1,721,315 research outputs found
Are reports of mechanical dysfunction in chronic oro-facial pain related to somatisation? A population based study
No full textObjectives: (i)To examine the association between self-reported mechanical factors and chronic oro-facial pain.(ii)To test the hypothesis that this relationship could be explained by (a) reporting of psychological factors (b) common association of self-reported mechanical factors with other unexplained syndromes. Methods: A population based cross-sectional study of 4200 randomly selected adults registered with a General Medical Practice in North West, England. The study examined the association of chronic oro-facial pain with a variety of self-reported mechanical factors: teeth grinding, facial trauma, missing teeth and the feeling that the teeth did not fit together properly. Information was also collected on demographic factors, psychological factors and the reporting of other frequently unexplained syndromes. Results: An adjusted response rate of 72% was achieved. Only two mechanical factors: teeth grinding (odds ratio (OR) 2.0, 95% CI 1.3-3.0) and facial trauma (OR 2.0; 95% CI 1.3-2.9) were independently associated with chronic oro-facial pain after adjusting for psychological factors. However, these factors were also commonly associated with the reporting of other frequently unexplained syndromes: teeth grinding (odds ratio (OR) 1.8, 95% CI 1.5-2.2), facial trauma (OR 2.1; 95% CI 1.7-2.6). Conclusions: Self-reported mechanical factors associated with chronic oro-facial pain are confounded, in part, by psychological factors and are equally common across other frequently unexplained syndromes. They may represent another feature of somatisation. Therefore the use of extensive invasive therapy such as occlusal adjustments and surgery to change mechanical factors may not be justified in many cases. © 2007 European Federation of Chapters of the International Association for the Study of Pain
Development and validation of classification criteria for idiopathic orofacial pain for use in population-based studies
No full textAim: To develop and validate a questionnaire-based tool which would enable classification of idiopathic orofacial pain in the general population. Methods: A postal questionnaire-based cross-sectional survey was made of 4,200 randomly selected adults who were registered with a general medical practice in North West England. The questionnaire collected information on a number of factors: demographics (age, gender), orofacial pain (duration, descriptors, site, pattern, intensity, disability, and consultation behavior), and comorbidities (reporting of other unexplained symptoms and psychosocial factors). Subjects reporting orofacial pain were interviewed by an examiner blinded to their exposure status and classified into 1 of 3 categories: (a) dentoalveolar, (b) musculoligamentouslsoft tissue, and (c) idiopathic orofacial pain. Results: A high adjusted response rate of 72% was achieved (crude response rate 60%). Of those who reported orofacial pain and were eligible for interview (n = 218), 197 (88%) were interviewed. Subjects classified by interview into the idiopathic category were more likely to report aching, nagging, and chronic pain pain at multiple sites. They were also more likely to report facial trauma and other chronic symptoms and to have consulted multiple health-care workers. Variables that most strongly predicted membership into the idiopathic category were female gender, nagging, aching pain which was worse when stressed, and topography (pain at multiple sites and unilateral pain). Conclusion: The classification criteria developed for idiopathic orofacial pain can be used as a screening tool for subjects with this condition in the general population
Primary care consultation predictors in men and women: A cohort study
No full textBackground. Women visit their doctors more than men, but comparatively few studies have explored gender differences in consultation in detail. Aims. To identify the factors that predicted the number of primary care consultations in men and women over a 5-year period. Design of study. Prospective cohort study with three waves of data collection by postal questionnaire. Setting. A single suburban general practice in Greater Manchester, UK. Method. Consultation data were sought from primary care records on a random sample of 800 adults. The main outcome measure was the number of consultations over the 5 years of the study. Questionnaire measures included the 12-item version of the General Health Questionnaire, the Illness Attitude Scales, a somatic symptom scale, a fatigue scale, and a functional assessment of disability. Results. Consultation data were obtained on 738 patients (445 women, 293 men, 92% of selected subjects). Longitudinal models of consultation over 5 years showed that changes in psychological distress were more strongly associated with consultation in women than in men, whereas cognitive factors (negative illness attitudes) were moss strongly associated with the consultation rate in men than women. Conclusion. The predictors of consultation in primary care may be different for men and women. A fuller understanding of the reasons for consultation may enable primary care doctors to better help individual patients, as well as perhaps contributing more generally to the development of gender specific interventions for those who consult unusually frequently. © British Journal of General Practice 2005
Use of over-the-counter supplements, sleep aids, and analgesic medicines in rheumatology: results of a cross-sectional survey
No full textObjectivesPain, fatigue, and sleep are common symptoms in patients with Rheumatic and Musculoskeletal diseases (RMDs) that may prompt the use of over-the-counter (OTC) supplements, sleep aids, and analgesics as self-management strategies. This study evaluated the prevalence of OTC supplements, sleep aids, pain relievers and the financial burden associated with their use in rheumatology.MethodsA web-based survey developed with patients, was administered in rheumatology clinics in an English hospital. Participants shared demographic information and detailed their use of OTC supplements, sleep aids, and pain relief in the past week. The data was analysed using descriptive statistics and logistic regression models to identify influencing factors.ResultsIn total 876 people consented to participate in the survey. Over half of patients (54.5%) reported daily supplement intake, typically spending £10/month (IQR 5-20), ranging up to £200 per month. The most commonly administered supplements were vitamin D, multivitamins, vitamin C, vitamin B/B complex, Omega 3/ 6 supplements, with multiple overlaps. Prescription, OTC, or non-prescription pain relief was reported by 82% of respondents, with sleep aids being used by 13%. Of the 327 patients who took NSAIDs, 165 (50.4%) also reported taking OTC supplements, while among the 131 patients using opioids (20.5%), 66 (50.3%) reported supplement use, some of which have documented interactions.ConclusionThe administration of OTC supplements, pain relief, and sleep aids is common in patients with RMDs. Health care professionals should be encouraged to proactively ask about these during consultations especially from a drug safety perspective, but also to provide timely, reliable advice about such strategies that may be sought by patients.<br/
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors?
No full textBackground: syndromes for which no physical or pathological changes can be found tend to be researched and managed in isolation although hypotheses suggest that they may be one entity. The objectives of our study were to investigate the co-occurrence, in the general population, of syndromes that are frequently unexplained and to evaluate whether they have common associated factors. Methods: we conducted a population-based cross-sectional survey that included 2299 subjects who were registered with a General Medical Practice in North-west England and who completed full postal questionnaires (response rate 72%). The study investigated four chronic syndromes that are frequently unexplained: chronic widespread pain, chronic oro-facial pain, irritable bowel syndrome, and chronic fatigue. Validated instruments were used to measure the occurrence of syndromes and to collect information on a variety of associated factors: demographic (age, gender), psychosocial (anxiety, depression, illness behaviour), life stressors, and reporting of somatic symptoms. Results: we found that 587 subjects (27%) reported one or more syndromes: 404 (18%) reported one, 134 (6%) reported two, 34 (2%) reported three, and 15 (1%) reported all four syndromes. The occurrence of multiple syndromes was greater than would be expected by chance (P < 0.001). There were factors that were common across syndromes: female gender [odds ratio (OR) = 1.8; 95% confidence interval (95% CI) 1.5-2.2], high levels of aspects of health anxiety like health worry preoccupation (OR = 3.5; 95% CI 2.8-4.4) and reassurance seeking behaviour (OR = 1.4; 95% CI 1.1-1.7), reporting of other somatic symptoms (OR = 3.6; 95% CI 2.9-4.4), and reporting of recent adverse life events (OR = 2.3; 95% CI 1.9-2.8). Conclusion: this study has shown that chronic syndromes that are frequently unexplained co-occur in the general population and share common associated factors. Primary care practitioners need to be aware of these characteristics so that management is appropriate at the outset.</p
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Psychosocial factors partially mediate the relationship between mechanical hyperalgesia and self-reported pain
Full text linkBackground and aim: Amplification of sensory signalling within the nervous system along with psychosocial factors contributes to the variation and severity of knee pain. Quantitative Sensory Testing (QST) is a non-invasive test battery that assesses sensory perception of thermal, pressure, mechanical and vibration stimuli used in the assessment of pain. Psychosocial factors also have an important role in explaining the occurrence of pain. The aim was to determine whether QST measures were associated with self-reported pain, and whether those associations were mediated by psychosocial factors.Methods: Participants with knee pain identified from a population-based cohort completed a tender point count and QST assessments (thermal, mechanical and pressure pain thresholds; wind-up; mechanical pain sensitivity; dynamic mechanical allodynia; vibration detection threshold) at the most painful knee and opposite forearm (if pain-free). Participants were asked to score for their global and knee pain intensities within the past month (range 0 to 10), and complete questionnaire items investigating anxiety, depression, illness perceptions, pain catastrophizing, and physical functioning. QST measures (independent variable) significantly correlated (Spearman’s rho) with self-reported pain intensity (dependent variable) were included in structural equation models with psychosocial factors (latent mediators).Results: 61 participants (36 women; median age 64 years) with complete data were included in subsequent analyses. Tender point count was significantly correlated with global pain intensity while dynamic mechanical allodynia at the knee and mechanical pain sensitivity and the knee and at the forearm were significantly correlated with both global pain and knee pain intensities. Latent psychosocial mediators were significant partial mediators for tender point (75% total effect), mechanical pain sensitivity (52% total effect) and dynamic mechanical allodynia at the knee (63% total effect) on global pain, and for mechanical pain sensitivity at the knee (35% total effect) on knee pain. Significant partial mediation was observed for pain intensity at the tested knee with knee MPS, but not with DMA at the knee.Conclusions: Mechanical hyperalgesia was associated with increased knee and global pain indicative of central sensitisation. Psychosocial factors were significant partial mediators, highlighting the importance of central emotional processing in pain perception.Implications: Associations between mechanical hyperalgesia at the forearm and knee, psychosocial factors, and increased levels of global and knee pain intensity provide evidence of central sensitisation as a key mechanism in knee pain
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