How to think about pain with the whole person in mind

Too often, pain is reduced to a simple symptom of illness or injury – a puzzle piece to fit into the differential diagnostic jigsaw. Pain reports that fit the emerging pathoanatomical picture are validated and treated accordingly. But many reports don’t fit this picture, and the widespread stigma associated with persistent pain is most commonly directed toward these individuals, whose symptoms aren’t well explained by known pain mechanisms. A root problem is not seeing the person in pain or the suffering they experience. This presentation aims to help participants develop a more comprehensive perspective on pain that better integrates its complexities within clinical practice. Participants will be introduced to the Multi-modal Assessment model of Pain (MAP; Wideman et al, Clinical Journal of Pain 2019; 35(3): 212). MAP offers a novel framework to understand the fundamentally subjective natures of pain and suffering and how they can be best addressed within clinical practice. MAP aims to help clinicians view pain, first and foremost, as an experience (like sadness), which may or may not correspond to specific pathology or diagnostic criteria (like clinical depression). MAP aims to facilitate a more compassionate approach to pain management by providing a rationale for why all reported pain should be validated, even when poorly understood. Viewing pain in this manner helps highlight the central importance of listening to patients’ narrative reports, trying to understand the meaning and context for their experiences of pain and using this understanding to help alleviate suffering.

How can music therapy support men at a specialist treatment unit in a prison setting in Aotearoa New Zealand?

<p>This study aimed to explore how the use of music therapy can support prisoners in a specialist treatment unit at a prison in Aotearoa New Zealand. The research was initially designed using action research methodology to evaluate how I, a music therapy student, can support men at a special treatment unit in a prison setting in Aotearoa New Zealand. Seven weeks into my placement a rapidly escalating response to the Covid-19 global pandemic put my placement on hold indefinitely. In response to the challenges of not being able to attend placement, the research framework was changed to exploratory research. My question evolved into a theoretical exploratory study seeking to find out how music therapy can provide support in prisons. Documentation of music therapy is scarce in the New Zealand context; thus, the exploration was guided by a broad international literature search. Thematic analysis was used to develop themes about the reviewed literature and from reflective data identified in my clinical journal. The findings provide a broad scope of understanding of how music therapy is used in prisons and three main themes were identified in the analysis. These were: the ecologies of music in prisons, practicing self-care, and awareness of theory in developing specific aims and goals. The results show that music can support prison populations in various ways depending on which context takes place; from an musicological viewpoint music facilitates the expression of cultural spheres, whereas from a medical standpoint, therapeutic approaches to music therapy provide effective rehabilitation and treatment for psychological ailments. Ample theoretical, clinical, and cultural preparation should be taken into account by therapists before embarking on any work into the prison environment.</p>

How can music therapy support men at a specialist treatment unit in a prison setting in Aotearoa New Zealand?

<p>This study aimed to explore how the use of music therapy can support prisoners in a specialist treatment unit at a prison in Aotearoa New Zealand. The research was initially designed using action research methodology to evaluate how I, a music therapy student, can support men at a special treatment unit in a prison setting in Aotearoa New Zealand. Seven weeks into my placement a rapidly escalating response to the Covid-19 global pandemic put my placement on hold indefinitely. In response to the challenges of not being able to attend placement, the research framework was changed to exploratory research. My question evolved into a theoretical exploratory study seeking to find out how music therapy can provide support in prisons. Documentation of music therapy is scarce in the New Zealand context; thus, the exploration was guided by a broad international literature search. Thematic analysis was used to develop themes about the reviewed literature and from reflective data identified in my clinical journal. The findings provide a broad scope of understanding of how music therapy is used in prisons and three main themes were identified in the analysis. These were: the ecologies of music in prisons, practicing self-care, and awareness of theory in developing specific aims and goals. The results show that music can support prison populations in various ways depending on which context takes place; from an musicological viewpoint music facilitates the expression of cultural spheres, whereas from a medical standpoint, therapeutic approaches to music therapy provide effective rehabilitation and treatment for psychological ailments. Ample theoretical, clinical, and cultural preparation should be taken into account by therapists before embarking on any work into the prison environment.</p>

The 20 most important questions for novices of full-endoscopic spinal surgery in China: a mixed-method study protocol

IntroductionThe full-endoscopic spinal surgery (FESS) procedure is widely accepted and welcomed in China. With the continuous development of minimally invasive surgery, the further expansion of indications and the greater diversity of techniques, spinal endoscopic surgery currently accounts for more than 10% of spinal surgery in China, ranking among the top in the world. However, the admission system and standardised training system for spinal endoscopic surgery are not perfect, which presents a challenge and disadvantage for novices.Methods and analysisExploratory mixed methods are applied for designing this study. First, we will collect questions from novices by allowing them to openly list their concerns to those who have completed FESS. These qualitative questions will be categorised using NVivo software. To produce the qualitative results, a questionnaire for the sequential two-round Delphi approach will be developed to identify the 20 most important questions from novices. This study is planned to be started at April 2021, and completed at March 2022.Ethics and disseminationThe Research Ethics Committee of Peking University Third Hospital provided a waiver for this Delphi protocol. We expect that the findings will be published in a clinical journal and presented at conferences. Furthermore, we hope that the results can contribute to answering the questions raised by novices of spinal endoscopy in the form of books and to improving the training system for spinal endoscopy surgery.

Utility of cognitive behavioral therapy to reduce pain in children with sickle cell disease

A clinical decision report appraising: Schatz J, Schlenz AM, McClellan CB, et al. Changes in coping, pain, and activity after cognitive-behavioral training. The Clinical Journal of Pain 2015;31(6):536-47 https://doi.org/10.1097/ajp.0000000000000183 for a child with sickle cell disease.

Incredible Repetition of Number 3 in Adorable Game of Cricket

Author, an orthopedic surgeon and passionate researcher in Clubfoot for over fifty years, published an article in International Orthopaedics (SICOT) in 2018; https://doi.org/10.1007/s00264-017-3741-6. In that article, there was an incredible discovery i.e., 23 times repetition, of number3, besides-the publication, DOI: https://doi.org/10.36811/cjo.2020.110002 CJO(Clinical Journal of Orthopedics): August-2020 and some references of repeating number 3 about CRICKET also in them. AIM: Motivated by this, the author explored the game of cricket further and this too was incredibly true, to be described under different headings in this article. Material has been derived from contents of cricket namely: equipment, actions, famous world cricketers, and places related to cricket. Methods were Google search, under three headings: firstly; many things in cricket are destined to happen at a fixed time and place, just like in author’s clubfoot publications. Secondly: Unprecedented repetitions of number 3 in cricket under various headings, and THIRDLY, on Google search, number 3 in numerology, symbolic of planet Jupiter, has innumerable good attributes for the related people. This number has been found to have myriad, evolutionary bonds, in every area of humanity, on planet earth and beyond, since ancient times, which are scientific, spiritual, socio-religious, political, etc. Conclusions: 1. Many events are completely scientific; 2. Others are unique coincidences with scientific explanation and 3. Still, others are amazing truths, proving again that “Truth is Stranger than Fiction”. Because of its uniqueness, this article needs to spread its wing.

Deprescribing tool for use in older Australians with life-limiting illnesses and limited life expectancy: a modified-Delphi study protocol

BackgroundMaking a meaningful decision on deprescribing of potentially inappropriate medications in older adults with life-limiting illnesses (LLIs) and limited life expectancy (LLE) is often challenging. Therefore, we aimed to elicit opinion and gain consensus on a deprescribing tool for use in this population.Methods and analysisA modified-Delphi method will be used to obtain a consensus from a panel of experts in geriatric therapeutics on a deprescribing tool for use in people aged ≥65 years with LLIs and LLE. Through an online survey, in the initial round, the panel will anonymously elicit their opinion on a series of items related to the conceptual model of the deprescribing tool, its practicality and deprescribing of medications, while on the controlled feedback in subsequent rounds till a consensus is reached or the panellists stop revising their answers. In each round, panel members will be using a 5-point Likert scale to rate their agreement with the statement. Consensus will be considered on ≥75% of agreement on the statements.Ethics and disseminationAll the participants will receive an invitation and participant information but they need to consent for the participation. Ethics approval has been granted from the University of Queensland Health and Behavioural Sciences, Low and Negligible Risk Ethics Sub-Committee (reference: 2020001069). The results of this project will be disseminated through conferences and a peer-reviewed clinical journal.