scholarly journals Exposure to Virtual Social Stimuli Modulates Subjective Pain Reports

2014 ◽  
Vol 19 (4) ◽  
pp. e103-e108 ◽  
Author(s):  
Jacob M Vigil ◽  
Daniel Torres ◽  
Alexander Wolff ◽  
Katy Hughes
Keyword(s):  
Health Care ◽  
Person Perception ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Contextual Factors ◽  
Cold Pressor ◽  
Health Care Practitioner ◽  
Social Stimuli ◽  
Patient Pain ◽  
Pain Reports

BACKGROUND: Contextual factors, including the gender of researchers, influence experimental and patient pain reports. It is currently not known how social stimuli influence pain percepts, nor which types of sensory modalities of communication, such as auditory, visual or olfactory cues associated with person perception and gender processing, produce these effects.OBJECTIVES: To determine whether exposure to two forms of social stimuli (audio and visual) from a virtual male or female stranger modulates cold pressor task (CPT) pain reports.METHODS: Participants with similar demographic characteristics conducted a CPT in solitude, without the physical presence of an experimenter or another person. During the CPT, participants were exposed to the voice and image of a virtual male or female stranger. The voices had analogous vocal prosody, provided no semantic information (spoken in a foreign language) and differed only in pitch; the images depicted a middle-age male or female health care practitioner.RESULTS: Male participants, but not females, showed higher CPT pain intensity when they were exposed to the female stimuli compared with the male stimuli. Follow-up analyses showed that the association between the social stimuli and variability in pain sensitivity was not moderated by individual differences in subjective (eg, self-image) or objective measurements of one’s physical stature.DISCUSSION: The findings show that exposure to virtual, gender-based auditory and visual social stimuli influences exogenous pain sensitivity.CONCLUSION: Further research on how contextual factors, such as the vocal properties of health care examiners and exposure to background voices, may influence momentary pain perception is necessary for creating more standardized methods for measuring patient pain reports in clinical settings.

scholarly journals Laboratory Personnel Gender and Cold Pressor Apparatus Affect Subjective Pain Reports

2014 ◽  
Vol 19 (1) ◽  
pp. e13-e18 ◽  
Author(s):  
Jacob M Vigil ◽  
Lauren N Rowell ◽  
Joe Alcock ◽  
Randy Maestes
Keyword(s):  
Pain Sensitivity ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Cold Pain ◽  
Laboratory Personnel ◽  
Subjective Pain ◽  
Lower Pain ◽  
Pain Reporting ◽  
Pain Reports

BACKGROUND: There is no standardized method for cold pressor pain tasks across experiments. Temperature, apparatus and aspects of experimenters vary widely among studies. It is well known that experimental pain tolerance is influenced by setting as well as the sex of the experimenter. It is not known whether other contextual factors influence experimental pain reporting.OBJECTIVES: The present two-part experiment examines whether minimizing and standardizing interactions with laboratory personnel (eg, limiting interaction with participants to consenting and questions and not during the actual pain task) eliminates the influence of examiner characteristics on subjective pain reports and whether using different cold pain apparatus (cooler versus machine) influences reports.METHODS:The present experiment manipulated the gender of the experimenter (male, female and transgender) and the type of cold pressor task (CPT) apparatus (ice cooler versus refrigerated bath circulator). Participants conducted the CPT at one of two pain levels (5°C or 16°C) without an experimenter present.RESULTS:Men and women showed lower pain sensitivity when they were processed by biological male personnel than by biological female personnel before the CPT. Women who interacted with a transgendered researcher likewise reported higher pain sensitivity than women processed by biological male or female researchers. The type of CPT apparatus, despite operating at equivalent temperatures, also influenced subjective pain reports.DISCUSSION: The findings show that even minimal interactions with laboratory personnel who differ in gender, and differences in laboratory materials impact the reliable measurement of pain.CONCLUSION: More standardized protocols for measuring pain across varying research and clinical settings should be developed.

scholarly journals Increased Pain Sensitivity in Low Blood Pressure

2008 ◽  
Vol 22 (1) ◽  
pp. 20-27 ◽  
Author(s):  
S. Duschek ◽  
W. Schwarzkopf ◽  
R. Schandry
Keyword(s):  
Blood Pressure ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Cold Pressor Test ◽  
Physiological Mechanism ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Mean Blood Pressure ◽  
Total Blood ◽  
Pressor Test

There is broad evidence for a functional interaction between the cardiovascular and pain regulatory systems. One result of this interaction is the reduced sensitivity to acute pain in individuals with elevated blood pressure, which has been established in numerous studies. In contrast to this, possible alterations in pain perception related to the lower range of blood pressure have not yet been investigated. In the present study pain sensitivity was assessed in 30 hypotensive women (mean blood pressure 95/56 mmHg) and 30 normotensive control persons (mean blood pressure 119/77 mmHg) based on a cold pressor test. Possible effects on pain perception of hypotension-related impairment of subjective state were controlled for by including a mood-scale. The hypotensive as compared to the normotensive group displayed lower pain threshold and pain tolerance levels, as well as increased sensory and affective experiences of pain. Moreover, a slight negative correlation was found, both in hypotensive and control persons, between pain sensitivity and the degree of blood pressure increase during the execution of the cold pressor test. In accordance with the previous findings on hypertension-related hypoalgesia, the present results suggest an inverse relationship between blood pressure and pain sensitivity across the total blood pressure spectrum. Different degrees of pain attenuation through afferent input from the arterial baroreceptor system are discussed as a physiological mechanism mediating this relationship.

Reduction in Pain Sensitivity from Pharmacological Elevation of Blood Pressure in Persons with Chronically Low Blood Pressure

2009 ◽  
Vol 23 (3) ◽  
pp. 104-112 ◽  
Author(s):  
Stefan Duschek ◽  
Heike Heiss ◽  
Boriana Buechner ◽  
Rainer Schandry
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Pain Perception ◽  
Drug Effects ◽  
Pressure Effects ◽  
Double Blind ◽  
Low Blood Pressure ◽  
Present Trial

Recent studies have revealed evidence for increased pain sensitivity in individuals with chronically low blood pressure. The present trial explored whether pain sensitivity can be reduced by pharmacological elevation of blood pressure. Effects of the sympathomimetic midodrine on threshold and tolerance to heat pain were examined in 52 hypotensive persons (mean blood pressure 96/61 mmHg) based on a randomized, placebo-controlled, double-blind design. Heat stimuli were applied to the forearm via a contact thermode. Confounding of drug effects on pain perception with changes in skin temperature, temperature sensitivity, and mood were statistically controlled for. Compared to placebo, higher pain threshold and tolerance, increased blood pressure, as well as reduced heart rate were observed under the sympathomimetic condition. Increases in systolic blood pressure between points of measurement correlated positively with increases in pain threshold and tolerance, and decreases in heart rate were associated with increases in pain threshold. The findings underline the causal role of hypotension in the augmented pain sensitivity related to this condition. Pain reduction as a function of heart rate decrease suggests involvement of a baroreceptor-related mechanism in the pain attrition. The increased proneness of persons with chronic hypotension toward clinical pain is discussed.

scholarly journals Pain Sensitivity in Schizophrenia Spectrum Disorders: A Narrative Review of Recent Work

2021 ◽  
Vol 2 (1) ◽  
pp. 48-58
Author(s):  
Alexandre González-Rodríguez ◽  
Javier Labad ◽  
Mary V. Seeman
Keyword(s):  
Pain Sensitivity ◽  
Pain Perception ◽  
Experimental Studies ◽  
Preliminary Evidence ◽  
Narrative Review ◽  
Sensory Threshold ◽  
Schizophrenia Spectrum Disorders ◽  
Physical Pain ◽  
Constant Pain ◽  
Search For Information

Many patients with schizophrenia seem relatively immune to physical pain while others complain of constant pain. This may result from disturbances or alterations of the sensory threshold for pain in populations with psychosis, a possibility for which there is some preliminary evidence. The inconsistency in pain perception may, in part, be explained by the treatments patients receive, but treatment-naïve patients also exhibit differences in response to pain. This suggests that decreased pain sensitivity may represent a specific psychosis endophenotype. Thus far, few experimental studies have investigated sensory thresholds, pain modalities, or other factors contributing to the perception or expression of physical pain in psychosis. A digital search for information on this topic was conducted in PubMed and Google Scholar. The result is a non-systematic, narrative review focusing on recent clinical and experimental findings of pain sensitivity in patients with psychosis. Importantly, physical and mental pain are closely connected constructs that may be difficult to differentiate. Our hope is that the review provides some clarity to the field in the specific context of schizophrenia.

The tolerance to stretch is linked with endogenous modulation of pain

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Morten Pallisgaard Støve ◽  
Rogerio Pessoto Hirata ◽  
Thorvaldur Skuli Palsson
Keyword(s):  
Range Of Motion ◽  
Pain Sensitivity ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Static Stretch ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressor Test ◽  
Pressure Pain Thresholds ◽  
Exercise Induced

Abstract Objectives The effect of stretching on joint range of motion is well documented, and although sensory perception has significance for changes in the tolerance to stretch following stretching the underlining mechanisms responsible for these changes is insufficiently understood. The aim of this study was to examine the influence of endogenous pain inhibitory mechanisms on stretch tolerance and to investigate the relationship between range of motion and changes in pain sensitivity. Methods Nineteen healthy males participated in this randomized, repeated-measures crossover study, conducted on 2 separate days. Knee extension range of motion, passive resistive torque, and pressure pain thresholds were recorded before, after, and 10 min after each of four experimental conditions; (i) Exercise-induced hypoalgesia, (ii) two bouts of static stretching, (iii) resting, and (iv) a remote, painful stimulus induced by the cold pressor test. Results Exercise-induced hypoalgesia and cold pressor test caused an increase in range of motion (p<0.034) and pressure pain thresholds (p<0.027). Moderate correlations in pressure pain thresholds were found between exercise-induced hypoalgesia and static stretch (Rho>0.507, p=0.01) and exercise-induced hypoalgesia and the cold pressor test (Rho=0.562, p=0.01). A weak correlation in pressure pain thresholds and changes in range of motion were found following the cold pressor test (Rho=0.460, p=0.047). However, a potential carryover hypoalgesic effect may have affected the results of the static stretch. Conclusions These results suggest that stretch tolerance may be linked with endogenous modulation of pain. Present results suggest, that stretch tolerance may merely be a marker for pain sensitivity which may have clinical significance given that stretching is often prescribed in the rehabilitation of different musculoskeletal pain conditions where reduced endogenous pain inhibition is frequently seen.

scholarly journals Perceived appropriateness of alcohol screening and brief advice programmes in Colombia, Mexico and Peru and barriers to their implementation in primary health care – a cross-sectional survey

2021 ◽  
Vol 22 ◽  
Author(s):  
Daša Kokole ◽  
Liesbeth Mercken ◽  
Eva Jané-Llopis ◽  
Guillermina Natera Rey ◽  
Miriam Arroyo ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Latin American ◽  
Contextual Factors ◽  
Alcohol Screening ◽  
Successful Implementation ◽  
Implementation Framework ◽  
Effective Measure ◽  
Primary Health ◽  
Brief Advice

Abstract Background: Providing alcohol screening and brief advice (SBA) in primary health care (PHC) can be an effective measure to reduce alcohol consumption. To aid successful implementation in an upper middle-income country context, this study investigates the perceived appropriateness of the programme and the perceived barriers to its implementation in PHC settings in three Latin American countries: Colombia, Mexico and Peru, as part of larger implementation study (SCALA). Methods: An online survey based on the Tailored Implementation for Chronic Diseases (TICD) implementation framework was disseminated in the three countries to key stakeholders with experience in the topic and/or setting (both health professionals and other roles, for example regional health administrators and national experts). In total, 55 respondents participated (66% response rate). For responses to both appropriateness and barriers questions, frequencies were computed, and country comparisons were made using Chi square and Kruskal–Wallis non-parametric tests. Results: Alcohol SBA was seen as an appropriate programme to reduce heavy alcohol use in PHC and a range of providers were considered suitable for its delivery, such as general practitioners, nurses, psychologists and social workers. Contextual factors such as patients’ normalised perception of their heavy drinking, lack of on-going support for providers, difficulty of accessing referral services and lenient alcohol control laws were the highest rated barriers. Country differences were found for two barriers: Peruvian respondents rated SBA guidelines as less clear than Mexican (Mann–Whitney U = −18.10, P = 0.001), and more strongly indicated lack of available screening instruments than Colombian (Mann–Whitney U = −12.82, P = 0.035) and Mexican respondents (Mann–Whitney U = −13.56, P = 0.018). Conclusions: The study shows the need to address contextual factors for successful implementation of SBA in practice. General congruence between the countries suggests that similar approaches can be used to encourage widespread implementation of SBA in all three studied countries, with minor tailoring based on the few country-specific barriers.

scholarly journals Navigating change – managers’ experience of implementation processes in disability health care: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anette Granberg ◽  
Marie Matérne ◽  
Lars-Olov Lundqvist ◽  
Anna Duberg
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Contextual Factors ◽  
Implementation Process ◽  
Public And Private ◽  
Implementation Processes ◽  
Telephone Interviews ◽  
External Conditions ◽  
The Many ◽  
Dance Intervention

Abstract Background Effective implementation processes play a central role in health care organizations and affect the care of patients. Managers are pivotal in facilitating the use of new practices, but their experience and how it affects the implementation outcome are still largely unknown. In the field of disability health care in particular, managers experiences have scarcely been investigated. Therefore, the aim of this study is to explore managers’ experiences of the implementation process when transferring new practices into disability health care settings. Methods Semi-structured individual telephone interviews were conducted with managers at disability health care organizations in four administrative regions in central Sweden. A total of 23 managers with formal managerial responsibility from both public and private health care were strategically selected to be interviewed. The interviews were analysed using reflexive thematic analysis with an inductive approach. Results The analysis resulted in two themes about factors influencing the implementation process: firstly, Contextual factors set the agenda for what can be achieved, which highlighted aspects that hinder or enable the implementation process, such as internal and external conditions, the workplace culture, the employees and managers’ attitudes and openness to change: secondly, Leadership in the winds of change, which described the challenges of balancing managerial tasks with leading the change, and the importance of a leadership that involves the participation of the employees. Conclusions This study explored how and to what extent managers address and manage the implementation process and the many associated challenges. The findings highlight the importance of leadership support and organizational structure in order to transfer new practices into the work setting, and to encourage an organizational culture for leading change that promotes positive outcomes. We suggest that identifying strategies by focusing on contextual factors and on aspects of leadership will facilitate implementation processes. Trial registration The SWAN (Structured Water Dance Intervention) study was retrospectively registered on April 9, 2019 and is available online at ClinicalTrials.gov (ID: NCT03908801).

scholarly journals Clinical Pharmacy Administration

1988 ◽  
Vol 22 (11) ◽  
pp. 903-905
Author(s):  
Thomas R. Einarson
Keyword(s):  
Health Care ◽  
Clinical Pharmacy ◽  
Applied Field ◽  
Research Evaluation ◽  
Financial Economic ◽  
Point Of View ◽  
Health Care Practitioner ◽  
Historical Perspectives ◽  
Pharmacy Administration ◽  
Separate Discipline

Clinical pharmacy administration has emerged as a separate discipline, but this new field has not been functionally defined. This article defines clinical pharmacy administration from an academic point of view and provides a framework within which it may be understood. It is an applied field of study that deals with the research, evaluation, and management of the patient, the drug, and the health care practitioner as they all relate to patient care. These entities and relationships are studied at the micro, macro, and global levels from financial, economic, managerial, legal, ethical, social, behavioral, educational, and historical perspectives. It is intended that this paper generate debate and discussion in order to refine and develop the field.

scholarly journals Motion Sickness and Migraine: Optokinetic Stimulation Increases Scalp Tenderness, Pain Sensitivity in the Fingers and Photophobia

Cephalalgia ◽  
2002 ◽  
Vol 22 (2) ◽  
pp. 117-124 ◽  
Author(s):  
PD Drummond
Keyword(s):  
Motion Sickness ◽  
Pain Sensitivity ◽  
Pain Perception ◽  
Optokinetic Stimulation ◽  
Nociceptive Pathways ◽  
General Influence

The aim of this study was to determine whether scalp tenderness and photophobia, two well-recognized symptoms of migraine, develop during the motion sickness induced by optokinetic stimulation. To investigate whether motion sickness has a general influence on pain perception, pain was also assessed in the fingertips. After optokinetic stimulation, nausea increased more and headache persisted longer in 21 migraine sufferers than in 15 non-headache controls. Scalp tenderness increased during optokinetic stimulation in nauseated subjects, and pain in the fingertips increased more and photophobia persisted longer in migraine sufferers than controls. These findings suggest that the disturbance responsible for nausea also sensitizes trigeminal nociceptive neurones or releases inhibitory controls on their discharge. A low nausea threshold and a propensity for sensitization to develop rapidly in nociceptive pathways may increase susceptibility to migraine.

Towards systematic reviews that inform health care management and policy-making

2005 ◽  
Vol 10 (1_suppl) ◽  
pp. 35-48 ◽  
Author(s):  
John Lavis ◽  
Huw Davies ◽  
Andy Oxman ◽  
Jean-Louis Denis ◽  
Karen Golden-Biddle ◽  
...  
Keyword(s):  
Health Care ◽  
Systematic Reviews ◽  
Policy Making ◽  
Care Management ◽  
Contextual Factors ◽  
Health Care Management ◽  
Health Care Managers ◽  
Executive Summary ◽  
Policy Makers ◽  
Care Managers

Objectives To identify ways to improve the usefulness of systematic reviews for health care managers and policy-makers that could then be evaluated prospectively. Methods We systematically reviewed studies of decision-making by health care managers and policy-makers, conducted interviews with a purposive sample of them in Canada and the United Kingdom (n=29), and reviewed the websites of research funders, producers/purveyors of research, and journals that include them among their target audiences (n=45). Results Our systematic review identified that factors such as interactions between researchers and health care policy-makers and timing/timeliness appear to increase the prospects for research use among policy-makers. Our interviews with health care managers and policy-makers suggest that they would benefit from having information that is relevant for decisions highlighted for them (e.g. contextual factors that affect a review's local applicability and information about the benefits, harms/risks and costs of interventions) and having reviews presented in a way that allows for rapid scanning for relevance and then graded entry (such as one page of take-home messages, a three-page executive summary and a 25-page report). Managers and policy-makers have mixed views about the helpfulness of recommendations. Our analysis of websites found that contextual factors were rarely highlighted, recommendations were often provided and graded entry formats were rarely used. Conclusions Researchers could help to ensure that the future flow of systematic reviews will better inform health care management and policy-making by involving health care managers and policy-makers in their production and better highlighting information that is relevant for decisions. Research funders could help to ensure that the global stock of systematic reviews will better inform health care management and policy-making by supporting and evaluating local adaptation processes such as developing and making available online more user-friendly ‘front ends’ for potentially relevant systematic reviews.

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