Medical Provider Reactions to an Adolescent Chronic Pain Complaint and a Dismissive Interaction

Childhood chronic pain impacts approximately 15-33% of children and adolescents and can significantly impact physical and psychosocial functioning. Children and adolescents with chronic pain have a decreased ability to participant in normal childhood activities and are more likely to have sleep difficulties, anxiety and depressive symptoms, and sedentary behavior. The etiology underlying chronic pain can be particularly difficult to diagnose because often, it does not have a clear physiological etiology and assessment relies almost solely on patient report. This often leads to under-treatment of pain and can lead to pain dismissal, particularly by medical providers. The literature regarding diagnosis and treatment of childhood chronic pain, pain dismissal in adult and adolescent populations, provider perspectives on chronic pain, and provider communication is reviewed. While there are studies examining the perception of pain dismissal in adult and adolescent populations, little is known about medical providers’ understanding and perception of dismissal. This study investigated the reaction of medical providers to two different scenarios: an adolescent pain complaint via a short vignette and a dismissive patient-provider scenario via a short video. Overall, medical provider participants did not endorse dismissive beliefs after reading a common adolescent headache complaint and were able to consistently identify dismissive language in the dismissive patient-provider scenario. Though significantly underpowered for interaction effects, the results suggest that there is a potential provider and patient gender interaction when participants viewed the dismissive scenario, such that mismatched gender dyads led to more polarized responses. Additionally, exploratory analyses suggest medium to large effect sizes when examining the impact of patient gender and type of scenario viewed (dismissive versus non-dismissive). Specifically, female patient gender appears to be polarizing, such that when viewing the dismissive scenario, participants who viewed the scenarios with the female patient rated the provider lower and when viewing the non-dismissive scenario, participants who viewed the scenarios with female patient rated the provider higher. The current study is a first step in understanding medical providers’ view of dismissive behavior, and has important implications for educational efforts to protect adolescent patients from the experience of dismissal. A discussion of future directions and clinical implications are included

Elizabeth Igler\u27s Scrapbook 1927-1928

Elizabeth Igler (1910-1995) went to Ward-Belmont during the 1927-1928 school year. She received her law degree from the University of Cincinnati Law School, graduating in 1932. She would go on to have a splendid law career and was one of the few practicing female lawyers in Cincinnati in the 1930s. She clerked for the Honorable Howard Bevis, Justice of the Ohio Supreme Court and became the first Solicitor for the Village of Glendale in 1934. She married Lawson E. Whitesides in 1935. She was a member of the Ohio State Bar Association for almost 60 years.https://repository.belmont.edu/scrapbooks/1023/thumbnail.jp

Determining Musical Preferences in Persons with Dementia: Comparing Caregiver Options to Stimulus Preference Assessment

The music therapy literature supports the use of individualized music in order to reduce problem behaviors among individuals with moderate to severe dementia; however, these interventions frequently rely on family members and/or staff to choose preferred music. Family members and caregivers are often inaccurate when choosing preferred stimuli for cognitively impaired individuals. The purpose of this study was to determine if family members and caregivers could accurately identify the preferred music of individuals with dementia. A single stimulus preference assessment was used to empirically determine preferred music and then these results were compared to family member and caregiver rankings. The results indicated that family members and caregivers were inaccurate in choosing preferred music, suggesting the need for a systematic preference assessment to be added to individualized music interventions

Commentary: A host-produced quorum-sensing autoinducer controls a phage lysis-lysogeny decision

With the recent publication by Silpe and Bassler (2019), considering phage detection of a bacterial quorum-sensing (QS) autoinducer, we now have as many as five examples of phage-associated intercellular communication (Table 1). Each potentially involves ecological inferences by phages as to concentrations of surrounding phage-infected or uninfected bacteria. While the utility of phage detection of bacterial QS molecules may at first glance appear to be straightforward, we suggest in this commentary that the underlying ecological explanation is unlikely to be simple

Einfluss der Bisskraft auf Kaumuskelaktivitätsverhältnisse bei einseitigem isometrischen Beißen mit unterschiedlichen okklusionsnahen Zahnabständen

Activity ratios of various elevator muscles are often used for the investigation of craniomandibular force distributions and neuromuscular control strategies. It is assumed that activity ratios are largely independent from the bite force. This could be shown for minimal occlusal distances (MID) of approximately 6 mm. Recent studies indicate, that the bite force could gain influence on the ratios at smaller MIDs from 0 to 3 mm, which occur during chewing. Therefore the question arises whether in small and clinically relevant MIDs the condition of bite force independence of activity ratios is met. To clarify this question it is necessary to measure forces during biting with MIDs of less than 3 mm, something that hadn´t been possible with conventional force sensors with heights of about 6 mm. Therefore, the aim of this work was to develop a method that allows to measure bite forces unilaterally, while minimizing MIDs and to investigate to what extent activity ratios for small MIDs correlate with the bite force. Furthermore it should be investigated what effect a possible bite force dependance has on a testing method, well described in literature, with bite forces controlled by volunteers, according to their subjective assessment.Aktivitätsverhältnisse verschiedener Kaumuskeln dienen häufig als Messgrößen zur Untersuchung craniomandibulärer Kraftverteilungen und neuromuskulärer Steuerungsstrategien. Dabei wird vorausgesetzt, dass Aktivitätsverhältnisse weitgehend unabhängig von der Bisskraft sind. Diese Annahme wurde für Zahnabstände (Bisssperrungen) von ca. 6 mm experimentell bestätigt. Neuere Untersuchungen legen jedoch nahe, dass bei kleineren Bisssperrungen von 0 bis 3 mm, die z. B. während der Kaufunktion auftreten, die Bisskraft einen stärkeren Einfluss auf Aktivitätsverhältnisse ausüben könnte. Daher stellt sich die Frage, ob auch bei kleinen, klinisch relevanten Bisssperrungen die Bedingung der Bisskraftunabhängigkeit von Aktivitätsverhältnissen erfüllt ist. Zur Klärung dieser Frage ist es nötig, Kräfte beim Beißen mit Zahnabständen von weniger als 3 mm zu messen, was mit den bisher üblichen Kraftsensoren mit Bauhöhen von ca. 6 mm und darüber nicht möglich ist. Ziel dieser Arbeit war es daher, eine Methode zu entwickeln, die es erlaubt, einseitige Bisskräfte mit möglichst geringer Bisssperrung zu messen und damit zu untersuchen, inwieweit Aktivitätsverhältnisse bei kleinen Bisssperrungen mit der Bisskraft korrelieren. Weiterhin sollte untersucht werden, welche Auswirkungen eine mögliche Bisskraftabhängigkeit auf eine in der Literatur häufig beschriebene Untersuchungsmethode hat, bei der Bisskräfte von Probanden selbst nach deren subjektivem Empfinden kontrolliert werden

Siketnémák és Vakok Oktatásügye 34 (1932) 05-06

A Siketnémák és Vakok Tanárai Országos Egyesületének hivatalos lapja 34. évfolyam, 5-6. szám Budapest, 1932. Előzménye a "Magyar Siketnéma-Oktatás a siketnémák oktatásával foglalkozók szakközlönye". A lap 1=41. évfolyam 1. számától (1939) "Magyar gyógypedagógiai tanárok közlönye a Magyar Gyógypedagógiai Tanárok Országos Egyesületének hivatalos lapja és szakfolyóirata" cím alatt folytatódott