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Carstensen SMD, Just SA, Velander M, Konge L, Hubel MS, Rajeeth Savarimuthu T, Pfeiffer Jensen M, Østergaard M, Terslev L. E-learning and practical performance in musculoskeletal ultrasound: a multicentre randomized study. Rheumatology (Oxford) 2023; 62:3547-3554. [PMID: 36943374 DOI: 10.1093/rheumatology/kead121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES To examine the effect of pre-course e-learning on residents' practical performance in musculoskeletal ultrasound (MSUS). METHODS This was a multicentre, randomized controlled study following the Consolidated Standards of Reporting Trials (CONSORT) statement. Residents with no or little MSUS experience were randomized to either an e-learning group or a traditional group. One week before a 2-day face-to-face MSUS course, the e-learning group received access to an interactive platform consisting of online lectures, assignments, and practical instruction videos aligned with the content of the course. The traditional group only received standard pre-course information (program, venue, and time). All participants performed a pre- and post-course practical MSUS examination and were assessed by two individual raters, blinded to the group allocation, using the validated Objective Structured Assessment of Ultrasound Skills (OSAUS) tool. RESULTS Twenty-eight participants completed the study. There were no statistically significant differences in the pre- or post-course practical MSUS performance between the e-learning group and the traditional group; the mean pre-course OSAUS score (s.d.) in the -learning group was 5.4 (3.7) compared with 5.2 (2.4) in the traditional group (P = 0.8), whereas the post-course OSAUS score in the e-learning group was 11.1 (2.8) compared with 10.9 (2.4) in the traditional group (P = 0.8). There was a significant difference between the mean pre- and post-course scores (5.74 points, P < 0.001). The OSAUS assessment tool demonstrated good inter-rater reliability (intra-class correlation = 0.84). CONCLUSION We found no significant impact of pre-course e-learning on novices' acquisition of practical MSUS skills. Hands-on training is of the utmost importance and improves MSUS performance significantly. The OSAUS assessment tool is an applicable tool with high interrater reliability. TRIAL REGISTRATION https://clinicaltrials.gov/ NCT04959162.
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Affiliation(s)
- Stine Maya Dreier Carstensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Copenhagen University Hospital-Rigshospitalet Glostrup, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, The University of Copenhagen, Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation, The Capital Region of Denmark, Copenhagen, Denmark
| | - Søren Andreas Just
- Section of Rheumatology, Department of Medicine, Svendborg Hospital-Odense University Hospital, Svendborg, Denmark
| | - Marie Velander
- Section of Rheumatology, Department of Medicine, Svendborg Hospital-Odense University Hospital, Svendborg, Denmark
| | - Lars Konge
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, The University of Copenhagen, Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation, The Capital Region of Denmark, Copenhagen, Denmark
| | - Martin Slusarczyk Hubel
- SDU Robotics, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | | | - Mogens Pfeiffer Jensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Copenhagen University Hospital-Rigshospitalet Glostrup, Copenhagen, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Copenhagen University Hospital-Rigshospitalet Glostrup, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, The University of Copenhagen, Copenhagen, Denmark
| | - Lene Terslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Copenhagen University Hospital-Rigshospitalet Glostrup, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, The University of Copenhagen, Copenhagen, Denmark
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Glintborg B, Jensen DV, Terslev L, Hendricks O, Østergaard M, Horskjær Rasmussen S, Jensen MP, Adelsten T, Colic A, Danebod K, Kildemand M, Loft AG, Munk HL, Pedersen JK, Østgård RD, Møller Sørensen C, Krogh NS, Agerbo J, Ziegler C, Hetland ML. Nationwide, large-scale implementation of an online system for remote entry of patient-reported outcomes in rheumatology: characteristics of users and non-users and time to first entry. RMD Open 2022; 8:rmdopen-2022-002549. [PMID: 36418086 PMCID: PMC9685239 DOI: 10.1136/rmdopen-2022-002549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
Aims In May 2020, a nationwide, web-based system for remote entry of patient-reported outcomes (PROs) in inflammatory rheumatic diseases was launched and implemented in routine care (DANBIO-from-home). After 1.5 years of use, we explored clinical characteristics of patients who did versus did not use the system, and the time to first entry of PROs. Methods All patients followed in DANBIO were informed about DANBIO-from-home by electronic invitations or when attending their clinic. Characteristics of patients who did/did not use DANBIO-from-home in the period after implementation were explored by multivariable logistic regression analyses including demographic and clinical variables (gender, age group, diagnosis, disease duration, use of biological disease-modifying agent (bDMARD), Health Assessment Questionnaire (HAQ), Patient Acceptable Symptom Scale (PASS)). Time from launch to first entry was presented as cumulative incidence curves by age group (<40/40–60/61–80/>80 years). Results Of 33 776 patients, 68% entered PROs using DANBIO-from-home at least once. Median (IQR) time to first entry was 27 (11–152) days. Factors associated with data entry in multivariate analyses (OR (95% CI)) were: female gender (1.19 (1.12 to 1.27)), bDMARD treatment (1.41 (1.33 to 1.50)), age 40–60 years (1.79 (1.63 to 1.97)), 61–80 years (1.87 (1.70 to 2.07), or age >80 years (0.57 (0.50 to 0.65)) (reference: age <40 years), lower HAQ (0.68 (0.65 to 0.71)) and PASS ‘no’ (1.09 (1.02 to 1.17). Diagnosis was not associated. Time to first entry of PROs was longest in patients <40 years of age (119 (24–184) days) and shortest in the 61–80 years age group (25 (8–139) days). Conclusion A nationwide online platform for PRO in rheumatology achieved widespread use. Higher age, male gender, conventional treatment and disability were associated with no use.
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Affiliation(s)
- Bente Glintborg
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Vendelbo Jensen
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Rheumatology, Center for Rheumatology and Spine Diseases, Gentofte University Hospital, Gentofte, Denmark
| | - Lene Terslev
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Oliver Hendricks
- Danish Hospital for Rheumatic Diseases, University of Southern Denmark, Sønderborg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Mikkel Østergaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Simon Horskjær Rasmussen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Mogens Pfeiffer Jensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Thomas Adelsten
- Department of Rheumatology, Zealand University Hospital Koge, Koge, Denmark
| | - Ada Colic
- Department of Rheumatology, Zealand University Hospital Koge, Koge, Denmark
| | - Kamilla Danebod
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Malene Kildemand
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | - Anne Gitte Loft
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - Heidi Lausten Munk
- Rheumatology Research Unit, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Jens Kristian Pedersen
- Department of Rheumatology, Odense University Hospital, Svendborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | | | | | - Jette Agerbo
- Danish Rheumatism Association/Gigtforeningen, Copenhagen, Denmark
| | - Connie Ziegler
- Danish Rheumatism Association/Gigtforeningen, Copenhagen, Denmark
| | - Merete Lund Hetland
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark
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Glintborg B, Jensen DV, Terslev L, Hendricks O, Østergaard M, Rasmussen SH, Jensen MP, Adelsten T, Colic A, Danebod K, Kildemand M, Loft AG, Munk HL, Pedersen JK, Østgård RD, Sørensen CM, Krogh NS, Agerbo JN, Ziegler C, Hetland ML. Long-term Behavioral Changes During the COVID-19 Pandemic and Impact of Vaccination in Patients With Inflammatory Rheumatic Diseases. J Rheumatol 2022; 49:1163-1172. [PMID: 35705237 DOI: 10.3899/jrheum.211280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To explore anxiety and self-isolation in patients with inflammatory rheumatic disease (IRD)15 months into the coronavirus disease 2019 (COVID-19) pandemic, including attitudes toward and effects of SARS-CoV-2 vaccination. METHODS A nationwide online survey was conducted at 3 timepoints: May 2020, November 2020, and May 2021. Patients with IRD followed in the Danish Rheumatology Quality Registry (DANBIO) were asked about the effects of the pandemic, including SARS-CoV-2 infection and their behavior, anxiety, and concerns. The May 2021 survey included attitudes toward SARS-CoV-2 and influenza vaccination. Characteristics associated with self-isolation in May 2021 were explored with adjusted logistic regression analyses that included patient characteristics and SARS-CoV-2 vaccination status. RESULTS Respondents to surveys 1, 2, and 3 included 12,789; 14,755; and 13,921 patients, respectively; 64% had rheumatoid arthritis and 63% were female. Anxiety and concerns were highest in May 2020 and decreased to stable levels in November 2020 and May 2021; 86%, 50%, and 52% of respondents reported self-isolation, respectively. In May 2021, 4% of respondents self-reported previous SARS-CoV-2 infection. The SARS-CoV-2 vaccine acceptance rate was 86%, and the proportion of patients vaccinated against influenza had increased from 50% in winter 2019-2020 to 64% in winter 2020-2021. The proportion of patients with anxiety appeared similar among those vaccinated and unvaccinated against SARS-CoV-2. In multivariable analyses, being unvaccinated, female gender, receiving biologic drugs, and poor quality of life were independently associated with self-isolation. CONCLUSION Levels of anxiety and self-isolation decreased after the initial lockdown period in patients with IRD. Half of the patients reported self-isolation in May 2021, a phase that included widespread reopening of society and large-scale vaccination. The lack of prepandemic data prevented a full understanding of the long-term effects of the pandemic on anxiety and self-isolation in patients with IRD.
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Affiliation(s)
- Bente Glintborg
- B. Glintborg, MD, PhD, DMSc, M. Østergaard, MD, PhD, DMSc, Professor, M.L. Hetland, MD, PhD, DMSc, Professor, DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen Rigshospitalet, Glostrup, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen;
| | - Dorte Vendelbo Jensen
- D.V. Jensen, MD, DANBIO, Rigshospitalet, Glostrup, Copenhagen, and Department of Rheumatology, Center for Rheumatology and Spine Diseases Gentofte and Herlev Hospital, Gentofte
| | - Lene Terslev
- L. Terslev, MD, PhD, Professor, M. Pfeiffer Jensen, MD, PhD, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen, Rigshospitalet, Glostrup, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
| | - Oliver Hendricks
- O. Hendricks, MD, Professor, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, and Department of Regional Health Research, University of Southern Denmark, Odense
| | - Mikkel Østergaard
- B. Glintborg, MD, PhD, DMSc, M. Østergaard, MD, PhD, DMSc, Professor, M.L. Hetland, MD, PhD, DMSc, Professor, DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen Rigshospitalet, Glostrup, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
| | - Simon Horskjær Rasmussen
- S.H. Rasmussen, PhD, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen
| | - Mogens Pfeiffer Jensen
- L. Terslev, MD, PhD, Professor, M. Pfeiffer Jensen, MD, PhD, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen, Rigshospitalet, Glostrup, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
| | - Thomas Adelsten
- T. Adelsten, MD, A. Colic, MD, Department of Rheumatology, Zealand University Hospital, Køge
| | - Ada Colic
- T. Adelsten, MD, A. Colic, MD, Department of Rheumatology, Zealand University Hospital, Køge
| | - Kamilla Danebod
- K. Danebod, MD, Department of Rheumatology, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Glostrup
| | - Malene Kildemand
- M. Kildemand, RN, Department of Rheumatology, Odense University Hospital, Odense
| | - Anne Gitte Loft
- A. Gitte Loft, MD, DMSc, Department of Rheumatology, Aarhus University Hospital, and Department of Clinical Medicine, Health, Aarhus University, Aarhus
| | - Heidi Lausten Munk
- H.L. Munk, MD, PhD, Rheumatology Research Unit, Odense University Hospital and University of Southern Denmark, Odense
| | - Jens Kristian Pedersen
- J.K. Pedersen, MD, PhD, Rheumatology Section, Department of Medicine, Odense University Hospital and Svendborg Hospital, Svendborg, and Department of Clinical Research, University of Southern Denmark, Odense
| | - René Drage Østgård
- R.D. Østgård, MD, PhD, Diagnostic Center, Silkeborg Regional Hospital, Silkeborg
| | | | | | - Jette Nørgaard Agerbo
- J.N. Agerbo, Patient Representative, C. Ziegler, Patient Representative, Gigtforeningen/Danish Rheumatism Association, Denmark
| | - Connie Ziegler
- J.N. Agerbo, Patient Representative, C. Ziegler, Patient Representative, Gigtforeningen/Danish Rheumatism Association, Denmark
| | - Merete Lund Hetland
- B. Glintborg, MD, PhD, DMSc, M. Østergaard, MD, PhD, DMSc, Professor, M.L. Hetland, MD, PhD, DMSc, Professor, DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, University Hospital of Copenhagen Rigshospitalet, Glostrup, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
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Carstensen SMD, Velander MJ, Konge L, Østergaard M, Pfeiffer Jensen M, Just SA, Terslev L. Training and assessment of musculoskeletal ultrasound and injection skills-a systematic review. Rheumatology (Oxford) 2022; 61:3889-3901. [PMID: 35218339 DOI: 10.1093/rheumatology/keac119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/17/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To examine how residents are trained and assessed in musculoskeletal ultrasound (MSUS), MSUS-guided and landmark-guided joint aspiration and injection. Additionally, to present the available assessment tools and examine their supporting validity evidence. METHODS A systematic search of PubMed, Cochrane Library, and Embase was conducted in accordance with the PRISMA guidelines and studies published from January 1, 2000 to May 31, 2021 were included. Two independent reviewers performed the search and data extraction. The studies were evaluated using the Medical Education Research Quality Instrument (MERSQI). RESULTS 9,884 articles were screened, and 43 were included; 3 were randomized studies, 21 pre- and post-test studies, 16 descriptive studies, and 3 studies developing assessment tools. The studies used various theoretical training modalities e.g. lectures, anatomical quizzes and e-learning. The practical training models varied from mannequins and cadavers to healthy volunteers and patients. The majority of studies used subjective "comfort level" as assessment, others used practical examination and/or theoretical examination. All training programs increased trainees' self-confidence, theoretical knowledge, and/or practical performance, however few used validated assessment tools to measure the effect. Only one study met the MERSQI high methodical quality cut-off score of 14. CONCLUSION The included studies were heterogeneous, and most were of poor methodological quality and not based on contemporary educational theories. This review highlights the need for educational studies using validated theoretical and practical assessment tools to ensure optimal MSUS training and assessment in rheumatology.
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Affiliation(s)
- Stine M D Carstensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet Glostrup Valdemar Hansens Vej 17, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Academy for Medical Education and Simulation, The Capital Region of Denmark, Copenhagen, Denmark
| | - Marie Juul Velander
- Section of Rheumatology, Department of Medicine, Svendborg Hospital-OUH Baagøes Allé 15, Svendborg, Denmark
| | - Lars Konge
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Academy for Medical Education and Simulation, The Capital Region of Denmark, Copenhagen, Denmark
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet Glostrup Valdemar Hansens Vej 17, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mogens Pfeiffer Jensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet Glostrup Valdemar Hansens Vej 17, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Andreas Just
- Section of Rheumatology, Department of Medicine, Svendborg Hospital-OUH Baagøes Allé 15, Svendborg, Denmark
| | - Lene Terslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet Glostrup Valdemar Hansens Vej 17, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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5
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Glintborg B, Jensen DV, Terslev L, Pfeiffer Jensen M, Hendricks O, Østergaard M, Engel S, Horskjær Rasmussen S, Adelsten T, Colic A, Danebod K, Kildemand M, Loft AG, Munk HL, Pedersen JK, Østgård RD, Møller Sørensen C, Krogh NS, Nørgaard Agerbo J, Ziegler C, Hetland ML. Impact of the COVID-19 pandemic on treat-to-target strategies and physical consultations in >7000 patients with inflammatory arthritis. Rheumatology (Oxford) 2021; 60:SI3-SI12. [PMID: 34146099 PMCID: PMC8344418 DOI: 10.1093/rheumatology/keab500] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/09/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To explore the impact of the COVID-19 pandemic on treat-to-target strategies (disease activity, remission rates) and access to physical consultations in patients with inflammatory rheumatic disease, as well as to explore characteristics of patients with/without physical consultations in the clinic and the impact of early vs established disease. METHODS Patients with RA, PsA or axial SpA (axSpA) prospectively followed in the nationwide DANBIO registry answered online questionnaires and reported patient-reported outcomes (PROs) in June and November 2020. Patient characteristics, disease activity and physical consultations in the clinic before and during the pandemic were identified in DANBIO [all patients and subgroups with early disease (disease duration ≤2 years)]. In individual patients, changes in PROs before and during the pandemic were calculated. Characteristics of patients with/without physical consultations were described (age, gender, education level, comorbidities, disease duration, treatment). RESULTS We included 7836 patients (22% of eligible patients), 12% of which had early disease. PROs were stable before and during the pandemic, with median changes approximating zero, as well as in patients with early disease. Remission rates were stable. The relative decrease in the number of patients with physical consultations was 21-72%, which was highest in axSpA. Characteristics of patients with/without physical consultations were similar. Self-reported satisfaction with treatment options and access was >70%; the preferred contact form was physical consultation (66%). CONCLUSION In this nationwide study performed during the first 8 months of the pandemic, patient satisfaction was high and the PROs and remission rates remained stable despite the remarkable reduction in physical consultations, as well as in patients with early disease. Characteristics of patients with/without physical consultations appeared similar.
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Affiliation(s)
- Bente Glintborg
- DANBIO and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
| | - Dorte Vendelbo Jensen
- DANBIO and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet
- Department of Rheumatology, Center for Rheumatology and Spine Diseases, Gentofte and Herlev Hospital
| | - Lene Terslev
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen
| | - Mogens Pfeiffer Jensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen
| | - Oliver Hendricks
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg
- Department of Regional Health Research, University of Southern Denmark, Odense
| | - Mikkel Østergaard
- DANBIO and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
| | - Sara Engel
- DANBIO and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet
| | - Simon Horskjær Rasmussen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen
| | - Thomas Adelsten
- Department of Rheumatology, Zealand University Hospital, Køge
| | - Ada Colic
- Department of Rheumatology, Zealand University Hospital, Køge
| | - Kamilla Danebod
- Department of Rheumatology, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet, Glostrup
| | | | - Anne Gitte Loft
- Department of Rheumatology, Aarhus University Hospital
- Department of Clinical Medicine, Health, Aarhus University, Aarhus
| | - Heidi Lausten Munk
- Department of Rheumatology, Odense University Hospital, Odense
- Department of Clinical Research, University of Southern Denmark, Odense
| | - Jens Kristian Pedersen
- Department of Clinical Research, University of Southern Denmark, Odense
- Rheumatology Section, Department of Medicine M, Odense University Hospital and Svendborg Hospital, Svendborg
| | - René Drage Østgård
- Rheumatology Section, Department of Medicine M, Odense University Hospital and Svendborg Hospital, Svendborg
- Diagnostic Center, Silkeborg Regional Hospital, Silkeborg
| | | | | | | | | | - Merete Lund Hetland
- DANBIO and Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
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6
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Glintborg B, Jensen DV, Engel S, Terslev L, Pfeiffer Jensen M, Hendricks O, Østergaard M, Horskjær Rasmussen S, Adelsten T, Colic A, Danebod K, Kildemand M, Loft AG, Munk HL, Pedersen JK, Østgård RD, Møller Sørensen C, Krogh NS, Nørgaard Agerbo J, Ziegler C, Lund Hetland M. Anxiety and concerns related to the work situation during the second wave of the COVID-19 pandemic in >5000 patients with inflammatory rheumatic disease followed in the DANBIO registry. RMD Open 2021; 7:rmdopen-2021-001649. [PMID: 33941664 PMCID: PMC8098969 DOI: 10.1136/rmdopen-2021-001649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 12/18/2022] Open
Affiliation(s)
- Bente Glintborg
- DANBIO, Rigshospitalet Glostrup, Glostrup, Denmark .,Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark.,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Dorte Vendelbo Jensen
- DANBIO, Rigshospitalet Glostrup, Glostrup, Denmark.,Department of Rheumatology, Center for Rheumatology and Spine Diseases, Gentofte University Hospital, Hellerup, Hovedstaden, Denmark
| | - Sara Engel
- DANBIO, Rigshospitalet Glostrup, Glostrup, Denmark.,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Lene Terslev
- DANBIO, Rigshospitalet Glostrup, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark.,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Mogens Pfeiffer Jensen
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark.,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Oliver Hendricks
- Danish Hospital for Rheumatology, University of Southern Denmark, Sønderborg, Syddanmark, Denmark.,Department of Regional Health Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Mikkel Østergaard
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark.,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Simon Horskjær Rasmussen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Thomas Adelsten
- Department of Rheumatology, Sjællands Universitetshospital Køge, Koge, Sjælland, Denmark
| | - Ada Colic
- Department of Rheumatology, Sjællands Universitetshospital Køge, Koge, Sjælland, Denmark
| | - Kamilla Danebod
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Malene Kildemand
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | - Anne Gitte Loft
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Health, Aarhus Universitet, Aarhus, Midtjylland, Denmark
| | - Heidi Lausten Munk
- Department of Rheumatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Jens Kristian Pedersen
- Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark.,Department of Medicine M, Svendborg, Odense University Hospital, Svendborg, Denmark
| | - René Drage Østgård
- Diagnostic center, Silkeborg Regional Hospital, Silkeborg, Midtjylland, Denmark
| | | | | | | | - Connie Ziegler
- Danish Rheumatism Association/Gigtforeningen, Copenhagen, Denmark
| | - Merete Lund Hetland
- DANBIO, Rigshospitalet Glostrup, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark.,Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
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Glintborg B, Jensen DV, Engel S, Terslev L, Pfeiffer Jensen M, Hendricks O, Ostergaard M, Horskjær Rasmussen S, Adelsten T, Colic A, Danebod K, Kildemand M, Loft AG, Munk HL, Pedersen JK, Østgård RD, Møller Sørensen C, Krogh NS, Agerbo J, Ziegler C, Hetland M. Self-protection strategies and health behaviour in patients with inflammatory rheumatic diseases during the COVID-19 pandemic: results and predictors in more than 12 000 patients with inflammatory rheumatic diseases followed in the Danish DANBIO registry. RMD Open 2021; 7:e001505. [PMID: 33402443 PMCID: PMC7786545 DOI: 10.1136/rmdopen-2020-001505] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 12/14/2022] Open
Abstract
AIMS In Danish patients with inflammatory rheumatic diseases to explore self-protection strategies and health behaviour including adherence to disease-modifying antirheumatic treatment (DMARD) during the initial phase of the COVID-19 pandemic and again after the reopening of the society started. Furthermore, to identify characteristics of patients with high levels of anxiety and self-isolation. METHODS Patients in routine care followed prospectively in the nationwide DANBIO registry were invited to answer an online questionnaire regarding disease activity and COVID-19 infection, behaviour in March and June 2020. Responses were linked to patient data in DANBIO. Characteristics potentially associated with anxiety, self-isolation and medication adherence (gender/age/diagnosis/education/work status/comorbidity/DMARD/smoking/EQ-5D/disease activity) were explored with multivariable logistic regression analyses. RESULTS We included 12 789 patients (8168 rheumatoid arthritis/2068 psoriatic arthritis/1758 axial spondyloarthritis/795 other) of whom 65% were women and 36% treated with biological DMARD. Self-reported COVID-19 prevalence was 0.3%. Patients reported that they were worried to get COVID-19 infection (March/June: 70%/45%) and self-isolated more than others of the same age (48%/38%). The fraction of patients who changed medication due to fear of COVID-19 were 4.1%/0.6%. Female gender, comorbidities, not working, lower education, biological treatment and poor European Quality of life, 5 dimensions were associated with both anxiety and self-isolation. CONCLUSION In >12 000 patients with inflammatory arthritis, we found widespread anxiety and self-isolation, but high medication adherence, in the initial phase of the COVID-19 pandemic. This persisted during the gradual opening of society during the following months. Attention to patients' anxiety and self-isolation is important during this and potential future epidemics.
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Affiliation(s)
- Bente Glintborg
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Dorte Vendelbo Jensen
- DANBIO, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Rheumatology, Center for Rheumatology and Spine Diseases, Gentofte University Hospital, Hellerup, Hovedstaden, Denmark
| | - Sara Engel
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Lene Terslev
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Mogens Pfeiffer Jensen
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Oliver Hendricks
- Danish Hospital for Rheumatic Diseases, University of Southern Denmark, Sønderborg, Syddanmark, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Mikkel Ostergaard
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Simon Horskjær Rasmussen
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Thomas Adelsten
- Department of Rheumatology, Sjællands Universitetshospital Køge, Koge, Sjælland, Denmark
| | - Ada Colic
- Department of Rheumatology, Sjællands Universitetshospital Køge, Koge, Sjælland, Denmark
| | - Kamilla Danebod
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Malene Kildemand
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | - Anne Gitte Loft
- Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Midtjylland, Denmark
| | - Heidi Lausten Munk
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
| | | | - René Drage Østgård
- Diagnostic Center, Silkeborg Regional Hospital, Silkeborg, Midtjylland, Denmark
| | | | | | - Jette Agerbo
- Danish Rheumatism Association/Gigtforeningen, Copenhagen, Denmark
| | - Connie Ziegler
- Danish Rheumatism Association/Gigtforeningen, Copenhagen, Denmark
| | - Merete Hetland
- DANBIO and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
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8
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Nimmaanrat S, Wongwiwattananon W, Siripreukpong S, Chongsuvivatwong V, Jensen MP. A prospective observational study to investigate the relationship between local anesthetic infiltration pain before spinal anesthesia and acute and chronic postsurgical pain in women undergoing elective cesarean delivery. Int J Obstet Anesth 2020; 45:56-60. [PMID: 33293186 DOI: 10.1016/j.ijoa.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/20/2020] [Accepted: 11/09/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cesarean delivery is one of the most common procedures performed worldwide. We conducted this prospective cohort study to evaluate the association between local anesthetic infiltration (LAI) pain prior to spinal anesthesia and pain and morphine consumption within 24 h after cesarean delivery (primary outcomes). A secondary objective was to assess the association between LAI pain and pain at one month postoperatively. METHODS Recruitment of 216 eligible women scheduled for elective cesarean delivery. Local infiltration before spinal anesthesia was performed using a 24-gauge needle and 3 mL 2% plain lidocaine. All subjects received 2.2 mL 0.5% hyperbaric bupivacaine with 200 µg morphine for spinal anesthesia. A 0-10 verbal numerical rating scale was used to assess LAI pain severity, and subsequent pain at 24 h, 1, 3 and 12 months. RESULTS We found a moderate correlation between LAI pain intensity and severity of acute pain at rest (rho=0.56, P <0.001) and with movement (rho=0.58, P <0.001) and a weak correlation with morphine consumption (rho=0.17, P=0.01) within 24 h postoperatively. We also found a positive correlation between LAI pain and the severity of persistent wound pain at rest (rho=0.30, P <0.001) and with movement (rho=0.52, P <0.001) at 1 month. The incidence of wound pain at 1, 3 and 12 months postoperatively was 37.1%, 7.0% and 1.4%, respectively. CONCLUSIONS Pain from LAI prior to spinal anesthesia is significantly associated with subsequent postoperative pain both acutely and at one month in women scheduled for elective cesarean delivery under spinal anesthesia.
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Affiliation(s)
- S Nimmaanrat
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand.
| | - W Wongwiwattananon
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - S Siripreukpong
- Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - V Chongsuvivatwong
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - M P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Jensen MP, Le Quesne J, Officer-Jones L, Teodòsio A, Thaventhiran J, Ficken C, Goddard M, Smith C, Menon D, Allinson KSJ. Neuropathological findings in two patients with fatal COVID-19. Neuropathol Appl Neurobiol 2020; 47:17-25. [PMID: 32895961 DOI: 10.1111/nan.12662] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/31/2020] [Accepted: 08/22/2020] [Indexed: 01/23/2023]
Abstract
AIMS To describe the neuropathological findings in two cases of fatal Coronavirus Disease 2019 (COVID-19) with neurological decline. METHODS Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was confirmed in both patients by reverse transcription polymerase chain reaction (RT-PCR) from nasopharyngeal swabs antemortem. Coronial autopsies were performed on both patients and histological sampling of the brain was undertaken with a variety of histochemical and immunohistochemical stains. RNAscope® in situ hybridization (ISH) using the V-nCoV2019-S probe and RT-PCR SARS-CoV-2 ribonucleic acid (RNA) was performed in paraffin-embedded brain tissue sampled from areas of pathology. RESULTS Case 1 demonstrated severe multifocal cortical infarction with extensive perivascular calcification and numerous megakaryocytes, consistent with a severe multi-territorial cerebral vascular injury. There was associated cerebral thrombotic microangiopathy. Case 2 demonstrated a brainstem encephalitis centred on the dorsal medulla and a subacute regional infarct involving the cerebellar cortex. In both cases, ISH and RT-PCR for SARS-CoV-2 RNA were negative in tissue sampled from the area of pathology. CONCLUSIONS Our case series adds calcifying cerebral cortical infarction with associated megakaryocytes and brainstem encephalitis to the spectrum of neuropathological findings that may contribute to the neurological decompensation seen in some COVID-19 patients. Viral RNA was not detected in post-mortem brain tissue, suggesting that these pathologies may not be a direct consequence of viral neuroinvasion and may represent para-infectious phenomena, relating to the systemic hyperinflammatory and hypercoagulable syndromes that both patients suffered.
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Affiliation(s)
| | - J Le Quesne
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK.,Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - A Teodòsio
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - J Thaventhiran
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - C Ficken
- MRC Toxicology Unit, University of Cambridge, Cambridge, UK
| | - M Goddard
- Department of Pathology, Royal Papworth Hospital, Cambridge, UK
| | - C Smith
- Department of Virology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - D Menon
- University Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - K S J Allinson
- Department of Pathology, Addenbrooke's Hospital, Cambridge, UK
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Day MA, Ehde DM, Burns J, Ward LC, Friedly JL, Thorn BE, Ciol MA, Mendoza E, Chan JF, Battalio S, Borckardt J, Jensen MP. A randomized trial to examine the mechanisms of cognitive, behavioral and mindfulness-based psychosocial treatments for chronic pain: Study protocol. Contemp Clin Trials 2020; 93:106000. [PMID: 32302791 PMCID: PMC7195020 DOI: 10.1016/j.cct.2020.106000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/27/2020] [Accepted: 04/13/2020] [Indexed: 11/28/2022]
Abstract
This randomized trial will evaluate the mechanisms of three chronic pain treatments: cognitive therapy (CT), mindfulness meditation (MM), and activation skills (AS). We will determine the extent to which late-treatment improvement in primary outcome (pain interference) is predicted by early-treatment changes in cognitive content, cognitive process, and/or activity level. The shared versus specific role of these mechanisms across the three treatments will be evaluated during treatment (Primary Aim), and immediately post-treatment to examine relapse mechanisms (Secondary Aim). We will enroll 300 individuals with chronic pain (with low back pain as a primary or secondary condition), with 240 projected to complete the study. Participants will be randomly assigned to eight, 1.5 h telehealth group sessions of CT, MM, or AS. Mechanisms and outcomes will be assessed twice daily during 2-week baseline, 4-week treatment period, and 4-week post-treatment epoch via random cue-elicited ecological momentary assessment (EMA); activity level will be monitored during these time epochs via daily monitoring with ActiGraph technology. The primary outcome will be measured by the PROMIS 5-item Pain Interference scale. Structural equation modeling (SEM) will be used to test the primary aims. This study is pre-registered on clinicaltrials.gov (Identifier: NCT03687762). This study will determine the temporal sequence of lagged mediation effects to evaluate rates of change in outcome as a function of change in mediators. The findings will provide an empirical basis for enhancing and streamlining psychosocial chronic pain interventions. Further, results will guide future efforts towards optimizing maintenance of gains to effectively reduce relapse risk.
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Affiliation(s)
- M A Day
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia.
| | - D M Ehde
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - J Burns
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - L C Ward
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - J L Friedly
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - B E Thorn
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - M A Ciol
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - E Mendoza
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - J F Chan
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - S Battalio
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - J Borckardt
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - M P Jensen
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
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Drewes AM, Arlien-Søborg MC, Lunde Jørgensen JO, Jensen MP. [Acromegaly and symptoms of the motor apparatus]. Ugeskr Laeger 2018; 180:V05170435. [PMID: 30417820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this case report, a 72-year-old woman presented with symptoms attributed to arthritis, and MRI indicated sacroiliitis. However, the patient also experienced enlargement of hands and feet in addition to sweating and snoring, which in combination with coarse facial features suggested acromegaly. This diagnosis was biochemically confirmed, and MRI revealed a pituitary adenoma, which was successfully removed by transsphenoidal surgery. Symptom relief and reduced swelling occurred immediately post-operatively. Acromegaly can masquerade as arthritis or osteoarthritis, which may delay diagnosis.
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Jensen MP, Fredberg U. [Not Available]. Ugeskr Laeger 2018; 180:V69339. [PMID: 29808811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Rees AF, Alfaro-Shigueto J, Barata PCR, Bjorndal KA, Bolten AB, Bourjea J, Broderick AC, Campbell LM, Cardona L, Carreras C, Casale P, Ceriani SA, Dutton PH, Eguchi T, Formia A, Fuentes MMPB, Fuller WJ, Girondot M, Godfrey MH, Hamann M, Hart KM, Hays GC, Hochscheid S, Kaska Y, Jensen MP, Mangel JC, Mortimer JA, Naro-Maciel E, Ng CKY, Nichols WJ, Phillott AD, Reina RD, Revuelta O, Schofield G, Seminoff JA, Shanker K, Tomás J, van de Merwe JP, Van Houtan KS, Vander Zanden HB, Wallace BP, Wedemeyer-Strombel KR, Work TM, Godley BJ. Are we working towards global research priorities for management and conservation of sea turtles? ENDANGER SPECIES RES 2016. [DOI: 10.3354/esr00801] [Citation(s) in RCA: 175] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Jensen MP, Pilcher N, FitzSimmons NN. Genetic markers provide insight on origins of immature green turtles Chelonia mydas with biased sex ratios at foraging grounds in Sabah, Malaysia. ENDANGER SPECIES RES 2016. [DOI: 10.3354/esr00763] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Jensen MP, Petersen WA, Bansemer A, Bharadwaj N, Carey LD, Cecil DJ, Collis SM, Del Genio AD, Dolan B, Gerlach J, Giangrande SE, Heymsfield A, Heymsfield G, Kollias P, Lang TJ, Nesbitt SW, Neumann A, Poellot M, Rutledge SA, Schwaller M, Tokay A, Williams CR, Wolff DB, Xie S, Zipser EJ. THE MIDLATITUDE CONTINENTAL CONVECTIVE CLOUDS EXPERIMENT (MC3E). Bull Am Meteorol Soc 2016; 97:1667-1686. [PMID: 32669729 PMCID: PMC7362300 DOI: 10.1175/bams-d-14-00228.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Abstract
The Midlatitude Continental Convective Clouds Experiment (MC3E), a field program jointly led by the U.S. Department of Energy’s Atmospheric Radiation Measurement (ARM) Program and the National Aeronautics and Space Administration’s (NASA) Global Precipitation Measurement (GPM) mission, was conducted in south-central Oklahoma during April–May 2011. MC3E science objectives were motivated by the need to improve our understanding of midlatitude continental convective cloud system life cycles, microphysics, and GPM precipitation retrieval algorithms. To achieve these objectives, a multiscale surface- and aircraft-based in situ and remote sensing observing strategy was employed. A variety of cloud and precipitation events were sampled during MC3E, of which results from three deep convective events are highlighted. Vertical structure, air motions, precipitation drop size distributions, and ice properties were retrieved from multiwavelength radar, profiler, and aircraft observations for a mesoscale convective system (MCS) on 11 May. Aircraft observations for another MCS observed on 20 May were used to test agreement between observed radar reflectivities and those calculated with forward-modeled reflectivity and microwave brightness temperatures using in situ particle size distributions and ice water content. Multiplatform observations of a supercell that occurred on 23 May allowed for an integrated analysis of kinematic and microphysical interactions. A core updraft of 25 m s−1 supported growth of hail and large raindrops. Data collected during the MC3E campaign are being used in a number of current and ongoing research projects and are available through the ARM and NASA data archives.
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Affiliation(s)
- M P Jensen
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - W A Petersen
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - A Bansemer
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - N Bharadwaj
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - L D Carey
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - D J Cecil
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - S M Collis
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - A D Del Genio
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - B Dolan
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - J Gerlach
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - S E Giangrande
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - A Heymsfield
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - G Heymsfield
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - P Kollias
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - T J Lang
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - S W Nesbitt
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - A Neumann
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - M Poellot
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - S A Rutledge
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - M Schwaller
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - A Tokay
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - C R Williams
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - D B Wolff
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - S Xie
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
| | - E J Zipser
- Jensen and Giangrande-Brookhaven National Laboratory, Upton, New York; Petersen, Gerlach, and Wolff-NASA Goddard Space Flight Center, Greenbelt, Maryland, and NASA Wallops Flight Facility, Wallops Island, Virginia; Bansemer and A. Heymsfield-National Center for Atmospheric Research, Boulder, Colorado; Bharadwaj-Pacific Northwest National Laboratory, Richland, Washington; Carey-University of Alabama in Huntsville, Huntsville, Alabama; Cecil and Lang-NASA Marshall Space Flight Center, Huntsville, Alabama; Collis-Argonne National Laboratory, Argonne, Illinois; Del Genio-NASA Goddard Institute for Space Studies, New York, New York; Dolan and Rutledge-Colorado State University, Fort Collins, Colorado; G. Heymsfield and Schwaller-NASA Goddard Space Flight Center, Greenbelt, Maryland; Kollias-McGill University, Montreal, Quebec, Canada; Nesbitt-University of Illinois at Urbana-Champaign, Urbana, Illinois; Neumann and Poellot-University of North Dakota, Grand Forks, North Dakota; Tokay-University of Maryland, Baltimore County, Baltimore, and NASA Goddard Space Flight Center, Greenbelt, Maryland; Williams-University of Colorado, Boulder, Boulder, Colorado; Xie-Lawrence Livermore National Laboratory, Livermore, California; Zipser-University of Utah, Salt Lake City, Utah
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Mendoza ME, Capafons A, Gralow JR, Syrjala KL, Suárez-Rodríguez JM, Fann JR, Jensen MP. Randomized controlled trial of the Valencia model of waking hypnosis plus CBT for pain, fatigue, and sleep management in patients with cancer and cancer survivors. Psychooncology 2016; 26:1832-1838. [PMID: 27467589 DOI: 10.1002/pon.4232] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 07/05/2016] [Accepted: 07/21/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study evaluated the efficacy of an intervention combining the Valencia model of waking hypnosis with cognitive-behavioral therapy (VMWH-CBT) in managing cancer-related pain, fatigue, and sleep problems in individuals with active cancer or who were post-treatment survivors. We hypothesized that four sessions of VMWH-CBT would result in greater improvement in participants' symptoms than four sessions of an education control intervention. Additionally, we examined the effects on several secondary outcome domains that are associated with increases in these symptoms (depression, pain interference, pain catastrophizing, and cancer treatment distress). METHODS The study design was a randomized controlled crossover clinical trial comparing the VMWH-CBT intervention with education control. Participants (N = 44) received four sessions of both treatments, in a counterbalanced order (n = 22 per order condition). RESULTS Participants were 89% female (N = 39) with mean age of 61 years (SD = 12.2). They reported significantly greater improvement after receiving the active treatment relative to the control condition in all the outcome measures. Treatment gains were maintained at 3-month follow-up. CONCLUSIONS This study supports the beneficial effects of the VMWH-CBT intervention relative to a control condition and that treatment gains remain stable. VMWH-CBT-trained clinicians should be accessible for managing symptoms both during and after cancer treatment, though the findings need to be replicated in larger samples of cancer survivors.
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Affiliation(s)
- M E Mendoza
- Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - A Capafons
- Personalitat, Avaluació i Tractaments Psicològics, University of Valencia, Valencia, Spain
| | - J R Gralow
- Oncology, University of Washington School of Medicine, Seattle, WA, USA
| | - K L Syrjala
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - J M Suárez-Rodríguez
- Mètodes de Investigació i Diagnòstic en Educació, University of Valencia, Valencia, Spain
| | - J R Fann
- Psychiatry and Psychology Service, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - M P Jensen
- Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Day MA, Lang CP, Newton-John TRO, Ehde DM, Jensen MP. A content review of cognitive process measures used in pain research within adult populations. Eur J Pain 2016; 21:45-60. [PMID: 27470291 DOI: 10.1002/ejp.917] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Previous research suggests that measures of cognitive process may be confounded by the inclusion of items that also assess cognitive content. The primary aims of this content review were to: (1) identify the domains of cognitive processes assessed by measures used in pain research; and (2) determine if pain-specific cognitive process measures with adequate psychometric properties exist. DATABASES AND DATA TREATMENT PsychInfo, CINAHL, PsycArticles, MEDLINE, and Academic Search Complete databases were searched to identify the measures of cognitive process used in pain research. Identified measures were double coded and the measure's items were rated as: (1) cognitive content; (2) cognitive process; (3) behavioural/social; and/or (4) emotional coping/responses to pain. RESULTS A total of 319 scales were identified; of these, 29 were coded as providing an un-confounded assessment of cognitive process, and 12 were pain-specific. The cognitive process domains assessed in these measures are Absorption, Dissociation, Reappraisal, Distraction/Suppression, Acceptance, Rumination, Non-Judgment, and Enhancement. Pain-specific, un-confounded measures were identified for: Dissociation, Reappraisal, Distraction/Suppression, and Acceptance. Psychometric properties of all 319 scales are reported in supplementary material. CONCLUSIONS To understand the importance of cognitive processes in influencing pain outcomes as well as explaining the efficacy of pain treatments, valid and pain-specific cognitive process measures that are not confounded with non-process domains (e.g., cognitive content) are needed. The findings of this content review suggest that future research focused on developing cognitive process measures is critical in order to advance our understanding of the mechanisms that underlie effective pain treatment. SIGNIFICANCE Many cognitive process measures used in pain research contain a 'mix' of items that assess cognitive process, cognitive content, and behavioural/emotional responses. Databases searched: PsychInfo, CINAHL, PsycArticles, MEDLINE and Academic Search Complete. This review describes the domains assessed by measures assessing cognitive processes in pain research, as well as the strengths and limitations of these measures.
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Affiliation(s)
- M A Day
- School of Psychology, The University of Queensland, Brisbane, Qld, Australia
| | - C P Lang
- School of Psychology, Australian Catholic University, Brisbane, Qld, Australia
| | - T R O Newton-John
- Graduate School of Health, University of Technology Sydney, NSW, Australia
| | - D M Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle, USA
| | - M P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, USA
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Abstract
Much remains unknown about the scope, nature, and impact of pain on the lives of persons with multiple sclerosis (MS). In the present study, 180 community dwelling adults with MS completed a postal survey that included demographic measures, MS disease measures, and several standardized measures of pain, including pain intensity, variability, location, and pain-related interference. Some 66% of the sample reported pain, 25% of whom reported severe pain. Persons with pain reported an average of 6.6 distinct pain sites. Using the Brief Pain Inventory Interference Scale, the average level of overall pain interference was 3.33 (0- 10 scale) in the group reporting pain. The highest levels of pain interference were reported for sleep, recreational activities, and work in and outside the home. Persons with pain were more likely to report greater MS disease severity, poorer psychological functioning, and poorer health than persons with MS but not pain. Persons with pain were also less likely to be employed. These findings are consistent with previous research that shows that pain is common in MS, that it is severe in a substantial subset of these individuals and has the potential to negatively impact physical and psychosocial functioning over and above the effects of MS itself.
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Affiliation(s)
- D M Ehde
- Department of Rehabilitation Medicine, Box 359740, 325 9th Avenue, University of Washington School of Medicine, Seattle, WA 98104-2499, USA.
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19
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Widerström-Noga E, Biering-Sørensen F, Bryce TN, Cardenas DD, Finnerup NB, Jensen MP, Richards JS, Richardson EJ, Siddall PJ. The International Spinal Cord Injury Pain Extended Data Set (Version 1.0). Spinal Cord 2016; 54:1036-1046. [DOI: 10.1038/sc.2016.51] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/25/2016] [Accepted: 03/12/2016] [Indexed: 11/09/2022]
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20
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Finnerup NB, Jensen MP, Norrbrink C, Trok K, Johannesen IL, Jensen TS, Werhagen L. A prospective study of pain and psychological functioning following traumatic spinal cord injury. Spinal Cord 2016; 54:816-821. [DOI: 10.1038/sc.2015.236] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 11/13/2015] [Accepted: 12/06/2015] [Indexed: 11/09/2022]
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21
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Wong WS, Lam HMJ, Chen PP, Chow YF, Wong S, Lim HS, Jensen MP, Fielding R. The fear-avoidance model of chronic pain: assessing the role of neuroticism and negative affect in pain catastrophizing using structural equation modeling. Int J Behav Med 2015; 22:118-31. [PMID: 24788315 DOI: 10.1007/s12529-014-9413-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Previous research on the fear-avoidance model (FAM) of chronic pain suggests that the personality traits of neuroticism and negative affect (NA) influence pain catastrophizing. However, the mechanisms of their influence on pain catastrophizing remain unclear. PURPOSE This study examined four possible models of relationships between neuroticism, NA, and pain catastrophizing within the FAM framework using structural equation modeling. METHOD A total of 401 patients with chronic musculoskeletal pain completed measures of neuroticism, NA, three core FAM components (pain catastrophizing, pain-related fear, and pain anxiety), and adjustment outcomes (pain-related disability and depression). RESULTS Regression analyses refuted the possibility that neuroticism and NA moderated each other's effect on pain catastrophic thoughts (p > 0.05). Results of structural equation modeling (SEM) evidenced superior data-model fit for the collapsed models in which neuroticism and NA were two secondary traits underlying a latent construct, negative emotion (disability: comparative fit index (CFI) = 0.93; depression: CFI = 0.91). CONCLUSION The results offer preliminary evidence that patients presenting with more neurotic symptom and heightened NA probably elicit more catastrophic thoughts about pain.
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Affiliation(s)
- W S Wong
- Department of Psychological Studies and Center for Psychosocial Health & Aging, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, Hong Kong, SAR, China,
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22
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Miró J, Castarlenas E, de la Vega R, Solé E, Tomé-Pires C, Jensen MP, Engel JM, Racine M. Validity of three rating scales for measuring pain intensity in youths with physical disabilities. Eur J Pain 2015; 20:130-7. [PMID: 25833415 DOI: 10.1002/ejp.704] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is growing evidence confirming that youths with physical disabilities are at risk for chronic pain. Although many scales for assessing pain intensity exist, it is unclear whether they are all equally suitable for youths. The aim of this study was to address this knowledge gap by comparing the validity of the Numerical Rating Scale (NRS-11), the Wong Baker FACES Pain Rating Scale (FACES), and a 6-point categorical Verbal Rating Scale (VRS-6) for assessing pain intensity among youths (aged 8-20) with physical disabilities. METHODS One hundred and thirteen youths (mean age = 14.19 years; SD = 2.9) were interviewed and asked to rate their current pain intensity and recalled (in the past week) worst, least, and average pain with the NRS-11 and the FACES. Participants were also asked to rate their average pain intensity during the past 4 weeks using a VRS-6, and were administered measures assessing pain interference, disability and psychological functioning. RESULTS Analyses showed that all of the pain intensity measures were associated positively with each other. Nevertheless, the NRS-11 appeared to out-perform both the VRS-6 and in particular the FACES scale with respect to: (1) the associations with the validity criterion (i.e. pain interference, disability and psychological functioning) and (2) a lack of any moderating effect of age on the association between the measure and the criterion variables. CONCLUSIONS The findings support the validity of the NRS-11 for assessing pain intensity in youths with physical disabilities between the ages of 8 and 20 years.
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Affiliation(s)
- J Miró
- Unit for the Study and Treatment of Pain - ALGOS, Universitat Rovira i Virgili, Catalonia, Spain.,Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - E Castarlenas
- Unit for the Study and Treatment of Pain - ALGOS, Universitat Rovira i Virgili, Catalonia, Spain.,Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - R de la Vega
- Unit for the Study and Treatment of Pain - ALGOS, Universitat Rovira i Virgili, Catalonia, Spain.,Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - E Solé
- Unit for the Study and Treatment of Pain - ALGOS, Universitat Rovira i Virgili, Catalonia, Spain.,Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - C Tomé-Pires
- Unit for the Study and Treatment of Pain - ALGOS, Universitat Rovira i Virgili, Catalonia, Spain.,Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - M P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, USA
| | - J M Engel
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, USA
| | - M Racine
- Lawson Health Research Institute, University of Western Ontario, London, Canada.,Beryl & Richard Ivey Rheumatology Day Programs, St. Joseph's Health Care, University of Western Ontario, London, Canada.,Clinical and Neurological Sciences Department, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
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23
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Tan G, Rintala DH, Jensen MP, Fukui T, Smith D, Williams W. A randomized controlled trial of hypnosis compared with biofeedback for adults with chronic low back pain. Eur J Pain 2014; 19:271-80. [PMID: 24934738 DOI: 10.1002/ejp.545] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND Chronic low back pain (CLBP) is common and results in significant costs to individuals, families and society. Although some research supports the efficacy of hypnosis for CLBP, we know little about the minimum dose needed to produce meaningful benefits, the roles of home practice and hypnotizability on outcome, or the maintenance of treatment benefits beyond 3 months. METHODS One hundred veterans with CLBP participated in a randomized, four-group design study. The groups were (1) an eight-session self-hypnosis training intervention without audio recordings for home practice; (2) an eight-session self-hypnosis training intervention with recordings; (3) a two-session self-hypnosis training intervention with recordings and brief weekly reminder telephone calls; and (4) an eight-session active (biofeedback) control intervention. RESULTS Participants in all four groups reported significant pre- to post-treatment improvements in pain intensity, pain interference and sleep quality. The hypnosis groups combined reported significantly more pain intensity reduction than the control group. There was no significant difference among the three hypnosis conditions. Over half of the participants who received hypnosis reported clinically meaningful (≥ 30%) reductions in pain intensity, and they maintained these benefits for at least 6 months after treatment. Neither hypnotizability nor amount of home practice was associated significantly with treatment outcome. CONCLUSIONS The findings indicate that two sessions of self-hypnosis training with audio recordings for home practice may be as effective as eight sessions of hypnosis treatment. If replicated in other patient samples, the findings have important implications for the application of hypnosis treatment for chronic pain management.
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Affiliation(s)
- G Tan
- Department of Psychology, National University of Singapore, Singapore
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24
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Larsen C, Jensen MP. [Rhabdomyolysis in a well-trained woman after unusually intense exercise]. Ugeskr Laeger 2014; 176:V01140001. [PMID: 25352283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 35-year-old woman was acutely hospitalized with oedema of the upper limbs, reduced force, severe movement reduction and muscle pain in both upper extremities. Her symptoms started after three days of intense exercise doing kayaking and a lot of pull-ups in crossfit. Rhabdomyolysis is a syndrome, characterized by muscle necrosis. Usually there is a marked elevation of creatine kinase (CK) concentration with symptoms as described and myoglobinuria (dark coloured urine). After hard muscular work there will often be asymptomatic, but significant elevations in CK concentration, and in rare cases life-threatening rhabdomyolysis with electrolyte imbalances and acute kidney failure.
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Affiliation(s)
- Christian Larsen
- Reumatologisk Afdeling U, Aarhus Universitets-hospital, Nørrebrogade 44, 8000 Aarhus C.
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25
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Widerström-Noga E, Biering-Sørensen F, Bryce TN, Cardenas DD, Finnerup NB, Jensen MP, Richards JS, Siddall PJ. The International Spinal Cord Injury Pain Basic Data Set (version 2.0). Spinal Cord 2014; 52:282-6. [DOI: 10.1038/sc.2014.4] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 12/11/2013] [Accepted: 01/03/2014] [Indexed: 11/09/2022]
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LaCasella EL, Epperly SP, Jensen MP, Stokes L, Dutton PH. Genetic stock composition of loggerhead turtles Caretta caretta bycaught in the pelagic waters of the North Atlantic. ENDANGER SPECIES RES 2013. [DOI: 10.3354/esr00535] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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27
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Jensen MP, Limpus CJ, Whiting SD, Guinea M, Prince RIT, Dethmers KEM, Adnyana IBW, Kennett R, FitzSimmons NN. Defining olive ridley turtle Lepidochelys olivacea management units in Australia and assessing the potential impact of mortality in ghost nets. ENDANGER SPECIES RES 2013. [DOI: 10.3354/esr00521] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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28
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Grønbæk H, Jensen MP. [Effect of fried bacon and parsley sauce on gastrointestinal symptoms in healthy old boys footballer]. Ugeskr Laeger 2012; 174:3074-3078. [PMID: 23286723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Knowledge of the importance of diet on gastrointestinal function and symptoms is generally poorly. In recent years, The New Nordic Food Culture is suggested to have favourable effects. Unfortunally there are huge waiting lists at the most popular restaurants, so we investigated the more traditional "Nordic kitchen". There are no previous studies concerning intake of fried bacon and parsley sauce (FBPS) in healthy middle-aged footballers. MATERIAL AND METHODS Non-blinded, non-randomized, crossover study with a questionnaire survey of 18 healthy old boys footballers before and after FBPS intake. Ten players responded to the questionnaire, including one who was not exposed to FBPS. RESULTS The median intake was 15 pieces of fried bacon (range 12-23), 1.5 dl parsley sauce (range 1-5 dl), and eight potatoes (range 6-30), but no dessert. We found a significantly increased stool frequency and a trend towards change in consistency compared to baseline. We found increased abdominal pain and a decrease in general well-being, but could not demonstrate any impact on complaints from the family. CONCLUSION In otherwise healthy old boys footballers the FBPS diet has great impact on a range of gastrointestinal symptoms. FBPS affected stool frequency and abdominal pain, but caused no effect on family complaints. We cannot exclude a dose-response effect or a gender/age phenomenon; and we suggest supplemental dose-response studies and studies including women of all ages. Further, we recommend a detailed dietary assessment before referring patients with gastrointestinal symptoms for invasive procedures like colonoscopy or CT-scanning. TRIAL REGISTRATION none FUNDING none.
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Affiliation(s)
- Henning Grønbæk
- Medicinsk Hepato-gastroenterologisk Afdeling V, Aarhus Universitetshospital, Nørrebrogade 44, 8000 Aarhus C, Denmark.
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Jensen MP, Widerström-Noga E, Richards JS, Finnerup NB, Biering-Sørensen F, Cardenas DD. Reliability and validity of the International Spinal Cord Injury Basic Pain Data Set items as self-report measures. Spinal Cord 2009; 48:230-8. [PMID: 19786975 PMCID: PMC2832715 DOI: 10.1038/sc.2009.112] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective To evaluate the psychometric properties of a subset of International Spinal Cord Injury Basic Pain Data Set (ISCIBPDS) items that could be used as self-report measures in surveys, longitudinal studies and clinical trials. Setting Community. Methods A subset of the ISCIBPDS items and measures of two validity criteria were administered in a postal survey to 184 individuals with spinal cord injury (SCI) and pain. The responses of the participants were evaluated to determine: (1) item response rates (as an estimate of ease of item completion); (2) internal consistency (as an estimate of the reliability of the multiple-item measures); and (3) concurrent validity. Results The results support the utility and validity of the ISCIBPDS items and scales that measure pain interference, intensity, site(s), frequency, duration, and timing (time of day of worst pain) in individuals with SCI and chronic pain. The results also provide psychometric information that can be used to select from among the ISCIBPDS items in settings that require even fewer items than are in the basic dataset.
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Affiliation(s)
- M P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98195-6490, USA.
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Abstract
STUDY DESIGN Postal survey. OBJECTIVES To examine if the intensity of pain in persons with spinal cord injury (SCI) varied as a function of pain site, and to identify the patient and SCI characteristics associated with pain location, pain intensity and pain interference in a sample of persons with SCI. SETTING Community sample, United States. METHODS A postal survey including measures of pain intensity, pain interference, other pain, demographic and medical characteristics was completed by 238 adults with SCI. RESULTS Average pain intensity was moderate and pain was common across the body. Demographic and medical variables, including SCI level, were generally not associated with pain prevalence, intensity and interference. However, persons with higher level injuries were more likely to report upper extremity pain than persons with paraplegic injuries. The lower body was the location of the highest pain ratings. CONCLUSION Persons with SCI tend to experience high pain intensity over multiple body locations. Lower body pain was as common as upper extremity pain, but tended to be more intense.
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Affiliation(s)
- P M Ullrich
- Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative, VA Puget Sound Healthcare System, Seattle, WA, USA.
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31
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Jensen MP, Kartin D. Organizing human functioning and rehabilitation research into distinct scientific fields. J Rehabil Med 2008; 40:490-1. [DOI: 10.2340/16501977-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Jensen MP, Abreu-Grobois FA, Frydenberg J, Loeschcke V. Microsatellites provide insight into contrasting mating patterns in arribada vs. non-arribada olive ridley sea turtle rookeries. Mol Ecol 2006; 15:2567-75. [PMID: 16842427 DOI: 10.1111/j.1365-294x.2006.02951.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Molecular studies of sea turtles have shown that the frequency of multiple paternity (MP) varies between species, and between rookeries of the same species. This study uses nuclear microsatellite markers to compare the incidence of MP in two neighbouring olive ridley rookeries on the Pacific coast of Costa Rica, with contrasting nesting behaviours -- the 'arribada' population nesting at Ostional and the solitary nesters of Playa Hermosa. Using two highly polymorphic microsatellite markers, we tested 13 nests from each location and found a significant difference (P < 0.001) between the level of MP of the arribada rookery (92%- the highest found for marine turtles) and that of the solitary nesting rookery (30%). Additional analyses based on six microsatellite loci revealed no genetic differentiation between nesting females from the two locations, or between nesting females and attendant males from the Ostional breeding area. Sixty-nine per cent of the nests with MP were fathered by a minimum of three different males, and three nests showed evidence of at least four fathers. The results suggest that the differences observed in levels of MP between arribada and solitary rookeries are due to an effect of abundance of individuals on the mating system. This is supported by a regression analysis combining other paternity studies on sea turtles which shows that levels of MP increase with increasing abundance of nesting females.
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Affiliation(s)
- M P Jensen
- Department of Biological Sciences, Ecology and Genetics, University of Aarhus, Ny Munkegade, Build. 540, DK-8000 Aarhus C, Denmark.
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Liu GK, Jensen MP, Almond PM. Systematic Behavior of Charge-Transfer Transitions and Energy Level Variation in Soft Donor Complexes of the Trivalent Lanthanides. J Phys Chem A 2006; 110:2081-8. [PMID: 16466241 DOI: 10.1021/jp0558674] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The systematic behavior of the charge-transfer (CT) energies in mixed 2,2'-bipyridyl (bipy), N,N-diethyldithiocarbamate (Et2dtc-) complexes of the trivalent lanthanides, Ln(Et2dtc)3(bipy), is investigated to understand the electronic structure of f-element complexes containing soft donor ligands. The energies of ligand to Ln3+ CT are extremely low in this system, an effect attributed to the presence of the soft donor ligands. The lowest CT energy level for the Sm3+, Eu3+, and Yb3+ complexes falls into the visible range. In Eu(Et2dtc)(bipy), the Eu3+ ion becomes nonluminescent because the CT energy stretches below the metastable 5D0 electronic state, whereas luminescence from the CT state and the 4f13 (2)F(5/2) state are observed in the Yb compound. The variation in the energy of the lowest level CT transition for the entire Ln(Et2dtc)3(bipy) series has been evaluated using the experimentally determined CT levels of the Sm3+, Eu3+, and Yb3+ compounds based on the systematic behavior of the lanthanides, which is invariant with respect to the type of ligand. The energy difference between the ground electronic states of the lanthanide ions and the ligand-centered valence band may also be calculated from these results.
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Affiliation(s)
- G K Liu
- Chemistry Division, Argonne National Laboratory, Argonne, Illinois 60439, USA.
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Chen XY, Jensen MP, Liu GK. Analysis of Energy Level Structure and Excited-State Dynamics in a Sm3+ Complex with Soft-Donor Ligands: Sm(Et2Dtc)3(bipy). J Phys Chem B 2005; 109:13991-9. [PMID: 16852756 DOI: 10.1021/jp0516700] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Using both laser-excited fluorescence and optical absorption methods, we have determined 57 crystal-field (CF) energy levels of Sm 3+ in crystals of Sm(Et2Dtc)3(bipy). The analysis of the energy levels is based on a model Hamiltonian consisting of both free-ion and CF terms. The CF modeling of the experimental energy levels yielded physically reasonable Hamiltonian parameters with a final rms deviation of 17.3 cm(-1). In comparison with Sm 3+ in other hosts, the CF splitting of Sm 3+ in the lattice of Sm(Et2Dtc)3(bipy) is rather weak. The observed fluorescence decay of the 4G(5/2) manifold is single-exponential, with a lifetime of 24.5 mus, indicating only one site of Sm3+ in the lattice. According to the Judd-Ofelt theory, values of three intensity parameters were obtained (Omega(2,4,6) = 1.57, 2.65, and 3.65, in units of 10(-20) cm(-1)). The calculated branching ratios for transitions from the 4G(5/2) manifold are in agreement with experimental values. The calculated radiative lifetime of the 4G(5/2) manifold is 3.24 ms, and the corresponding fluorescence quantum efficiency is only 0.75%. Efficient multiphonon relaxation processes induced by the localized high-frequency vibrational modes in the bipyridyl group may lead to the extremely low quantum efficiency observed. The thermal line broadening and shifts of the 4G(5/2)(1) --> 6F(1/2) transition were observed and fitted very well by the McCumber-Sturge equations with an assumption of Raman phonon scattering processes as the leading relaxation mechanism. The Debye temperature for this crystal is predicted to be 350 K.
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Affiliation(s)
- X Y Chen
- Chemistry Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
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Abstract
STUDY DESIGN Cross-sectional and longitudinal postal survey. OBJECTIVES To (1) compare the severity of pain in persons with spinal cord injury (SCI) to national norms, (2) examine the association between pain and measures of (a) psychological functioning, (b) community integration and (c) pain interference with daily activities, and (3) examine the change in the prevalence and intensity of pain over time. SETTING Community. METHODS A total of 147 adults with SCI were surveyed twice, 2-6 years apart. Main outcome measures included presence/absence of pain in general and at specific body sites, 0-10 numerical rating scale of average pain intensity, modified Brief Pain Inventory Pain Interference scale, SF-36 Bodily Pain scale, SF-36 Mental Health scale, Community Integration Questionnaire. RESULTS Pain was more severe, on average, in this sample of patients with SCI than it is in normative samples. The presence of pain was associated with trends towards poorer psychological functioning and social integration, and the intensity of pain was associated with interference with a number of important basic activities of daily living. Little systematic change was found in pain over a 2-6-year-period, although there was evidence that the prevalence of shoulder pain increases over time. CONCLUSION The current findings underscore the serious nature of pain in persons with SCI and provide additional support for the need to identify effective treatments for SCI-related pain.
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Affiliation(s)
- M P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98195-6490, USA
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Jensen MP, Turner JA, Romano JM. Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment. J Consult Clin Psychol 2001. [PMID: 11550731 DOI: 10.1037//0022-006x.69.4.655] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To examine the associations between changes in cognitions and coping and multidisciplinary pain treatment outcomes, the authors had 141 patients with chronic pain complete measures of adjustment, beliefs, catastrophizing, and coping; in addition, their significant others rated patient physical functioning at pretreatment, posttreatment, and 6- and 12-month follow-ups. Decreases in guarding and resting and in the belief that pain signals damage were associated with decreases in patient disability. Increases in perceived control over pain and decreases in catastrophizing and in the belief that one is disabled were associated with decreases in self-reported patient disability, pain intensity, and depression. The results are consistent with the hypothesis, derived from cognitive-behavioral models of chronic pain, that the outcomes of multidisciplinary pain treatment are associated with changes in patient cognitions and coping responses.
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Affiliation(s)
- M P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle 98195-6490, USA.
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Jensen MP, Turner JA, Romano JM. Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment. J Consult Clin Psychol 2001; 69:655-62. [PMID: 11550731 DOI: 10.1037/0022-006x.69.4.655] [Citation(s) in RCA: 309] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
To examine the associations between changes in cognitions and coping and multidisciplinary pain treatment outcomes, the authors had 141 patients with chronic pain complete measures of adjustment, beliefs, catastrophizing, and coping; in addition, their significant others rated patient physical functioning at pretreatment, posttreatment, and 6- and 12-month follow-ups. Decreases in guarding and resting and in the belief that pain signals damage were associated with decreases in patient disability. Increases in perceived control over pain and decreases in catastrophizing and in the belief that one is disabled were associated with decreases in self-reported patient disability, pain intensity, and depression. The results are consistent with the hypothesis, derived from cognitive-behavioral models of chronic pain, that the outcomes of multidisciplinary pain treatment are associated with changes in patient cognitions and coping responses.
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Affiliation(s)
- M P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle 98195-6490, USA.
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Abresch RT, Jensen MP, Carter GT. Health-related quality of life in peripheral neuropathy. Phys Med Rehabil Clin N Am 2001; 12:461-72. [PMID: 11345018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
It is now possible for the clinician to use multidimensional measures to assess the quality of life of their patients. Some of the more widely used instruments to measure HRQOL are the Medical Outcomes Study Short Form 36, the Nottingham Health Profile, the Sickness Impact Profile, and the World Health Organization Quality of Life instrument. Potential uses of quality of life assessment tools include: (1) monitoring the health and social status of a given population, (2) evaluating health care policy, (3) conducting clinical trials, (4) assessing the effectiveness of rehabilitation services, (5) justifying the allocation of limited social and health care resources, and (6) tailoring management to the needs of the patient.
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Affiliation(s)
- R T Abresch
- Research and Training Center on Neuromuscular Disease, Department of Physical Medicine and Rehabilitation, University of California Davis, Sacramento, California, USA.
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Abstract
Cognitive-behavioral models of chronic pain hypothesize that how a person copes with pain influences how well he or she adjusts to the pain. Several measures have been developed to assess pain coping, but no studies have yet examined whether these measures are complementary or redundant. In the current study, two pain coping measures (the Chronic Pain Coping Inventory, CPCI, and the Coping Strategies Questionnaire, CSQ) were completed by a large number (N=564) of primarily male veterans referred to a chronic pain program. Regression analyses indicated that the CPCI scales did not contribute unique variance to the prediction of depression over and above the CSQ scales. The CSQ Catastrophizing scale was the single most powerful predictor of depression, although several other CSQ scales (Coping Self-Statements, Diverting Attention, and Increasing Behavioral Activities) also contributed. Both the CPCI and the CSQ contributed unique variance to the prediction of disability, although the CPCI scales appear to be more strongly related to disability than the CSQ scales. The CPCI Guarding scale was the single most powerful predictor of disability of all the coping responses assessed in this study. Other scales predicting disability were the CPCI Seeking Social Support, the CSQ Catastrophizing, and the CSQ Increasing Behavioral Activities. While both CSQ and CPCI contribute unique but modest variance to the prediction of pain severity, the CSQ Catastrophizing scale was the single most powerful predictor of pain severity. The findings of this study are consistent with cognitive-behavioral models of pain. Future research will need to determine whether changes in coping responses (catastrophizing and guarding, in particular) merely reflect, or actually influence, adjustment to chronic pain. In the meantime, clinicians would be wise to give these coping responses particular attention in chronic pain programs.
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Affiliation(s)
- G Tan
- Department of Veterans Affairs, Medical Center, 2002 Holcombe Boulevard, Houston TX 77030, USA
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Abstract
Patients with fibromyalgia syndrome (FS) experience a decreased ability to participate in both vocational and avocational activities. Although many treatment programs advocate activity pacing techniques, 'pacing' is a poorly understood concept for which there are no available measures. The present study describes a brief six-item pacing scale that can be administered as part of the Chronic Pain Coping Inventory (CPCI). Preliminary data indicate that this scale is a valid, reliable index of the pacing construct that is associated with physical impairment in patients with FS and is unrelated to simple task persistence.
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Affiliation(s)
- W R Nielson
- Department of Medicine, Division of Rheumatology, University of Western Ontario, ON, London, Canada.
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Affiliation(s)
- M Von Korff
- Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA.
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Abstract
Few data have been published regarding the natural history, course of symptoms, and quality of life in Complex Regional Pain Syndrome (CRPS). To obtain preliminary data regarding these important issues in CRPS, a set of patient self-report questionnaires were mailed to patients with the diagnosis of CRPS who had been assessed and/or treated at a tertiary university-based pain center in the United States. Self-reports of demographic information, symptoms, the Neuropathic Pain Scale, and a modified Brief Pain Inventory (mBPI) were received from 31 CRPS patients. Approximately 75% of patients reported initial symptoms of pain, swelling, coldness, and color changes. An additional 71% had weakness and inability to move the extremity as initial symptoms. Weakness at some time during their course of CRPS was described by 97%. A majority reported no overall improvement or worsening of symptoms over time (mean 3.3 years). The pain descriptors with the highest mean values were "deep" (6.4/10), "unpleasant" (6.4), "sensitive" (5.7), "surface" (5.4), and "dull" (5.3) pains. Significant sleep disturbance was reported by 80%. CRPS had a severe impact on quality of life, with substantial interference reported in 9 of 10 mBPI activity items by a majority of these patients. These findings should be viewed with caution and should not be generalized to the entire CRPS population because the cohort was small and select. A large multicenter prospective study needs to be performed to validate these preliminary findings.
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Affiliation(s)
- B S Galer
- Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY 10003, USA
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Ehde DM, Czerniecki JM, Smith DG, Campbell KM, Edwards WT, Jensen MP, Robinson LR. Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. Arch Phys Med Rehabil 2000; 81:1039-44. [PMID: 10943752 DOI: 10.1053/apmr.2000.7583] [Citation(s) in RCA: 302] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To determine the characteristics of phantom limb sensation, phantom limb pain, and residual limb pain, and to evaluate pain-related disability associated with phantom limb pain. DESIGN Retrospective, cross-sectional survey. Six or more months after lower limb amputation, participants (n = 255) completed an amputation pain questionnaire that included several standardized pain measures. SETTING Community-based survey from clinical databases. PARTICIPANTS A community-based sample of persons with lower limb amputations. MAIN OUTCOME MEASURES Frequency, duration, intensity, and quality of phantom limb and residual limb pain, and pain-related disability as measured by the Chronic Pain Grade. RESULTS Of the respondents, 79% reported phantom limb sensations, 72% reported phantom limb pain, and 74% reported residual limb pain. Many described their phantom limb and residual limb pain as episodic and not particularly bothersome. Most participants with phantom limb pain were classified into the two low pain-related disability categories: grade I, low disability/low pain intensity (47%) or grade II, low disability/high pain intensity (28%). Many participants reported having pain in other anatomic locations, including the back (52%). CONCLUSIONS Phantom limb and residual limb pain are common after a lower limb amputation. For most, the pain is episodic and not particularly disabling. However, for a notable subset, the pain may be quite disabling. Pain after amputation should be viewed from a broad perspective that considers other anatomic sites as well as the impact of pain on functioning.
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Affiliation(s)
- D M Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle 98104-2499, USA
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Abstract
Physical and psychosocial disability in patients with chronic pain have been shown to be associated with patients' pain-related beliefs, tendency to catastrophize, and pain coping strategy use. However, little is known about whether beliefs, catastrophizing, and coping strategies are independently associated with patient adjustment. Identification of specific beliefs, cognitive responses, and coping strategies strongly and independently associated with physical and psychosocial functioning would suggest the importance of targeting those variables for modification in treatment. One hundred sixty-nine patients entering a multidisciplinary pain treatment program completed measures of pain, beliefs, coping, catastrophizing, physical disability, and depression. Principal components analyses were used to create belief and coping components, which were then entered in multiple regression analyses predicting physical disability and depression. Belief scores significantly and independently predicted both physical disability and depression, after controlling for age, sex, pain intensity, catastrophizing, and coping. Coping scores significantly and independently predicted physical disability, but not depression, whereas catastrophizing independently predicted depression, but not physical disability. These findings suggest the importance of targeting specific pain-related beliefs and coping strategies, as well as catastrophizing, for modification in the treatment of patients with chronic pain.
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Affiliation(s)
- J A Turner
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 356560, Seattle, USA.
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Abstract
Cognitions and beliefs appear important in predicting adjustment to chronic pain. The current study examines how cognitions and beliefs are related to psychosocial functioning. One hundred and sixty-three chronic pain out-patients were assessed. Regression analyses were performed using scores on the Pain Beliefs and Perceptions Inventory and the Inventory of Negative Thoughts in Response to Pain as predictor variables and responses to the West Haven Yale Multidimensional Pain Inventory as criterion variables. Pain cognitions and pain beliefs were correlated. After controlling for demographics, employment status and pain severity, pain beliefs and cognitions accounted for a significant amount of the variance in general activity, pain interference, and affective distress. Negative cognitions, particularly negative self-statements, were more predictive of outcome than pain beliefs. Although these data are correlational, they provide additional support for a biopsychosocial model of adjustment to chronic pain.
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Affiliation(s)
- M W Stroud
- Department of Rehabilitation, University of Washington, Box 356490, Seattle, WA 98195, USA
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Abstract
A prospective survey study was performed in patients with painful diabetic polyneuropathy (PDN) to assess the nature and scope of their pain. Pain associated with diabetic neuropathy is commonly encountered in clinical practice. Yet, little is known regarding the pain experience and impact on quality of life in persons with painful diabetic neuropathy. These 105 patients noted an average of 6/10 pain, most often described as 'burning', 'electric', 'sharp', and 'dull/ache', which, for most, is worse at night time and when tired or stressed. On average, patients reported that the pain caused substantial interference in sleep and enjoyment of life and moderate interference in recreational activities, normal work, mobility, general activity, social activities, and mood. Unexpectedly, a potential genetic predisposition to the development of painful neuropathy was suggested by the fact that a majority (56%) reported a family member with PDN. Thus, this study found that pain associated with diabetic neuropathy is a significant medical issue that has a substantial impact on the quality of life of many people with this condition.
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Affiliation(s)
- B S Galer
- Department of Pain Medicine and Palliative Care, Institute for Education and Research in Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY 10003, USA.
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Abstract
Reliable and valid measures of pain are essential for conducting research on chronic pain. The purpose of this longitudinal study was to compare the reliability and validity of several measures of pain intensity. One hundred twenty-three patients with chronic pain were administered telephone interview versions of 0-10 scales of current, worst, least and average pain, immediately prior to beginning a multidisciplinary treatment program. The measures were administered again to these subjects 2 weeks (n=108), 1 month (n=106) and 2 months (n=105) after the end of treatment. The validity (defined as ability to detect changes in pain intensity over the course of treatment up to the 2-month follow-up assessment) and reliability (defined as stability over time in the 2 months after treatment) of these four measures and of composite combinations of these measures were examined. Contrary to prediction, the composite measures did not show a statistically significant superiority to the individual ratings in terms of their ability to detect change in pain intensity from pre-treatment to various points after treatment. The composite scores did, however, show greater stability than did the individual ratings after treatment. The practical conclusions of this study are; (1), individual 0-10 pain intensity ratings have sufficient psychometric strengths to be used in chronic pain research, especially research that involves group comparison designs with relatively large sample sizes, but, (2), composites of 0-10 ratings may be more useful when maximal reliability is necessary, (e.g. in studies with relatively small sample sizes, or in clinical settings where monitoring of changes in pain intensity in individuals is needed).
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Affiliation(s)
- M P Jensen
- Department of Rehabilitation Medicine, Box 356490, University of Washington School of Medicine, Seattle 98195-6490, USA
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Abstract
OBJECTIVE To examine the nature and scope of pain in persons with cerebral palsy (CP). DESIGN Standardized interviews to assess demographics, pain experiences, and the impact of pain on activities. SUBJECTS Ninety-three adults with CP recruited from medical clinics at the University of Washington and local residential and community housing for persons with developmental disabilities. MAIN OUTCOME MEASURES Weekly and 3-month pain intensities, chronic pain grade, interference in daily activities caused by pain, and pain-exacerbating and pain-relieving factors. RESULTS Sixty-two subjects (67%) reported one or more areas of pain of > or =3 months' duration. Lower extremity pain and back pain were the most common complaints. Fifty-six percent of the subjects reporting pain indicated it occurred daily. Mean average pain intensity, graded on a scale of 0 (no pain) to 10 (pain as bad as could be), was 3.16 (SD = 2.45) in the preceding week and 4.45 (SD = 2.34) in the previous 3 months. Approximately 53% of subjects reporting pain indicated their average pain was of moderate to severe intensity (average pain rated as > or =5). Using Von Korff's Chronic Pain Grade classification system, the majority of subjects who reported pain fell into either grade I (low disability, low pain intensity; 51%) or grade II (low disability, high pain intensity; 39%). Subjects reported many factors that exacerbate pain (eg, stress or weather) or decrease it (eg, exercise or rest). CONCLUSIONS The data suggest that pain is common in adults with CP. In many subjects, pain levels were moderate to intense.
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Affiliation(s)
- L Schwartz
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle 98195-6490, USA
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Abstract
According to the cognitive-behavioral model of chronic pain, patient beliefs about their chronic pain influence their behavioral and psychological functioning. Previous correlational and longitudinal studies have supported this hypothesis. However, since previous research has relied almost exclusively on patient self-report to assess both beliefs and functioning, shared method variance may explain some of the relationships found. The aim of the current study was to replicate and extend previous research on the relationship between pain beliefs and patient functioning and behavior by assessing the latter based on three sources of information: patient report, spouse report and direct observation. A total of 121 patients with chronic pain completed self-report measures of beliefs and function. Their spouses completed a measure of patient pain behavior, and both participated in a protocol, from which patient pain behaviors were coded by trained observers. Previously reported relationships between patient beliefs about pain and patient-reported functioning were replicated. Measures of patient beliefs were more strongly associated with self-report measures of pain behaviors and functioning than with spouse and observer ratings of patient pain behaviors. However, significant associations between patient beliefs and both spouse- and observer-reported frequency of patient pain behaviors were found. These findings argue for the generalizability of the relationship found between patient beliefs and patient behaviors across assessment domains, and for the continued application of the cognitive-behavioral model to the understanding of patient adjustment to chronic pain.
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Affiliation(s)
- M P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle 98195-6490, USA.
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Abstract
Mycobacterium tuberculosis resides within the highly oxidative environment of the human macrophage and previous reports have indicated that these mycobacteria are susceptible to reactive nitrogen intermediates including peroxynitrite. This work provides evidence that the Mycobacterium tuberculosis hemoprotein KatG acts as an efficient peroxynitritase exhibiting a kapp of 1.4 x 10(5) M-1s-1 for peroxynitrite decomposition at pH 7.4 and 37 degrees C. The ability of KatG to act as a peroxynitritase adds to its growing list of enzymatic activities and may in part explain the ability of Mycobacterium tuberculosis to persist in macrophages.
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Affiliation(s)
- N L Wengenack
- Department of Biochemistry and Molecular Biology and Section of Hematology Research, Mayo Clinic and Foundation, Rochester, Minnesota, 55905, USA
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