Intense Physical Pain Research Articles

Microneedles with Two-Stage Glucose-Sensitive Controlled Release for Long-Term Insulin Delivery.

Diabetes patients cannot complete effective blood glucose regulation due to their impaired pancreatic function. At present, subcutaneous insulin injection is the only treatment for patients with type 1 and severe type 2 diabetes. However, long-term subcutaneous injection will cause patients with intense physical pain and lasting psychological burden. In addition, subcutaneous injection will lead to hypoglycemia risk to a large extent because of the uncontrollable release of insulin. In this work, we developed a glucose-sensitive microneedle patch based on phenylboronic acid (PBA)-modified chitosan (CS) particles and poly(vinyl alcohol) (PVA)/poly(vinylpyrrolidone) (PVP) hydrogel for the efficient delivery of insulin. Meanwhile, through the double glucose-sensitive response process of CS-PBA particle and external hydrogel, the sudden release of insulin was well restrained, and a more persistent blood glucose control was achieved. Finally, the painless, minimally invasive, and efficient treatment effect of the glucose-sensitive microneedle patch indicated its great advantages as a new generation of injection therapy.

Stress during the COVID-19 Pandemic Moderates Pain Perception and Momentary Oxytocin Levels.

Self-reported pain levels have been associated with increased stress levels during the COVID-19 pandemic. Less is known about the long-term effects of stress on individuals' physical and emotional pain levels and their associations with the neuropeptide hormone oxytocin. We aimed to predict momentary pain through individual stress levels and momentary oxytocin levels at genuinely high-stress phases, namely during COVID-related lockdowns. In a cross-sectional (n = 254) and a longitudinal (n = 196) assessment during lockdowns in Germany, participants completed a 2-day ecological momentary assessment (EMA) protocol (collecting six saliva samples on two consecutive days each and simultaneously reporting on stress, physical, and emotional pain levels) in 2020, as well as one year later, in 2021. Hierarchical linear modeling revealed significant positive associations between individuals' stress levels and physical pain, both cross-sectionally (b = 0.017; t(103) = 3.345; p = 0.001) and longitudinally (b = 0.009; t(110) = 2.025; p = 0.045). Similarly, subjective stress ratings showed significant positive associations with emotional pain on a within-person (b = 0.014; t(63) = 3.594; p < 0.001) as well as on a between-person (b = 0.026; t(122) = 5.191; p < 0.001) level. Participants further displayed significantly lower salivary oxytocin when experiencing higher levels of emotional pain (b = -0.120; t(163) = -2.493; p = 0.014). In addition, high-stress levels significantly moderated the association between physical pain and salivary oxytocin (b = -0.012; t(32) = -2.150; p = 0.039). Based on mechanistic and experimental research, oxytocinergic mechanisms have long been suggested to modulate pain experiences, however, this has not yet been investigated in everyday life. Our data, which was collected from a large sample experiencing continued stress, in this case, during the COVID-19 pandemic, suggests that individuals experience more intense physical pain and elevated stress levels, as shown by particularly low salivary oxytocin concentrations.

Clinical Outcome, Socioeconomic Status and Psychological Constrains of Patients Undergoing Preimplantation Genetic Testing (PGT) in Northern Greece

Background and objectives: Preimplantation genetic testing (PGT) offers patients the possibility of having a healthy baby free of chromosomal or genetic disorders. The present study focuses on the application of PGT for patients located in Northern Greece, investigating their clinical outcomes, their motives, and their overall physical and emotional experience during the treatment, in association with their socioeconomic background. Materials and Methods: Couples who underwent PGT for a monogenic condition (PGT-M, n = 19 cycles) or aneuploidy (PGT-A, n = 22 cycles) participated in the study. Fertilization, implantation, and pregnancy rates were recorded for all cycles. The couples were asked to fill in a questionnaire about the consultation they had received prior to treatment, their sociodemographic information, and the psychological impact PGT had on both the female and male partner. Results: The fertilization, implantation, and ongoing pregnancy rates for the PGT-M and PGT-A cycles were 81.3%, 70.6%, and 52.9%, and 78.2%, 64.3%, and 57.1%, respectively. Females experienced more intense physical pain than their male partners while psychological pain was encountered by both partners and occasionally in higher instances in males. No typical socioeconomic background of the patients referred for PGT in Northern Greece was noticed. Conclusion: PGT is an attractive alternative to prenatal diagnosis (PND), aiming to establisha healthy pregnancy by identifying and avoiding the transfer of chromosomally or genetically abnormal embryos to the uterus. Although the benefits of PGT were well-received by all patients undergoing the procedure, psychological pain was evident and especially prominent in patients with a previous affected child or no normal embryos for transfer. Holistic counseling is of utmost importance in order to make patients’ experience during their journey to have a healthy baby less emotionally demanding and help them make the right choices for the future.

Emotional impact of clinical practice in Burns Unit among nursing students: a qualitative study.

Background and aim of the work.In Burns Units, the long professional relationship with patients suffering from intense physical pain and psychological distress, which cannot be completely resolved or minimized, exposes nurses to very intense emotions and stressful experiences. Learning to care for patients with such medical conditions can arouse many emotions also in nursing students, that can be both positive and negative.The goal of this study was to describe the emotional impact experienced by nursing students in a Italian Burns Unit.Methods.A qualitative research was implemented among 16 undergraduate nursing students, before and after clinical practice in a Burns Unit, through a semi-structured interview.Results.Strong and conflicting emotions from nursing students were reported in the preliminary stage of the internship. Their enthusiasm and curiosity for a new opportunity countered their fear and anxiety of not feeling able to deal with the clinical situation. The internship experience ranged from emotions of joy at the healing of patients to impotence and frustration at not being able to alleviate intense and lasting suffering. All students reported that the internship was experienced as an important opportunity for personal and professional growth.Conclusions.In light ofthe results, we highlight that nurse trainers should support studentsto take full advantage of this training, helping them to express their emotions and, in the same time, to learn to manage them profitably. (www.actabiomedica.it)

Impulsive Incantations - Voicing Migraine

When migraine arrives, not only the body suffers. The voice too is impacted by a condition that introduces itself with such great force. As a migraine-suffering singer I notice these changes and become fascinated by the aesthetics of a failing voice in a failing body. This exposition reflects upon the relevancy of Migraine Music as an aesthetic phenomenon and by focusing on the specific area of the vocal and the sonant, I project the issue into a broader context of language, speech and communication. First, I find the migraineur’s voice to be missing as it is silenced by society. Then, I study the failing of the voice when constricted by intense physical pain and I turn to the voice as it is transformed by migraine-specific symptoms. I study these deficiencies of the voice on a theoretical level in order to approach them through my artistic practice as a migraining singer. The artistic work accompanying this research is entitled Impulsive Incantations, and aims at voicing the migraine body through evocative text, vocal improvisations and a migrainous singing technique.

La douleur sociale au centre des conduites suicidaires

BackgroundIntolerable pain is often reported in suicide notes. Moreover, the frequency of life events preceding a suicidal act is high, especially interpersonal difficulties. Such adversity is the source of psychological or social pain. MethodsWe propose a narrative review to discuss the role of pain in the suicidal process while having a focus on social ties. ResultsUsing Ecological Momentary Assessment in suicide attempters it has been shown that being alone increased suicidal ideation while being with close others significantly reduced this risk. At a neuroanatomical level, suicidal vulnerability is associated with dysfunctional insula activation during social exclusion, a region involved in social and physical pain processing. Social pain elicited by social exclusion or devaluation shares common neurobiological patterns with physical pain. It is also an exemplar of psychological pain. Despite the complexity of its definition, higher psychological pain levels are associated with suicidal ideation and acts. Finally, intense physical pain or chronic pain are strong risk factors of suicidal ideation and act. Interestingly, suicide notes often report the existence of an intolerable pain. Presence of psychological pain and difficulties in communication predict the lethality and seriousness of suicide attempts. Moreover, presence of psychological pain is associated with more impulsive choices in suicidal patients, suggesting that a suicidal act is a means to escape intolerable suffering despite negative long-term consequences (i.e. death). Analgesics are usually used to get relief from pain but are also frequently involved in suicidal overdoses. It has been shown that opioid analgesics are associated with an increased risk of suicide. Higher consumption of opioid analgesics has been shown in suicidal patients in comparison to patients with history of depression but no suicidal act and healthy controls whereas non-suicidal patients were those reporting higher presence of pain in comparison to healthy controls. It may suggest that opioids are being used by suicidal patients to get relief from psychological/social pain rather than from physical pain. Involvement of opioidergic system in suicidal process opens new therapeutic strategies. Recently, the time-limited, short-term use of very low dosages of sublingual buprenorphine (vs. placebo) was associated with decreased suicidal ideation and mental pain in severely suicidal patients without substance abuse. In a randomized controlled trial comparing a 7-week acceptance and commitment therapy (ACT) versus relaxation group, as adjunct to treatment as usual for adult outpatients suffering from a current suicidal behavior disorder, ACT has shown its effectiveness in reducing suicidal ideation and psychological pain. Evidence indicates that maintaining contact either via letter, postcard or telephone with at-risk adults following discharge from care services after a suicide attempt can reduce reattempt risk. Based on these results, a preventive program of recontact for suicide attempters, VIGILANS, has been developed in France in usual care. ConclusionThe approach of the suicidal issue by the angle of pain and social disconnection offers new advances to improve clinical assessment, to identify new biological pathways involved in suicidal risk, and to propose innovative therapeutic and preventive actions.

Pain "Is" the Club: Identity and Membership in the Natural Childbirth Community

Based upon interview data collected from 50 respondents, this study examines how expectant mothers navigate the divide between natural and non-natural childbirth when faced with the dilemma of using chemical pain management. The vast majority of participants in this study had strong intentions of delivering without any type of chemical pain management, but when faced with intense physical pain and/or coaxing from medical authorities, made the decision to use an epidural. Respondent accounts illustrate that the decision to use an epidural effectively removed them from membership in the “natural childbirth club.” In order to better understand this process of group inclusion/exclusion, I draw upon the symbolic interaction frameworks of George Herbert Mead (1934) and Norbert Wiley (1995), paying special attention to their theories of the self. This study concludes that the decision to use chemical pain management in the childbirth process is often done so at the expense of changes in identity with respect to the Generalized Other of the “natural childbirth” community.

The Lancet Technology: December, 2011

The Lancet Technology: December, 2011

Humphry Davy

Humphry Davy

The Reinforcing Properties of Repeated Deliberate Self-Harm

The current study tested hypotheses derived from Joiner's (2005) interpersonal theory of suicide, which proposes that deliberate self-harm (DSH) becomes increasingly more reinforcing with repetition. One hundred six participants with a history of DSH completed questionnaires about their emotions and experience of physical pain during their most recent DSH episode. Consistent with prediction, people with more numerous past DSH episodes felt more soothed, more relieved, and calmer following their most recent episode of DSH. Contrary to prediction, greater numbers of past DSH episodes were associated with more intense physical pain during the most recent episode. The findings suggest that the emotion regulation functions of DSH may become more reinforcing with repetition.

The sufferings and self care of hospitalized elderly - ethnography study

Elderly oncological patients are marked by several limitatons and impositions generated by the disease and aging process, which lead them to hospitalization. This is a qualitative research with an ethnographic approach. This study took place at a clinical ward in a reference hospital for cancer treatment, in the city of Curitiba, Parana. This study aimed to interpret hospitalized elderly cancer patients suffering and the self care performed to minimize their suffering. The data was collected in 2007, from April to June, by participant observation and ethnographic interview. The following methodological phases were considered to analyze the data: domain, taxonomic and thematic. As a result of the research, four cultural domains emerged as well as a cultural theme titled: “through the elderly calvary of pain, the belief that sustains life”. Intense physical pain, lack of appetite, breathing difficulty and impossibility of walking and working are noticed by the elderly as the main suffering related to cancer. It is concluded that informers make direct allusion to a calvary in which religion was used as the most essential self care.

Experiences of pain and distress in hip fracture patients

Summary The aims were to investigate: (1) experiences of physical pain in elderly patients with hip fracture; (2) if background variables, confusion, experiences of pain and distress and interventions aimed at reducing pain and distress, functional ability, pain in the ambulance, and type of fracture varied between patients with more intense physical pain and patients with less intense physical pain. The sample included 49 patients, 70 years or older, with hip fracture. Structured instruments were used to interview and observe the patients on four occasions during the hospital stay. The patients' experiences of physical pain decreased during the hospital stay. Physical pain at rest was lower than pain with movement. Patients who scored physical pain as more intense (group B) during the visit to the hospital had significantly more unfavourable experiences in the sensory, emotional, and existential dimensions the day before discharge from the hospital compared with the patients who scored pain as less intense (group A). The patients in group B perceived the interventions as less favourable than group A. Furthermore, group B had more intense physical pain in the ambulance than the patients in the other group. More patients in group B than in group A had additional health problems.

The "Right" versus the "Wrong" Child: Shades of Pain in Bend Sinister and Pnin

Trying to determine why Bend Sinister goes into such excruciating detail in its portrayal of violence against the most vulnerable, the article will analyze the means by which Nabokov communicates the most language-resistant phenomenon-the intense physical pain of another. The article will show how the writer deconstructs the process of torture in order for the reader to then reconstruct it in his imagination, the result of which is a literal, physical feeling of pain. Continuously upsetting the reader's world, in Bend Sinister Nabokov transforms a nanny, a nurse and a female doctor, the figures traditionally associated with nurturing and mothering, into the members of a fine-tuned murder team. Followed by a curious reader, the trio of the Bachofen sisters (Mariette, Linda, and Doktor Amalia) carefully and professionally carries out specifically assigned roles in the torture and murder of the eight-year-old David. The article will discuss the figure of Arvid Krug, "somebody else's child," "the wrong boy," and its significance in Nabokov's challenge to the reader's compassion.