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An Innovative and Accessible Biofeedback Intervention for Improving Self-Regulatory Skills in Pediatric Chronic Pain: A Pilot Study.

Although biofeedback has been considered an effective treatment component for pediatric chronic pain, little research has examined the generalizability to activities outside of the treatment setting. The current study aimed to examine the effects of a biofeedback intervention involving individual and group sessions to facilitate increased self-regulatory skills for chronic pain management and to translate these skills to meaningful activities promoting functional restoration. Participants included 104 adolescents (ages 12-18) attending an intensive interdisciplinary pain rehabilitation program for chronic pain/symptoms and completed biofeedback training as part of the program. The biofeedback protocol consisted of six sessions, including an assessment of baseline physiologic states, diaphragmatic breath training, and various biofeedback screens to reinforce self-regulatory skills within individual- and group-based formats. As expected, patients showed significant reductions in respiration rates and muscle tension from admission to discharge. Ratings of perceived confidence also increased from admission to post-treatment, suggesting greater self-efficacy in patients using self-regulatory skills during their daily functional activities. An individual- and group-based biofeedback protocol with a focus on training skills in activities relevant to adolescents' lives has the potential to improve self-regulation skills and generalize these skills to real-world settings. Future randomized controlled trials are necessary to examine the efficacy of biofeedback interventions to improve physiologic regulation and enhance treatment outcomes for pediatric chronic pain.

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[Ericksonian hypnosis and mindfulness meditation: Towards a behavioral medicine in nephrology].

The utilization of behavioral medicine, like Ericksonian hypnosis and mindfulness meditation, in the patient care is increasing. Psychological disorders associated with chronic renal failure are similar to the post-traumatic stress disorder and need a continuous personnel adjustment. Preventing depression, managing stress, pain and emotions, like anger, guiltiness and shame, is of importance in individual who suffer of chronic kidney disease, but also in their family caregivers and in health-care workers. The objective of this report is to describe how Ericksonian hypnosis, mindfulness meditation and compassion meditation could support chronic kidney disease patients, their caregivers and the health-care professional.

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Impact of EMA regulatory label changes on systemic diclofenac initiation, discontinuation, and switching to other pain medicines in Scotland, England, Denmark, and The Netherlands.

In June 2013 a European Medicines Agency referral procedure concluded that diclofenac was associated with an elevated risk of acute cardiovascular events and contraindications, warnings, and changes to the product information were implemented across the European Union. This study measured the impact of the regulatory action on the prescribing of systemic diclofenac in Denmark, The Netherlands, England, and Scotland.

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A National Survey of the Prevalence of Chronic Pain in Nursing Students and the Associated Factors.

To examine the prevalence of chronic pain and the associated factors among nursing students.

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Upper extremity regional anesthesia techniques: A comprehensive review for clinical anesthesiologists.

Surgeries and chronic pain states of the upper extremity are quite common and pose unique challenges for the clinical anesthesiology and pain specialists. Most innervation of the upper extremity involves the brachial plexus. The four most common brachial plexus blocks performed in clinical setting include the interscalene, supraclavicular, infraclavicular, and axillary brachial plexus blocks. These blocks are most commonly performed with the use of ultrasound-guided techniques, whereby analgesia is achieved by anesthetizing the brachial plexus at different levels such as the roots, divisions, cords, and branches. Additional regional anesthetic techniques for upper extremity surgery include wrist, intercostobrachial, and digital nerve blocks, which are most frequently performed using landmark anatomical techniques. This review provides a comprehensive summary of each of these blocks including anatomy, best practice techniques, and potential complications.

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Comparisons of Monopolar Lesion Volumes with Hypertonic Saline Solution in Radiofrequency Ablation: A Randomized, Double-Blind, Ex Vivo Study.

Chronic degeneration of the zygapophyseal joints in the cervical or lumbar spine are common causes of axial back pain. Radiofrequency (RF) ablation is a treatment modality in the denervation of facet joint-related pain. Although multiple factors have been theorized to contribute to the size of the optimal RF lesion, the addition of hypertonic saline solution has been posited to create larger RF lesion sizes.

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Psychotherapy research is needed to improve clinical practice for clients with HIV.

This introductory article to the special issue on psychotherapy and HIV provides an overview of the state of HIV intervention research, recommendations for future psychotherapy practice, and an emphasis on how psychotherapy researchers focusing on HIV should move away from the typical public health model. We provide information about how historical bias impacts HIV clinical decision-making now. In addition, we include an analysis of how public health definitions of intervention research have limited psychotherapy research-specifically the importance of common factors and process-oriented components in psychotherapy. In this introductory article, we highlight the 13 articles that comprise the 5 following sections included in the special issue: (a) General Guidelines for Psychotherapy Practice for People With HIV, (b) HIV Stigma in Psychotherapy Process and Techniques, (c) Sexual Functioning and Romantic Relationships for People with HIV, (d) A Focus on Specific Disorders (Chronic Pain and Trauma) Comorbid With HIV, and (e) A Focus on Specific Populations (Adolescents and South African Populations). We conclude by offering recommendations to researchers to focus on the sociocultural context for clients with HIV and for psychotherapists to use an intersectional approach in their work with clients with HIV. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

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Interactive group-based orientation sessions: A method to improve adherence and retention in pragmatic clinical trials.

Intervention adherence and trial retention are challenging for clinical trials testing intensive behavioral interventions. Operational constraints or trial designs may preclude using effective retention strategies such as financial incentives. We examined whether implementing pre-enrollment orientation sessions was associated with higher intervention adherence and retention in a pragmatic clinical trial.

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An 80-Year Old Man Presenting with Fevers, Altered Mental Status, and Joint Effusions.

An 80-year-old man with atrial fibrillation, hypertension, osteoarthritis status post bilateral total shoulder arthroplasty and right hip arthroplasty, recent diagnosis of dementia, and monoclonal gammopathy of undetermined significance (MGUS), was admitted with fever, joint pain, and weakness. Prior to his first admission for these symptoms, he had been living independently at home with his wife and exercised multiple times weekly. Two months prior to the current hospitalization, he had an admission to another hospital for acute functional decline with leg weakness that had developed over the course of around two weeks, altered mental status with episodes of confusion, and fever to 102.2 degrees Fahrenheit.

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The effectiveness of photobiomodulation in the management of temporomandibular pain sensitivity in rats: behavioral and neurochemical effects.

This study analyzed the effects of photobiomodulation (PBM) with low-level laser therapy on nociceptive behavior and neuronal activity in the trigeminal nucleus after experimental unilateral temporomandibular joint (TMJ) disc injury. The animals were divided into 4 groups (n = 10 each): group 1, surgical injury of the articular disc and PBM; group 2, sham-operated subjected to PBM; group 3, surgical injury of the articular disc; and group 4, control (Naïve). Ten sessions of PBM were performed using GaAs laser with a wavelength of 904 nm, power of 75 W pico, average power of 0.043 W, area of the beam of 0.13 cm, duration of the pulses of 60 nseg (in the frequency of 9500 Hz), energy density of 5.95 J/cm, energy per point of 0.7 J, and power density of 333.8 mW/cm, and the irradiation was done for 18 s per point. Neuropathic symptoms were evaluated using the von Frey test. Trigeminal ganglion samples underwent immunoblotting to examine the expression of substance P, vanilloid transient potential receptor of subtype-1 (TRPV-1), and peptide related to the calcitonin gene (CGRP). There was a total decrease in pain sensitivity after the second session of PBM in operated animals, and this decrease remains until the last session. There was a significant decrease in the expression of SP, TRPV-1, and CGRP after PBM. Photobiomodulation therapy was effective in reducing nociceptive behavior and trigeminal nucleus neuronal activity after TMJ disc injury.

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