bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Family Caregiving Experience of Outpatient ECT
Authors: Sethi Stephanie , Williams Reg Arthur 
Published: December 2003

BACKGROUND: Given its safety and efficacy, electroconvulsive therapy (ECT) is increasingly being provided on an outpatient basis. However, there is limited understanding about the educational needs of the family in providing care to one of its members who is receiving outpatient ECT. OBJECTIVE: The purpose of this study was to identify the needs of family members who were providing care to clients receiving outpatient ECT. STUDY DESIGN: Interviews were conducted with eight family members. Themes were identified using Giorgi’s method of data analysis. RESULTS: Five themes were identified: (1) Family members experienced fear and despair as a result of the ineffectiveness of medications. (2) ECT provided hope, and there were no negative attitudes toward ECT. (3) Stress and coping were factors and had two components: (a) Depressive symptoms created distress and interfered with family coping mechanisms, and (b) caregiving tasks associated with outpatient ECT were not stressful as long as the patient improved. (4) Distressed relationships improved after ECT. (5) Families wanted more emotional support and information. CONCLUSION: Results of this study suggest that it is the caregiving associated with severe depressive symptoms, rather than with the ECT, that creates family distress. The need for more information and emotional support is an important finding that can direct the development of nursing interventions.
Re‐exploring the relationship between flexibility and the external environment
Authors: Pagell Mark , Krause Daniel R 
Published: December 2003

AbstractThe organizational structure literature has long posited that increases in uncertainty should lead to organic (adaptable) structures [T. Burnes, G.M. Stalker, The Management of Innovation, Tavistock Publications, London, 1961]. Similarly, the operations management literature has focused on the importance of flexibility as a competitive weapon [e.g., De Meyer et al., 1989 Strategic Manage. J. 10 (1989) 135], and as a response to environmental uncertainty [Manage. Sci. 33 (1987) 509; Manage. Sci. 39 (1993) 395]. However, our recent attempts to empirically validate a relationship between environmental uncertainty and operational flexibility in manufacturing plants have failed to show a significant relationship [J. Operations Manage. 3 (1999) 307]. The present research attempts to rectify these contradictory findings by replicating and extending the works of [Manage. Sci. 33 (1987) 509] as well as [J. Operations Manage. 3 (1999) 307]. The results find no support for the proposition that firms that respond to increased uncertainty with increased flexibility will experience increased performance.
Impaired health status, sleep disorders, and pain in the craniomandibular and cervical spinal regions
Authors: Lobbezoo Frank , Visscher Corine M , Naeije Machiel 
Published: December 2003

AbstractThis study investigated the relationship between health status (i.e., physical well‐being and quality of life), sleep disorders (e.g., insomnia, sleep‐related depression and anxiety), and musculoskeletal pain in the craniomandibular and cervical spinal regions. The number of painful body areas below the cervical spine (i.e., widespread pain) was also taken into account. Two questionnaires, viz., the RAND 36‐item Health Survey Questionnaire and the Dutch Sleep Disorders Questionnaire (SDQ), were administered to 103 persons who could unequivocally be classified into one of four mutually exclusive groups: No pain, craniomandibular pain (CMP), cervical spinal pain (CSP), and both CMP and CSP. Body drawings were used for the self‐report of widespread pain. Multivariate analysis of variance showed effects of gender, group, and widespread pain on the questionnaire scales; not of age. As shown by univariate analysis of variance, men suffered more from sleep apnea than did women. No other gender differences were found. Simple contrast analyses following univariate analyses of the group and widespread pain effects showed that, in general, more questionnaire scales, both of the RAND‐36 and of the SDQ, reached statistical significance with an increase in the number of painful areas. It was concluded that both musculoskeletal pain in the trigemino‐cervical area and widespread body pain are associated with an increased impairment of health status. Also, sleep disorders are frequently found in patients with chronic pain in the craniomandibular and cervical spinal regions as well as in patients with widespread pain. The more painful areas there are, the likelier it is that sleep disorders are present.
When pain is not fully explained by organic lesion: a psychiatric perspective on chronic pain patients
Authors: Ciaramella A , Grosso S , Poli P , Gioia A , Inghirami S , Massimetti G , Conti L 
Published: December 2003

AbstractRecent literature demonstrates the relationship between psychopathology and medically unexplained pain, even if the results of several studies show a high degree of variability.The present study was planned with the aim of analysing both the possible relationship between the level (low/high) of organicity and the presence of psychopathology, and the degree to which these differences are related to methodological problems. Between 1998 and 2000, four hundred and thirty six consecutive patients seen at the Pisa Pain Therapy and Palliative Care Unit were requested to fill in a questionnaire, the GHQ‐12, to screen the subjects probably with (GHQ‐12 > 3) or without (GHQ‐12 ≤ 3) psychopathology. All the patients scoring above the GHQ‐12 threshold (score of 3), and a randomised sample of those scoring below the GHQ‐12 threshold, were included in the study. These patients were then interviewed using three different instruments: the Mini International Neuropsychiatric Interview (MINI) for a standardised psychiatric diagnosis, the Semistructured Interview for Depression (SID) for the characterisation of temperament, and the Italian Pain Questionnaire (IPQ) for the evaluation of pain. Our results suggest that Somatisation Disorders are more frequent in the medically unexplained pain group than in the medically explained pain group, whereas the other psychiatric disorders have a similar prevalence in the two pain groups. Mood and anxiety disorders are correlated with high scores on GHQ‐12 and medically explained pain has a higher prevalence of GHQ‐12 > 3 than the medically unexplained pain group. These results confirm that methodology is an important factor that could modify results in psychiatric research. Both medically unexplained pain and the presence of psychopathology are significantly correlated with sex, and age: females and young patients have a higher prevalence of psychopathology and of medically unexplained pain. Our results suggest that in the correlation between the low organicity of pain and psychopathology, the age and sex play a relevant role.
Evidence for a direct relationship between cognitive and physical change during an education intervention in people with chronic low back pain
Authors: Moseley G.Lorimer 
Published: December 2003

AbstractBackground. Unhelpful pain cognitions of patients with chronic low back pain (LBP) may limit physical performance and undermine physical assessment. It is not known whether a direct relationship exists between pain cognitions and physical performance.Aims. To determine if a relationship exists between change in pain cognitions and change in physical performance when chronic LBP patients participate in a single one‐to‐one education intervention during which they have no opportunity to be active.Methods. In a quasi‐experiment using a convenience sample, moderately disabled chronic LBP patients (n=121) participated in a one‐to‐one education session about either lumbar spine physiology or pain physiology. Multiple regression analysis evaluated the relationship between change in pain cognitions measured by the survey of pain attitudes (SOPA) and the pain catastrophising scale (PCS) and change in physical performance, measured by the straight leg raise (SLR) and standing forward bending range.Results. There was a strong relationship between cognitive change and change in straight leg raise (SLR) and forward bending (r=0.88 and 0.79, respectively, P<0.01), mostly explained by change in the conviction that pain means tissue damage and catastrophising.Conclusions. Change in pain cognitions is associated with change in physical performance, even when there is no opportunity to be physically active. Unhelpful pain cognitions should be considered when interpreting physical assessments.
The course of non‐malignant chronic pain: a 12‐year follow‐up of a cohort from the general population
Authors: Andersson H.Ingemar 
Published: December 2003

AbstractThe high prevalence of chronic pain (duration >3 months) reported from different populations indicates a public health problem. Knowledge of the long‐term course of chronic non‐malignant pain is incomplete and scarce.This paper describes a follow‐up of a cohort recruited from a survey in the general population. The cohort (n=214) consisted initially of individuals with widespread or located (neck—shoulder) pain or without chronic pain. The individuals were initially examined and replied to questionnaires on pain, social factors, lifestyle, medication and health care after two and 12 years. The deaths during the period were obtained from the population register. Complete data exist for 77% of the eligible individuals.After 12 years one‐third of the individuals initially without pain reported chronic pain, and among those with initial chronic pain 85% still reported chronic pain. The number of painful areas was the strongest predictor of chronic pain 12 years later (OR 15.8; >3 locations vs. 0) whereas a social factor (having a close friend) decreased the risk (OR 0.44). The onset of chronic pain during the same period was related to the physical workload (work with bent positions; OR 5.31; yes vs. no). Mortality was significantly higher in the group initially reporting widespread pain compared with the other groups. The chronicity of widespread chronic pain supports early and intense intervention among individuals with located pain. The association between chronic widespread pain and increased mortality needs further investigation but may deepen the view of chronic pain as a public health problem.
The tridimensional personality theory and pain: harm avoidance and reward dependence traits correlate with pain perception in healthy volunteers
Authors: Pud Dorit , Eisenberg Elon , Sprecher Elliot , Rogowski Zeev , Yarnitsky David 
Published: December 2003

AbstractThe aim of the present study was to examine the possible role of personality traits in determining the variability of pain perception among individuals. More specifically, it was intended to test whether or not the three personality dimensions suggested by Cloninger in 1987 – mainly harm avoidance (HA), but also reward dependence (RD), and novelty seeking (NS), can predict interpersonal differences in responsiveness to experimental pain. Seventy healthy volunteers participated in the study. Their personality traits were evaluated through Cloninger's tridimensional personality questionnaire (TPQ). Pain threshold (latency to pain onset), pain magnitude (VAS), and pain tolerance (time to withdrawal) were measured by using the cold pressor test. Bonferroni‐adjusted correlations were found between HA and the pain parameters as follows: a negative correlation between HA and threshold (ρ=−0.297, Padj=0.039); no significant correlation between HA and tolerance (ρ=−0.219, Padj=0.207); and a trend for a positive correlation between HA and VAS (ρ=0.266, Padj=0.081). Possible correlations between pain perception and the various possible combinations of high and low scoring for each of the three traits were also investigated. Correlations were found only for the combinations of high/low HA and high/low RD. The low HA/low RD combination demonstrated the lowest responsiveness to pain (VAS 65.2 ± 21.4; tolerance 107.6 ± 71.8 s), whereas the high HA/low RD combination was correlated with the highest responsiveness (VAS 83.3 ± 10.8; tolerance 30.8 ± 28.4 s). The results indicate that HA personality trait correlates best with pain responsiveness. As such, a high HA are likely to predict a heightened pain response. RD may modify this pattern. The possible relevant behavioral and neuro‐chemical mechanisms are discussed.
Comorbidity of pain problems and depressive symptoms in young women: results from a cross‐sectional survey among women aged 15–24 in Hungary
Authors: Réthelyi János M , Berghammer Rita , Ittzés András , Szumska Irena , Purebl György , Csoboth Csilla 
Published: December 2003

AbstractFrequent headaches and musculoskeletal pain problems were assessed as part of a cross‐sectional health survey in a representative sample of 3615 young Hungarian women, aged 15–24 (mean age: 19.0 years). The representative sample was obtained by a multilevel stratified sampling procedure based on national statistical data, the refusal rate was 6%. Depressive symptomatology was assessed as well using the shortened form of the Beck Depression Inventory. The overall prevalence of frequent headaches was 43.8% in the sample, 25.8% of the investigated population reported chronic musculoskeletal pain problems. The co‐prevalence rate of depression was significantly higher in the group of interviewees reporting pain problems, 11.2% in the group indicating frequent headaches (χ2=53.1, p<0.001), 10.3% in the group reporting musculoskeletal pain problems (χ2=12.4, p<0.001). In contrast, the prevalence of depressive symptomatology was 4.6% and 6.6% in the subgroups denying frequent headaches and musculoskeletal pain, respectively. The prevalence of chronic pain problems decreased with higher age, increased with the smaller size of residence and was lower in the non‐student employment group, however, these differences across sociodemographic variables did not remain significant if tested by a multivariate logistic regression analysis.The high co‐prevalence rates of depression in interviewees reporting chronic pain problem draws attention to the development of such secondary health problems and underscores the importance of early prevention. Epidemiological studies provide data for the better planning and management of prevention programs.
Neck flexor muscle fatigue is side specific in patients with unilateral neck pain
Authors: Falla Deborah , Jull Gwendolen , Rainoldi Alberto , Merletti Roberto 
Published: December 2003

AbstractDespite the evidence of greater fatigability of the cervical flexor muscles in neck pain patients, the effect of unilaterality of neck pain on muscle fatigue has not been investigated. This study compared myoelectric manifestations of sternocleidomastoid (SCM) and anterior scalene (AS) muscle fatigue between the painful and non‐painful sides in patients with chronic unilateral neck pain. Myoelectric signals were recorded from the sternal head of SCM and the AS muscles bilaterally during sub‐maximal isometric cervical flexion contractions at 25% and 50% of the maximum voluntary contraction (MVC). The time course of the mean power frequency, average rectified value and conduction velocity of the electromyographic signals were calculated to quantify myoelectric manifestations of muscle fatigue. Results revealed greater estimates of the initial value and slope of the mean frequency for both the SCM and AS muscles on the side of the patient's neck pain at 25% and 50% of MVC. These results indicate greater myoelectric manifestations of muscle fatigue of the superficial cervical flexor muscles ipsilateral to the side of pain. This suggests a specificity of the effect of pain on muscle function and hence the need for specificity of therapeutic exercise in the management of neck pain patients.
Clinical study of chronic pain in hereditary myopathies
Authors: Delorme Thierry , Boureau François , Eymard Bruno , Laforet Pascal , Cottrel Frédérique 
Published: December 2003

AbstractIn the field of neuromuscular diseases, pain and its management remain imperfectly understood and described. We study 68 unselected, consecutive adult patients attending a multidisciplinary consultation for hereditary myopathy. Forty‐six (67%) were suffering from chronic pain. Pain was assessed with self report questionnaire and a standardized clinical evaluation. Mean duration of the pain was 7.2 ± 8.9 years, and multiple body sites were involved in 91% of cases. Usual pain intensity (Visual Analogue Scale 0–100) was moderate (39.5 ± 26.2). For 42 patients (91%) the principal cause of the pain was of muscular origin, with frequent features of myofascial pain syndromes (MPS, 50%) and fibromyalgia (FMS, 26%). Pain was the major complaint for 6.3% of the patients. Pain management was essentially based on physiotherapy. Only a minority of patients (38%) has an appropriate drug treatment. Common analgesics appeared to be very effective in these patients.
Psychosocial experiences among primary care patients with and without musculoskeletal pain
Authors: Soares Joaquim J.F , Jablonska Beata 
Published: December 2003

AbstractWe examined differences in demographic/financial characteristics, burnout, job demands/control/strain and symptoms of depression as measured by GHQ among primary care patients with (n=838) and without pain (n=135). In addition, we examined factors associated with the presence of pain by means of logistic regression analyses among all participants, and inter‐relations between demographic/financial/pain/health variables, symptoms of depression, burnout, and disability by means of multivariate regression analyses among pain patients. The patients completed a questionnaire about areas such as job strain and burnout. The design was cross‐sectional and data were collected during 15 consecutive days. The univariate analyses showed that pain patients, compared with patients without pain, were more often females, older, divorced, foreign‐born, had been more often on sick‐leave, were more preoccupied with how to make ends meet and had greater difficulties in raising a reasonable sum of money within a specific period of time. In addition, they had greater levels of depression symptoms, burnout, and job strain. However, the multivariate analyses showed that symptoms of depression and burnout were more associated with such variables as sick‐leave and divorce than by pain parameters. The logistic regression revealed that the presence of pain was associated with female gender, sick‐leave, and high levels of job strain and mean total burnout. Finally, pain patients had a severe clinical situation in terms of, for example, constant, intense, and prolonged pain, and experienced a high degree of disability due to pain. We corroborated previous findings and may have provided new insights into the experiences of pain patients that may be of importance when considering intervention. Although we pointed to some important factors associated with pain, symptoms of depression and burnout, much of their variation remains to be explained. Thus, further research appears necessary, not least concerning the role of burnout as an antecedent to pain.
Predator–prey interactions between Dugesia gonocephala and free‐living nematodes
Authors: Beier S. , Bolley M. , Traunspurger W. 
Published: December 2003

Summary1. Three groups of laboratory experiments clarified the role of nematodes as a potential food resource for the triclad Dugesia gonocephala. The first group measured the functional response of adult D. gonocephala feeding on juvenile or adult Caenorhabditis elegans. The feeding rates of D. gonocephala on adult and juvenile C. elegans followed a type II functional response. The maximum number of adult nematodes and juvenile nematodes eaten by a single D. gonocephala individual within 3 h was 94 and 197 nematodes, respectively.2. A second group of microcosm experiments investigated the effect of D. gonocephala on the density and the vertical distribution of a nematode community in fine sand. The following treatments were performed: (i) microcosms with 400 nematodes and (ii) microcosms with 400 nematodes and one D. gonocephala. After 5 days, nematodes as a group, as well as the dominant species Tobrilus pellucidus and Trischistoma monohystera, showed no significant difference in vertical patterns between the treatments with and without D. gonocephala.3. The third group of experiments determined whether grain size of the sediment (sand, fine gravel and coarse gravel) altered the ability of D. gonocephala to consume adult C. elegans. Sand and fine gravel reduced the predation effectiveness of D. gonocephala by 100%, whereas the predator consumed nematodes in coarse gravel (19 nematodes within 3 h).
The TWEAK Is Weak for Alcohol Screening Among Female Veterans Affairs Outpatients
Authors: Bush Kristen R. , Kivlahan Daniel R. , Davis Tania M. , Dobie Dorcas J. , Sporleder Jennifer L. , Epler Amee J. , Bradley Katharine A. 
Published: December 2003

Background: The optimal brief questionnaire for alcohol screening among female patients has not yet been identified. This study compared the performance of the TWEAK (tolerance, worried, eye‐opener, amnesia, cutdown), the Alcohol Use Disorders Identification Test (AUDIT), and the AUDIT Consumption (AUDIT‐C) as self‐administered screening tests for hazardous drinking and/or active alcohol abuse or dependence among female Veterans Affairs (VA) outpatients.Methods: Women were included in the study if they received care at VA Puget Sound and completed both a self‐administered survey containing the AUDIT and TWEAK screening questionnaires and subsequent in‐person interviews with the Alcohol Use Disorders and Associated Disabilities Interview Schedule. Sensitivities, specificities, positive and negative likelihood ratios, and areas under Receiver Operating Characteristic curves were computed for each screening questionnaire compared with two interview‐based comparison standards: (1) active DSM‐IV alcohol abuse or dependence and (2) hazardous drinking and/or active DSM‐IV alcohol abuse or dependence, the more appropriate target for primary care screening.Results: Of 393 women who completed screening questionnaires and interviews, 39 (9.9%) met diagnostic criteria for alcohol abuse or dependence, and 89 (22.7%) met criteria for hazardous drinking or alcohol abuse or dependence. The TWEAK had relatively low sensitivities (0.62 and 0.44) but adequate specificities (0.86 and 0.89) for both interview‐based comparison standards, even at its lowest cut‐point (≥1). The AUDIT and AUDIT‐C were superior, with the following areas under the receiver operating characteristic curve for active alcohol abuse or dependence and hazardous drinking and/or active alcohol abuse or dependence, respectively: AUDIT, 0.90 [95% confidence interval (CI), 0.85–0.95] and 0.87 (95% CI, 0.84–0.91); AUDIT‐C, 0.91 (95% CI, 0.88–0.95) and 0.91 (95% CI, 0.88–0.94); and TWEAK, 0.76 (95% CI, 0.66–0.86) and 0.67 (95% CI, 0.60–0.74).Conclusions: The TWEAK has low sensitivity as an alcohol‐screening questionnaire among female VA outpatients and should be evaluated further before being used in other female primary care populations. The three‐item AUDIT‐C was the optimal brief alcohol‐screening questionnaire in this study.