scholarly journals The Predictive Role of Executive Functions and Psychological Factors on Chronic Pain after Orthopaedic Surgery: A Longitudinal Cohort Study

2020 ◽  
Vol 10 (10) ◽  
pp. 685 ◽  
Author(s):  
Emanuele Maria Giusti ◽  
Chiara Manna ◽  
Giorgia Varallo ◽  
Roberto Cattivelli ◽  
Gian Mauro Manzoni ◽  
...  
Keyword(s):  
Visual Attention ◽  
Executive Functions ◽  
Pain Intensity ◽  
State Anxiety ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Pain Catastrophizing ◽  
Surgical Pain ◽  
Chronic Post Surgical Pain ◽  
Psychological Risk

Prevention and treatment of chronic post-surgical pain should be based on the early identification of patients at risk. The presence of a deficit in executive functions, along with the presence of psychological risk factors, could impair the use of appropriate pain coping strategies and might facilitate the transition to chronic post-surgical pain. A longitudinal cohort study was implemented. Patients listed for orthopaedic surgery were enrolled. Variables measured before surgery were pain intensity, the sensory, affective, cognitive and mixed components of pain, state and trait variables associated with the psychological status of the patient, fear of movement, pain catastrophizing, visual attention and cognitive flexibility. Pain intensity and the components of pain were re-evaluated after surgery and after three months. A linear mixed model was used to assess the predictors of pain intensity, and a multivariate linear mixed model was used to assess the predictors of the pain components. 167 patients were enrolled. Controlling for sex, age, pain duration and surgical procedure, catastrophizing and visual attention were predictors of pain intensity at follow-up. The sensory component of pain was predicted by state anxiety, healthcare-related fears, pain catastrophizing and visual attention. Anxiety and catastrophizing were predictors of the affective and evaluative components of pain. The mixed component of pain was predicted by state anxiety, healthcare-related fears and pain catastrophizing. Executive functions, along with psychological risk factors, shape the course of post-surgical pain. The efficacy of preventive and rehabilitation treatment could be possibly enhanced if these factors are treated.

scholarly journals Functional Disability in Adolescents with Chronic Pain: Comparing an Interdisciplinary Exposure Program to Usual Care

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 288
Author(s):  
Carolien Dekker ◽  
Mariëlle Goossens ◽  
Bjorn Winkens ◽  
Silvia Remerie ◽  
Caroline Bastiaenen ◽  
...  
Keyword(s):  
Usual Care ◽  
Pain Intensity ◽  
Mixed Model ◽  
Functional Disability ◽  
Linear Mixed Model ◽  
Pain Catastrophizing ◽  
Controlled Trial ◽  
Outpatient Rehabilitation ◽  
Multicenter Rct

(1) Background: Chronic musculoskeletal pain (CMP) in adolescents can negatively affect physical, psychological, and social functioning, resulting in functional disability. This randomized controlled trial (RCT) aimed to evaluate the effectiveness of an outpatient rehabilitation program based on graded exposure in vivo (EP) compared with care as usual (CAU: interdisciplinary outpatient rehabilitation care). Both EP and CAU aim to improve functional ability in adolescents with CMP. (2) Methods: Pragmatic multicenter RCT with 12-month follow-up. Adolescents (12–21 years) with CMP were invited to participate. Primary outcome: functional disability; secondary outcomes: perceived harmfulness; pain catastrophizing; pain intensity. Data analysis: intention-to-treat linear mixed model. (3) Results: Sixty adolescents (mean 16 years) were randomized; data for 53 were analyzed. Adolescents in EP showed relevant and significant decreases in functional disability (estimated mean difference at least −8.81, p ≤ 0.01) compared with CAU at all times. Significant differences in favor of EP were found for perceived harmfulness at all times (p ≤ 0.002), for pain catastrophizing at 2 months (p = 0.039) and for pain intensity at 4 and 10 months (p ≤ 0.028). (4) Conclusion: EP leads to a significant and clinically relevant decrease in functional disability compared with usual care.

scholarly journals The Effects of Ethnically Congruent Music on Eye Movements and Food Choice—A Cross-Cultural Comparison between Danish and Chinese Consumers

Foods ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 1109
Author(s):  
Danni Peng-Li ◽  
Raymond C. K. Chan ◽  
Derek V. Byrne ◽  
Qian Janice Wang
Keyword(s):  
Visual Attention ◽  
Food Choice ◽  
Cultural Context ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Semantic Networks ◽  
Field Studies ◽  
Western Music ◽  
Chi Square ◽  
Eastern Music

Musical fit refers to the congruence between music and attributes of a food or product in context, which can prime consumer behavior through semantic networks in memory. The vast majority of research on this topic dealing with musical fit in a cultural context has thus far been limited to monocultural groups in field studies, where uncontrolled confounds can potentially influence the study outcome. To overcome these limitations, and in order to explore the effects of ethnically congruent music on visual attention and food choice across cultures, the present study recruited 199 participants from China (n = 98) and Denmark (n = 101) for an in-laboratory food choice paradigm with eye-tracking data collection. For each culture group, the study used a between-subject design with half of the participants listening to only instrumental “Eastern” music and the other half only listening to instrumental “Western” music, while both groups engaged in a food choice task involving “Eastern” and “Western” food. Chi-square tests revealed a clear ethnic congruency effect between music and food choice across culture, whereby Eastern (vs. Western) food was chosen more during the Eastern music condition, and Western (vs. Eastern) food was chosen more in the Western music condition. Furthermore, results from a generalized linear mixed model suggested that Chinese participants fixated more on Western (vs. Eastern) food when Western music was played, whereas Danish participants fixated more on Eastern (vs. Western) food when Eastern music was played. Interestingly, no such priming effects were found when participants listened to music from their own culture, suggesting that music-evoked visual attention may be culturally dependent. Collectively, our findings demonstrate that ambient music can have a significant impact on consumers’ explicit and implicit behaviors, while at the same time highlighting the importance of culture-specific sensory marketing applications in the global food industry.

Evaluation of Driver Comprehension and Visual Attention of the Flashing Yellow Arrow Display for Permissive Right Turns

2019 ◽  
Vol 2673 (8) ◽  
pp. 397-407 ◽  
Author(s):  
Hisham Jashami ◽  
David S. Hurwitz ◽  
Christopher Monsere ◽  
Sirisha Kothuri
Keyword(s):  
Visual Attention ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Driving Simulator ◽  
Probit Model ◽  
Flashing Yellow Arrow ◽  
Different Response ◽  
Turning Maneuver ◽  
Yellow Arrow ◽  
Right Turns

This research explored driver comprehension and behaviors in Oregon with respect to right-turn signal displays focusing on the Flashing Yellow Arrow (FYA) in a driving simulator. A counterbalanced, factorial design was chosen to explore three independent variables: signal indication type and active display, length of the right-turn bay, and presence of pedestrians. Driver decision-making and visual attention were considered. Data were obtained from 46 participants (21 women, 25 men) turning right 736 times in 16 experimental scenarios. A Mixed-effects Ordered Probit Model and a Linear mixed model were used to examine the influence of driver demographics on observed performance. Results suggest that the FYA indication improves driver comprehension and behavioral responses to the permissive right-turn condition. When presented with the FYA indication in the presence of pedestrians, nearly all drivers exhibited caution while turning and yielding to pedestrians and stopping when necessary. For the same turning maneuver, drivers presented with a circular green (CG) indication were less likely to exhibit correct behavior. At least for Oregon drivers, another clear finding was a general lack of understanding of the steady red arrow (SRA) display for right turns. Most drivers assume the SRA indication requires a different response than the circular red (CR) and remain stopped during the entire red interval, thus resulting in efficiency losses. These findings suggest that transportation agencies could potentially improve driver yielding behavior and pedestrian safety at signalized intersections with high volumes of permissive right turns from exclusive right-turn lanes by using the FYA display in lieu of a steady CG display.

scholarly journals The Role of Pain Catastrophizing in the Provision of Rescue Analgesia by Health Care Providers Following Major Joint Arthroplasty

2014 ◽  
Vol 6;17 (6;12) ◽  
pp. 515-524
Author(s):  
Patrícia R. Pinto
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Pain Intensity ◽  
Health Care Providers ◽  
Psychological Factors ◽  
Pain Catastrophizing ◽  
Care Providers ◽  
Rescue Analgesia ◽  
Psychological Variables ◽  
Surgical Pain

Background: After surgery, patient reports or health care professional evaluations of heightened acute pain intensity should lead to extra analgesia provision, which is designated by rescue analgesia (RA). Whether RA is administered or not, it is not directly dependent on the patient but rather on clinical decisions, which should be based on pain management guidelines. There is a general lack of studies focusing on pain-related decision-making regarding RA provision. Objectives: This study aimed to examine which pre and post-surgical factors, beyond acute postsurgical pain intensity, might influence clinical decisions on RA administration after major joint arthroplasties (MJA). Methods: A consecutive sample of 110 patients undergoing MJA was fully assessed 24 hours before (T1) and 48 hours after (T2) surgery. Before surgery, baseline demographic, clinical, and psychological variables were evaluated and after surgery the main outcome was RA provision, with acute post-surgical pain intensity being also registered. Study Design: Prospective observational cohort study. Setting: Central hospital in northern Portugal. Results: Logistic regression analysis revealed that RA provision, after MJA, is influenced by a patient-related psychological factor, pain catastrophizing (OR = 1.143; 95% CI 1.044 – 1.253, P = 0.004), above and beyond acute post-surgical pain intensity. Additionally, the type of arthroplasty (OR = 2.806; 95% CI 1.002 – 7.857, P = 0.050) also affected RA provision. Other patient-related factors such as gender, previous pain states, pre-surgical optimism, and post-surgical anxiety did not reveal any predictive role in RA administration. Limitations: This is a single-site study, only confined to MJA patients. Conclusions: The findings of this study shed light on the importance of psychological factors in determining RA provision following MJA. This encourages further reflection on acute postsurgical pain management by health care providers, namely by raising clinicians’ awareness about the factors that influence patient-provider interactions, as well as their impact on decision-making regarding RA provision. A global assessment of patients, wherein psychological variables are taken into account, is warranted in order to improve the quality of surgical pain management. Finally, these findings provide support for the design of acute post-surgical pain management interventions directed at clinicians, in order to augment professionals’ awareness about the potential influence of patient-related psychological factors on RA decisions. Key words: Rescue analgesia, major joint arthroplasty, post-surgical pain intensity, psychological factors, pre-surgical pain catastrophizing, patient-provider interactions, pain-related decisionmaking, predictive analysis

scholarly journals Application and utility of a clinical framework for spinally referred neck-arm pain: A cross-sectional and longitudinal study protocol

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244137
Author(s):  
Camilla Kapitza ◽  
Kerstin Lüdtke ◽  
Brigitte Tampin ◽  
Nikolaus Ballenberger
Keyword(s):  
Study Protocol ◽  
Central Sensitization ◽  
Regression Models ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Clinical Course ◽  
Pain Catastrophizing ◽  
Neck Disability Index ◽  
Pain Mechanisms ◽  
Arm Pain

Background The clinical presentation of neck-arm pain is heterogeneous with varying underlying pain types (nociceptive/neuropathic/mixed) and pain mechanisms (peripheral/central sensitization). A mechanism-based clinical framework for spinally referred pain has been proposed, which classifies into (1) somatic pain, (2) neural mechanosensitivity, (3) radicular pain, (4) radiculopathy and mixed pain presentations. This study aims to (i) investigate the application of the clinical framework in patients with neck-arm pain, (ii) determine their somatosensory, clinical and psychosocial profile and (iii) observe their clinical course over time. Method We describe a study protocol. Patients with unilateral neck-arm pain (n = 180) will undergo a clinical examination, after which they will be classified into subgroups according to the proposed clinical framework. Standardized quantitative sensory testing (QST) measurements will be taken in their main pain area and contralateral side. Participants will have to complete questionnaires to assess function (Neck Disability Index), psychosocial factors (Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, Depression, anxiety and stress scale), neuropathic pain (Douleur Neuropathique 4 Questions, PainDETECT Questionnaire) and central sensitization features (Central Sensitization Inventory). Follow-ups at three, six and 12 months include the baseline questionnaires. The differences of QST data and questionnaire outcomes between and within groups will be analyzed using (M)AN(C)OVA and/or regression models. Repeated measurement analysis of variance or a linear mixed model will be used to calculate the differences between three, six, and 12 months outcomes. Multiple regression models will be used to analyze potential predictors for the clinical course. Conclusion The rationale for this study is to assess the usability and utility of the proposed clinical framework as well as to identify possible differing somatosensory and psychosocial phenotypes between the subgroups. This could increase our knowledge of the underlying pain mechanisms. The longitudinal analysis may help to assess possible predictors for pain persistency.

When pain after surgery doesn't go away…

2009 ◽  
Vol 37 (1) ◽  
pp. 318-322 ◽  
Author(s):  
Siún Burke ◽  
George D. Shorten
Keyword(s):  
Pain Catastrophizing ◽  
Clinical Problem ◽  
Minimally Invasive Surgical ◽  
Analgesic Regimen ◽  
Surgical Pain ◽  
Post Operative Pain ◽  
Sensitization Process ◽  
Important Clinical Problem ◽  
Chronic Post Surgical Pain ◽  
Selection Of

Chronic post-surgical pain is a common, under-recognized and important clinical problem which affects millions of patients worldwide. It results from a series of neuroplastic changes associated most commonly with peripheral nerve injury at the time of surgery. Predisposing factors include the type of surgery, pre-operative and acute post-operative pain intensity, and probably psychological (e.g. pain-catastrophizing) and genetic factors [e.g. GCH1 (GTP cyclohydrolase 1) haplotype]. Preventive measures which are currently available include selection of a minimally invasive surgical technique and an aggressive multimodal perioperative analgesic regimen. Very promising therapeutic agents which target the sensitization process are currently in development.

Analyzing discontinuities in longitudinal count data: A multilevel generalized linear mixed model.

2020 ◽  
Author(s):  
James L. Peugh ◽  
Sarah J. Beal ◽  
Meghan E. McGrady ◽  
Michael D. Toland ◽  
Constance Mara
Keyword(s):  
Count Data ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Generalized Linear Mixed Model ◽  
Longitudinal Count Data

Predicting bycatch hotspots based on suitable habitat derived from fishery-independent data

2020 ◽  
Vol 641 ◽  
pp. 159-175
Author(s):  
J Runnebaum ◽  
KR Tanaka ◽  
L Guan ◽  
J Cao ◽  
L O’Brien ◽  
...  
Keyword(s):  
Habitat Suitability ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Gulf Of Maine ◽  
Homarus Americanus ◽  
Management Tool ◽  
American Lobster ◽  
Suitable Habitat ◽  
Climate Conditions ◽  
Suitability Index

Bycatch remains a global problem in managing sustainable fisheries. A critical aspect of management is understanding the timing and spatial extent of bycatch. Fisheries management often relies on observed bycatch data, which are not always available due to a lack of reporting or observer coverage. Alternatively, analyzing the overlap in suitable habitat for the target and non-target species can provide a spatial management tool to understand where bycatch interactions are likely to occur. Potential bycatch hotspots based on suitable habitat were predicted for cusk Brosme brosme incidentally caught in the Gulf of Maine American lobster Homarus americanus fishery. Data from multiple fisheries-independent surveys were combined in a delta-generalized linear mixed model to generate spatially explicit density estimates for use in an independent habitat suitability index. The habitat suitability indices for American lobster and cusk were then compared to predict potential bycatch hotspot locations. Suitable habitat for American lobster has increased between 1980 and 2013 while suitable habitat for cusk decreased throughout most of the Gulf of Maine, except for Georges Basin and the Great South Channel. The proportion of overlap in suitable habitat varied interannually but decreased slightly in the spring and remained relatively stable in the fall over the time series. As Gulf of Maine temperatures continue to increase, the interactions between American lobster and cusk are predicted to decline as cusk habitat continues to constrict. This framework can contribute to fisheries managers’ understanding of changes in habitat overlap as climate conditions continue to change and alter where bycatch interactions could occur.

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