Coping Similarity And Psychosocial Risk Factors In Couples With Chronic Pain

Chronic pain is an important public health problem that is associated with a host of negative individual and relationship outcomes. Chronic pain is a chronic stressor that both the individual in pain and their spouse must cope with. The current study examined how pain coping similarity within the couple predicted not only patient adjustment, but also spouse adjustment in a longitudinal study. Participants were 108 heterosexual couples in which one partner had chronic pain. The participants completed measures at 3 time points at 6 month intervals. Both the patient and spouse individually completed questionnaires pertaining to their marriage, mood, pain and relationship. The sample was diverse for both patients (41.7% Caucasian, 47.2% African-American), and spouses (41.7% Caucasian, 46.3% African-American). The gender of the patients was balanced with 45.4% male (n = 49). The average ages of patients and spouses were 52.29 years and 52.00 years, respectively, and were married an average of 21.26 years. Patients reported average pain duration of 11.72 years. Overall, there were sparse findings in regards to couples coping similarity; however, the findings on each partner\u27s coping strategies and adjustment were more plentiful. The current study found that patients\u27 self-reported coping strategies were associated with concurrent patient-reported adjustment. Further, both patients\u27 and spouses\u27 coping strategies were generally predictive of patient and spouse adjustment over time. A majority of the previous research on coping strategies has focused on concurrent associations between one\u27s own coping and individual adjustment (i.e., pain and depressive symptoms) in patients and the current study supports many of these findings. The current study takes previous research further by examining similarity, spouse adjustment, perceived spousal support, and patient and spouse adjustment over time. It has also examined possible contributing variables to previous findings (i.e., relationship adjustment, perceived spousal support, and spousal adjustment) in an effort to capture the psychosocial complexities of chronic pain. Finally, this is the first study to examine coping and perceived spousal support in couples with chronic pain. Results have implications for research and practice that focuses on patient and their families as well as identifying strategies that best relate to adjustment

Alcohol Cues, Craving, and Relapse: Insights from Animal Models

Alcoholism is a chronic relapsing and remitting disorder, where relapse to drinking is often triggered by an intense desire for alcohol (craving) and the consequent motivation to obtain alcohol (seeking). Environmental stimuli (cues) associated with past alcohol use are believed to strongly contribute to relapse, as exposure to these cues can trigger intense feelings of craving and drive alcohol seeking. Over the past several decades, much progress has been made in identifying the neurobiological correlates of alcohol seeking and relapse. Much of this progress is owed to the development of animal models and advanced techniques to manipulate neural activity. In this chapter, we describe some of the most commonly used rodent models of alcohol intake and seeking as well as the methods used to identify the neural structures and circuits involved in alcohol-mediated behavior. Several of the most routinely identified brain structures in alcohol seeking are also described

Weighted Blankets and Sleep Quality in Children with Autism Spectrum Disorders: A Single-Subject Design

Purpose: The purpose of the single-subject study was to explore the possible relationship between weighted blanket applications and sleep quality in children with autism spectrum disorder (ASD) and behavioral manifestations of sensory processing deficits. Method: Two 4-year-old participants diagnosed with ASD who also experienced sleep disturbances took part in a single-subject design study. Objective sleep measures and caregiver surveys were tracked for a baseline period of 7 days followed by a 14-day weighted blanket intervention and a 7-day withdrawal phase. Results: Caregiver reports and objective data were evaluated using visual analysis and the percentage of non-overlapping data methods. The results suggest minimal changes in sleep patterns because of the weighted blanket intervention. Findings included using a weighted blanket intervention enhanced morning mood after night use and a significantly decreased time to fall asleep for one participant. Conclusion: The converging evidence from a small but growing literature base indicates that weighted blankets may not strongly influence sleep quality in some children with ASD and sensory processing deficits who demonstrate increased sleep disturbances. Future directions include studies replicating the single-subject design with increased participants and updated outcome measures

Injustice perceptions about pain: parent–child discordance is associated with worse functional outcomes

Pain is experienced within and influenced by social environments. For children with chronic pain, the child–parent relationship and parental beliefs about pain are particularly important and may influence pain outcomes. Pain-related injustice perceptions have recently been identified as an important cognitive–emotional factor for children with pain. The current study aimed to better understand the pain-related injustice perceptions of children with chronic pain and their parents. The sample consisted of 253 pediatric chronic pain patients (mean age = 14.1 years, 74% female) presenting to a tertiary pain clinic. Patients completed measures of pain intensity, pain-related injustice perceptions, stress, functional disability, and quality of life. Parents completed a measure of pain-related injustice perceptions about their child's pain. Child–parent dyads were categorized into 1 of 4 categories based on the degree of concordance or discordance between their scores on the injustice measures. One-way analysis of variances examined differences in pain intensity, stress, functional disability, and quality of life across the 4 dyad categories. Our findings indicated that both the degree (concordant vs discordant) and direction (discordant low child–high parent vs discordant high child–low parent) of similarity between child and parent injustice perceptions were associated with child-reported pain intensity, stress, functional disability, and quality of life. The poorest outcomes were reported when children considered their pain as highly unjust, but their parents did not. These findings highlight the important role of parents in the context of pain-related injustice perceptions in pediatric chronic pain

Morbid and Mortal Inequities among Indigenous People in Canada and the United States during the COVID-19 Pandemic Critical Review of Relative Risks and Protections

The COVID-19 pandemic focused the world’s attention on gross racialized health inequities and injustices. For political and scientific reasons much less is known about the plight of Indigenous peoples than about other ethnic groups. In fact, some of the early pandemic evidence suggested that Indigenous peoples, while clearly experiencing prevalent structural violence probably also experience certain cultural protections. Aiming to begin to clarify their relative risks and protections, we conducted a rapid critical research review and sample-weighted synthesis or meta-analysis of the publishedand gray literature on four COVID-19-relevant outcomes in Canada and the United States between January 1, 2020 and August 1, 2021: vaccination, infection, severe infection, and death rates. Twenty-nine Indigenous-non-Indigenous comparative surveys or cohorts that observed 33, typically age-standardized, incidence or mortality rates or their proxies were included. Consistent with structural violence theory, we found that Indigenous peoples were significantly more likely to be infected, to experience severe COVID-19 illness, or to die as a result of their illness, Indigenous mortal risks (RR = 2.45) being significantly greater than Indigenous morbid risks (RR = 1.40). Consistent with cultural strengths theory, vaccinations seemed equitably distributed (RR = 1.02) with a suggestion of greater vaccine willingness among Indigenous peoples in some places. Clearly, much work remains to be done to decolonize Indigenous research and ultimately practices and policies in North America. Indigenous knowledge user-researcher teams and their allies have much to teach about cultural and ultimately, policy protections

Motor vehicle collision‑related injuries and deaths among Indigenous Peoples in Canada: Meta‑analysis of geo‑structural factors

Introduction: Indigenous Peoples are much more likely than non‑Indigenous Peoples to be seriously injured or die in motor vehicle collisions (MVCs). This study updates and extends a previous systematic review, suggesting that future re‑ search ought to incorporate social–environmental factors. Methods: We conducted a systematic review and meta‑analysis of the published and grey literature on MVCs involving Indigenous Peoples in Canada between 2010 and 2020. We focussed on personal (e.g. driving an old vehicle) and community social– environmental–economic factors (e.g. prevalent low socioeconomic status). Results: Eleven comparative cohorts that resulted in 23 at minimum, age‑standardised, mortality or morbidity rate outcomes were included in our meta‑analysis. Indigenous Peoples were twice as likely as non‑Indigenous Peoples to be seriously injured (rate ratio [RRpooled] = 2.18) and more than 3 times as likely to die (RRpooled = 3.40) in MVCs. Such great risks to Indigenous Peoples do not seem to have diminished over the past generation. Furthermore, such risks were greater on-reserves and in smaller, rural and remote, places. Conclusion: Such places may lack community resources, including fewer transportation and healthcare infrastructural investments, resulting in poorer road conditions in Indigenous communities and longer delays to trauma care. This seems to add further evidence of geo‑structural violence (geographical and institutional violence) perpetrated against Indigenous Peoples in yet more struc‑ tures (i.e. institutions) of Canadian society. Canada’s system of highways and road‑ ways and its remote health‑care system represent legitimate policy targets in aiming to solve this public health problem

Vessel Ligation in Transoral Robotic Surgery: Survey of the American Head and Neck Society

Objectives: Hemorrhage after transoral robotic surgery (TORS) surgery ranges from minor self-limited bleeding to lethal complications. To decrease risk, several publications have suggested ligation of the external carotid artery or its branches, even though statistically it has not been shown to be effective. The current study anonymously surveyed members of American Head and Neck Society (AHNS) on how they manage vessel ligation in TORS for oncological indications to better understand this practice.Methods: AHNS sent an email invitation to members with 2 weekly follow-up emails. Participants anonymously completed 10 questions regarding how long they have performed TORS, how many cancer-related TORS they have performed both overall and within the past year, timing of neck dissection, ligation of vessels, and changes in their practice.Results: In total, 165 surveys were completed by AHNS surgeons. The average respondent had performed TORS for 3–5 years and performs \u3c20 of cases for oncological purposes per year. Of the respondents, 83.7% ligate vessels. The most frequent vessels ligated were the lingual artery (77.7%), facial artery (63.3%), ascending pharyngeal artery (30.1%), superior thyroid artery (13.3%), and external carotid artery (9%). The most common reason for surgeons to ligate vessels was that it was either learned during training (28.3%) or incorporated due to suggestion or discussion with peers (28.3). Additionally, 14% were found to ligate after experiences related to fatal or near fatal patient events. Conclusions: Prophylactic vessel ligation is a common practice among AHNS surgeons. Training or discussion with peers is the most common reason for vessel ligation given, with the lingual artery being the most commonly ligated. However, the choice of which vessel to be ligated remains controversial. Further investigation should focus on the different individual vessels that are ligated and the affect that has on complication rates.https://scholarlycommons.henryford.com/merf2019clinres/1066/thumbnail.jp

Analysis of benefits of sargassum on Galveston Island and indications for beach management policy

Sargassum fluitans and natans, types of brown algae, wash up on Galveston Island, Texas annually from May to August. Sargassum smells bad, hurts tourism and impairs sea turtle hatchings. Coastal managers are confronted with the difficult choice of cleaning Sargassum off the beach or leaving it alone. The current beach management practice is to rake the algae with tractors and deposit it at the base of the dunes. The environmental impacts of raking and ecological benefits of Sargassum are unknown. The Galveston Island Park Board of Trustees (GIPBT) used to rake all beaches under their management before Hurricane Alicia in 1983. Then, citizens started to complain that raking was causing erosion. Now, there are people who argue for both raking and leaving the beach alone. Environmental policies require complex decisions that take into consideration social, economical, ecological, and cultural values. The GIPBT initiated the Sargassum Policy Committee to gain knowledge of different stakeholder values and scientific research to develop beach management. The first study analyzed elevation changes over a year period on raked and unraked beaches on both the West and East end of Galveston Island. The Analysis ofVariance results indicated that there is not a difference in elevation changes between the raked and unraked beaches over a year.The second study analyzed the effects of Sargassum on the dune plant Panicum amarum. Plants were asexually grown in a greenhouse in sand without (control) and with Sargassum. The effects of small versus large amounts, top versus mixed with sand and washed versus unwashed Sargassum were tested. The results indicated that the addition of Sargassum increased plant growth. The treatments with large amounts of Sargassum and unwashed treatments showed significant growth changes at the 95% confidence level. The last component analyzed the collaborative potential of the Sargassum Policy Committee through observations of meetings and surveys of the members. Daniel and Walker’s Progressive Triangle was used to assess the relationship, procedural and substance dimensions of collaborative learning. Then, suggestions were made for increasing collaboration. The combination of scientific research and stakeholder values has resulted in the creation of sound beach management

Sex Differences in Health Related Quality of Life in Head & Neck Cancer One Year After Treatment

Background: Head and neck cancer (HNC) makes up about 3% of all cancers and is treated with systemic therapy, radiation, surgery, or a combination of these. HNC treatment can be associated with decreased patient reported health related quality of life (HR-QoL), which can lead to depression. The majority of studies found that females reported worse patient reported HR-QoL than males, however, there were a few that did not have a significant difference in overall patient reported QoL. With the discovery of patient oriented outcomes (PROs) in clinical practice affecting patient satisfaction, provider-patient relationship, and overall patient mortality, it is vital to include PROs in the creation of treatment plans. Objectives: The objectives of this project are to highlight the differences in HR-QoL between men and women. Ultimately, using these PROs clinically will help to improve patient care, augment patient-provider trust, and optimize treatment plans. Using PROs and recognizing where unconscious biases of providers come into play is pinnacle, and this project aims to highlight how men and women\u27s experiences are different in the treatment of HNC. Methods: Participants were given the FACT-H&N instrument one year after treatment for head and neck cancer at a single tertiary academic center to assess different aspects of Hr-QoL. Sex differences were analyzed between the groups. A Wilcoxon Rank Sum test was performed to assess associations with sex and survey responses, as well as to assess associations with total laryngectomy and survey responses. Results: There were 100 participants from a single academic center of which 73% were men and 27% women. Several of the questions had significant differences between men and women: I feel ill (P=0.0299), I am satisfied with my family communication about my illness P=0.0075), I am satisfied with my sex life (P=0.0496), My voice has its usual quality and strength (P=0.0057), I can swallow naturally and easily (P=0.0437), and I can eat solid foods (P=0.0248). There were no significant differences between men and women with laryngectomies. Conclusions: Overall, men felt more ill, were less satisfied with their sex lives, were less likely to feel a normal strength and quality of voice, felt decreased ability to swallow normally, and felt they could not eat solid foods; women were less satisfied with communication about their disease to their families. For those who had undergone laryngectomy, there were no significant differences between men and women. Different aspects of quality of life for men and women are affected by head and neck cancer. Monitoring PROs are becoming increasingly standard of care for patients, and providers need to be equipped understand how to interpret data accordingly and understand the inherent biases