Attitudes of patients toward adoption of 3D technology in pain assessment: Qualitative perspective

This article is made available through the Brunel Open Access Publishing Fund. © Fotios Spyridonis, Gheorghita Ghinea, Andrew O Frank. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 10.04.2013. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.This article has been made available through the Brunel Open Access Publishing Fund.Background: Past research has revealed that insufficient pain assessment could, and often, has negative implications on the provision of quality health care. While current available clinical approaches have proven to be valid interventions, they are expensive and can often fail in providing efficient pain measurements. The increase in the prevalence of pain calls for more intuitive pain assessment solutions. Computerized alternatives have already been proposed both in the literature and in commerce, but may lack essential qualities such as accuracy of the collected clinical information and effective patient-clinician interaction. In response to this concern, 3-dimensional (3D) technology could become the innovative intervention needed to support and improve the pain assessment process. Objective: The purpose of this analysis was to describe qualitative findings from a study which was designed to explore patients’ perceptions of adopting 3D technology in the assessment of their pain experience related to important themes that might positively or negatively influence the quality of the pain assessment process. Methods: The perceptions of 60 individuals with some form of pain in the area of Greater London were collected through semi-structured interviews. Of the 60 respondents, 24 (43%) produced usable responses and were analyzed for content using principles of the grounded theory approach and thematic analysis, in order to gain insight into the participants’ beliefs and attitudes towards adopting 3D technology in pain assessment. Results: The analysis identified 4 high-level core themes that were representative of the participants’ responses. These themes indicated that most respondents valued “the potential of 3D technology to facilitate better assessment of pain” as the most useful outcome of adopting a 3D approach. Respondents also expressed their opinions on the usability of the 3D approach, with no important concerns reported about its perceived ease of use. Our findings finally, showed that respondents appreciated the perceived clinical utility of the proposed approach, which could further have an influence on their intention to use it. Conclusions: These findings highlighted factors that are seen as essential for improving the assessment of pain, and demonstrated the need for a strong focus on patient-clinician communication. The participants of this analysis believed that the introduction of 3D technology in the process might be a useful mechanism for such a positive health care outcome. The study’s findings could also be used to make recommendations concerning the potential for inclusion of 3D technology in current clinical pain tools for the purpose of improving the quality of health care

3-D pain drawings-mobile data collection using a PDA

A large number of the adult population suffers from some kind of back pain during their lifetime. Part of the process of diagnosing and treating such back pain is for a clinician to collect information as to the type and location of the pain that is being suffered.Traditional approaches to gathering and visualizing this pain data have relied on simple 2-D representations of the human body, where different types of sensation are recorded with various monochrome symbols. Although patients have been shown to prefer such drawings to traditional questionnaires, these pain drawings can be limited in their ability to accurately record pain. The work described in this paper proposes an alternative that uses a 3-D representation of the human body, which can be marked in color to visualize and record the pain data. This study has shown that the new approach is a promising development in this area of medical practice and has been positively received by patients and clinicians alike

Pain management following new and long-standing spinal cord injury: A pilot study of changes in pain intensity experienced during the day

The aim of the study was to examine variations in pain intensity during the day experienced by patients with spinal cord injury. Fourteen consecutive patients had clinical and demographic data recorded. Pain intensity was recorded using a Graphic Rating Scale (GRS) at 2-3-h intervals. Patients were grouped according to maximum GRS into mild and severe groups at assessment (T0). Changes of one-third in GRS were deemed clinically significant. Eight men and six women (mean age 53.1; SD 16.5; range 28-75) were studied. Seven patients with mild pain tended to deteriorate and those with severe pain to improve. Eight patients demonstrated clinically significant changes. These findings suggest inadequate pain control early morning for one group and increasing pain during the day for another. Use of such simple scores over time would enhance pain rehabilitation for all spinal cord injury patients. Usual GRS reporting may mask clinically significant, treatable, changes in pain

Recurrence Formulas for Fully Exponentially Correlated Four-Body Wavefunctions

Formulas are presented for the recursive generation of four-body integrals in which the integrand consists of arbitrary integer powers (>= -1) of all the interparticle distances r_ij, multiplied by an exponential containing an arbitrary linear combination of all the r_ij. These integrals are generalizations of those encountered using Hylleraas basis functions, and include all that are needed to make energy computations on the Li atom and other four-body systems with a fully exponentially correlated Slater-type basis of arbitrary quantum numbers. The only quantities needed to start the recursion are the basic four-body integral first evaluated by Fromm and Hill, plus some easily evaluated three-body "boundary" integrals. The computational labor in constructing integral sets for practical computations is less than when the integrals are generated using explicit formulas obtained by differentiating the basic integral with respect to its parameters. Computations are facilitated by using a symbolic algebra program (MAPLE) to compute array index pointers and present syntactically correct FORTRAN source code as output; in this way it is possible to obtain error-free high-speed evaluations with minimal effort. The work can be checked by verifying sum rules the integrals must satisfy.Comment: 10 pages, no figures, accepted by Phys. Rev. A (January 2009

Magnetic Fields in Stellar Jets

Although several lines of evidence suggest that jets from young stars are driven magnetically from accretion disks, existing observations of field strengths in the bow shocks of these flows imply that magnetic fields play only a minor role in the dynamics at these locations. To investigate this apparent discrepancy we performed numerical simulations of expanding magnetized jets with stochastically variable input velocities with the AstroBEAR MHD code. Because the magnetic field B is proportional to the density n within compression and rarefaction regions, the magnetic signal speed drops in rarefactions and increases in the compressed areas of velocity-variable flows. In contrast, B ~ n^0.5 for a steady-state conical flow with a toroidal field, so the Alfven speed in that case is constant along the entire jet. The simulations show that the combined effects of shocks, rarefactions, and divergent flow cause magnetic fields to scale with density as an intermediate power 1 > p > 0.5. Because p > 0.5, the Alfven speed in rarefactions decreases on average as the jet propagates away from the star. This behavior is extremely important to the flow dynamics because it means that a typical Alfven velocity in the jet close to the star is significantly larger than it is in the rarefactions ahead of bow shocks at larger distances, the one place where the field is a measurable quantity. We find that the observed values of weak fields at large distances are consistent with strong fields required to drive the observed mass loss close to the star. For a typical stellar jet the crossover point inside which velocity perturbations of 30 - 40 km/s no longer produce shocks is ~ 300 AU from the source

Thermal effects on cephalopod energy metabolism - A case study for Sepia officinalis

Cephalopods are the largest, most active invertebrates and there is considerable evidence for their convergent evolution with fishes. However, most active cephalopods display standard and active metabolic rates that are several-fold higher than comparably sized fishes. Shifting habitat temperatures due to climate change will therefore affect a cephalopods energy metabolism much more than that of a fish. Prediction of the probable outcome of cephalopod-fish competition thus requires quantitative information concerning whole animal energetics and corresponding efficiencies. Migrating cephalopods such as squid and cuttlefish grow rapidly to maturity, carry few food reserves and have little overlap of generations. This "live fast, die young" life history strategy means that they require niches capable of sustaining high power requirements and rapid growth. This presentation aims to draw a bottom-up picture of the cellular basis of energy metabolism of the cuttlefish Sepia officinalis, from its molecular basis to whole animal energetics based on laboratory experiments and field data. We assessed the proportionality of standard vs active metabolic rate and the daily energetic requirements using field tracking data in combination with lab based respirometry and video analysis. Effects of environmental temperature on mitochondrial energy coupling were investigated in whole animals using in vivo 31P-NMR spectroscopy. As efficient energy turnover needs sufficient oxygen supply, also thermal effects on the blood oxygen-binding capacities of the respiratory pigment haemocyanin and the differential expression of its isoforms were investigated.Supported by NERC grant NERC/A/S/2002/00812

Where's the Doughnut? LBV bubbles and Aspherical Fast Winds

In this paper we address the issue of the origin of LBV bipolar bubbles. Previous studies have explained the shapes of LBV nebulae, such as $\eta$ Car, by invoking the interaction of an isotropic fast wind with a previously deposited, slow aspherical wind (a ``slow torus''). In this paper we focus on the opposite scenario where an aspherical fast wind expands into a previously deposited isotropic slow wind. Using high resolution hydrodynamic simulations, which include the effects of radiative cooling, we have completed a series of numerical experiments to test if and how aspherical fast winds effect wind blown bubble morphologies. Our experiments explore a variety of models for the latitudinal variations of fast wind flow parameters. The simulations demonstrate that aspherical fast winds can produce strongly bipolar outflows. In addition the properties of outflows recover some important aspects of LBV bubbles which the previous "slow torus" models can not.Comment: 23 pages, 6 figures, to appear the Astrophysical Journa

Safety hazards associated with the charging of lithium/sulfur dioxide cells

A continuing research program to assess the responses of spirally wound, lithium/sulfur dioxide cells to charging as functions of charging current, temperature, and cell condition prior to charging is described. Partially discharged cells that are charged at currents greater than one ampere explode with the time to explosion inversely proportional to the charging current. Cells charged at currents of less than one ampere may fail in one of several modes. The data allows an empirical prediction of when certain cells will fail given a constant charging current

A comparison of the entanglement measures negativity and concurrence

In this paper we investigate two different entanglement measures in the case of mixed states of two qubits. We prove that the negativity of a state can never exceed its concurrence and is always larger then $\sqrt{(1-C)^2+C^2}-(1-C)$ where $C$ is the concurrence of the state. Furthermore we derive an explicit expression for the states for which the upper or lower bound is satisfied. Finally we show that similar results hold if the relative entropy of entanglement and the entanglement of formation are compared

Hydrodynamical Models of Outflow Collimation in YSOs

We explore the physics of time-dependent hydrodynamic collimation of jets from Young Stellar Objects (YSOs). Using parameters appropriate to YSOs we have carried out high resolution hydrodynamic simulations modeling the interaction of a central wind with an environment characterized by a moderate opening angle toroidal density distribution. The results show that the the wind/environment interaction produces strongly collimated supersonic jets. The jet is composed of shocked wind gas. Using analytical models of wind blown bubble evolution we show that the scenario studied here should be applicable to YSOs and can, in principle, initiate collimation on the correct scales (R ~ 100 AU). The simulations reveal a number of time-dependent non-linear features not anticipated in previous analytical studies including: a prolate wind shock; a chimney of cold swept-up ambient material dragged into the bubble cavity; a plug of dense material between the jet and bow shocks. We find that the collimation of the jet occurs through both de Laval nozzles and focusing of the wind via the prolate wind shock. Using an analytical model for shock focusing we demonstrate that a prolate wind shock can, by itself, produce highly collimated supersonic jets.Comment: Accepted by ApJ, 31 pages with 12 figures (3 JPEG's) now included, using aasms.sty, Also available in postscript via a gzipped tar file at ftp://s1.msi.umn.edu/pub/afrank/SFIC1/SFIC.tar.g