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Pain is the most famous member of bodily feelings including orgasms, tickles, itches and tingles among others. These feelings are normally attributed to the locations of the body and seem to have several features like duration, intensity and volume which are attributed to quantities or physical objects. For most patients seeking for clinical help, pain is often the most common problem and the most common nursing diagnosis. Generally, pain can be defined as the distressful, unpleasant and uncomfortable feeling that affects the quality of a person's life especially if it's unrelieved. Unrelieved pain may cause both physical and emotional effects, affect families and increase health care costs on the individual and society. Consequently, pain has become the most serious problem in the health care industry and a significant interest of many philosophers. This has led to paradox of thoughts that pain is a condition that we perceive in the body…
Aydede, M. (2009, May 29). Pain. Retrieved from Stanford Encyclopedia of Philosophy
Stanford University website: http://plato.stanford.edu/entries/pain/
Cheng, S, Foster, R. L & Huang C. (2003, April 23). Concept Analysis of Pain. Retrieved February 13, 2011, from http://www.tzuchi.com.tw/file/DivIntro/nursing/content/92-3/3.pdf
Pagin, P. (n.d.). Sensation Terms. Retrieved February 13, 2011, from http://people.su.se/~ppagin/papers/sensations.pdf
As such, a person may be injured in one location, but perceives pain in another location of the body (Voscopoulos & Lema, 2010). eferred pain can be both acute and chronic, depending on the injury or sickness which causes it in each patient case. The one major difference is that referred pain "is experienced at some remove from where the pain actually begins" (Complimentary Therapists, 2013).
There are a number of patient factors that affect the physiology of pain experienced by each unique individual. Essentially, "chemical, mechanical, and thermal receptors along with leucocytes and macrophages, determine the intensity, location, and duration" of various types of pain (Voscopoulos & Lema, 2010). A number of patient factors, like diet, age, and medical health history can influence the type of pain experienced. Additionally, emotional states of patients can also impact the type of pain experienced, along with the ability to heal…
Complimentary Therapists. (2013). What is pain? Pain. Web. http://www.complementary-therapists.com/pain/
Voscopoulos, C. & Lema, M. (2010). When does acute pain become chronic? British Journal of Anaesthesia, 105(1), 69-85. Web. http://bja.oxfordjournals.org/content/105/suppl_1/i69.full
Pain Management of Obstetric Patients
DEALING WITH IRTH PAINS
Causes and Management Intervention
Two Sources of Pain
Pain is classified into nociceptive or neuropathic (ICEA, 2014). Nociceptive pain develops from tissue, muscle or bones. It is dull, aching, burning, stretching or beating. It crosses through mylenated nerve fibers. Neuropathic pain, on the other hand, emanates from the nerves when some damage has been inflicted on them (ICEA, 2014). It may be chronic when it is numbing, tingling or burning. Over-stimulation of the nerve fibers can damage them as in a burned-out state (ICEA),
The three stages of the birth process are antepartum or before birth, intrapartum or during delivery, and postpartum or following childbirth or delivery (ICEA, 2014).
Antepartum -- These are visceral and somatic or perineal (ICEA, 2014). Visceral pain emanates from the internal organs located in the abdominal and pelvic cavities and spreads and referred to nerve pathways.…
Ekabua, J.E., et al. (2011). Awareness of birth preparedness and complication readiness
in Southeastern Nigeria. ISRN Obstetrics and Gynecology: International Scholarly
Researchers Notices. Retrieved on November 20, 2014 from http://www.ncbi.hlm.nih.sgov/pmc/articles/PMC314473
Hughes, A., et al. (2009). Mindfulness approaches to childbirth and parenting. Vol. 17 #
Pain Issues ith the Dying Process
Palliative care for the terminally ill has spurred multiple analyses of the Nursing Profession's commitment to relieve pain endured by terminally ill patients. Though intently examining numerable aspects of palliative care, the most of the literature shows a logical gap in its apparent assumption that medication hastens death. Some healthcare professionals have challenged that assumption, undertaking studies of carefully assembled data from groups of terminally ill patients and have found that palliative care is not the "slow euthanasia" evidently inferred by most medical theorists.
"Pain Assessment and Management in Palliative Care" by Nessa Coyle and Mary Layman-Goldstein (Coyle & Layman-Goldstein, 2001), discussing AACN capacities in the assessment and treatment of pain, particularly in peri-death treatment;
b. "Symptoms and Attitudes of 100 Consecutive Patients Admitted to an Acute Hospice/Palliative Care Unit" by K. Ng and C.F. Gunten (Ng & Gunten, 1998), reporting the results of…
Billings, J.A., & Block, S.D. (1996). Slow Euthanasia. Journal of Palliative Care, Vol. 12, No. 4, 21-30.
Claessens, P., & Broeckaert, B. (2011). Palliative Sedation, Not Slow Euthanasia: A Prospective, Longitudinal Study of Sedation in Flemish Palliative Care Units. Journal of Pain and Symptom Management, Vol. 41, No. 1, 14-24.
Coyle, N., & Layman-Goldstein, M. (2001). Pain Assessment and Management in Palliative Care. In M.L. Matzo, & D.W. Sherman, Palliative Care Nursing: Quality Care to the End of Life (pp. 362-486). New York, NY: Springer.
Given, B.A. (2001). Family Support in Advanced Cancer, Vol. 54, No. 4. CA - A Cancer Journal for Clinicians, 213-31.
Pain & Pain elief Following Hip eplacement Surgery a Qualitative Study
Qualitative research Assignment
esearch design relies on the appropriateness of either qualitative or quantitative methods in achieving the objectives of the study. In the study, two research studies that use these different methods to accomplish their objectives are evaluated. One of the studies uses descriptive qualitative approach while the other exploits cross-sectional survey.
The analysis in this section requires that the analyst compares the article to quantitative articles he/she read - in general (the difference between the two types of studies) (LoBiondo-Wood and Haber, 2014). The differences in these two methodologies in the studies are evident. For instance, the descriptive qualitative approach is explorative in nature since it offers detailed explanation for the research topic while the cross-sectional survey focuses on enumerating and categorizing features through statistical figures in order to explain its observation (Explorable.com, n.d). The qualitative and…
Explorable.com (n.d). Quantitative and Qualitative Research. Retrieved 20 September 2014 from https://explorable.com/quantitative-and-qualitative-research
Jaye C (2002). Doing qualitative research in general practice: methodological utility and engagement. Retrieved 20 September 2014 from http://fampra.oxfordjournals.org/content/19/5/557.full
Lindberg, M., Grov, E., Gay, C., Rustoen, T., Granheim, T., Amlie, E., & Lerdal, A. (2013). Pain characteristics and self-rated health after elective orthopaedic surgery - a cross-sectional survey. Journal Of Clinical Nursing, 22(9/10), 1242-1253. doi:10.1111/jocn.12149Joelsson, M., Olsson, L., & Jakobsson, E. (2010). Patients' experience of pain and pain relief following hip replacement surgery. Journal Of Clinical Nursing, 19(19/20), 2832-2838. doi:10.1111/j.1365-2702.2010.03215.x
LoBiondo-Wood, G. And Haber, J. (2014). Nursing Research - Methods and Critical Appraisal for Evidence-Based Practice, 8th edition. Mosby.
Shakespeare is pointing out how normal these two are. They find love and they experience the good side of love. They bask in the passion and desire more.
The truly sad aspect of love is that it cannot be good all of the time. In fact, many would argue that love would not be as good as it is without pain. Love does not stay good all the time for everyone, especially Romeo and Juliet. Shakespeare brings us to the pain of love rather quickly in the play as the couple begins to encounter trouble at almost every turn. They will do anything to be together and if this means faking death and running away, they have no problem doing it. The risks are strange and compelling and while Juliet is wise to stop and weight everything before she drinks the potion, she still puts all of her faith in…
Myers, Henry Alonzo. (1963) "Tragedy and Comedy." A Midsummer Night's Dream. Wolfgang Clemen, ed. New York: Signet Classics. Print.
Shakespeare, William. (1994) Romeo and Juliet. The Complete Works of William Shakespeare.
New York: Barnes and Noble Books. Print.
Pain Assessment Tools: The Brief Pain Inventory and the Initial Pain Assessment Tool
Using the Brief Pain Inventory and the Initial Pain Assessment Tool to assess a friend who was complaining of sore muscles, I was immediately struck by the superiority of the Initial Pain Assessment Tool. It seemed to gather all of the information that the Brief Pain Inventory obtains from a patient, as well as other information that would be helpful in a treatment scenario. However, the Brief Pain Inventory has some minor advantages over the Initial Pain Assessment Tool. The main differences in the two assessment tools are: the inclusion of a pain scale; the ability to assess how and when the pain began; a space for a qualitative, rather than just a quantitative, description of the pain; and whether or not the patient finds the current pain level tolerable. After looking at all of the factors,…
There are graphics as well as characters on the scale, making it easier for younger patients to use the scale. In addition, the Pain Sensory Tool appears to be more accurate than other tests, such as the Poker Chip Tool.
However, the Pain Sensory Tool does have drawbacks. Some patients may not know how to mark their pain on the Tool. Younger children had a difficult time understanding the instrument, which requires greater work by the healthcare provider to use the tool as a means for assessing and treating pain. In addition, younger children may be unable to understand a visual analogue scale. Furthermore, while more accurate than the Poker Chip Tool, the Pain Sensory Tool is not that accurate.
The Pain Sensory Tool seems like a well-designed instrument, as long as it is used as part of a healthcare provider's means of determining how much pain is being experienced…
Cheng, S., N. Hester, R. Foster, and J. Wang. (2003). Assessment of the convergent validity of pain intensity in the pain sensory tool. Journal of Nursing Research, 11(2), 93-99.
Pain in the (Supply) Chain" focuses on the Exceso company in its attempt to meet wildly ambitious sales goals at the end of the quarter through the integration of an extremely aggressive promotion strategy. The question that comes into play is simple: is this strategy worth following through with? In looking at the case study in detail, one can see that there are certain areas of strategy that could stand to be improved upon.
First, CEO R. Foley Vinton notes that the machines which are running for production have provided a 98% yield, but hesitates to mention the fact that the machines are only running at a 60% capacity. The machines are also dealing with unexplained breakdowns that can essentially halt or destroy production should another breakdown occur. In looking at this scenario there are at least two areas for improvement. First, a running of the machines despite faulty machinery…
Best Practices for the Pain Management of Broken Hips
Achieving the Institute of Medicine's goal of ensuring that 90% of health care decisions are evidence-based by 2020 will require identifying current gaps between research, findings, and practice implementation. One practice identified in the Agency for Healthcare esearch and Quality (AHQ) comparative effectiveness research site concerns pain management for broken hips. This paper examines a gap that currently exists between research findings and the implication of those findings in this practice, followed by a summary of the research in the conclusion.
Discussion of the practice
Although anyone can break a hip, broken hips are more common among the elderly and can be caused by a fall or simply by the weakening of the femur with age (Managing pain from a broken hip, 2011). For instance, the AHQ reports that, "[The incidence] of hip fractures increases substantially with age, rising for men…
Baker, D. W. (2017). Joint Commission statement on pain management. Joint Commission. Retrieved from https://www.jointcommission.org/joint_commission_statement_on_ pain_management/.
Managing pain from a broken hip. (2011). Agency for Healthcare Research and Quality. Retrieved from https://effectivehealthcare.ahrq.gov/ehc/products/95/677/Hip Fracture_Consumer_20110517.pdf.
Moore, B. A. & Anderson, D. (2016, January). Stepped care model for pain management and quality of pain care in long-term opioid therapy. Journal of Rehabilitation Research & Development, 53(1), 137-140.
Pain management interventions for hip fracture. (2011). Agency for Healthcare Research and Quality. Retrieved from https://effectivehealthcare.ahrq.gov/ehc/products/95/67 6/CER30_executivesummary_20110517.pdf.
Severe abdominal pain with bloody diarrhea at a frequency of twenty times per day can be a sign of a serious condition. In fact, the healthcare team should treat the issue as a medical emergency given the possibility of a life-threatening illness (Holtz, Neill & Tarr, 2009). Immediately I would question the patient regarding her medical and family history, including questions related to whether or not this was the first time she has experienced these symptoms. I would also inquire about the patient’s recent travels because it is possible the symptoms point to an infectious disease or a food-borne illness. Whatever the situation, the patient must first replenish the depleted fluids and electrolytes immediately during the administration of diagnostic procedures and patient monitoring. Also, it would be important to find out if the patient is on any medications including antibiotics, and whether or not she was pregnant. Some medications can…
Public Health: Countering Opioid Overdoses
The opioid epidemic is a severe public health crisis that must be attended to with urgency in the U.S. It has spread in due part to the problem of care providers over-prescribing strong and addictive opioids or pain relief to patients, who in turn become long-term opioid addicts (Brummett et al., 2017). Illegal opioids are also hitting the streets from other sources, compounding the problem; however, since many health care providers are unable to impact what happens on the streets (in terms of keeping drugs out of the country), they can make a difference by intervening in their facilities. It is true that patients have a right to expect pain relief, but the short-sightedness of health care professionals who prescribe opioids to patients is often a major setback for the fight against opioid abuse. One solution is to cut back on the strength of…
Brummett, C. M., Waljee, J. F., Goesling, J., Moser, S., Lin, P., Englesbe, M. J., ... & Nallamothu, B. K. (2017). New persistent opioid use after minor and major surgical procedures in US adults. JAMA surgery, 152(6), e170504-e170504.
Harbaugh, C. M., Lee, J. S., Hu, H. M., McCabe, S. E., Voepel-Lewis, T., Englesbe, M.J., ... & Waljee, J. F. (2018). Persistent opioid use among pediatric patients after surgery. Pediatrics, 141(1), e20172439.
Kemper, K. J., & Danhauer, S. C. (2005). Music as therapy. South Med J, 98(3), 282-8.
Rowsell, L., Wong, K., Yee, B., Eckert, D. J., Somogyi, A., Duffin, J., ... & Wang, D. (2016). Identifying obstructive sleep apnea patients vulnerable to opioid-induced respiratory depression-a randomized double-blind placebo-controlled crossover trial. Am J Respir Crit Care Med, 193, A4321.
Volkow, N. D., & McLellan, A. T. (2016). Opioid abuse in chronic pain—misconceptions and mitigation strategies.
Welch, H., Schwartz, L. & Woloshin, S. (2011). Overdiagnosed. Beacon Hill.
Causes and Treatments for Sciatica
One of the harsh realities of the frail human condition is the fact that most people will suffer from some degree of low back pain at some point in their lives. Even people with relatively sedentary lifestyle can experience debilitating injuries to their lower back, and the potential for such injuries is exacerbated further when individuals engage in various sports activities. One such lower back and hip problem is sciatica, which is caused by spinal nerve root compression. Fortunately, there are a number of evidence-based interventions available for treating this condition, including both pharmacological and psychotherapeutic modalities. The purpose of this paper was to provide a review of the relevant peer-reviewed and scholarly literature concerning the common mechanisms of injury, anatomy of the injury (which structures are involved), presenting signs/symptoms, diagnostic procedures and/or special tests, and the basic healing process, rehabilitation, or surgery that needs…
Abitbol, J. J. (2018). Six leading causes of sciatica. Spine Universe. Retrieved from https://www.spineuniverse.com/conditions/sciatica/6-leading-causes-sciatica.
Hamilton, L. (2012, May). Q & A. Dance Magazine, 86(5), 24.
Lau, A. & Han, J. (2010, July). The truth about treating low back pain. Current Psychiatry, 9(7), 38-44.
Onac, I. A. & Moldovan, A. R. (2012, March). Medication, physiotherapy and cognitive behavior therapy for the treatment of chronic back pain: A clinical trial. Journal of Evidence-Based Psychotherapies, 12(1), 23-27.
Sciatica. (2018). Merck Manual. Retrieved from https://www.merckmanuals.com/professional/ musculoskeletal-and-connective-tissue-disorders/neck-and-back-pain/sciatica.
Sciatica overview. (2018). Mayo Clinic. Retrieved from https://www.mayoclinicorg/diseases-conditions/sciatica/symptoms-causes/syc-20377435.
Singh, A. & Singh, O. (2013, January-June). A preliminary clinical evaluation of external snehan and asanas in the patients of sciatica. International Journal of Yoga, 6(1), 71-74.
The problems at the work place were detected over a long period of time and are a part of the history of development. The development of technology was very rapid which must also have brought in the needed changes in the workplace functions and norms. Unfortunately the basic structure of health protection came to be discussed only in the beginning of 1960s. The occupational medicine became a separate field of study since then and the occupational health service was born. The motto which the service wanted to achieve was an ergonomic system that could fit the job and the worker and simultaneously identify and eliminate health hazards. (Wilkinson, 50) There were many statues passed that created safety at the workplace. The greatest step in this regard was the OSHA regulations.
The OSHA act of 1970 was the single piece of legislation that gave an impetus to the work…
N.A. Comparative table of pain distribution. ( http://www.aans.org/education/journal/neurosurgical/may98/4-5-p1/8204f3.GIF )
Charlton, Samuel G; O'brien, Thomas G. Handbook of Human Factors Testing and Evaluation. Lawrence Erlbaum Associates. Mahwah, NJ. 2002.
Harrington, Lisa. H. The Safety Zone. http://www.inboundlogistics.com/articles/features/0506_feature01.shtml
fuse the content of the third chapter from the class text and a selected article. The salient and primary point to be taken from the chapter reading is concept analysis and frameworks. The important point from the article that will be focused on is aggression in the emergency department. To be certain, the emergency department of any hospital or other medical institution is a place where the presence of aggression can emerge in some instances. While some may say that concept analysis and frameworks are just a lot of navel-gazing, this is far from the truth so long as the practice is taken serious and is done as needed.
As explained by the class text, it is important to have proper concept development and research because there is a common language that must exist. To use a simpler example, three widgets to one person should always be three widgets to…
Bresler, S., & Gaskell, M. (2015). Risk assessment for patient perpetrated violence: Analysis of three assaults against healthcare workers. Work, 51(1), 73-77.
McEwen, M., & Wills, E. (2011). Theoretical basis for nursing. Philadelphia: Wolters
Kluwer/Lippincott Williams & Wilkins.
The procedure appears to have been rushed forward faster than was entirely necessary, which contributed to several other factors that had a direct impact on Mr. B's health and condition. This issue marks the intersection between human resource issues and medical issues in the case as described (Hoot & Aronsky 2008).
Over-administration of sedation clearly occurred, and the patient's potential nervousness might have contributed to increased blood pressure and thus led to a greater quantity of sedatives being administered than were needed. This is in part due to the speed with which the procedure was performed.
The patient's history does not appear to have been fully considered before sedatives were administered and other actions were taken. This at least in part a result of the lack of adequate staffing in the emergency department and the rush with which the procedure was accomplished. A better understanding of Mr. B's initial condition…
Hoot, N. & Aronsky, D. (2008). Systematic Review of Emergency Department Crowding: Causes, Effects, and Solutions. Annals of Emergency Medicine 52(2): 126-36.
Koppissetti, V. & Chandra, N. (2011). Influence of Alcohol and Smoking on Drug Action: A Step for better utilization of drugs. Journal of Chemical and Pharmaceutical Research. 3(1): 242-8.
Stanton, M. (n.d.) Hospital Nurse Staffing and Quality of Care. Research in Action 14.
Combining these two methods is one effective strategy in mitigating pain in children (Cohen).
Additional strategies that involve both the patient and family are evident, particularly when dealing with chronic pain. Children sometimes internalize pain, believing that they must restrict their activity, particularly when parents worry and hesitate to allow them to be active. Parents see play as worsening of the situation or a relapse, contributing to an overprotectivness. This, in turn, reflects on the self-image of the child. In any case, experts recommend that parents not react in a negative way -- either by thinking the child is faking pain or becoming so overprotective that the child is a virtual prisoner. Instead, the psychological strategy should be to set realistic and evolving strategies so that there is not a continue pessimism regarding future health outcomes. This, for adolescents, is critical since there is also a self-esteem issue that goes…
The Handbook of Chronic Pain. (2007). New York: Nova Science Publishers.
Handbook of Pediatric Chronic Pain. (2011). New York: Springer.
Carter, B., & Threlkeld, M. (2012). Psychosocial perspectives in the treatment of pediatric chronic pain. Pediatric Rheumatology, 10(15), 1-11. Retrieved January 2013, from Pediatric Rheumatology: http://www.ped-rheum.com/content/pdf/1546-0096-10-15.pdf
Christie, D., & Wilson, C. (2005). CBT in Pediatric and Adolescent Health. Developmental Neurorehabilitation, 8(4), 241-47.
Ingenious Pain Andrew Miller
prompt: One major themes discussed Alain de
One of the central philosophical components of Friedrich Nietzsche's varied stance is the fact that pain is integral to providing meaning to the human life. This basic tenet is echoed in Andrew Miller's Novel, Ingenious Pain, which chronicles a protagonist who is born with a marked inability to perceive suffering or physical pain -- whether it is his or that of someone else (Barnard). Although the life of James Dyer -- the protagonist -- is highly eventful and full of action, it is curiously devoid of much meaning from Dyer's perspective, until a change encounter with a woman named Mary bestows upon him the capacity to feel pain. The sudden transition for the young man, and the fledgling empathy he eventually develops as a result, eventually overrides his life and leads to his death. Yet in the process, Dyer's…
Barnard, Josie. "No Feelings, But Sensational." The Independent. Web. 1997. http://www.independent.co.uk/arts-entertainment/books/book-review -- no-feelings-but-sensational-1273299.html
Miller, Andrew. Ingenious Pain. New York: Sceptre Publishers. 1998. Print.
Miller, Karen. "Fiction Review: Ingenious Pain." www.publishersweekly.com. 1997. Web. http://www.publishersweekly.com/978-0-15-100258-0
Nietzsche, Friedrich. The Twilight of the Gods. www.handprint.com. 1895. Web. http://www.handprint.com/SC/NIE/GotDamer.html
Perception of Pain
Uses of Pain in nursing
Definitions of Pain from Dictionaries
Uses of Pain in psychology
Antecedents and Consequences
CONCEPT ANALYSIS OF PECEPTION OF PAIN
The aim of this paper is to increase the understanding of the perception of pain. The researcher purpose to clarify describe the characteristics of pain and recognize antecedents that effect the idea of pain and the likely outcomes of pain by utilizing Avant's and Walker (2005) theory of study. Also, a model case shows how pain is connected to these serious characteristics contrary case and a borderline case are shown to distinguish the perception of pain from other notions. Empirical referents show the current point-of-view of the perception of pain. (Akyol & Salmond, 2009)
Concept Analysis of Characteristics of Pain
The goal of this paper is to expand the understanding of the concept of…
Akyol, O., Karayurt, O., & Salmond, S. (2009). Experiences of pain and satisfaction with pain management in patients undergoing total knee replacement. Orthopedic Nursing, 28(2), 79-85.
Chan, S., Hadjistavropoulos, T., Carleton, R.N., & Hadjistavropoulos, H. (2012). Predicting adjustment to chronic pain in older adults. Canadian Journal of Behavioral Science, 44(3), 192-199.
Eggermont, L.H.P., Bean, J.F., Guralnik, J.M., & Leveille, S.G. (2009). Comparing pain severity vs. pain location in the MOBILIZE Boston study: Chronic pain and lower extremity function*. The Journals of Gerontology, 64A (7), 763-70.
Gelinas, C., Fortier, M., Viens, C., Fillion, L., & Puntillo, K. (2004). PAIN ASSESSMENT AND Management IN CRITICALLY ILL INTUBATED PATIENTS: A RETROSPECTIVE STUDY. American Journal of Critical Care, 13(2), 126-35.
reduce the amount of pain perceived. Many people have the ability to reduce perceived pain through psychological thought and understanding. Not all people can handle their pain in this manner, but it can help many chronic pain patients deal with their illnesses and their constant pain.
One technique is using positive coping mechanisms to deal with the pain, and the psychologist may be able to work with the patient in developing these coping mechanisms. Experts note, "People who feel that they have a number of successful methods for coping with pain may suffer less than those who behave and feel helpless, hopeless, and demoralized" (Turk, Monarch & Williams, 2004, p. 222). If the patient has a history of coping well with other stressful events, then they may be a good candidate for using coping mechanisms. Some of these coping mechanisms include relaxation, pain medication, and psychological counseling to help increase…
Bruehl, S., & Chung, O.Y. (2004). Chapter 9 Psychological interventions for acute pain. In Pain: Psychological perspectives, Hadjistavropoulos, T. & Craig, K.D. (Eds.) (pp. 245-264). Mahwah, NJ: Lawrence Erlbaum Associates. Retrieved October 13, 2005, from Questia database: http://www.questia.com/PM.qst?a=o& ; d=104331529
Turk, D.C., Monarch, E.S., & Williams, A.D. (2004). Chapter 8 Assessment of chronic pain sufferers. In Pain: Psychological perspectives, Hadjistavropoulos, T. & Craig, K.D. (Eds.) (pp. 209-239). Mahwah, NJ: Lawrence Erlbaum Associates. Retrieved October 13, 2005, from Questia database:
suffer anymore: Access to pain treatment as a human right, Human ights Watch author Diederick Lohman discusses the issue of pain management as a human rights issue. Lohman addresses the fact that it has long been established that pain relieving drugs, particularly narcotics, are an essential element of healthcare. In fact, he points out that in 1961, the world community adopted the 1961 Single Convention on Narcotic Drugs, which instructed countries to make pain relieving medications available to people (Lohman, 2009). However, the reality is that, even now the majority of the world's people lack access to pain-relieving medication. This is particularly true in low and middle income countries. Moreover, the lack of access impacts patients at all levels, even those whose conditions are terminal, so that they literally die in pain.
In the article, Lohman cites an extraordinary amount of facts and figures to back up his assertion that…
Brennan, F., Carr, D., and Cousins, M. (2007). Pain management: A fundamental human right.
Anesthesia & Analgesia, 105(1), 205-221.
Lohman, D. (2009). "Please do not make us suffer any more:" Access to pain treatment as a human right. New York: Human Rights Watch.
Purdue Pharma LP (2012). Ethics & Pain. Retrieved February 5, 2013 from In the Face of Pain
Music and Pain
The use of music in relation to relaxation and pain control is universal in application. Many cultures use music, tones, chanting, drums, or other forms of biofeedback to treat patients in acute pain, women in labor, recovery, and now, most recently, in pre- and post-operative care. In fact, the therapeutic value of music has been recognized as vital and powerful since Ancient Times; archaeological evidence shows flutes carved from bone in pictures of physicians healing patients, Greek physicians used music and vibration to heal, aid in digestion and induce sleep; the Early Egyptians used musical incantations to help with the healing process; and certainly, numerous native tribes use singing and chanting as part of their healing rituals (Nilsson, 2008).
Further, most postoperative patients have pain, despite the use of analgesia. Nurses are constantly trying to be more effective in delivering pain medication. One study showed that patients…
Ghetti, C. (2011). Active music engagement with emotional-approach coping to improve well being in liver and kidney translplant recipients. Journal of Music Therapy. 48 (4): 463-85.
Good, M., et.al. (2010). Supplementing Relaxation and Music for Pain After Surgery. Nursing Research. 59 (4): 259-69.
Goodwin C.J. (2010). Research in Psychology: Methods and Design. New York: John
Chronic musculoskeletal pain necessitates the maintenance of good extensibility in order for normal functioning to be enhanced. This enhancement results in improvements in strength, endurance, fitness, and psychological well-being (Law et al., 2009). Programs promoting the improvement of movement for people with chronic musculoskeletal pain usually include stretching components. Stretching helps to improve functioning through improved range of motion within joints, and therefore muscle extensibility (Law et al., 2009).
The study by Law et al. (2009) emphasized the importance of tolerance and extensibility for individuals with chronic musculoskeletal pain. The purpose of the study, which was clearly outlined in the report, was to explore whether stretch affects either or both of these factors. The researchers hypothesized that individuals with chronic musculoskeletal pain may respond to stretch differently than individuals who do not experience chronic pain. Further to this suggestion, the researchers suggest that individuals with chronic musculoskeletal pain may show…
Law, R.Y., Harvey, L.A., Nicholas, M.K., Tonkin, L., De Sousa, M., Finniss, D.G. (2009). Stretch exercises increase tolerance to stretch in patieints with chronic musculoskeletal pain: a randomized controlled trial. Physical Therapy, 89(10), 1016-26.
43). The pain assessment guidelines set forth in this article will have an immediate effect on my first encounter with a patient, particularly if that patient is a chronic pain sufferer or end-of life patient. The sixth defined responsibility in the INPA is also of particular importance in regards to the information contained in this article; this is the responsibility to "evaluate with the patient/client the status of the goal achievement as a basis for reassessment" (INPA, 2007, p. 43). The evaluation of pain and the assessment of necessary and reasonable care in end-of-life patients is a complex task, as this article points out, so the implications of this article's information on this task of the registered nurse are huge.
Its affects on the practical nurse are similar, though heightened. Many of the basic responsibilities of the registered nurse and the practical nurse are the same; for instance, the language…
Indiana Code and Indiana Administrative Code. (2007). Indiana nurse practice act.
Sherman, D., Matzo, M., Pace, J. & R. Virani. (2004). "Learning pain assessment and management: A goal of the end-of-life nursing education consortium." The journal of continuing education in nursing, 35 (3), pp. 107-120.
The changes in the age demographic of the U.S. As well as the need to reduce overall spending in health care are significant reasons why advanced practice and specialty provision practitioner's skill sets and demands have changed. It is for this reason as well as for patient efficacy that such a subspecialty should be offered at a postgraduate level to AAs. These advanced practice alternative providers can be successfully and efficiently trained to provide services at a significantly lower rate, creating a potential opportunity for more people to receive advanced pain management care in a broader setting. This could only improve outcomes for chronic pain sufferers and broaden the scope of opportunity for AAs and possibly other advanced practice alternative providers. As need continues to rise alternatives must be sought within the system to provide care to patients who will likely need pain management service in growing numbers in…
American Board of Pain Medicine Website. Retrieved February, 21, 2008 at http://www.abpm.org/
Bandlow, D. (1995). M.D. Monopoly: How Nurses Can Help Relieve Spiraling Health-Care Costs. Policy Review, (74), 89.
Block, a.R., Kremer, E.F., & Fernandez, E. (Eds.). (1999). Handbook of Pain Syndromes: Biopsychosocial Perspectives. Mahwah, NJ: Lawrence Erlbaum Associates.
Block, a.R. (1996). Presurgical Psychological Screening in Chronic Pain Syndromes: A Guide for the Behavioral Health Practitioner. Mahwah, NJ: Lawrence Erlbaum Associates.
History of RSD
The history and the discovery of RSD (Reflex Sympathetic Dystrophy) Syndrome and its symptoms have typically been associated with wars. While there is no doubt that RSD from physical stress and injury existed earlier, it was left up to war physicians to assign pathology to it. Silas Weir Mitchell, an army doctor during the Civil War, described the symptoms of "burning pain" left in soldiers long after the bullets have been removed. He attributed these residual and long lasting pains to major nerve injury. Weir was the first to call RSD causalgia (currently, specifically known as CRPS-2), which is Greek for "burning pain." He wrote that, "Under such torments, the temper changes, the most amiable grow irritable, the soldier becomes a coward, and the strongest man is scarcely less nervous than the most hysterical girl." Weir accurately reflected the symptoms. (PARC, 2004). Mitchell accurately described the symptoms…
Allen, G., Galer, B.S., & Schwartz, L. (1999). Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients. Pain, 80(3), 539-544.
Aronoff, G.M., Harden, N., Stanton-Hicks, M., Dorto, A.J., Ensalada, L.H., Klimek, E.H., Mandel, S., & Williams, J.M. (2002). American Academy of Disability Evaluating Physicians (AADEP) Position Paper: Complex Regional Pain Syndrome I (RSD): Impairment and Disability Issues. Pain Med, 3(3), 274-288.
Bakewell, S. (1995). The Autonomic Nervous System. Update in Anesthesia, 6(5), 1.
Barolat, G., Schwartzman, R., & Woo, R. (1989). Epidural spinal cord stimulation in the management of reflex sympathetic dystrophy. Stereotact Funct Neurosurg, 53(1), 29-39.
Alternatives to Pain Medication
Given the growing concerns over opioid addictions in recent years and the potential for tolerance, clinicians continue to search for efficacious alternatives to convention pain medications (Moore & Anderson, 2016). Fortunately, a number of alternatives to conventional pan medication are readily available, including cannabis, yoga, hypnosis, mind-body meditation, therapeutic touch, herbal remedies, acupuncture, biofeedback, massage therapy, homeopathic practices (Tan & Craine, 2007) and aromatherapy (Esposito & Bystrek, 2014). To learn more about these alternatives, this paper provides an initial reference list of ten relevant peer-reviewed and scholarly sources concerning pain medication alternatives, followed by a description of clinical guidelines and an implementation plan for these alternatives. A discussion concerning the manner in which the implementation of the intervention should be tested is followed by an assessment of potential barriers and strategies intended to gain cooperation from individuals who will be implementing the change. Finally, a timeline…
Clinical practice guidelines. (2016). U.S. National Center for Complementary and Integrative Health. Retrieved from https://nccih.nih.gov/health/providers/clinicalpractice.htm .
Levin, R. F. & Feldman, H. R. (2006). Teaching evidence-based practice in nursing: A guide for academic and clinical settings. New York: Springer Publishing Company.
Moore, B. A. & Anderson, D. (2016, Janury). Stepped care model for pain management and quality of pain care in long-term opioid therapy. Journal of Rehabilitation Research & Development, 53(1), 137-141.
Pain management guidelines. (2016). U.S. Agency for Healthcare Research and Quality. Retrieved from https://www.guideline.gov/summaries/summary/9744 ?.
Pain and Suffering
Pain is an abstract and complex topic, which is influenced by a serious of psychological and environmental variables. We all have experienced pain although at varying intensities. Since the psychological factors play a great role in influencing how we perceive pain, therefore, it renders pain a highly subjective experience. esearchers have tried to differentiate between physical and mental pain (Campbell & Edwards 2012). In this essay, I describe physical pain from mental pain. I also show how various people respond to pain, contrast two different responses to pain. I also highlight how Asian culture compares with Hispanic culture in responding to pain.
Describe physical pain from mental or soul pain.
The two major types of pain can be classified as physical and mental. Since physical and mental pains are subjective, complex phenomenon, defining them seems to be a challenge. The International Association for the Study of Pain…
Campbell C. M & Edwards, R. R. (2012). Ethnic Differences in Pain and Pain Management. Pain Management. Vol. 2(3): 219 -- 230.
Edwards RR, Moric M, Husfeldt B, Buvanendran A, & Ivankovich O. (2005). Ethnic Similarities and Differences in the Chronic Pain Experience: A Comparison of African-American, Hispanic, and White Patients. Pain Medicine. Vol. 6(1):88-98.
feasible to measure pain because it is located in the thalamus. Is pain able to be measured objectively? Just as a blood pressure of 220/110 will give us some information about the cardiovascular system, assessing the peripheral pain pathway can help in the diagnosis and treatment of a patient's pain. Part of this paper will discuss the pain problem. People tend to view reports of pain with suspicion and disbelief. How is pain assessed at this time? Are there any objective markers of pain? How efficient are the current measurements of pain? Is the electromyography (EMG) test a good measurement of the nerve pain pathway? The pain pathway from the free nerve ending in the amydala hypothalamus will also be reviewed. The following section will discuss various instrumentations that currently exist, and how the pain sensory of the a-delta fibers can be measured. Another section will discuss the pathophysiology and…
National Institute of Health data supports that 40% of patients seeking medical consultation do so because they are experiencing pain. Most of these cases are neck and low back ones. The problem faced by physicians is determining whether the pain is real, imagined or is being magnified to procure a prescription for medication. Since pain is considered subjective, without any objective method to quantify it, the physician is in a position where he must rely on his/her evaluation of indirect findings and belief in the patient's veracity to determine if the problem is real, imagined or if the patient is magnifying the symptoms in order to obtain pain medication. Since there are usually little objective concomitant findings, the physician is left in a position where he either does or does not believes the patient. What is a physician to do?
"Chronic pain poses significant challenges in the lives of many people. At the root of many of these challenges are the behavior patterns pain naturally coordinates. For example, in some cases, attempts to control, reduce, or cure pain through medication, medical procedures, or lifestyle changes can prove unsuccessful, and can dominate all other potential goals. The experience of chronic pain also includes other discouraging, painful, or unwanted psychological experiences, such as thoughts, feelings, and memories. Attempts to control or reduce some of these psychological experiences also can prove unsuccessful and even harmful, further reducing quality of life" (Thompson M, 2011).
An important question any pain physician needs to address is how to properly evaluate spinal pain. How would a physician know if someone is symptom magnifying? Please note that symptom magnification should not be confused with the term "malingering," which is defined as the deliberate
Mindfulness Meditation Training on Experimentally Induced Pain" by Zeidan et al., (2010), published in the Journal of Pain, presents the results of research to investigate
The research addresses a gap in the research examining the benefit of meditation in attenuating pain symptoms. The research problem is clearly articulated, with the title clearly stating the content of the paper and the introduction expressing and justifying the issue. Past research has demonstrated that meditation programs, such as mindfulness-based stress reduction (MBS) programs have been correlated with positive health outcomes, including pain attenuation. The most common form of program is the MBS. In the context of pain management the eight-week length of the program renders it difficult for some patients, such as suffers of chronic pain, as they may not have the ability, or the time, required to complete the course. The research undertaken by Zeidan et al. (2010) addresses this problem, implementing…
Zeidan, Fadel, Gordon, Nakia S., Merchant, Junaid, Goolkasian, Paula, (2010), The Effects of Brief Mindfulness Meditation Training on Experimentally Induced Pain, The Journal of Pain, 11(3), 199-209
A Caucasian Man with Hip Pain
Decision Point One
The patient presents physical, social, and psychological complications. He is experiencing pain in his hip but is considered to be an unsuitable candidate for a hip replacement because of his age. The initial diagnosis was torn cartilage but the patient has also been diagnosed with complex regional pain syndrome (CPS). He previously worked as a machinist but has since been unemployed and has a conflicted relationship with his girlfriend who has accused him of being a junky. The patient does exhibit some symptoms of depression.
The patient has previously complained about the negative side effects of some of the drugs he has been given to address his pain symptoms, including constipation and sleepiness. Given this, the use of the tricyclic antidepressants like amitriptyline would seem counterproductive given that these drugs often produce similar side effects ("Amitriptyline," 2016). However, Savella…
Amitriptyline. (2016). Mayo Clinic. Retrieved from:
FAQs. (2017). Biofreeze. Retrieved from: http://www.biofreeze.com/faqs
Lidocaine. (2017). Mayo Clinic. Retrieved from:
Therefore, the research offers reliable data supporting the emerging medication.
The sample included 878 patients with low back pain or pain from osteoarthritis of the knee or hip. Patients were randomly assigned to Tapentadol or control drug oxycodone and took their medications for 90 days Doses for Tapentadol were flexible with either 50 or 100 mg offered every 4 to 6 hours, up to a maximum of 600 mg/day. Instances of nausea, vomiting, and constipation were significantly lower in the Tapentadol group vs. The oxycodone group. Doses were flexible and mimicked real life administrations of the medications.
However, the control group was given 10 mg or 15 mg of oxycodone IR every four to six hours. The lack of standardization of doses and the flexible administration of the drugs compromise the reliability and validity of the study. Nurses should also take note that rates of other side-effects such as drowsiness…
Also, when this option is not used, the number and nature of other types of pain management methods will be investigated. The sample size will be in the range of 100 patients in addition to their primary care-giving family members, which might range between 100 and 200.
A power analysis will be done to determine the divergence of choices from the ones that are expected. In cases where pain management in hospitals have been relatively effective, it is expected that fewer patients and families would opt for sedation, for example, whereas those who remained with their families for as long as possible before the end stage, as well as those for whom pain medication has stopped functioning adequately, are expected to more readily choose this form of pain management.
End-of-life care is a very emotional stage in the lives of both sufferers and their families. Ethical research will be ensured…
Claessens, P., & Broeckaert, B. (2011). Palliative Sedation, Not Slow Euthanasia: A Prospective, Longitudinal Study of Sedation in Flemish Palliative Care Units. Journal of Pain and Symptom Management, Vol. 41, No. 1, 14-24.
Given, B.A. (2001). Family Support in Advanced Cancer, Vol. 54, No. 4. CA - A Cancer Journal for Clinicians, 213-31.
Kahn, D.L., & Steeves, R.H. (1996). An Understanding of Suffering Grounded in Clinical Practice and Research. In B.R. Ferrell, Suffering (pp. 3-28). Sudbury, MA: Jones and Bartlett.
Certainly in nature, one who was too ill to move would not last long. They would certainly not be placed on a feeding tube, having a machine breathing for them, mechanical devices doing all but forcing their heart to beat. Does having the power to extend life mean that physicians then have a duty to do so? According to Lachs, "Medicine does not surrender its vocation in serving the desires of individuals: since health and continued life are among our primary wishes, its career consists in just this service." If the primary duty of a physician is to honor their patient's wishes for health, then if a patient desires death as an end to suffering, that physician does not have a duty to prolong that patient's life. Rather, prolonging life against the wishes of the patient breaches the duty of the profession.
hy, then, do physicians continue to take incredible…
"Ethics." Internet Encyclopedia of Philosophy. 19 March 2011.
The Hippocratic Oath; Modern Version. PBS.com. 19 March 2011.
Lach, John. "When Abstract Moralizing Runs Amok." (please insert the book information, as it was not on the pages sent)
Singer, Peter. "Voluntary Euthanasia: A Utilitarian Perspective." (see note, above)
Interventional Pain Clinic (IPC) as part of PeaceHealth Southwest Washington Hospital, located in Vancouver, Washington. This descriptive essay will be used to assist in developing focus on future projects with this class. This essay will give a background and history of this institution before investigating some of the specific purposes of the pain clinic. This community need will be explained and how this need does or does not specifically address the population this facility is attempting to serve.
PeaceHealth Southwest Medical Center has deep roots within this pacific northwest community. The original building was established in 1858 and the hospital was called St. Joseph Hospital. This hospital was originally founded by Mother Joseph Pariseasu and it is the oldest hospital in this part of the country. The other side of this merger began with Clark General Hospital which opened in 1929 to honor and serve military veterans and later changed…
PeaceHealth Southwest Medical Center Homepage. Visited 5 July 2013. Retrieved from http://www.swmedicalcenter.org/default.cfm
Candace, a 15-year-old softball player, presents due to ankle pain that developed after she twisted her ankle during a game. Ankle sprains and pain are common occurrences in athletes to an extent that they continue to be the subject of interest in sports medicine (McGovern & Martin, 2016). As evident in Candace’s situation, ankle sprains and injuries are common among individuals who are physically active. Therefore, early diagnosis and management of these conditions is crucial toward enhancing the patient’s health and wellbeing. The diagnosis process requires obtaining information to support possible differentials of strain, sprain, tear, or fracture. Information for proper diagnosis and identification of these factors is obtained through history and objective assessment. Some of the information needed include history of ankle injury, severity of injury, history of fracture, anatomical features, and clinical history.
Once diagnosis is made, a suitable intervention plan for treatment or management of…
Pilot Study of elationships Among Pain Characteristics
Mood Disturbances, and Acculturation in a Community
Sample of Chinese-American Patients With Cancer
Edrington, J., Sun, A., Wong, C., Dodd, M., Padilla, G., Paul, S., & Miaskowski, C.
This study is a pilot study to determine how level of acculturation and mood affect the intensity and functional aspects of pain in Chinese-American cancer patients. The purpose of the study is to determine if the pain perception of Chinese-American cancer patients is consistent with some past research on other ethnic groups (particularly Hispanic and African-Americans) that find that the level of acculturation is negatively related to the patients' self-reported pain intensity and the relief from pain associated with cancer. The researchers use the definition of acculturation as the process by which immigrants take on or embrace values, beliefs, customs, norms, and the lifestyle of the mainstream culture. Thus the Americanized the group is the…
Bates, M.S., Edwards, W.T., & Anderson, K.O. (1993). Ethnocultural influences on variation in chronic pain perception. Pain, 52, 101-112.
Edrington, J., Sun, A., Wong, C., Dodd, M., Padilla, G., Paul, S., & Miaskowski, C. (2010). A pilot study of relationships among pain characteristics, mood disturbances, and acculturation in a community sample of Chinese-American patients with cancer. Oncology Nursing Forum, 37 (2), 172-181.
Gregory, R.J. (2011). Psychological Testing: History, Principles, and Applications (Sixth Edition). Boston: Allyn & Bacon.
Koyama, T., McHaffie, J.G., Laurienti, P.J., & Coghill, R.C. (2005). The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Sciences, 102, 12950-12955.
Reavey, P. (010). Spatial markings: Memory, agency and child sexual abuse. Memory Studies.
According to Reavey (010), a critical component of recovery from childhood sexual abuse is reasserting the victim's sense of agency and control over her own life. All too often it is common when treating survivors to encourage them to see themselves as passive victims. The focus of Reavey's text is the spatial component of memory: women experience the trauma of abuse again and again because of the parallels between their current physical situation and that of their past, abusive histories. Reavey suggests that viewing the self as constantly in flux and changing and creating a new narrative linking past and present in a more positive way is a far more helpful concept to instill over the course of therapy. One of the challenges many women experience in dealing with abuse is that it takes place in a…
2011 4: 23.
According to Burton (2011), although pain is undeniably a 'real' thing, memories of pain can cause the actual, somatic trauma to linger long after the physical condition has passed. She cites one woman who was 'tricked' using a mirror to realize that she no longer was experiencing pain in one of her hands due to repetitive stress injury. "Mirror therapy illustrates the radical account of corporeal memory that is now current in the biomedical sciences, in which the body is a complex amalgam of fleshy reality and cerebral projection -- images and reality have merged, and the brain has the capacity to 're-member' its physiological attitudes" (Burton 2011: 30). Although Burton acknowledges that there is often a great deal of mistrust of biological sciences as reductive amongst humanities scholars, she suggests that the treatment of chronic pain can be useful as a study of the intersection of personal experience and medicine. Chronic pain is ill-understood by the medical community and often notoriously difficult to treat. Analyzing how memory can cause pain to be stored in the body and how tricking one's memory can release it shows how humanities-based understandings of medicine can prove useful for the biological sciences.
Pain is all too often negated or dismissed: rather Burton suggests an empathetic understanding of its causality and a holistic approach to pain treatment. Burton's article provides a starting point for many other treatments which try to address the intersection of pain and memory. Massage, yoga, and other forms of general exercise all encourage participants to construct a new concept of themselves through the reengineering of the body and a reconfiguration of the relationship of the individual to his or her physicality in the past, present, and future.
Assessing the Abdomen
The chief complaint of JR is that his “stomach hurts” and he is experiencing diarrhea, from which he has been unable to obtain any relief. His pain in his abdomen started 3 days earlier and he has taken no medication for it. The pain is midrange, though it was very high today when it began. He ate but experienced nausea afterwards. JR is 47, suffers from hypertension, diabetes and had an issue of gastrointestinal bleeding four years ago. He is on a number of medications to address his high blood pressure and diabetes. He has no known drug allergies, no history of colon cancer. His father and mother both had hypertension; his father has type 2 diabetes; his mother suffered from Gastroesophageal reflux disease and high fatty concentration in the blood (hyperlipidemia).
JR occasionally imbibed alcohol. He is overweight at 248 lbs with a 5’10” height. He…
The existence of human suffering poses a unique theological problem. If God is omniscient, omnipotent, and all-loving, then why does suffering exist? Indeed, this difficulty is confronted in scripture itself: perhaps the most important look into the problem of suffering comes in the Old Testament story of Job. Mainstream Christianity continues to have a variety of ways of approaching this theological question, although historically Christians had a much broader spectrum of responses. For example, today's mainstream Christianity is a result of the establishment of orthodoxy in the face of Gnostic Christians, who used the existence of suffering as a way of questioning whether God was indeed omnipotent or all-loving. Gnosticism instead posits a "demiurge" or "alien god" that created this world and its suffering without being omnipotent or good. ut the oldest mainstream form of Christian orthodoxy today -- represented by the Roman Catholic faith…
Barron, Bishop Robert. "Stephen Colbert, J. R. R. Tolkien, John Henry Newman, and the Providence of God," Word on Fire. Web. 4 Dec 2015.
English Standard Version Study Bible.
John Paul II. Salvifici Doloris. 1984. http://w2.vatican.va/content/john-paul-ii/en/apost_letters/1984/documents/hf_jp-ii_apl_11021984_salvifici-doloris.html
Keller, Timothy. Walking With God Through Pain and Suffering. New York: Riverhead Books, 2015.
Turner resented the boy's efforts, and accused the members of Homer's Rocket Club of starting a bomb club, much the same way Homer's father's friend Doc warned the boys that they would blow themselves to kingdom come. Mr. Turner only begins to look differently at what came to be known as the Rocket Club after the high school's football season was threatened, because of the school's poor academic record. Homer's instincts and his mother's wise words were correct -- Sputnik changed everything, and America's leaders agreed that America had to look to the future. Homer was a defiant boy of conventional wisdom, a rebel, but not because of the clothes he wore or because of his anger, but because of his determination to look beyond the confines of Coalwood and to use his mind.
Homer's efforts were encouraged by his teacher Miss Riley, a rebel in her own right. She…
Hickman, Homer. Rocket Boys. New York: Delta, 2000.
Banks Find New Ways to Ease Pain of Bad Loans describes the various ways banks holding large amounts of bad, or soon to be bad loans are, in effect, hiding these bad assets. For instance Astoria Financial Corp. extended the number of payments a customer had to miss before the loan would be listed as "nonperforming." By extending the number of missed payments from two to three, Astoria wiped close to $40 million off it's books. Well Fargo did a similar thing by extending the number of days a customer had to miss payments from 120 to 180 before writing these loans off. Bank Atlantic Bancorp tried something a bit different, they created an entirely new subsidiary and transferred $100 million of troubled loans to this new subsidiary. They managed to simply erase the bad loans from their books while avoiding federal regulators by creating a new subsidiary that was…
Emotions of Love and Lust in the orks of Victor Hugo
Victor Hugo is easily one of the major figures of world literature. Hugo has been responsible for painting some of the most compelling portraits of the struggle of the human condition and how certain emotional conditions continue to subsist among untold levels of depravity and suffering. One can examine The Hunchback of Notre Dame and Les Miserables as portraits of not only human suffering but as literary demonstrations of how even lust can continue to subsist throughout the human condition even when under intense strain. This paper will examine how Hugo is able to showcase the carnal longings of humanity throughout those works.
The Hunchback of Notre Dame demonstrates two different types of lust, emotional lust and sensual lust (Chris, 2010). Emotional lust in this case is first represented by the words and actions by the gypsy Esmeralda and…
Chris, T. (2010, November 10). Two Kinds of Lust: Lessons from The Hunchback of Notre Dame. Retrieved from Wordpress.com: http://mytwocents.wordpress.com/2010/11/09/two-kinds-of-lust-lessons-from-the-hunchback-of-notre-dame/
Grossman, K. (1994). Figuring Transcendence in Les Miserables: Hugo's Romantic Sublime. Springfield: SIU Press.
Hugo, V. (2010). Les Miserables. London: Courier Dove Publications.
-- . (2013). The Hunchback of Notre Dame. New York: United Holdings Group.
theories on motivation that relate to an employee switching from salary to commission. The Maslow "Hierarchy of Needs" theory is applicable and appropriate; Maslow believed that people are motivated to fulfill basic needs first, then they move on to other needs. He presents five levels in his hierarchy of needs and the first is "physiological needs": these are survival needs -- food, water, air to breathe and sleep. The motivation to earn more money covers the ability to buy food and to have fresh water. The second level of Maslow's Hierarchy of needs is the most applicable to the switch from salary to commission; that second on the hierarchy are "security needs" -- steady employment, access to healthcare, a safe place to live and shelter from the environment. The other needs (social, esteem, and "self-actualizing") fit into the change from salary to commission, but of those "self-actualizing" is particularly germane…
Cherry, K. (2014). Hierarchy of Needs. About.com Psychology. Retrieved April 18, 2014, from http://psychology.about.com .
University of Cambridge. (2009). Vroom's Expectancy Theory. Retrieved April 18, 2014, from http://www.ifm.eng.cam.ac.uk .
Morgan, Edmund S., Joseph
Birth of the Republic, which was written by the late professor Edmund Morgan, is extremely ambitious in scope. Its purpose is to recount the history of the initial founding of the United States -- which was originally envisioned as a republic. As such, the author covers the approximate 25-year period that began with the end of the French and Indian ar and which ended with the formulation and ratification of the Constitution. During this tumultuous time period which included the Revolutionary ar, the rise and fall of the Articles of Confederation, and the increasing dissatisfaction with the British government, the mores of the men who would found this country were exuded and tested. The author's central premise is that those mores were more than simple political rhetoric that disguised a need for personal gain, and instead represented a dedication to values that likely has not been…
Hattem, Michael. "Reconsidering Edmund Morgan's The Birth of the Republic, 1763-1789." www.earlyamericanists.com. 2013. Web. http://earlyamericanists.com/2013/03/13/reconsidering-edmund-morgans-the-birth-of-the-republic-1763-89/
Morgan, Edmund S., and Joseph J. Ellis. Birth of the Republic, 1763-89. Chicago: University of Chicago Press. ISBN 9780226923420.
Participants filled out a Short-Form McGill Questionnaire, an Arthritis Self-Efficacy Scale, and Fibromyalgia Impact Questionnaire in order to measure their levels of pain over the past few weeks. What the researchers found through statistical analysis was self-management strategies that reduced pain over time were most effective in the group that was exposed to guided imagery techniques. The level of guided imagery therapy was not itself significant, but more of the fact of whether or not it was present in the patient's therapy or not. This helps illustrate the effectiveness of guided imagery in managing long-term chronic pain when there are no fundamental cures present within traditional therapeutic practices. Pain management symptoms improved, but the symptoms overall remained. This shows that guided imagery is not a cure in and of itself, but rather an effective way to reduce and manage the pain that is present in chronic conditions like fibromyalgia.
Ferrell, Betty R., et al. "Pain management for elderly patients with cancer at home." CANCER-PHILADELPHIA- 74 (1994): 2139-2139.
Menzies, V., Taylor, a.G., & Bourguignon, C. (2006). Effects of guided imagery on outcomes of pain, functional status, and self-efficacy in persons diagnosed with fibromyalgia. Journal of Alternative & Complementary Medicine, 12(1), 23-30.
Weydert, J.A., Shapiro, D.E., Acra, S.A., Monheim, C.J., Chambers, a.S., & Ball, T.M. (2006). Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial. BMC pediatrics, 6(1), 29.
Her life has been a hard one. She raises the children, walks half a mile to a well in rural Mexico to fetch water every day. When she leaves three days a week to serve as a domestic in a nearby motel, her oldest daughter, 11, looks after the children.
Maria makes tortillas every morning and boils the water for purification. Her hands are strong, her skin is leathery, the result of a lifetime of hard work and painful experiences. Her husband is working in the fields in California so she doesn't see him very often, but he sends her money through Western Union so she can pay the rent on their little home. He knows a baby is expected but the grape crops in California must be picked when they are ready, so he can't leave to come home and be with his wife. His back is permanently painful…
The practice of manipulative thrust therapy can be dangerous and cases of injuries and tragic events have been recorded. Cases of vertebral artery dissection (VAD) have been recorded in people that had the cervical spine manipulation technique done and research on the cases from 1966 to 1993 concluded 30% could be attributed to the procedure (Cleland 2007). VADs are spontaneous and can be normally present at the initial onset of headaches or neck pain. This represents the conclusion that the VAD was present before the technique is performed on a patient complaining of neck pain. The debate over the truth is still being waged. Even authors have joined the debate but they are touted as biased and do not support the evidenced based in research (User's Guide 2008).
Other debates rage as well. The risks of the manipulative thrusts therapies are actually no worse the risks from NSAIDs and cervical…
Anonymous. "Activator turns 35." Dynamic Chiropractic. Dynamic Chiropractic CA. 2001. HighBeam Research. 24 Apr. 2010 .
Anonymous. "Study Finds "Manual Therapy" Effective for Shoulder Dysfunction/Pain." Dynamic Chiropractic. Dynamic Chiropractic CA. 2004. HighBeam Research. 24 Apr. 2010 .
Anonymous. "Journal of Manipulative and Physiological Therapeutics." Dynamic Chiropractic. Dynamic Chiropractic CA. 2006. HighBeam Research. 24 Apr. 2010 .
Australian Journal of Physiotherapy 2001 Vol. 47-163-24 April 2010
Healing Touch Annotated Bib
Bardia, A., et.al. (2006). Efficacy of Complementary and Alternative Medicine Therapies in elieving Cancer Pain: A Systematic eview. Journal of Clinical Oncology. 24 (34): 457-64.
Anecdotal evidence abounds regarding the use of complementary and alternative medicine therapies when dealing with issues of pain. One of the clear issues is that there is a lack of rigorous and well-developed scholarly literature on the subject. In this study, 18 trials were reviewed totaling 1,499 patients. Seven trials reported significant benefits using CAM, seven reported intermediate or short-term benefits, and four studies reported no benefits. The researchers conclude that there are a number of variables and a number of types of CAM, all which require more methodologically sound studies in order to determine actual efficacy of individual interventions.
Jones, T., Glover, L. (2012). Exploring the Psychological Processes Underlying Touch:
Lessons From the Alexander Technique. Clinical Psychology and Psychotherapy. EPub:…
Bardia, A., et.al. (2006). Efficacy of Complementary and Alternative Medicine Therapies in Relieving Cancer Pain: A Systematic Review. Journal of Clinical Oncology. 24 (34): 457-64.
Jones, T., Glover, L. (2012). Exploring the Psychological Processes Underlying Touch:
Lessons From the Alexander Technique. Clinical Psychology and Psychotherapy. EPub: doi 10.1002/cpp.1824.
Kelly, A., et.al. (2004). Therapeutic Touch, Quiet Time, and Dialogue: Perceptions of Women With Breast Cancer. Oncology Nursing Forum. 31 (3): 625-31.
This strength, however, comes at the price of an explanation of the detailed mechanisms by which abdominal pain is created by each of the identified illnesses. The article's primary strength is found in its directness and its effective summary of necessary information, in the brevity through which this is achieved necessarily limits the scope of the article. Though the article would perhaps have been more interesting with more in depth explanations, it was still a highly interesting read and provided an effective and concise review of some knowledge already obtained as well as presenting new knowledge.
The health assessment strategies described in this article would be highly beneficially in any practice not already using similar assessment methods. The efficiency and reliability of the methods the authors describe would be of great benefit to patients and staff alike, saving abundant time, energy, and resources that can then be devoted to treatment…
Cole, E.; Lynch, a. & Cugnoni, H. (2006). Assessment of the patient with acute abdominal pain. Nursing standard 20(38), 56-61.
MacPherson, Thorpe, and Thomas (2006) reported an interesting qualitative study on the use of acupuncture in the treatment of low back pain. They report the results of a qualitative study nested within a large quantitative study (there were actually tow qualitative studies performed but the current study only addresses one of them). The quantitative study design was one of a large randomized controlled trial that compared acupuncture against typical general practitioner care. The study was carried out York between the years 1999 and 2003. The acupuncture treatment for the study was founded on the principles of Traditional Chinese Medicine (TCM) using six acupuncturists who all had a minimum of three years of post-qualification clinical experience. The acupuncturists were encouraged by the researchers to provide their typical treatment so that the study would evaluate the effect of routine care for lower back pain, each acupuncturist making meticulous notes of the aspects…
Campbell, A. (2006). Point specificity of acupuncture in the light of recent myofascial pain.
Acupuncture Medicine, 24(3), 118-122.
MacPherson, H., Thorpe, L., & Thomas, K. (2006). Beyond needling therapeutic processes in acupuncture care: A qualitative study nested within a low-back pain trial. Journal of Alternative and Complementary Medicine, 12, 873-880.
Both Margery Kempe and the woman who can be called her mentor, Julian of Norwich, highlight the roles that women have played in Christian history. Although the Roman Catholic Church has officially canonized neither of them, the Anglican Church recognizes and honors both. Margery Kempe and Julian of Norwich both wrote extensively, and their writings have survived as testimony of the hardships women especially endured given their low social status, and how religion helped women to attain personal power and peace. Moreover, their writings reveal a mature theology that can be considered humanist as well as feminist. Margery Kempe and Julian of Norwich both share in common experiences of hallucinations related to near death experiences. Their both having near-death experiences linked the two women and anchored them to Christ as well. Kempe eventually came to visit Julian of Norwich, and the two shared in common a visionary love…
Julian of Norwich. The Shewings of Julian of Norwich. Retrieved online: http://d.lib.rochester.edu/teams/text/the-shewings-of-julian-of-norwich-introduction
Kempe, Margery. The Book of Margery Kempe. Retrieved online: http://d.lib.rochester.edu/teams/text/staley-book-of-margery-kempe-book-i-part-i
mith, CA & Crowther, CA (2009) Acupuncture for induction of labour, Cochrane Database of ystematic Reviews, 1, 1-26
The pregnant woman is induced when the pregnancy is becoming dangerous either for herself or for the unborn child. Generally done by drugs, mith and Crowther (2009) reviewed the effects of induction that has been impelled by acupuncture which has been historically used to help induce labor and to reduce labor pain. mith and Crowther (2009) conducted a review that included three trials involving 212 women. They concluded that clinical evidence of the effectiveness of acupuncture as applied to this situation is limited, although some qualitative small studies do suggest that women who receive acupuncture receive fewer methods of induction than do women who receive the standard care of induction.
This article is particularly significant given that we are living in a period when increasingly more people turn to holistic or alternative…
Ernst, E. (2002), A systematic review of systematic reviews of homeopathy, British Journal of Clinical Pharmacology 54 (6): 577 -- 82
Eysenck, HJ (1994) Systematic Reviews: Meta-analysis and its problems BMJ,309:789
Livestrong.com. How does massage therapy work?
Nursing Case Study
The first concern is that Mrs. Baker is taking a new drug that has side effects such as she is experiencing. Although the other high blood pressure medication has similar side effects (Drugs.com, 2012), she has been taking it for a long period of time and should not be experiencing as much difficulty. It seems germane to ask her how long she has been taking the hydrochlorothiazide though. One of the first thoughts is how well do the two medications work together, which is something her doctor understands, and if she can have an increase in side effects because of the increase in medication. The second question the symptoms, especially the fact that she seemed "confused and beside herself" on the phone, is to determine if there are other symptoms of stroke. Her breathing difficulties could be a symptom of the medication, and so could the confusion,…
Drugs.Com. (2012). The side effect of Lisinopril. Retrieved from http://www.drugs.com/sfx/lisinopril-side-effects.html
"Some Enemies of Science" J.B.S. Haldane
The vivisection debate: J.B.S. Haldane's "Some enemies of science"
The vivisection debate is an old one. As early as 1928, the scientist J.B.S. Haldane rigorously defended the practice of vivisection against its earliest detractors, arguing that even moderate government regulation of scientific behavior to protect animal rights was hypocritical, given the way that animals were treated in other spheres of human life. In contrast, David Suzuki's 1989 essay "The pain of animals" highlights the central paradox of animal experimentation. On one hand, animal experiments are only useful because of our biological similarities to animals. On the other hand, we assert our right to exploit animals based upon our inherent differences from them. The intelligence of animals such as the chimpanzee is analogous to a two-year-old child and yet through logical sleight of hand we justify using chimps in the laboratory by calling them…
Haldane, J.B.S. (2004). Some enemies of science. The Nelson Introduction to Literature (2nd
Ed). Valleau, Al & Jack Finnbogason. (Eds.). Toronto: Thomson Nelson.
Suzuki, David. (2004). The pain of animals. The Nelson Introduction to Literature (2nd
Ed). Valleau, Al & Jack Finnbogason. (Eds.). Toronto: Thomson Nelson.
Capturing the anguish and agony which consumes those caring for loved ones at the end of life is an exceedingly difficult task, but essayists Katy Butler and Rachel Riederer have harnessed their unique literary abilities in vastly different ways to achieve the same ambitious objective. Published within the 2011 edition of the annual anthology of American creative nonfiction The Best American Essays, Butler's haunting elegy hat Broke My Mother's Heart and Riederer's visceral portrayal of her own injurious accident Patient each deploy disparate rhetorical styles to impart a shared premise. ith the rancorous debate over health care and its most efficient and effective form of delivery currently embroiling the nation's political, private and public sectors, penning a polemic railing against the medical industry hardly represents an exercise in intellectual courage, which is why the contributions made by Butler and Reiderer are refreshing in their candid and emotionally honest approach to…
Butler, Katy. "What Broke My Father's Heart." The Best American Essays 2011.
Edward Danticat and Robert Atwan. New York, NY: Houghton Mifflin Harcourt
Publishing Company, 2011. 12-24. Print.
French, John and Raven, Bertram. "The Bases of Social Power." In D. Cartwright (Ed.), Studies
pain thresholds of cancer patients, with a particular focus on Chinese-American outpatients who have been treated for cancer.
hich databases will you use?
hat key words did you use in the Search Strategy fields?
EBSCOHost: Cancer, cancer pain, cancer pain thresholds, cancer patients pain, cancer pain management
ProQuest: Cancer, cancer and pain management, cancer and pain, cancer and patients, cancer pain
Infotrac: Cancer, cancer pain, cancer patients, cancer struggle
How many articles are found in each keyword search?
EBSCOHost: Cancer (1,215,732), cancer pain (5,409), cancer pain thresholds (4), cancer patients pain (699), cancer pain management (480)
ProQuest: Cancer (13,323), cancer and pain management (5), cancer and pain (28), cancer and patients (144), cancer pain (80)
Infotrac: Cancer (47,737), cancer pain (93), cancer patients (2,321), cancer struggle (334)
Is this research qualitative or quantitative? hat is the study design? hat criteria did you use to determine the study…
Edrington, J., Angela Sun, Candice Wong, Marylin Dodd, Geraldine Padilla, Steven Paul, and Christine Miaskowski, (2010). "A Pilot Study of Relationships Among Pain Characteristics, Mood Disturbances, and Acculturation in a Community Sample of Chinese-American Patients with Cancer." Oncology Nursing Forum, 37(2).
pain when it comes to being different. In both Zora Neale Hurston's essay "How It Feels to Be Colored Me" and Richard Rodriguez's " Aria: Memoir of a Bilingual Childhood" the two writers discuss the differences they come upon that molded their principles and sentiments as they grew older. For Hurston hers was about being of a dissimilar race than her environment. For Rodriguez, his was about being different by communicating in another language. Both felt the effect it had on not just their lives, but also their thoughts as they matured into adulthood.
Rodriguez and Hurston viewed their differences as some sort of handicap. Each author imagined themselves in some way as being handicapped in life, of either not comprehending the language or not comprehending being of a different race. However, both authors found a way to overcome their personal struggles through turning these thoughts and struggles into growing…
The quantitative approach, meanwhile, will make use of the survey method, focusing on three (3) segments each for males and females (criteria mentioned earlier in the preceding section).
The diary method is recommended because this will generate information that is insightful and in-depth, as it provides participants with an opportunity to express their thoughts and feelings without being conscious of the people who might be interviewing them or be with them, as what happens during an FGD.
Focus Group Discussion (FGD)
The FGDs will provide breadth of information about perceived pain. There will be twelve (12) mini-groups per segment, broken down into the following discussant types:
Youth/Young Adult (13-25 years old)
Adults (26-55 years old)
Youth/Young Adult (13-25 years old)
Adults (26-55 years old)
The survey method will make use of the multi-stage sampling, using once again the respondent criteria enumerated…
Babl, F. (2008). "Procedural pain and distress in young children as perceived by medical and nursing staff." Pediatric Anesthesia, Vol. 18.
Carlson, K. (2000). "Using distraction to reduce reported pain, fear, and behavioral distress in children and adolescents: a multisite study." JSPN, Vol. 5, No. 2.
Hama, a. (2004). "Sex differences in pain perception: a biological perspective." Mankind Quarterly, Vol. XLIV, Nos. 3 & 4.
Ibid., (2000). "Racial differences in pain perception: a biological basis." Mankind Quarterly, Vol. XLI, No. 1.
There are a number of points of interest regarding "Massage therapy in post-operative rehabilitation of children and adolescents with cerebral palsy - a pilot study." On the whole this is an extremely well-organized article, which is one of its primary strengths. The different sections and phases of the research are well documented. There are a variety of tables that elucidate several components related to the literature review, the results, and the particulars of the subjects considered in the research. However, there is more than one area of the study in which the researchers could have benefited from the use of more substantial effort and a more thorough methodology, which is certainly reflected in the results and the conclusion.
The central weakness of this study is the fact that all of the results were based on research performed on just six subjects. To the credit of the researchers they…
O'Conner, P. (2003). Woe is I: The grammarphobe's guide to better English in plain English. New York: Riverhead Books