interventions were efficacious in managing pediatric needle pain, including distraction, hypnosis, and combined cognitive behavioural interventions. Considerable additional research in the area has been published since that time. Objectives To provide an update to our 2006 review assessing the efficacy of psychological interventions for needle-related procedural pain and distress in children and adolescents. Search methods Searches of the following databases were conducted for relevant randomized controlled trials (RCTs): Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; PsycINFO; the Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Web of Science. Requests for relevant studies were also posted on various electronic list servers. We ran an updated search in March 2012, and again in March 2013. Selection criteria Participants included children and adolescents aged two to 19 years undergoing needle-related procedures. Only RCTs with at least five participants in each study arm comparing a psychological intervention group with a control or comparison group were eligible for inclusion. Data collection and analysis Two review authors extracted data and assessed trial quality and a third author helped with data extraction and coding for one non- English study. Included studies were coded for quality using the Cochrane Risk of bias tool. Standardized mean differences with 95% confidence intervals were computed for all analyses using Review Manager 5.2 software. Psychological interventions for needle-related procedural pain and distress in children and adolescents (Review) 1 Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Main results Thirty-nine trials with 3394 participants were included. The most commonly studied needle procedures were venipuncture, intravenous (IV) line insertion, and immunization. Studies included children aged two to 19 years, with the most evidence available for children under 12 years of age. Consistent with the original review, the most commonly studied psychological interventions for needle procedures were distraction, hypnosis, and cognitive behavioural therapy (CBT). The majority of included studies (19 of 39) examined distraction only. The additional studies from this review update continued to provide strong evidence for the efficacy of distraction and hypnosis. No evidence was available to support the efficacy of preparation and information, combined CBT (at least two or more cognitive or behavioural strategies combined), parent coaching plus distraction, suggestion, or virtual reality for reducing children’s pain and distress. No conclusions could be drawn about interventions of memory alteration, parent positioning plus distraction, blowing out air, or distraction plus suggestion, as evidence was available from single studies only. In addition, the Risk of bias scores indicated several domains with high or unclear bias scores (for example, selection, detection, and performance bias) suggesting that the methodological rigour and reporting of RCTs of psychological interventions continue to have considerable room for improvement. Authors’ conclusions Overall, there is strong evidence supporting the efficacy of distraction and hypnosis for needle-related pain and distress in children and adolescents, with no evidence currently available for preparation and information or both, combined CBT, parent coaching plus distraction, suggestion, or virtual reality. Additional research is needed to further assess interventions that have only been investigated in one RCT to date (that is, memory alteration, parent positioning plus distraction, blowing out air, and distraction plus suggestion). There are continuing issues with the quality of trials examining psychological interventions for needle-related pain and distress. PLAIN LANGUAGE SUMMARY Psychological interventions for needle-related procedural pain and distress in children and adolescents Psychological interventions (for example, distraction, hypnosis, coping skills training) are treatments used to reduce pain and distress (anxiety and fear, or both) that children and adolescents experience while undergoing
Load more
Loading...
Loading...
Loading...
Loading...
Loading...

132 pages remaining, click to load more.

Recommended publications
  • The Relation Between Tender Points and Fibromyalgia Symptom Variables
    268 Annals of the Rheumatic Diseases 1997;56:268–271 CONCISE REPORTS Ann Rheum Dis: first published as 10.1136/ard.56.4.268 on 1 April 1997. Downloaded from The relation between tender points and fibromyalgia symptom variables: evidence that fibromyalgia is not a discrete disorder in the clinic Frederick Wolfe Abstract Fibromyalgia represents the intersection of a Objective—To investigate the relation considerably abnormal and reduced pain between measures of pain threshold and threshold with a series of clinical distress vari- symptoms of distress to determine if ables, including pain, fatigue, sleep distur- fibromyalgia is a discrete construct/ bance, anxiety, and depression, among others. disorder in the clinic. In the clinic, it is best diagnosed by counting Methods—627 patients seen at an the number of tender points a patient has. In outpatient rheumatology centre from 1993 the presence of 11 or more tender points and to 1996 underwent tender point and dolor- widespread pain, fibromyalgia is diagnosed (classified) according to American College of imetry examinations. All completed the Rheumatology (ACR) Criteria.1 assessment scales for fatigue, sleep The ability to diagnose fibromyalgia with disturbance, anxiety, depression, global commonly agreed upon criteria has stimulated severity, pain, functional disability, and a research into basic and clinic aspects of the composite measure of distress con- syndrome. In general, research has used structed from scores of sleep disturbance, ‘normals’ or patients with other rheumatic dis- fatigue, anxiety, depression, and global eases as control subjects. This comparison, of severity—the rheumatology distress index fibromyalgia with such control subjects, (RDI). implies that fibromyalgia is a discrete entity.
    [Show full text]
  • Pain” in the Modern Neurosciences: a Historical Account of the Visualization Technologies Used in the Development of an “Algesiogenic Pathology”, 1850 to 2000
    Brain Sci. 2015, 5, 521-545; doi:10.3390/brainsci5040521 OPEN ACCESS brain sciences ISSN 2076-3425 www.mdpi.com/journal/brainsci/ Review Objectifying “Pain” in the Modern Neurosciences: A Historical Account of the Visualization Technologies Used in the Development of an “Algesiogenic Pathology”, 1850 to 2000 Frank W. Stahnisch Department of Community Health Sciences & Department of History, The University of Calgary, 3280 Hospital Drive NW, Calgary T2N 4Z6, AB, Canada; E-Mail: fwstahni@ucalgary.ca; Tel.: +1-403-210-6290. Academic Editor: Patrick W. Stroman Received: 31 August 2015 / Accepted: 9 November 2015 / Published: 17 November 2015 Abstract: Particularly with the fundamental works of the Leipzig school of experimental psychophysiology (between the 1850s and 1880s), the modern neurosciences witnessed an increasing interest in attempts to objectify “pain” as a bodily signal and physiological value. This development has led to refined psychological test repertoires and new clinical measurement techniques, which became progressively paired with imaging approaches and sophisticated theories about neuropathological pain etiology. With the advent of electroencephalography since the middle of the 20th century, and through the use of brain stimulation technologies and modern neuroimaging, the chosen scientific route towards an ever more refined “objectification” of pain phenomena took firm root in Western medicine. This article provides a broad overview of landmark events and key imaging technologies, which represent the long developmental path of a field that could be called “algesiogenic pathology.” Keywords: pain; history of medicine; Leipzig; Montreal; New York; nineteenth century; precursors to functional neuroimaging of pain; twentieth century “The past of a present-day science is not the same thing as that science in the past.” (Georges Canguilhem) [1] 1.
    [Show full text]
  • Download Article (PDF)
    ORIGINAL CONTRIBUTION Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: Results of a randomized clinical pilot project RUSSELL G. GAMBER, DO; JAY H. SHORES, PHD; DAVID P. RUSSO, BA; CYNTHIA JIMENEZ, RN; BENARD R. RUBIN, DO Osteopathic physicians caring for patients with fibro- treatments for FM incorporate nonpharmacologic ap- myalgia syndrome (FM) often use osteopathic manipu- proaches such as OMT. lative treatment (OMT) in conjunction with other forms of (Key words: osteopathic manipulative treatment, standard medical care. Despite a growing body of evi- orthopedic manipulation, fibromyalgia, clinical trials) dence on the efficacy of manual therapy for the treatment of selected acute musculoskeletal conditions, the role of ibromyalgia (FM) syndrome is a common nonarticular, OMT in treating patients with chronic conditions such Frheumatic musculoskeletal pain disorder for which a as FM remains largely unknown. definite cause has yet to be identified.1 Diffuse muscu- Twenty-four female patients meeting American Col- loskeletal pain and aching, the presence of multiple tender lege of Rheumatology criteria for FM were randomly points (TP), disturbed sleep, fatigue, and morning stiffness assigned to one of four treatment groups: (1) manipulation characterize the syndrome. Central to the American College group, (2) manipulation and teaching group, (3) moist of Rheumatology’s FM diagnostic criteria are the presence of heat group, and (4) control group, which received no addi-
    [Show full text]
  • Advances in Spinal Cord Stimulation
    From DEPT OF CLINICAL NEUROSCIENCE Karolinska Institutet, Stockholm, Sweden ADVANCES IN SPINAL CORD STIMULATION ENHANCEMENT OF EFFICACY, IMPROVED SURGICAL TECHNIQUE AND A NEW INDICATION Göran Lind Stockholm 2012 All previously published papers were reproduced with permission from the publisher. Published by Karolinska Institutet. Printed by Larserics Digital Print AB, Bromma © Göran Lind, 2012 ISBN 978-91-7457-938-3 ABSTRACT Introduction and aim: Spinal cord stimulation (SCS) has been used for treatment of otherwise therapy-resistant chronic neuropathic pain for about four decades. However, 30-40 % of the patients do not benefit from SCS, despite careful case selection and technical advances. In search of ways to improve the outcome mechanisms underlying the pain relieving effect of SCS have been extensively explored. Experimental findings suggest a possibility to enhance the effect of SCS by concomitant intrathecal (i.t.) administration of pharmaceuticals, such as baclofen, clonidine and adenosine. Animal research has indicated that hypersensitivity to colonic dilatation can be attenuated by SCS. This finding, as well as related clinical observations, forms a basis for the possibility of treating irritable bowel syndrome (IBS) with SCS. Implantation of an SCS system with a plate electrode requires extensive surgery. This can be painful and cumbersome for the patient, since finding an optimal electrode position demands patient cooperation with reporting of stimulation evoked sensations. Aims of the thesis were to study: 1) if co-administration of baclofen (Study I and III), clonidine (Study III) or adenosine (Study I) can enhance the effect of SCS, 2) if long-term i.t. administration of a drug will continue to support the effect of SCS over time (Study II), 3) if implantation of plate electrodes can be performed in spinal anesthesia, retaining the possibility for the patient to feel and report stimulation evoked paresthesias and 4) if SCS can be used as a treatment option for IBS, otherwise resistant to therapy.
    [Show full text]
  • Psychological Interventions for Needle-Related Procedural Pain and Distress in Children and Adolescents (Review)
    Psychological interventions for needle-related procedural pain and distress in children and adolescents (Review) Uman LS, Chambers CT, McGrath PJ, Kisely S This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2007, Issue 3 http://www.thecochranelibrary.com Psychological interventions for needle-related procedural pain and distress in children and adolescents (Review) 1 Copyright © 2007 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd TABLE OF CONTENTS ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 BACKGROUND .................................... 2 OBJECTIVES ..................................... 3 CRITERIA FOR CONSIDERING STUDIES FOR THIS REVIEW . ......... 3 SEARCH METHODS FOR IDENTIFICATION OF STUDIES . ....... 5 METHODSOFTHEREVIEW . 6 DESCRIPTIONOFSTUDIES . 8 METHODOLOGICALQUALITY . 10 RESULTS....................................... 11 DISCUSSION ..................................... 14 AUTHORS’CONCLUSIONS . 16 POTENTIALCONFLICTOFINTEREST . 17 ACKNOWLEDGEMENTS . 17 SOURCESOFSUPPORT . 18 REFERENCES ..................................... 18 TABLES ....................................... 23 Characteristics of included studies . ....... 23 Characteristics of excluded studies . ....... 38 ADDITIONALTABLES. 40 Table 01. Definitions of Medical Procedures . ......... 40 Table02.Distraction . 41 Table 03. Information / Preparation . ........ 41 Table04.Hypnosis . 41 Table05.VirtualReality . 42 Table06.MemoryAlteration. .... 42
    [Show full text]
  • Evidence-Based Management of Acute Musculoskeletal Pain
    cute Neck Pain Acute Neck Pain Acute Neck Pain Acute Neck Pain Acute Neck Pain Acute Neck Pain Acute te Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Acute Shoulder Pain Ac Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pa Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pa Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pa Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Pain Acute Thoratic Spinal Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Lo Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Low Back Pain Acute Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain Anterior Knee Pain v Anterior Knee Pain Ant Anterior Knee Pain Anterior Knee Pain
    [Show full text]
  • Fibromyalgia and Diffuse Myalgia
    RHEUMATOLOGY 1522–5720/05 $15.00 + .00 FIBROMYALGIA AND DIFFUSE MYALGIA James M. Gill, MD, MPH, and Anna Quisel, MD PREVALENCE, PRESENTATION, AND PROGRESSION OF THE PATIENT WITH FIBROMYALGIA Chronic pain is one of the most common complaints encountered by primary care clinicians. Often, patients present not with well localized pain but with diffuse and nonspecific myalgias. Fibromyalgia is the most common etiology for this type of pain. In community-based studies, 2% [1] and 1.2% to 6.2% of school-age children screened positive for fibromyalgia [2–4]. Women and girls are at higher risk than males, and risk increases with age, peaking between 55 and 79 years [1,5]. Persons suffering from fibromyalgia most commonly complain of widespread pain. The pain is usually bilateral and is usually worse in the neck and trunk [6]. Additional symptoms include fatigue, waking unrefreshed, morning stiffness, paresthesias, and headaches [6–12]. Compared with patients with other rheumatologic conditions, persons with fibromyalgia more often suffer from comorbid conditions [13], including chronic fatigue syndrome, migraine headaches, irritable bowel syndrome, irritable bladder symptoms, temporomandibular joint syn- drome, myofascial pain syndrome, restless leg syndrome, and affective disorders [13–15]. Fibromyalgia can cause significant morbidity [1,16,17]. Patients with fibromyalgia require an average of 2.7 drugs at any time for fibromyalgia- related symptoms and have an average of 10 outpatient visits per year, with one hospitalization every 3 years [13]. Fibromyalgia
    [Show full text]
  • INVESTIGATING the TRANSITION from CHRONIC LOW BACK OR NECK PAIN to WIDESPREAD PAIN and FIBROMYLGIA by Lindsay Lancaster Kindler
    INVESTIGATING THE TRANSITION FROM CHRONIC LOW BACK OR NECK PAIN TO WIDESPREAD PAIN AND FIBROMYLGIA By Lindsay Lancaster Kindler, MSN, RN, CNS A Dissertation Presented to Oregon Health & Science University School of Nursing In partial fulfillment of the requirements for the degree of Doctor of Philosophy April 14, 2009 ii ACKNOWLEDGEMENTS This dissertation research was supported by a National Institute of Nursing Research Institutional National Service Research Award (5 T32 NR007061-15), a National Institute of Nursing Research Individual National Service Research Award (1 F31 NR010301-01), the Oregon Health & Sciences University Dean’s Award for Doctoral Dissertation, the Sigma Theta Tau Beta Psi Research Award, and a University Club Foundation Fellowship Award. The generous funding provided by these institutions enabled the participants of this study to be compensated for their time and energy and allowed me to express my appreciation to several individuals who assisted with testing a subset of these participants for fibromyalgia. This funding also allowed me to present my research twelve times at various regional, national, and international conferences. Equally as important, this financial support paid for necessary research materials and services such as printing and mailing study surveys and invitation letters. Without the support provided to me by these considerate institutions, this research would not have been possible. Lastly, the generous award from the University Club Foundation will help me move into the next phase of my research career; a post-doctoral fellowship at the University of Florida. Although I alone will be receiving this doctoral degree, it should really include the names of the many individuals who made this journey possible.
    [Show full text]
  • Challenges in Pain Assessment: Pain Intensity Scales
    [Downloaded free from http://www.indianjpain.org on Monday, August 18, 2014, IP: 218.241.189.21] || Click here to download free Android application for this journal Review Article Challenges in pain assessment: Pain intensity scales Praveen Kumar, Laxmi Tripathi1 Department of Pharmaceutical Chemistry, Moradabad Educational Trust, Group of Institutions, Moradabad, 1S. D. College of Pharmacy and Vocational Studies, Muzaffarnagar, Uttar Pradesh, India ABSTRACT Pain assessment remains a challenge to medical professionals and received much attention over the past decade. Effective management of pain remains an important indicator of the quality of care provided to patients. Pain scales are useful for clinically assessing how intensely patients are feeling pain and for monitoring the effectiveness of treatments at different points in time. A number of questionnaires have been developed to assess chronic pain. They are mainly used as research tools to assess the effect of a treatment in a clinical trial but may be used in specialist pain clinics. This review comprises the basic information of pain intensity scales and questionnaires. Various pain assessment tools are summarized. Pain assessment and management protocols are also highlighted. Key words: Pain assessment, pain intensity scales, pain assessment tools, pain assessment and management protocols, questionnaires Introduction observational (behavioral), or physiological data [Table 1]. Self-report is considered primary and should French philosopher Simone Weil noted that “Pain is the be obtained if possible. Pain scales are available root of knowledge.” In 1982, singer John Mellencamp for neonates, infants, children, adolescents, adults, proudly sang that it “Hurts so good.” Everywhere, seniors, and persons whose communication is impaired.
    [Show full text]
  • Evidence-Based Management of Acute Musculoskeletal Pain
    RESCINDED This publication was rescinded by National Health and Medical Research Council in 2013 and is available on the Internet ONLY for historical purposes. Important Notice This notice is not to be erased and must be included on any printed version of this publication. This publication was rescinded by the National Health and Medical Research Council in 2013. The National Health and Medical Research Council has made this publication available on its Internet Archives site as a service to the public for historical and research purposes ONLY. Rescinded publications are publications that no longer represent the Council’s position on the matters contained therein. This means that the Council no longer endorses, supports or approves these rescinded publications. The National Health and Medical Research Council gives no assurance as to the accuracy or relevance of any of the information contained in this rescinded publication. The National Health and Medical Research Council assumes no legal liability or responsibility for errors or omissions contained within this rescinded publication for any loss or damage incurred as a result of reliance on this publication. Every user of this rescinded publication acknowledges that the information contained in it may not be accurate, complete or of relevance to the user’s purposes. The user undertakes the responsibility for assessing the accuracy, completeness and relevance of the contents of this rescinded publication, including seeking independent verification of information sought to be relied upon for the user’s purposes. Every user of this rescinded publication is responsible for ensuring that each printed version contains this disclaimer notice, including the date of recision and the date of downloading the archived Internet version.
    [Show full text]
  • Proof and Evaluation of Pain and Suffering in Personal Injury Litigation Jack H
    PROOF AND EVALUATION OF PAIN AND SUFFERING IN PERSONAL INJURY LITIGATION JACK H. OLENDER* PAST, PRESENT AND FUTURE "pain and suffering" are well- recognized elements of damages in personal injury actions.' Medical science in its present state of development offers considerable aid in determining existence of pain resulting from personal injury and in predicting probabilities of future pain. Unfortunately, it is less helpful in establishing the severity of pain and suffering with much precision. Therefore, as would be expected, the problem of evaluating pain and suffering is a difficult one for juries. The current split of authority on the propriety of plaintiff's counsel utilizing mathematical formulae for evaluating pain and suffering in argument before the jury is a result of these inherent difficulties in evaluation of pain. In this article, first the legal theories for evaluating pain and suffer- ing are considered. Then, the nature of pain and methods for its measurement are discussed. Next, the methods of proving pain and suffering are examined, and last, pain and suffering as an element of damages is evaluated. I. WHAT IS PAIN AND SUFFRING "WORTH"? The fact-finder determines what pain and suffering is worth, or, * A.B. 1957, LL.B. 596o, University of Pittsburgh; LL.M. i96i, George Washing- ton University. Member of the District of Columbia Bar. This article is based on a thesis submitted in partial fulfillment of the LL.M. degree requirements at the George Washington University School of Law. The author gratefully acknowledges the helpful guidance of Professor J. Forrester Davison. ' Recovery for past pain and suffering is also allowed in survival actions.
    [Show full text]
  • Role of TRPV1 in Colonic Mucin Production and Gut Microbiota Profile
    bioRxiv preprint doi: https://doi.org/10.1101/2020.04.17.046011; this version posted April 18, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC 4.0 International license. 1 Role of TRPV1 in colonic mucin production and gut microbiota profile 2 Vijay Kumar1,2, Neha Mahajan1,3, Pragyanshu Khare1, Kanthi Kiran Kondepudi1, Mahendra 3 Bishnoi 1# 4 1National Agri-Food Biotechnology Institute (NABI), Knowledge City-Sector 81, SAS 5 Nagar, Punjab 140306, India. 6 2Department of Biotechnology, Panjab University, Sector-25, Chandigarh 160014, India. 7 3Regional Centre for Biotechnology, Faridabad-Gurgaon expressway, Faridabad, Haryana 8 121001, India. 9 Running title: TRPV1 and mucin production 10 #Corresponding author 11 Mahendra Bishnoi, PhD 12 Scientist and Group Leader, TR(I)P for Health Laboratory 13 Department of Food and Nutritional Biotechnology 14 National Agri-Food Biotechnology Institute (NABI), 15 Knowledge City-Sector 81, SAS Nagar, Punjab 140306, India. 16 Email: mbishnoi@nabi.res.in; mbishnoi@gmail.com 17 Phone no. +91-172-5220261; +91-9914469090 1 bioRxiv preprint doi: https://doi.org/10.1101/2020.04.17.046011; this version posted April 18, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC 4.0 International license. 18 ABSTRACT 19 PURPOSE: This study focuses on exploring the role of sensory cation channel Transient 20 Receptor Potential channel subfamily Vanilloid 1 (TRPV1) in gut health, specifically mucus 21 secretion and microflora profile in gut.
    [Show full text]