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The purpose of this study was to: 1) examine existing interprofessional pain management curricula in a DPT and MOT program by mapping pain subject matter to the IASP interprofessional content to determine gaps, vertical and horizontal coherence and integration 2) evaluate pain knowledge and attitudes early and late curriculum within the current pre-licensure Doctor of Physical Therapy (DPT) and Master of Occupational Therapy (MOT) students, and 3) to define changes needed within the existing interprofessional pain management curricula to better prepare students for clinical experiences and professional practice. Pain content was mapped to the IASP core competencies to identify gaps in content and coherence. Students were evaluated on existing pain knowledge and attitudes using the City of Boston's Rehabilitation Professional's Knowledge and Attitudes Survey Regarding Pain (COBS). Two hundred and forty physical and occupational therapy students completed the study. The mean percentage of correct responses of 70.6% +/-25.6% did not significantly change across didactic terms. Curricular mapping can inform planning, design, implementation, and evaluation of the curriculum and alignment with IASP guidelines.

Empathy in healthcare professionals is associated with better treatment outcomes and higher satisfaction among patients with chronic pain. Activity patterns play an essential role in the adjustment of these patients and, as a pain behaviour, may have a communicative function and elicit distinct empathic responses. This study investigated whether the activity pattern profiles characteristic of these patients had differential effects on the empathic response (empathic distress and compassion/sympathy) of future healthcare professionals. Healthcare professionals should improve their knowledge about the role of different activity patterns in the well-being of people with chronic pain and receive specific training in empathic skills. We controlled for several variables that could affect the empathic response (sex, age, academic degree, previous experience of chronic pain, and dispositional empathy). A total of 228 undergraduates performed an experimental task using vignettes depicting four activity pattern profiles displayed by people with chronic pain and completed questionnaires measuring dispositional and situational empathy. We conducted a MANCOVA analysis Undergraduates showed more compassion/sympathy toward the medium cycler profile than toward the doer profile. Participants' age was associated with empathic distress. Sex, academic degree, and previous experiences with chronic pain were not associated with their empathic response to the vignettes. Dispositional perspective-taking and empathic concern were significantly associated with compassion/sympathy responses, and personal distress was significantly associated with empathic distress. Activity pattern profiles may have a communicative function and elicit different empathic responses toward people with chronic pain. Individual differences in dispositional empathy play an important role on situational empathic responses.

Pain is human-universal since it is experienced by people across the world. However, since it is related to personal feelings, different people may feel it in a different way and rely on language to communicate. This paper presents a cross-cultural comparison of the study of the emotion of pain in Indonesian by examining the usage of two near-synonyms: "sakit" and "nyeri." This study aims to provide a new insight for L2 learners of Indonesian regarding the study of emotion. A corpus-driven method by using the usage-feature analysis (Glynn, 2010b) is employed to test the hypothesis on the semasiological structure of pain from Indonesian dictionary. The corpus data of Indonesian News 2020 with a total of 15,206,710 tokens were extracted from the Leipzig Corpora Data Collection of Indonesian (Goldhahn et al., 2012). A total of 400 examples of "sakit" and "nyeri" were extracted from the corpus data using AntConc version 4.1.2 (Laurence, 2022) for manual annotation. The manual coding of the lexemes was conducted based on cross-linguistic dimensions of pain proposed by Wierzbicka (2016). After manual annotation, two statistical analyses were conducted in R (R Core Team, 2022), namely Binary Correspondence Analysis (Glynn, 2014) and Binomial Regression Analysis (Levshina, 2015). The result of exploratory analysis shows that "sakit" and "nyeri" can be distinguished by bodily focus and intensity. However, the confirmatory analysis confirms bodily focus as the significant predictor. It means "nyeri" is strongly associated with pain on the part of body relative to "sakit." The finding of the current study may have an implication for the possibility of combining cross-cultural competence with L2 vocabulary learning by making use of corpora in L2 learning design.

The brain organizes somatosensory experience based on the body location from which it originated and the pathway by which in arrived. Here, I present a classroom discussion-based activity centered around the concept of a phantom limb to allow students to explore how cortical representation of sensory experience can be altered. The goal of the activity is to allow students to explore concepts surrounding plasticity of cortical representation. The mouse barrel cortex, a common model system for studying these effects, will be presented to explore potential mechanisms of the change. Finally, the students will hypothesis how the mirror box therapy can be used to ameliorate phantom limb pain without the use of pharmacological treatment. The activity is designed for second- or third-year biology or physiology majors and can be conducted in a single class period. Students can work in small groups answering questions before discussing their answers as a class. There are many opportunities to expand the discussion described.

Genito-Pelvic Pain/Penetration Disorder is a common sexual disorder that affects an individual's sexual health and overall well-being. Education is a therapeutic resource that presents several advantages, and it can potentially generate improvements both in pain and sexual functioning-related outcomes in patients suffering from this affliction. The objective of this study was to assess if a therapeutic educational program produced improvements in the different domains of the Female Sexual Function Index in participants suffering from Genito-Pelvic Pain Penetration Disorder. Participants were randomized into a group that received a face-to-face therapeutic educational program, a group that received the same program but online, or a control group. The Female Sexual Function Index was assessed, and analysis of the change in the domains for every group was performed using multiple t-tests. Improvements were found in the face-to-face intervention group, but only the "Pain" domain showed significant improvements (-1.1 points, p < 0.05). Improvements were also found in the online group, but they were only significant in the "Pain" and "Satisfaction" domains (-0.8 points, p < 0.05 for both). A therapeutic educational program improves pain-related outcomes, and it shows a positive tendency to also improve sexual functioning-related outcomes in patients suffering from Genito-Pelvic Pain/Penetration Disorder. Registration: Clinical Trials (NCT05114473).

Purpose: What is happening in the perceived world of young people who have non-suicidal self-injury? The answer to this question explains many quantitative research findings in the field of NSSI. The current qualitative research design is Husserl's descriptive phenomenology. Design/methodology/approach: The participants included 17-29-year-old youths with self-injury and were selected with a targeted sampling approach and a conspicuous sampling method based on the theoretical saturation criterion of 21 people. Data were collected in a semi-structured interview and analyzed in the MAXQDA2022 software using the Attride-Stirling (2001) method. Validation of data was done by the method of simultaneous review of colleagues and simultaneous review of participants. Findings: The themes emerging from the analysis of the findings are the three organizing themes of "vulnerable temperament" which includes height and head, high pain sensitivity threshold and desire for nothingness, "traumatic family" which includes disorganization, crisis and devaluation in the family and "developmental injuries" that are associated with physical, sexual and emotional abuse and neglect. The content of these themes seriously harms a person's self-perception through the emotions of fear, shame, anger and despair and is integrated into the overarching theme of "damaged self". Originality/value: "Damaged Self" provides causal explanations related to the formation of self-injurious behaviors and these behaviors are in harmony with the damage that a person observes in his perception of himself.

Background: Chronic migraines result in debilitating pain requiring complex and multifaceted daily management, including acting purposefully to attenuate symptoms and decrease impairment. Experiencing migraines may be more psychologically challenging for adolescent and young adult (AYA) women due to complex and recurrent stressors. Purpose: This study examined the relationships between illness specific cognitive appraisal mechanisms (i.e., illness uncertainty and illness intrusiveness) and psychological adjustment (i.e., anxious and depressive symptoms) in AYA women with self-reported chronic migraines. Methods: AYA women (N = 74, M[subscript age] = 20.19, SD = 3.41) with chronic migraines completed measures of illness uncertainty, illness intrusiveness, anxious, and depressive symptoms. Results: Two hierarchical regression analyses indicated that illness uncertainty (B = 0.44, p < 0.001) and intrusiveness (B = 0.27, p = 0.026) significantly predicted anxious, F(4, 68) = 12.83, p < 0.001, and depressive symptoms, F(4, 68) = 8.48, p < 0.001, B = 0.31, p = 0.021 and B = 0.27, p = 0.037. Discussion: Greater illness uncertainty and illness intrusiveness were associated with greater anxious and depressive symptoms. Thus, it may be that AYA women who experience chronic migraines have increased perceptions of ambiguity, unpredictability, and disruption to their life that significantly contribute to their psychological adjustment outcomes. Translation to Health Education Practice: This study demonstrates a need for health education on the role of illness related cognitive appraisal mechanisms for AYA women with chronic migraines.

Background: Pediatric programs focused on treating chronic pain often do not include an educational liaison (EL) to coordinate services between the patient's medical home and school. As chronic pain in youth can have deleterious effects on school functioning, collaboration between the medical home and the school system are needed to assure these students receive appropriate accommodations. Contributions to Theory: This manuscript describes a model of coordinated care for students with chronic pain that includes a systemic strategy for collaborative care across settings. Specifically, the role of an EL is described in the context of advocating for the patient to receive appropriate educational accommodations. Conclusions: This paper provides a guide for caregivers and professionals to assure appropriate access to support services across settings. Recommendations are included for school accommodations and services to improve academic functioning and outcomes for students with chronic pain.

This study investigates the individual difference antecedents of students' behavioural intention to use VR-based learning systems, especially from an integrated perspective of Big Five personality traits and perceived physiological vulnerability to IT use (PPVITU). Data collected from 149 respondents are tested against the research model using the partial least squares structural equation method (PLS-SEM). The results indicate that extraversion and neuroticism positively affect perceived usefulness, conscientiousness negatively influences usefulness, and agreeableness and neuroticism have positive effects on perceived enjoyment. Furthermore, this study finds that musculoskeletal discomfort: neck and shoulder back pain (one PPVITU component) positively influences perceived ease of use. The findings of this study provide several important theoretical and practical implications for promoting VR-based learning system use behaviour.

Background: There is little research comparatively assessing prevalence of pain between older people either with or without intellectual disability. This paper explores health and social factors associated with chronic pain in these two groups. Method: A cross-sectional survey was undertaken in New South Wales and Queensland, Australia. Inclusion criteria were adults either with or without intellectual disability, aged 60 years and older, and currently living in community-settings. Univariate and multivariable analyses were undertaken on a sample of 391 adults with intellectual disability and 920 adults without intellectual disability. Results: Key findings included higher prevalence of pain in the intellectual disability group, along with higher rates of osteoarthritis, falls, oral health problems, and mood disorders. Conclusions: Mitigating risk factors for conditions that cause chronic pain in older adults is crucial. As longevity increases, the healthcare sector needs to prioritise chronic pain management for people with intellectual disabilities through appropriate treatment strategies.

Students in the field of painting work long hours and in inappropriate postures. In this qualitative study, it was aimed to evaluate the experience and awareness of art education teacher candidates about performance-based musculoskeletal disorders and their views on preparatory physical exercises. Semi-structured interviews were conducted with 22 senior students studying at Trakya University, Department of Art Education. As a result of the thematic analysis, twelve sub-themes emerged under five major themes (i.e. "Exercise experience", "Physical pains", "Effects of exercise", "Breath awareness/Breath hold, "Spent time"). Complaints of neck, low back pain, and then backache and holding breath are common among art education teacher candidates. More research is needed to raise awareness of musculoskeletal pain of students in the field of painting, as well as to prevent such disorders, and to plan and implement ergonomic processes.

Musicians who play instruments may suffer from some musculoskeletal disorders due to intense and long working processes, wrong posture-holding, insufficient bodily awareness. Preparatory physical exercises can be used to prevent or alleviate these disorders. These are aimed at warming up, opening-stretching, strengthening the joints and muscles and maintaining the correct posture in order to prepare the body for playing. In this study, it was aimed to reveal the pre-service music teacher candidates' physical exercises for instrument practice. A qualitative method was used in the research; a semi-structured interview form was applied to the study group. In the analysis of the data, the thematic analysis technique was used. As a result of the analysis, 4 main themes including "exercise experience", "breath awareness", "physical pains" and "effects of exercise" and 9 sub themes and 49 codes depending on these themes were revealed. As a result of the research, it was concluded that music teacher candidates did not do regular exercise work for instrument study, they experienced physical pain due to instrument study, their breath awareness was not at a sufficient level, and exercise had physical and psychological effects on instrument performance. In addition to medical treatments for musician injuries related to instrument playing, physical awareness and exercise training that prevent these disorders play an extremely important role. In instrument education, besides technical and musical concepts, it is necessary to research and apply ways to bring physical awareness to students. [Paper presented at the International Conference on New Horizons in Education (INTE) (July 28-29, 2022).]

The study aims to analyse the phenomenon in a holistic and comprehensive way according to the perceptions of education workers who experience presenteeism more frequently and reveal the relationship of presenteeism with the sociological, psychological, and theological dynamics of Turkish society. The study was conducted with a phenomenological design, one of the qualitative research methods. The study group consists of five teachers and five school administrators working in Elazig, a province in Türkiye in the 2020-2021 academic year. It was determined that educators can voluntarily decide to work when they are not feeling well due to motivations such as a sense of responsibility, conscience, commitment to work, public service, and religious sensitivity. In addition, some participants stated that due to organisational pressure, economic difficulties, and workload, employees make a forced decision to work when they are not well. Finally, in addition to the negative results of presenteeism, positive results, which are rarely seen in the literature, were also obtained. Therefore, the experience of presenteeism should be evaluated considering its positive and negative effects on organisations and employees. Finally, suggestions were developed to monitor the situation of employees experiencing presenteeism, develop policies regarding this, and prevent them from being forced to work in bad situations they cannot tolerate.

Many people with intellectual disabilities (ID) depend on caregivers for pain identification and pain management decisions. Therefore, the aim was to explore caregivers' experience with pain in Prader-Willi syndrome (PWS), Williams syndrome (WS), and Fragile-X syndrome (FXS). A questionnaire was developed to gather third-party reporting of mainly pain presence, expression, and coping. Questions had single or multiple choice answers and open text fields, without verification of the putative information. The questionnaire was sent digitally to associations and interest groups for the syndromes and healthcare institutions for people with ID. After excluding absent, unknown, or uncertain genetic diagnoses and people without ID, the remaining 243 responses originated by caregivers (90.6% parents) of children and adults with PWS (n = 165), WS (n = 53), and FXS (n = 25) in English, French, Dutch, and German speaking countries. More than half of all respondents reported the presence of known physical conditions that could be painful (58.4%) and pain observed during the past three months (54.3%, of which 70.9% chronic). Results reveal caregivers' barriers in identifying pain (e.g., interpreting pain expression and sensitivity). Respondents cope with pain mainly by seeking (para) medical help and observe both passive and active coping in people with the syndromes. Within limitations of the study's scope and design (e.g., used questionnaire), the results open a discussion about the validity of caregivers's perspective on pain. In-depth analysis in a more representative sample is recommended, as well as solutions for clinical practice such as training and education material about pain.

The purpose of this study was to better understand how the current COVID-19 global health pandemic has professionally and emotionally impacted elementary-level teachers. Teachers experienced diverse challenges during this unprecedented time with a rapid shift from in-person to online learning. Two overarching themes emerged based on participant experiences: abandoning best practices and increased stress and emotional pain. Implications for practice included the need for school leaders to evaluate the current level of support being provided to teachers and assess areas of need to support professional and emotional growth with the backdrop of the pandemic. We encourage future research with all educators to better understand how they are experiencing this health pandemic including the school leaders themselves.

A mismatch between furniture and body characteristics can cause musculoskeletal discomfort during prolonged sitting for a variety of learners. The purpose of this study was to explore university students' perceived changes in pain and/or discomfort, perceived level of comfort, and perceived ability to focus and learn while using four common desk chair styles. After recording standing and seated height, sixty-seven university students completed a survey tool which contained six sections: (1) demographics, (2) type of desk chair used and time in desk chair, (3) pain and/or discomfort rating and location prior to and after desk chair use, (4) impact of desk chair on pain and/or discomfort, (5) rating of desk chair comfort, and (6) rating of desk chair adjustability. A desk chair with padding and a large frame was rated significantly highest in overall comfort. Participants reported significantly increased upper back pain when using a desk chair with minimal arm support. During periods of prolonged seating, desk chairs should accommodate various sized bodies and have cushioning, as well as support for the upper body.

The concept of 'flexible seating' has emerged as a possibility to meeting the goals of an active learning classroom. Recent scholarship has suggested that numerous student learning predictors are enhanced when interacting with flexible seating. This study aims to fill a gap in the literature by investigating the effects of flexible seating from a physical perspective in the higher education setting. Seventy-five participants engaged in mixed-method data collection and analysis strategies that included observations and field notes, a validated online survey, and open-ended question prompts. A thematic review and descriptive analysis revealed almost 80% of the respondents indicated that the flexible seating had a positive effect on their experience in the course related to the following themes: (a) Movement Opportunity; (b) Back Pain & Comfort; (c) Anxiety & Restlessness; and (d) Focus & Engagement. This research provides evidence that physically comfortable classrooms promote a sense of well-being, keep minds focused, and limit distractions, and that physically comfortable classrooms with increased movement opportunities for students make possible mental and emotional health benefits, as well. Results indicate the need for campuses to (re)consider the purposes and roles of seating styles within the 21st century classrooms, with seating selection based on principles of universal design.

Background: People with profound intellectual disabilities are a population with complex comorbidities. Total pain recognises the interconnectedness of aspects of pain; social, psychological, physical, emotional, spiritual. Pain is under-recognised due to communication challenges and carers perceptions. This review's purpose is to synthesise current literature and provide guidance for future research and care. Methods: Five databases were searched in this mixed methods systematic review (Cinahl, Medline, Psycinfo, Web of Science, Scopus). Articles retrieved were reported via a PRISMA flow diagram. Quality appraisal utilised the mixed methods appraisal tool (MMAT). A convergent qualitative design was the method of data synthesis. Results: Data from 16 included articles generated four themes; Absent voices, reductionist assessment, pain intensity, valuing expertise. Data included physical pain only. Conclusion: Multifaceted pain needs inclusion in research. Assessment must consider the unique expressions of pain by individuals with profound intellectual disabilities. A sharing of expertise may improve pain care.

This study aimed to investigate whether the COVID-19 lockdown affect pain, exam anxiety and general anxiety in students preparing for university exam. A total of 364 students were divided into groups as high school seniors (HS, n = 241) and high school graduates (HG, n = 123). Visual Analog Scale (VAS) for neck and low-back pain, Beck Anxiety Inventory for general anxiety, Exam Anxiety Scale (EAS) for exam anxiety were used. Both groups showed high level of exam anxiety and generalized anxiety (p < 0.05). After COVID-19, neck and low-back pain rates, and VAS pain scores of both groups increased (p < 0.05). Neck pain before COVID-19 and neck and low-back pain after COVID-19 were higher in female students than males (p < 0.05). The COVID-19 lockdown negatively affected the neck and low-back pain level, exam anxiety and general anxiety of both HS and high school graduate students. We suggest that community healthcare services should regard physiotherapy and rehabilitation interventions to treat students with neck and low-back pain via exercise strategies. Psychological and emotional support also could be provided to reduce students' general anxiety and exam anxiety. Future studies should establish the consider menstrual cycle status in female students, and the computer-using time of students.

We review ethnographic methods that allow researchers to assess distress in a culturally sensitive manner. We begin with an overview of standardized biomedical and psychological approaches to assessing distress cross-culturally. We then focus on literature describing the development of reliable and valid culturally sensitive assessment tools that can serve as complements or alternatives to biomedical categories and diagnostic frameworks. The methods we describe are useful in identifying forms of suffering--expressed in culturally salient idioms of distress--that might be misidentified by biomedical classifications. We highlight the utility of a cognitive anthropological theoretical approach for developing measures that attend to local cultural categories of knowledge and experience. Attending to cultural insider perspectives is necessary because expressions of distress, thresholds of tolerance for distress, expectations about stress inherent in life, conceptions of the good life, symptom expression, and modes of help-seeking vary across cultures.

To investigate the association between labor epidural analgesia exposure and the risk of autism spectrum disorder in offspring, this meta-analysis reviewed relevant literature from Medline, Cochrane Library, Google Scholar, and EMBASE databases from inception to May 2022 to evaluate the overall adjusted risk of autism spectrum disorder in offspring (primary outcome) and adjusted risks of autism spectrum disorder focusing on sibling-matched data, children who were delivered vaginally, and duration of labor epidural analgesia exposure (secondary outcomes). Pooled results of seven eligible observational studies involving 4,021,406 children revealed slightly higher risks of autism spectrum disorder in children with labor epidural analgesia exposure than those without (hazard ratio = 1.11, 95% confidence interval: 1.06-1.16, I[superscript 2] = 67%, seven studies, level of evidence: very low). Consistent findings were found in subgroup analysis focusing on sibling data (hazard ratio: 1.10, 95% confidence interval: 1.02-1.18, I[superscript 2] = 0%, five studies) and children delivered vaginally (hazard ratio: 1.11, 95% confidence interval: 1.06-1.17, I[superscript 2] = 64%, seven studies). The tendency of an increased risk of autism spectrum disorder in children exposed to labor epidural analgesia <4 h was not observed in those exposed to labor epidural analgesia >8 h (two studies). Although our results demonstrated a slightly increased risk of autism spectrum disorder in offspring with previous labor epidural analgesia exposure, the small effect size and lack of cumulative dose-response effect precluded tangible evidence supporting the association.

Background: Case studies are often used to supplement lecture material to students of psychology. Recent research on the use of online support forums has been shown to be more effective in increasing student attainment of course learning objectives than the use of case studies. Objective: The current research replicated two studies on the use of online support forums and extended this work to chronic pain and compared midterm exam scores from two different semesters when case studies and online support forums were used as a supplementary learning exercise. Method: Following a lecture on chronic pain students were randomly assigned to either the case study or online support forum condition and asked to rate their experience based on four learning objectives. Results: Students who took part in the online support forum learning exercise rated the four learning objectives higher and obtained higher marks on a midterm exam than students in the case study exercise. Conclusion: Reading people's personal accounts of their experience with chronic pain through online support forums is more effective in increasing student understanding of the effects of chronic pain than the traditional case study. Teaching Implications: Implications for teaching material that is highly emotional are discussed.

Background: Persons with profound intellectual and multiple disabilities (PIMD) are vulnerable when it comes to experiencing pain. Reliable assessment of pain-related behaviour in these persons is difficult. "Aim" To determine how pain items can be reliably scored in adults with PIMD. Methods: We developed an instruction protocol for the assessment of pain-related behaviour in four phases. We used videos of 57 adults with PIMD during potentially painful situations. The items were assessed for inter-rater reliability (Cohen's kappa or percentage of agreement). Results: The developed instruction protocol appeared to be adequate. Twelve items had satisfactory inter-rater reliability (n = 9: 0.30-1.00; n = 3: 85%-100%). Discussion: Calibrating and adjustments to the instructions and item set appeared to be crucial to reliably score 12 items in adults with PIMD. Further research should focus on creating an assessment instrument based on these reliably scored items.

Autism spectrum disorders (ASD) are characterized by reduced pain empathy--a process that is grounded in first-hand pain perception. Because autistic traits are continuously distributed in the general population, we hypothesized that first-hand pain sensitivity would mediate the link between autistic traits and pain empathy. After controlling for alexithymia, higher autistic traits were associated with lower cognitive and emotional empathy in response to others' pain, as well as lower sensitivity to cold and heat pain (higher cold pain tolerance and lower laser heat pain-intensity ratings). Importantly, pain sensitivity fully mediated the link between autistic traits and pain empathy. These findings highlight the role of atypical first-hand pain sensitivity in the lack of pain empathy observed in people with high autistic traits or ASD.

Autistic people experience heightened rates of physical health problems but may also experience elevated levels of somatic symptoms (e.g. pain, headache, gastrointestinal symptoms) due to psychological factors which are common in autism. This online study sought to compare rates of somatic symptoms (Patient Health Questionnaire-15) in older adolescents and adults who were autistic (n = 51), non-autistic (n = 119) and who suspected they were autistic (n = 32), while controlling for health conditions. We investigated psychological risk factors that may predispose individuals to experience somatic symptoms, including alexithymia (General Alexithymia Factor Score), interoception (Body Awareness Questionnaire) and intolerance of uncertainty (Intolerance of Uncertainty Scale). Diagnosed autistic individuals had higher rates of alexithymia and intolerance of uncertainty. We also found higher somatic symptoms in diagnosed autistic individuals, controlling for mental and physical health. However, hierarchical regression showed that somatic symptoms were predicted by physical and mental health conditions, female gender, alexithymia, and intolerance of uncertainty, regardless of autism status. The results suggest that autistic and non-autistic individuals experience more bodily discomfort in part due to gender, physical and mental health, alexithymia, and difficulty tolerating uncertainty. Implications for mental and physical health care in autism are discussed.

Background: Patients rarely dispose of left-over opioids after surgery. Disposal serves as a primary prevention against misuse, overdose, and diversion. However, current interventions promoting disposal have mixed efficacy. Increasing disposal in rural communities could prevent or reduce the harms caused by prescription opioids. Aims: Identify barriers and facilitators to disposal in the rural communities of the United States Mountain West region. Methods: We conducted a qualitative description study with 30 participants from Arizona, Idaho, Montana, Nevada, Oregon, Utah, and Wyoming. We used a phronetic iterative approach combining inductive content and thematic analysis with deductive interpretation through the Precaution Adoption Process Model (PAPM). Results: We identified four broad themes: (a) awareness, engagement, and education; (b) low perceived risk associated with nondisposal; (c) deciding to keep left-over opioids for future use; and (d) converting decisions into action. Most participants were aware of the importance of disposal but perceived the risks of nondisposal as low. Participants kept opioids for future use due to uncertainty about their recovery and future treatments, breakdowns in the patient-provider relationship, chronic illness or pain, or potential future injury. The rural context, particularly convenience, cost, and environmental contamination, contributes to decisional burden. Conclusions: We identified PAPM stage-specific barriers to disposal of left-over opioids. Future interventions should account for where patients are along the spectrum of deciding to dispose or not dispose as well as promoting harm-reduction strategies for those who choose not to dispose.

Fibromyalgia Syndrome (FMS) is a chronic pain syndrome that often coexists with common musculoskeletal pain, sleep disorders, bowel syndrome, mood disorders, and fatigue. Although the aetiology of FMS pain has not been elucidated yet, psychotherapy methods are used in addition to physical methods to treat these pains. This study aims to examine the effect of psychodrama on a 62- year-old patient with back and chest pain and who lived alone. This patient participated in psychodrama group psychotherapy with 8 members who were all female and diagnosed with FMS. An informed consent form was obtained from the case for the study. This research is important because there are very few studies on fibromyalgia complaints with psychodrama group therapy, and it contributes to the literature. Studying the case with past trauma and losses in the psychodrama scene has led to a significant reduction in fibromyalgia complaints. As a result, the patient's pain level decreased from 90% to 32.5%, and the anxiety level decreased from advanced to normal. Thus, psychodrama group psychotherapy was found to be effective in reducing FMS pain.

This study was designed as a prospective, randomized controlled trial. A total of 90 preterm infants who underwent retinopathy of prematurity (ROP) examinations were categorized into three groups, a control group, a white noise group (WN), and a classical music group (CM), each comprising 30 preterm infants. The study data were obtained using an information form and the Premature Infant Pain Profile. During (WN: 9.70±3.02; CM: 11.2±2.28) and after the examination (WN: 3.60±2.11; CM: 3.77±1.83), the preterm infants in the WN and CM groups had lower mean pain scores and heart rates (181.17±15.76 and 3150.10±17.03 vs. 173.30±20.66 and 146.67±18.17, respectively; p<0.001) and higher mean oxygen saturation values (93.60±3.87 and 97.83±1.93 vs. 95.73±2.52 and 98.27±1.82, respectively; p<0.05) than those in the control group; the differences were statistically significant. The WN and CM listened to by the preterm infants during ROP examinations had positive effects on pain and heart rate and oxygen saturation values.

Objective: The current study examined the mediating role of distress tolerance on the association between pain-related disability and addiction to opioids, past-month opioid use, and risky opioid use among an ethno-racially diverse sample of young adults with current pain. Methods: Participants were 141 undergraduate college students (78.7% female, M age = 22.50, SD = 5.41) who reported experiencing current pain. Results: Results indicated that distress tolerance statistically significantly explained the relationship between pain-related disability and addiction to opioids, past-month opioid use, and risky opioid use after controlling for the variance accounted for by pain intensity, negative affectivity, gender, and other substance misuses. Conclusions: Clinical implications are discussed in terms of targeting distress tolerance in the context of pain-related disability among young adults with pain who are at risk for opioid misuse.

Objective: College students' prescription stimulant and opioid misuse (PSM and POM) share psychosocial risks with other substance use. We sought to extend a prior study of these issues. Methods: National College Health Assessment (2015-2016) participants ages 18-24 years (n = 79,336) reporting 12-month PSM (defined as use of a drug not prescribed to them), 30-day other illicit drug use (non-cannabis), both, or neither, were compared on other substance use, psychopathology, academic adjustment, attention deficit hyperactivity disorder, and chronic pain. Models were repeated for POM. Results: Relative to those who only misused the prescription drug, those who used other illicit drugs had lower odds of chronic pain and academic problems, but higher odds on nearly every other outcome especially if they also misused the prescription drug. Conclusions: Findings suggest PSM and POM are on a continuum of risk shared with illicit drug use, but also are linked to outcomes specific to these drugs' perceived medical purposes.

Background" Reducing opioid reliance in chronic pain treatment may best be accomplished with interdisciplinary teams. Shared Medical Appointments (SMAs) are one format whereby an interdisciplinary team partners with groups of patients to provide health education and clinical care. The Whole Health (WH) model is an emerging framework whereby the care team partners with the patient to reach shared goals with emphasis on self-care and healing modalities. Purpose: Assess the impact of a WH Education intervention in patients with chronic pain and long-term opioid use within the framework of Shared Medical Appointment (SMA). Results: Retrospective chart review of 86 participants indicated significant opioid reduction at 12 and 24 months. The rate of opioid reduction in the SMA group surpassed the rate of decline of the host or national VA cohorts. Overall pain perception did not increase while patient satisfaction and safety indices improved. Discussion: Results of the intervention suggest that a WH education model in a SMA is one approach to help patients reduce long-term opioid reliance. Translation to Health Education Practice: Trained Whole Health Coaches/Education Specialists are key personnel in the implementation of the WHSMA model of care and facilitators of behavioral change that results in improved wellness outcomes. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars.

This study aimed to compare the effect of using white noise, embracing, and facilitated tucking on heel lance blood sampling in newborns. The study was a randomized controlled trial. Newborns totalling 160 were included in the study. The primary outcomes were evaluated pain and crying durations before, during, and after the procedure. The secondary outcomes were evaluated as physiological changes before, during, and after the procedure. The crying durations during and after the heel lance blood sampling were found significantly lower in the newborns in the embracing group compared to those in the other groups (p < 0.05). The average NIPS score of the newborns who were embraced by their mothers during (3.67 ± 2.76) and after (1.55 ± 2.6) heel lance blood sampling was found significantly lower than the other groups (p < 0.05). Maternal embracing during and after the heel lance blood sampling procedure may be effective in reducing crying duration and pain level in newborns.

Augmentative and alternative communication (AAC) has been used by patients with acquired expressive communication disorders as an alternative to natural speech. The use of symbols to express pain, which is intangible, is challenging because designing a series of comprehensible symbols to represent personal experiences such as pain is not straightforward. This study describes (a) the development of symbols to express pain that were derived from Chinese pain-related similes and metaphors for an AAC mobile application developed specifically for this study known as PainDiary and (b) an assessment of the appropriateness of the app compared to conventional methods of collecting pain information. The symbols depicted headache pain and discomfort, which is prevalent among neurosurgical patients. The participants were 31 patients diagnosed with acquired expressive communication disorders who were receiving treatment in a neurosurgery general ward of Chang Gung Memorial Hospital in Taiwan and 14 nurses who worked on the ward. Pain information was collected by nurses using conventional methods and the PainDiary app. Assessment data, including the accuracy and efficiency of and user satisfaction with PainDiary, are compared. The results show that use of the app was effective in reporting pain and that patients required less time to report a pain event. The results further indicate that the PainDiary app was better received by younger individuals than by their older counterparts.

Early care and education (ECE) teachers are constantly moving throughout their day with varying physical demands akin to those of athletes. Teachers are continuously bending, stooping, and squatting to lift and carry children as well as sitting on the floor or in child-sized furniture--all activities that require substantial fitness. This said, many ECE teachers have health issues including obesity, diminished aerobic capacity, and perceived stress, which can adversely influence their physical well-being and place them at risk for work-related musculoskeletal issues. This study of ECE teachers, which is part of a larger study of overall teacher wellness, involved direct, on-site measures of ECE teachers' cardiorespiratory capacity and in-classroom ergonomic assessment of activities. These measures were then triangulated with self-reported health information to better understand the current status of various aspects of teachers' physical well-being and correlational analysis was then used to identify potential risk and/or protective factors. Research Findings: ECE teachers are constantly moving throughout their day with varying physical demands and stressors that, combined with unfavorable working conditions, contribute to developing musculoskeletal pain and poor cardiorespiratory fitness. Practice or Policy: Many of the physical wellness issues identified in this study can be mitigated through modest changes that could be incorporated into teachers' daily work behaviors and activities, such as education and programs to enhance the physical wellness of these "educational athletes" and better-prepare them for the "sport of teaching."

With the recent outbreak of coronavirus disease, people are advised to keep social distance. Schools are closed and people work from home. Some community research has had to be suspended to prevent the spread of the disease. Researchers have had to think of ways to deliver and continue their studies. With a large coverage of networks and the availability of electric devices, online delivery is a possible solution. In this article, the experience of conducting an online pain management programme is used to illustrate how the strategies and elements of online learning can be adopted to the conducting of research. Self-paced learning, learner control and self-directed learning are the approaches adopted in the online pain management programme and generated a positive learning experience. The difficulties encountered in the research process including the observation of the participants' performance and reactions, are discussed, and the solutions devised by the research team are offered as an example.

This study examines how a course that includes recognizing pain and suffering inflicted during intractable conflicts affects Indigenous Minority Group students' willingness to reconcile. The study employed a mixed-methods approach, combining quantitative and qualitative research tools with a pre-/post- questionnaire examining Israeli-Palestinian indigenous minority group students' willingness to reconcile with the Israeli-Jewish majority group during an outbreak in violence (May 2021 Riots in Israel). Recognition entails creating space for minority students' narratives and listening to their pain and anger related to their history and lived experiences as a minority. Findings show that students who received recognition maintain a steady will to reconcile and students who did not receive such recognition express a decrease in their willingness to reconcile. Such a distinction in results demonstrates the importance of recognizing a minority group's narrative while an intractable conflict occurs.

Objective: College student populations are considered at greater risk of contracting influenza due to their close living conditions. Despite this increased risk, college students are reluctant to obtain annual vaccination. This pilot study sought to determine perceptions of students on a college campus who received the annual influenza vaccination via an intradermal route. Participants and methods: Forty-nine college students participated in the IRB approved study. After receiving the intradermal influenza vaccination, participants completed a demographic survey and vaccination perceptions questionnaire. Results: Participants were more likely to want to have an intradermal injection in the future and reported less pain with the intradermal injection. Additionally, individuals who reported greater pain with the intramuscular injection in the past were significantly more likely to want to receive an intradermal injection in the future (p < 0.019). Conclusions: Results suggest that intradermal route of vaccination may be more appealing to the college population.

Objective: We examine role of ACEs and pathways to risk of opioid misuse among young adults. Participants and Methods: A cross-sectional survey of validated measures of ACEs, risk of opioid misuse, and health conditions with a sample of 1,402 students from a large public university followed by multivariate logistic regression and pathway analysis. Results: Majority (61%) of participants reported at least one ACE. A dose-response relationship between numbers of ACEs with risk for opioid misuse was present. Compared to participants with no ACEs, participants with [greater than or equal to]4 ACEs and 0-3 ACEs were 2.93 (95% CI: 1.95, 4.39; p < 0.001) and 1.96 (95% CI: 1.46, 2.65; p < 0.001) times more likely to be at risk for opioid misuse, respectively. Having at least one existing or past health condition significantly mediated the association. Conclusions: Our findings suggest need to include assessment of ACEs as a screening criterion for opioid prescription and administration among college-aged individuals.

Objective: This study examined whether studying in a Consciousness-Based Education institution influenced college students' mental and physical health. Participants and methods: Undergraduate college students (n = 321) completed the Duke Health Profile, assessing 11 areas of mental and physical health, both as entering freshmen (2008-2014) and at graduation. The archived data was analyzed from 2019 to 2020. Results: Using ANOVA for all 11 subscales revealed significant increases in physical, mental, and general health, self-esteem (P < 0.001), perceived health (P < 0.017); and significant decreases in anxiety, depression, and anxiety-depression (P < 0.001). There were no significant group effects on pain, disability, or social health. Conclusions: Consciousness-Based Education was found to buffer the effects of stress on mental and physical health in college students. Consciousness-Based Education's influence in lowering anxiety and depression while improving self-esteem and general health presents an effective tool for educators and administrators to consider in assisting students combating the stress of college life.

Objectives: To explore the effect of autonomy to choose exercise-therapy (ET) for nonspecific chronic low back pain (NSCLBP) on treatment adherence and clinical outcomes. Participants: Forty-six students were recruited from Ariel University. Methods: Every two gender-and-age-matched students were allocated to either self-selected exercise group (SSE) or pre-determined exercise group (PDE). Subjects completed 4-weeks exercise and filled a training-log. Oswestry disability-index (ODI) and numerical pain-rating scores (NPRS) were measured, as well as exercise quality-performance. Results: ODI and NPRS improved in both groups, with no between-group differences. Exercise quality-performance was also similar between groups. A trend for better exercise-adherence was found in the SSE-group (75.3% vs 65.0% adherence, p = 0.08, effect size d = 0.59). Meaningful NPRS improvement was demonstrated in 54.5% of SSE-group participants compared with 33.3% in the PDE-group. Conclusions: Autonomy may serve as a factor to enhance treatment adherence and clinical outcomes of ET for NSCLBP among students.

Objective: To evaluate the prevalence of low back pain (LBP) among physiotherapy students during the COVID-19 lockdown in the State of Israel. Participants/methods: One hundred and sixty four physiotherapy students from all four-year student levels were invited to participate. One hundred and thirty-seven students (83.5%) were recruited in the study with 79 females (57.7%) and 58 males (42.3%). We used a structured anonymous questionnaire that sought standard information on age, height, weight, sports activity and low back pain (LBP) prevalence during three periods. Results: No significant differences were noted in the prevalence of LBP between the lockdown period compared to 12-month period in all four-year levels. More so, our findings showed that LBP prevalence among physiotherapy students was greater during the 12-month period compared to the lifetime period. Conclusions: This study indicates that COVID-19 lockdown has no negative impact on the prevalence of LBP among physiotherapy students.

Musculoskeletal disorders (MSDs) related to occupational work or termed as WMSDs are the most common health issues that are experienced by many workers. Either due to the human errors or inconvenient and faulty workplaces, this illness has caused both employers and employees great economic losses. However, when observing the prevalence of MSDs among motorcyclists, again the focus was put among those that use motorcycles during their duties making it very much work-related. For example, police riders, postal delivery workers, and currently food delivery services. But how about those non-occupational motorcyclists or commuting workers or students that only use their motorcycle to commute to work, riding to class or weekend-motorcyclists going for prolonged motorcycle rides? Upon this matter, it became the motivation of this study to look into the possibilities of MSDs prevalence especially related to muscle fatigue among these groups of motorcyclists based on a survey and indoor prolonged motorcycle riding simulations that were conducted earlier. This includes how education and proper training could help them to reduce the risk of experiencing MSDs. Outcomes of this study suggested several other MSD issues that are possible to take place involving other body regions and establishing a prolonged riding guideline could educate them to be more aware of this issue. These possible MSDs were found to not being highlighted in work-related MSDs literature with respect to motorcyclists and very few detailed guidelines are available to educate motorcyclists for a much safer prolonged riding which provide gaps for further investigation and validation.

The training and learning activities for students are primarily conducted in closed environments. The symptoms resulting from living environments in occupied buildings are referred to as "sick building syndrome (SBS)." The aim of this study is to evaluate the SBS associated with the age of a school building. In this research, grounded research design, which is a type of mixed-method approach, was preferred because qualitative and quantitative methods were used to support each other. Four different schools were selected based on the ages of the school buildings by criterion sampling method. These schools were identified to be 1-, 5-, 10-, and 40-year old buildings. Thus, the research sample comprised a total of 423 students. The students were provided with a questionnaire and the data obtained were analyzed with IBM SPSS 25 software. At the end of the research, it was observed that 329 students experience symptoms in the school, and the most commonly experienced physical symptoms are headache (188 students), physical and mental fatigue (175 students), and concentration disorder (142 students). Moreover, a significant relationship was observed between the symptoms experienced by the students during their time in the school and the symptoms they experienced after school. It was revealed that the most uncomfortable places are corridors and washrooms. In general, it can be concluded that the SBS symptoms are observed in four different buildings, and they vary depending on comfort conditions such as hygiene, ventilation, and heating instead of the age of the school building. Furthermore, it was noted that school principals responsible for the administration of school buildings have an important role in the improving or deteriorating of SBS symptoms.

Background: The frequency and intensity of physical activity are directly related to health in the general population. However, to our knowledge, no study has looked at that relationship in people with intellectual disability. Method: The aim of this study was to determine whether there were differences in the health of 407 people with intellectual disability according to the frequency and intensity of physical activity. The method involved cross-sectional study of secondary data. Findings: Results showed that the ability to express pain, number of orthopaedic and physiotherapy consultations, body mass index and percentage of psychosis/schizophrenia diagnoses differed with the frequency and intensity of physical activity. Conclusion: Other studies are needed to learn more about physical activity factors that could improve the health of people with intellectual disability.

Background: This study aimed to investigate the associations of oral health literacy (OHL), sense of coherence (SOC) and other covariates with self-reported school performance (SRSP) in adolescents enrolled in public schools in Brazil. Methods: This was a cross-sectional study conducted with adolescents aged from 14 to 18 years enrolled in 6 public schools in Piracicaba, São Paulo, Brazil. Researchers carried out data collection at schools using a self-administered structured questionnaire. The dependent variable was SRSP. The explanatory factors included were sociodemographic characteristics, OHL, SOC, self-rated oral health, health behaviors, and experience of bullying. Analyses included simple and multiple logistic regression models. Results: The final sample consisted of 385 adolescents with a mean age of 16 years. Poor school performance was associated (95%CI) with being male, with more than 1 sibling, individual whose last visit to the dentist was due to dental pain, with a lower level of OHL and SOC. Conclusions: OHL and SOC were important factors associated with SRSP performance together with other sociodemographic and oral health-related variables in high school students. Our findings reinforce the importance of intersectoral actions between the health and education sectors to promote better school performance among adolescents, including actions to improve OHL and SOC.

We studied whether there exist variations in pain responses between different intellectual and developmental disability (IDD) etiologies. Self-reports and facial expressions (Facial Action Coding System = FACS) were recorded during experimental pressure stimuli and compared among 31 individuals with IDD--13 with cerebral palsy (CP), nine with Down syndrome (DS), nine with unspecified origin (UIDD)--and among 15 typically developing controls (TDCs). The CP and DS groups had higher pain ratings and FACS scores compared to the UIDD and TDC groups, and steeper stimulus-response functions. The DS group exhibited the most diverse facial expressions. There were variations in the foci of facial expressions between groups. It appears that different IDD etiologies display distinct pain responses.

Low breastfeeding rates are driven by multiple bio-psycho-social factors. Experience of breastfeeding is known to differ by maternal demographic factors (age, education and ethnicity) but there is less recognition of factors such as neurodivergence. This review, prospectively registered with PROSPERO (registration number: CRD42021271465), systematically identified qualitative research, commentaries and personal accounts related to Autistic mothers and infant feeding. Database searching identified 1225 records, with thematic synthesis undertaken on 22 (eight peer-reviewed studies and 14 grey literature) pieces. Our analysis identified that maternity and infant feeding services were built on a lack of understanding of Autistic needs, and were often inaccessible at a time when Autistic mothers already felt a loss of control and lack of social support. Specifically relating to breastfeeding, knowledge and determination were often high, and a minority of mothers reported positive breastfeeding experiences. However, sensory challenges, pain and interoceptive differences (exacerbated by a lack of support) made breastfeeding impossible for some. Infant formula was viewed as second-best to breastmilk, but a minority of mothers found the ritual of preparing bottles of formula positive. There is an urgent need for maternity and infant feeding services to accommodate the needs of Autistic mothers, including service design and staff training.